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PloS One 2024This study aimed to uncover the competitive advantages of King Khalid University (KKU) as a higher educational institution and identify the strategies needed to...
This study aimed to uncover the competitive advantages of King Khalid University (KKU) as a higher educational institution and identify the strategies needed to strengthen its competitive stance through a qualitative case study approach. Data were collected via detailed interviews with 30 university staff, comprising 19 faculty members and 11 academic leaders. Following this, the data were qualitatively analyzed using MAXQDA 2022 software. The results showed that KKU has 30 sub-competitive strengths, including work ethics, future vision, academic excellence, creativity, teamwork, respect for intellectual property, continuous customer-focused improvement, a positive workplace environment, organizational trust, and the ability to attract international students. Additionally, the study identified 8 challenges hindering KKU's advancement in global university rankings, spanning academic, human, and administrative areas. To improve its standing in international rankings, thematic analysis revealed 11 strategies to enhance KKU's competitiveness. These include aligning academic programs with job market demands, enhancing research facilities, boosting funding for academic and research endeavors, fostering international academic and scientific partnerships, and upgrading the technological infrastructure for academics and administration. The analysis underscores the need for KKU to adopt a comprehensive suite of academic, human, and administrative strategies to bolster its competitive position. This is crucial for KKU's rise in global university rankings and its alignment with the National Vision 2030, aiming to place over five Saudi universities among the top 100 or 200 globally.
Topics: Universities; Humans; Saudi Arabia; Faculty; Male; Female; Students
PubMed: 38709768
DOI: 10.1371/journal.pone.0302887 -
PeerJ 2024Humans continuously maintain and adjust posture during gait, standing, and sitting. The difficulty of postural control is reportedly increased during unstable stances,...
BACKGROUND
Humans continuously maintain and adjust posture during gait, standing, and sitting. The difficulty of postural control is reportedly increased during unstable stances, such as unipedal standing and with closed eyes. Although balance is slightly impaired in healthy young adults in such unstable stances, they rarely fall. The brain recognizes the change in sensory inputs and outputs motor commands to the musculoskeletal system. However, such changes in cortical activity associated with the maintenance of balance following periods of instability require further clarified.
METHODS
In this study, a total of 15 male participants performed two postural control tasks and the center of pressure displacement and electroencephalogram were simultaneously measured. In addition, the correlation between amplitude of center of pressure displacement and power spectral density of electroencephalogram was analyzed.
RESULTS
The movement of the center of pressure was larger in unipedal standing than in bipedal standing under both eye open and eye closed conditions. It was also larger under the eye closed condition compared with when the eyes were open in unipedal standing. The amplitude of high-frequency bandwidth (1-3 Hz) of the center of pressure displacement was larger during more difficult postural tasks than during easier ones, suggesting that the continuous maintenance of posture was required. The power spectral densities of the theta activity in the frontal area and the gamma activity in the parietal area were higher during more difficult postural tasks than during easier ones across two postural control tasks, and these correlate with the increase in amplitude of high-frequency bandwidth of the center of pressure displacement.
CONCLUSIONS
Taken together, specific activation patterns of the neocortex are suggested to be important for the postural maintenance during unstable stances.
Topics: Humans; Postural Balance; Male; Electroencephalography; Young Adult; Adult; Posture; Cerebral Cortex; Standing Position
PubMed: 38708344
DOI: 10.7717/peerj.17313 -
PloS One 2024Heart rate variability (HRV) is a noninvasive approach to studying the autonomic modulation of heart rate in experimental settings, such as active standing sympathetic...
Heart rate variability (HRV) is a noninvasive approach to studying the autonomic modulation of heart rate in experimental settings, such as active standing sympathetic stimulation. It is known that patients with end-stage renal disease during active standing have few changes in HRV dynamics, which are improved after hemodialysis. However, it is unknown whether the response to active standing is recovered after definitive treatment with kidney transplantation. This work aims to assess the change in HRV dynamics in the supine position and active standing through time and frequency-based metrics, as well as recurrence plot quantitative analysis (RQA). We studied HRV dynamics by obtaining 5-minute electrocardiographic recordings from kidney transplant recipients who underwent an active standing test. The mean duration of heartbeats and their standard deviation diminished in active standing, compared with the supine position. Also, the low-frequency component of HRV and the presence of diagonal and vertical structures in RQA were predominant. A larger estimated glomerular filtration rate was significantly correlated with broader HRV in the supine position and during active standing. The narrower HRV during active standing may indicate a sympathetic response to external stimuli, which is expected in a functional cardiovascular system, and may be influenced by renal function.
Topics: Humans; Heart Rate; Kidney Transplantation; Male; Kidney Failure, Chronic; Female; Middle Aged; Electrocardiography; Adult; Glomerular Filtration Rate; Supine Position; Recurrence; Standing Position
PubMed: 38691560
DOI: 10.1371/journal.pone.0299156 -
Pediatric Radiology Jun 2024Idiopathic scoliosis is common in adolescence. Due to the rapid growth of the spine, it must be monitored closely with radiographs to ensure timely intervention when...
BACKGROUND
Idiopathic scoliosis is common in adolescence. Due to the rapid growth of the spine, it must be monitored closely with radiographs to ensure timely intervention when therapy is needed. As these radiographs continue into young adulthood, patients are repeatedly exposed to ionizing radiation.
OBJECTIVE
This study aimed to investigate whether real-time magnetic resonance imaging (MRI) is equivalent to conventional radiography in juvenile idiopathic scoliosis for determining curvature, rotation and the Risser stage. Additionally, the time requirement should be quantified.
MATERIALS AND METHODS
Children with idiopathic scoliosis who had postero-anterior whole-spine radiography for clinical indications were included in this prospective study. A real-time spine MRI was performed at 3 tesla in the supine position, capturing images in both the coronal and sagittal planes. The scoliosis was assessed using Cobb angle, rotation was evaluated based on Nash and Moe criteria, and the Risser stage was determined for each modality. The correlations between modalities and a correction factor for the Cobb angle between the standing and supine position were calculated.
RESULTS
A total of 33 children (aged 5-17 years), who met the inclusion criteria, were recruited. The Cobb angle (R = 0.972; P < 0.01) was positively correlated with a correction factor of 1.07 between modalities. Additionally, the degree of rotation (R = 0.92; P < 0.01) and the Risser stage (R = 0.93; P < 0.01) demonstrated a strong correlation.
CONCLUSION
Real-time MRI is equivalent to conventional radiography in determining baseline parameters. Furthermore, it is radiation-free and less time-consuming.
Topics: Humans; Scoliosis; Adolescent; Child; Male; Female; Magnetic Resonance Imaging; Child, Preschool; Prospective Studies; Radiography
PubMed: 38687346
DOI: 10.1007/s00247-024-05919-3 -
Cureus Mar 2024Cardiac autonomic neuropathy (CAN) is a disorder affecting the autonomic nerves that regulate the cardiovascular system, leading to irregular heart rate and blood...
INTRODUCTION
Cardiac autonomic neuropathy (CAN) is a disorder affecting the autonomic nerves that regulate the cardiovascular system, leading to irregular heart rate and blood pressure control. It is commonly associated with diabetes mellitus but can also result from other conditions such as autoimmune disorders, chronic kidney disease, alcohol abuse, and certain medications. Screening for CAN is essential, particularly in individuals with poor glycemic control, cardiovascular risk factors, or complications. Early identification of CAN is vital for timely intervention to prevent or manage cardiovascular complications effectively. Regular screening helps detect CAN before symptoms emerge, enabling early intervention to slow or halt its progression. This study examined the relationship between sudomotor function and cardiovascular reflex tests.
MATERIAL AND METHODS
This was a cross-sectional study conducted between June 2019 and June 2020. The study included 271 subjects aged 18 years and above who provided informed consent, were diagnosed with type 2 diabetes mellitus (T2DM), and were overweight or obese. Exclusion criteria encompassed patients with other types of diabetes, pregnant women, those with recent neoplasm diagnoses, stroke sequelae, history of myocardial infarction, or pelvic limb amputations. The assessment of cardiac autonomic neuropathy involved conducting an electrocardiogram and evaluating the QTc interval in the morning before taking medication. Additionally, cardiovascular reflex tests (CART) were conducted, including assessments of heart rate variability during deep breathing, the Valsalva maneuver, and changes in orthostatic position. Simultaneously, the diagnosis of CAN was assessed by performing a sweat test using a Sudoscan assessment (Impeto Medical, Moulineaux, France). Results: More than half of the participants (52%, n=143) were female. Significant differences in statistical measures were noted between females and males regarding age, systolic blood pressure, fasting blood glucose, A1c level, total cholesterol, triglycerides, gamma-glutamyl transferase, and bilirubin levels. Within the CAN-diagnosed group (CAN+), 40.92% were classified as mild cases (n=90), 47.27% as moderate cases (n=104), and 11.81% as severe cases (n=26). Among the CAN+ group, 54% (n=119) were women. Electrochemical skin conductance was lower in the CAN+ group than the CAN- group in hands (67.34±15.51 μS versus 72.38±12.12 μS, p=0.008) and feet (73.37±13.38 μS versus 82.84 ±10.29 μS, p<0.001). The Sudoscan-CAN score significantly correlated with Ewing scores (r= 0.522, p<0.001). In multiple linear regression analysis, the Sudoscan-CAN score remained significantly associated with age, high BMI, long-standing diabetes, and Ewing score.
CONCLUSIONS
Sudoscan demonstrates potential in identifying patients with an increased risk of CAN. Its integration into clinical practice can improve patient outcomes through early detection, risk stratification, and personalized treatment approaches. Its non-invasive, portable, and user-friendly features render it suitable for utilization in outreach programs or resource-constrained settings as part of screening efforts designed to pinpoint high-risk individuals for additional assessment.
PubMed: 38686272
DOI: 10.7759/cureus.57226 -
Journal of Vascular Surgery. Venous and... Jul 2024We investigated the feasibility and efficacy of assessing calf perforating veins (PVs) using the ankle pump in a sitting position (AP-sit) method by color Doppler... (Clinical Trial)
Clinical Trial Comparative Study
OBJECTIVE
We investigated the feasibility and efficacy of assessing calf perforating veins (PVs) using the ankle pump in a sitting position (AP-sit) method by color Doppler ultrasound.
METHODS
We performed a multicenter prospective clinical trial between November 2022 and October 2023. Eligible patients with chronic venous disease and healthy controls were enrolled. The calf PVs were assessed using three different methods: manual compression in a standing position, manual compression in a sitting position, and AP-sit method. The reflux durations and detection rate of incompetent PVs (IPVs) were compared among the three methods. The number and diameter of calf PVs and distribution of IPVs were analyzed.
RESULTS
A total of 50 patients with chronic venous disease and 50 healthy controls were included. There were 173 calves analyzed, including 97 healthy calves and 76 calves with chronic venous disease. The number of PVs per calf was higher in the diseased calves (median, 7.0; interquartile range [IQR], 6.0-8.0) than in the healthy calves (median, 5.0; IQR, 3.0-6.0; P < .001). The diameter of IPVs (median, 2.3 mm; IQR, 2.0-3.1 mm) was larger than that of competent PVs (median, 1.4 mm; IQR, 1.2-1.7 mm). Most of the IPVs (78.8%) were located in the medial and posterior middle of the calf. The reflux duration induced by the AP-sit method was greater than that induced by the manual compression methods (P < .001). Although the AP-sit method had a higher detection rate (92.0%) of IPVs than the manual compression methods (71.7% and 74.3% for standing and sitting, respectively; P < .001), especially in the distal lower leg, the manual compression methods found IPVs not found using the AP-sit method.
CONCLUSIONS
Diseased calves with chronic venous disease have more PVs than do healthy calves. IPVs are commonly larger than competent PVs, with most IPVs located in the medial and posterior middle of the calf. Most importantly, the AP-sit method provides a convenient and effective approach for assessing the calf PVs, especially those located in the distal calf, as an alternative or complementary method to traditional manual compression, which is valuable in the daily practice of sonographers.
Topics: Ultrasonography, Doppler, Color; Prospective Studies; Humans; Female; Male; Middle Aged; Venous Insufficiency; Chronic Disease; Feasibility Studies; Sitting Position; Predictive Value of Tests; Adult; Aged; Patient Positioning; Case-Control Studies; Leg; Veins; Regional Blood Flow
PubMed: 38679143
DOI: 10.1016/j.jvsv.2024.101897 -
Biomedicines Apr 2024Foot drop syndrome (FDS), characterized by severe weakness and atrophy of the dorsiflexion muscles of the feet, is commonly found in patients with severe acquired brain...
BACKGROUND
Foot drop syndrome (FDS), characterized by severe weakness and atrophy of the dorsiflexion muscles of the feet, is commonly found in patients with severe acquired brain injury (ABI). If the syndrome is unilateral, the cause is often a peroneal neuropathy (PN), due to compression of the nervous trunk on the neck of the fibula at the knee level; less frequently, the cause is a previous or concomitant lumbar radiculopathy. Bilateral syndromes are caused by polyneuropathies and myopathies. Central causes, due to brain or spinal injury, mimic this syndrome but are usually accompanied by other symptoms, such as spasticity. Critical illness polyneuropathy (CIP) and myopathy (CIM), isolated or in combination (critical illness polyneuromyopathy, CIPNM), have been shown to constitute an important cause of FDS in patients with ABI. Assessing the causes of FDS in the intensive rehabilitation unit (IRU) has several limitations, which include the complexity of the electrophysiological tests, limited availability of neurophysiology consultants, and the severe disturbance in consciousness and lack of cooperation from patients.
OBJECTIVES
We sought to propose a simplified electrophysiological screening that identifies FDS causes, particularly PN and CIPNM, to help clinicians to recognize the significant clinical predictors of poor outcomes in severe ABI at admission to IRU.
METHODS
This prospective, single-center study included 20 severe ABI patients with FDS (11 females/9 males, mean age 55.10 + 16.26; CRS-R= 11.90 + 6.32; LCF: 3.30 + 1.30; DRS: 21.45 + 3.33), with prolonged rehabilitation treatment (≥2 months). We applied direct tibialis anterior muscle stimulation (DMS) associated with peroneal nerve motor conduction evaluation, across the fibular head (NCS), to identify CIP and/or CIM and to exclude demyelinating or compressive unilateral PN.
RESULTS
At admission to IRU, simplified electrophysiological screening reported four unilateral PN, four CIP and six CIM with a CIPNM overall prevalence estimate of about 50%. After 2 months, the CIPNM group showed significantly poorer outcomes compared to other ABI patients without CIPNM, as demonstrated by the lower probability of achieving endotracheal-tube weaning (20% versus 90%) and lower CRS-R and DRS scores. Due to the subacute rehabilitation setting of our study, it was not possible to evaluate the motor results of recovery of the standing position, functional walking and balance, impaired by the presence of unilateral PN.
CONCLUSIONS
The implementation of the proposed simplified electrophysiological screening may enable the early identification of unilateral PN or CIPNM in severe ABI patients, thereby contributing to better functional prognosis in rehabilitative settings.
PubMed: 38672232
DOI: 10.3390/biomedicines12040878 -
BMJ Open Apr 2024The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes... (Observational Study)
Observational Study
INTRODUCTION
The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic.
METHODS AND ANALYSIS
Collecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design.
ETHICS AND DISSEMINATION
This protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.
Topics: Humans; HIV Infections; Social Stigma; Syndemic; Male; United States; Noncommunicable Diseases; Adult; Observational Studies as Topic; Research Design; Middle Aged; Sexual and Gender Minorities; Prevalence; Health Status Disparities; Healthcare Disparities
PubMed: 38670612
DOI: 10.1136/bmjopen-2023-075368 -
International Journal of Exercise... 2024The purpose of this study was to examine the effects of standing versus sitting body position on the craniovertebral angle (CVA) in young adults without pathology; and...
The purpose of this study was to examine the effects of standing versus sitting body position on the craniovertebral angle (CVA) in young adults without pathology; and to investigate whether mean differences between positional CVA measures in subjects with severe forward head posture (FHP) are distinct from age-matched controls with normal head posture. Ninety-eight young adults (68 women, 30 men) without pathology (OVERALL; = 98) volunteered for the study; those with CVA > 53° were also included in a normal posture group (NORM; = 14); those with CVA < 45° were also included in a severe FHP group (SEV; = 15). CVA assessments were conducted in standing and sitting. Mean difference comparison of change in mean CVA between conditions revealed significantly ( < 0.05) higher CVA values in standing condition (OVERALL: 50.0 ± 5.2°; NORM: 56.6 ± 2.7°; SEV: 41.2 ± 3.2°) compared to sitting condition (OVERALL: 47.8 ± 5.7°; NORM: 55.9 ± 2.8°; SEV: 39.0 ± 4.0°). Mean difference comparison of between-group change in mean CVA between conditions revealed greater CVA change ( < 0.05) in the SEV group (2.2 ± 2.1°) versus the NORM group (0.8 ± 1.2°). Sitting CVA values may be lower (indicating greater FHP) than standing CVA values in young adults. Differences between standing and sitting CVA measures may be greater in young adults with severe FHP compared to peers with normal head posture. Study findings support standing as a standardized body position for CVA assessment in young adults without pathology.
PubMed: 38665167
DOI: No ID Found -
Scientific Reports Apr 2024To compare the biomechanical properties of several anterior pelvic ring external fixators with two new configurations in the treatment of Tile C pelvic fractures, in... (Comparative Study)
Comparative Study
To compare the biomechanical properties of several anterior pelvic ring external fixators with two new configurations in the treatment of Tile C pelvic fractures, in order to evaluate the effectiveness of the new configurations and provide a reference for their clinical application. A finite element model of a Tile C pelvic ring injury (unilateral longitudinal sacral fracture and ipsilateral pubic fracture) was constructed. The pelvis was fixed with iliac crest external fixator (IC), anterior inferior iliac spine external fixator (AIIS), combination of IC and AIIS, combination of anterior superior iliac spine external fixator (ASIS) and AIIS, and S1 sacroiliac screw in 5 types of models. The stability indices of the anterior and posterior pelvic rings under vertical longitudinal load, left-right compression load and anterior-posterior shear load were quantified and compared. In the simulated bipedal standing position, the results of the vertical displacement of the midpoint on the upper surface of the sacrum are consistent with the displacement of the posterior rotation angle, and the order from largest to smallest is IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. The longitudinal displacement of IC is greater than that of the other models. The displacements of ASIS + AIIS and IC + AIIS are similar and the latter is smaller. In the simulated semi-recumbent position, the vertical displacement and posterior rotation angle displacement of the midpoint on the upper surface of the sacrum are also consistent, ranking from large to small: IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. Under the simulated left-right compression load state, the lateral displacements of the highest point of the lateral sacral fracture end are consistent with the highest point of the lateral pubic fracture end, and the order from large to small is S1 screw, IC, AIIS, ASIS + AIIS and IC + AIIS, among which the displacements of S1 screw and IC are larger, and the displacements of ASIS + AIIS and IC + AIIS are similar and smaller than those of other models. The displacements of IC + AIIS are smaller than those of ASIS + AIIS. Under the simulated anterior-posterior shear load condition, the posterior displacements of the highest point of the lateral sacral fracture end and the highest point of the lateral pubic fracture end are also consistent, ranking from large to small: IC, AIIS, ASIS + AIIS, IC + AIIS and S1 screw. Among them, the displacements of IC and AIIS are larger. The displacements of ASIS + AIIS and IC + AIIS are similar and the latter are smaller. For the unstable pelvic injury represented by Tile C pelvic fracture, the biomechanical various stabilities of the combination of IC and AIIS are superior to those of the external fixators of conventional configurations. The biomechanical stabilities of the combination of ASIS and AIIS are also better than those of the external fixators of conventional configurations, and slightly worse than those of the combination of IC and AIIS. Compared with sacroiliac screw and conventional external fixators, the lateral stabilities of IC + AIIS and ASIS + AIIS are particularly prominent.
Topics: Humans; External Fixators; Biomechanical Phenomena; Pelvic Bones; Fractures, Bone; Fracture Fixation; Finite Element Analysis; Sacrum; Bone Screws
PubMed: 38664538
DOI: 10.1038/s41598-024-60341-x