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Ahmed Al-Wathinani

    Ahmed Al-Wathinani

    Mass-casualty incidents and disaster scenarios pose significant challenges for medical facilities, necessitating robust preparedness measures. This study aimed to evaluate the preparedness of a specific medical facility in Poland, using... more
    Mass-casualty incidents and disaster scenarios pose significant challenges for medical facilities, necessitating robust preparedness measures. This study aimed to evaluate the preparedness of a specific medical facility in Poland, using the hospital safety index (HSI). A comprehensive analysis of structural, functional, and organizational factors was conducted, assessing facility infrastructure, technical facilities, safety standards, work organization, cooperation with external facilities, human resource management, crisis planning, and communication strategies. The facility exhibited strengths in infrastructural requirements and inter-facility cooperation. Areas of improvement included adherence to safety procedures, crisis communication, and the frequency of evacuation drills. Furthermore, recommendations were provided for enhancing nurse reserves, adopting lean management, promoting a safety culture, and refining business continuity plans. The findings should be interpreted with...
    Background: Hypertension is a prevalent condition with a variety of accompanying symptoms. Gender differences, specific blood pressure readings, and early signs of organ complications present intricate interplays in hypertensive... more
    Background: Hypertension is a prevalent condition with a variety of accompanying symptoms. Gender differences, specific blood pressure readings, and early signs of organ complications present intricate interplays in hypertensive individuals. Objective: This study aimed to investigate the relationship between hypertension and its accompanying symptoms, emphasizing gender-specific differences and potential indicators of organ complications. Methods: Data from 2002 participants were analyzed from a retrospective study, focusing on the presentation of symptoms, blood pressure values, and potential organ complications associated with these symptoms. Results: Of the participants, 68.8% were women with an average age of 69. Women were, on average, 8 years older than men. The average systolic blood pressure (SBP) was 188 mmHg. High-blood pressure was accompanied by symptoms in 84.9% of participants. Among those with an SBP > 180 mmHg, headaches were reported by 24.7%, and dizziness by 15...
    This article presents a comprehensive rapid review of the current disaster risk reduction (DRR) efforts in Saudi Arabia, a country exposed to a variety of hazards such as extreme heat, droughts, floods, dust, and sandstorms, along with... more
    This article presents a comprehensive rapid review of the current disaster risk reduction (DRR) efforts in Saudi Arabia, a country exposed to a variety of hazards such as extreme heat, droughts, floods, dust, and sandstorms, along with threats from terrorism and violence. Employing a rapid review approach, our aim was to provide timely insights into DRR strategies, with an emphasis on the unique geographical and socio-political context of Saudi Arabia. This study serves as a valuable reference for similar hazard-prone regions worldwide. Our review encompasses Saudi Arabia’s progress in key areas, such as improving building codes and infrastructure, developing early warning systems, raising public awareness, and strengthening emergency response capabilities. While Saudi Arabia has made commendable strides in implementing international best practices for DRR, our review also identified specific areas where further development and enhancement are needed. These include the need for more...
    Healthcare providers in prehospital care and emergency departments are often at the frontline of medical crises, facing a range of ethical dilemmas, particularly when it comes to patients refusing treatment. This study aimed to delve into... more
    Healthcare providers in prehospital care and emergency departments are often at the frontline of medical crises, facing a range of ethical dilemmas, particularly when it comes to patients refusing treatment. This study aimed to delve into the attitudes of these providers toward treatment refusal, unearthing the strategies they employ in navigating such challenging situations while actively working in prehospital emergency health services. Our findings showed that, as the participants’ age and experience increased, so did their inclination to respect patient autonomy and avoid persuading them to change their decision about treatment. It was noted that doctors, paramedics, and emergency medical technicians demonstrated a deeper understanding of patients’ rights than other medical specialists. However, even with this understanding, the prioritization of patients’ rights tended to diminish in life-threatening situations, giving rise to ethical dilemmas. This underlines the complexity of...
    Saudi Arabia’s health sector faces pressing challenges in disaster and prehospital care delivery, such as prolonged response times, limited access to remote areas, and strained medical resources. Integrating drone technology has emerged... more
    Saudi Arabia’s health sector faces pressing challenges in disaster and prehospital care delivery, such as prolonged response times, limited access to remote areas, and strained medical resources. Integrating drone technology has emerged as an innovative approach to address these challenges and revolutionize healthcare delivery. Drones can significantly enhance response times, increase access to underserved areas, and reduce the burden on existing medical infrastructure. A detailed analysis of global case studies demonstrates the successful use of drones in healthcare delivery, emphasizing the importance of regulatory frameworks and public–private partnerships. These examples provide valuable insights into Saudi Arabia’s health sector transformation. The potential benefits of integrating drone technology include improved patient outcomes, increased efficiency, and cost savings. To ensure the successful implementation of this transformative approach, it is crucial to establish clear r...
    Ambulance personnel are among the groups with high mental health risks. This study aims to investigate the role of managerial support in determining the mental well-being of ambulance personnel, a group at high risk for mental health... more
    Ambulance personnel are among the groups with high mental health risks. This study aims to investigate the role of managerial support in determining the mental well-being of ambulance personnel, a group at high risk for mental health issues. A descriptive, cross-sectional survey design was conducted in Riyadh, Saudi Arabia, in February 2022, involving a convenience sample of 354 ambulance personnel. An online survey was distributed via social media platforms. Manager behavior and mental well-being were assessed using the Manager Behavior Questionnaire (MBQ) and the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). The participants represented nearly equal-sized groups from different agencies, with 50.3% residing in the Riyadh Region and 67.5% aged between 25 and 34. The mean score for manager behavior was 2.92 ± 1.124, while the mental well-being scale’s mean score was 3.398 ± 0.8219. Variance analyses revealed statistically significant differences in manager behavior conce...
    Emergency department staff are at high risk of experiencing violence and aggression from patients and visitors, which can have negative impacts on healthcare providers in the ED. The aim of this study was to explore the role of healthcare... more
    Emergency department staff are at high risk of experiencing violence and aggression from patients and visitors, which can have negative impacts on healthcare providers in the ED. The aim of this study was to explore the role of healthcare providers in addressing local violence in Riyadh EDs and investigate their preparedness for managing violent incidents. We used a descriptive, correlational design with survey methodology to collect data from a convenience sample of nurses, ED technicians, physicians, and advanced practice providers in Riyadh city’s EDs. To examine the associations, we used an analysis of variance (ANOVA) for unadjusted relationships and an analysis of covariance (ANCOVA) for adjusted associations. Measures included a demographic survey, and clinicians responded to an online survey. A total of 206 ED staff participated in the questionnaire, and 59% reported experiencing physical violence during an ED shift, with 61% of incidents being caused by relatives. Additiona...
    1 Department of Community and Family Medicine., King Saud University, Riyadh 11451, Saudi Arabia. 2 Department of Aviation Security, Military University of Aviation, 08521 Dęblin, Poland. 3 Department of Information Systems and Business... more
    1 Department of Community and Family Medicine., King Saud University, Riyadh 11451, Saudi Arabia. 2 Department of Aviation Security, Military University of Aviation, 08521 Dęblin, Poland. 3 Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, 33199 FL, USA 4 Division of Disaster Medicine, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 5 Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia. 6 Department of Emergency Medical Services, Prince Sultan Bin Abdulaziz College Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia. 7 Department of Accident and Trauma, Prince Sultan Bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh 11451, Saudi Arabia.
    Background and objective:Healthcare professionals have an important role in increasing awareness and protecting populations from natural disasters. This study aimed to assess the perception of healthcare students toward societal... more
    Background and objective:Healthcare professionals have an important role in increasing awareness and protecting populations from natural disasters. This study aimed to assess the perception of healthcare students toward societal vulnerability in the context of population aging.MethodsThis is a cross-sectional questionnaire-based study conducted among students from two different health colleges over 4 months from February to May 2021. Descriptive analysis was used to assess the perception, and inferential testing was used to assess the various association of knowledge toward societal vulnerability using SPSS.ResultsThe majority of respondents were male (69.2%), between 20 and 24 years of age (91.2%), and studying for a nursing degree (76.6%). Only 4.7% had previously completed a previous degree. The mean score of perceptions on the Aging and Disaster Vulnerability Scale among nursing students was 42.5 ± 10.3 (0–65) while for paramedicine 48.1 ± 9.7 (0–65). Similarly, the mean score a...
    In the event of a crisis, rapid and effective assistance for victims is essential, and in many cases, medical assistance is required. To manage the situation efficiently, it is necessary to have a proactive management system in place that... more
    In the event of a crisis, rapid and effective assistance for victims is essential, and in many cases, medical assistance is required. To manage the situation efficiently, it is necessary to have a proactive management system in place that ensures professional assistance to victims and the safety of medical personnel. We evaluated the perceptions of students and graduates in public health studies at the Medical University of Lublin, Poland, concerning their preparation and management skills for crises such as the COVID-19 pandemic. This pilot study was conducted in March 2020; we employed an online survey with an anonymous questionnaire that was addressed to students and graduates with an educational focus in healthcare organization and management. The study involved 55 people, including 14 men and 41 women. Among the respondents, 41.8% currently worked in a healthcare facility and only 21.7% of them had participated in training related to preparation for emergencies and disasters in...
    Additional file 1. Questionnaire. Original developed questionnaire for this study (English version).
    According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked... more
    According to the World Health Organization (WHO), more than half of all road fatalities involve vulnerable road users, i.e., pedestrians, cyclists, and motorcyclists. Poland is classified as one of the European Union (EU) countries marked by low road safety, with a higher frequency of accidents involving pedestrians compared to other EU countries (31% of all fatalities). Among unprotected road users, a significant group of victims are pedestrians, who are often under the influence of alcohol. This study aims to analyze the impact of alcohol on the risk of occurrence and consequences of road accidents among pedestrians. The source of data was the medical documentation of the Department of Forensic Medicine of the Medical University of Warsaw. In more than half of pedestrian deaths, the presence of alcohol was found; regardless of the place of the event and the place of death, among the victims under the influence of alcohol, males dominated; the average age of the victims under the i...
    Suicide is one of the ten most common causes of death in the world. Of all deaths from suicide, 22% can be attributed to the use of alcohol, which means that every fifth suicide would not occur if alcohol were not consumed by the... more
    Suicide is one of the ten most common causes of death in the world. Of all deaths from suicide, 22% can be attributed to the use of alcohol, which means that every fifth suicide would not occur if alcohol were not consumed by the population. People under the influence of alcohol choose more radical and effective methods of dying by suicide, e.g., throwing themselves under a moving vehicle, such as a train. The presented analysis aimed to determine important risk factors affecting railway suicide in Poland and their relation to the state of alcohol intoxication of the victims, and the relationship between ethyl alcohol consumption and the phenomenon of suicide. Documentation obtained from the Department of Forensic Medicine at the Medical University of Warsaw, in the form of death registers and forensic medical records concerning examination and autopsy, was analyzed. This made it possible to identify suicide victims from among pedestrian victims of railway accidents recorded during ...
    BackgroundEffective preparedness to respond to mass casualty incidents and disasters requires a well-planned and integrated effort by all involved professionals, particularly those who are working in healthcare, who are equipped with... more
    BackgroundEffective preparedness to respond to mass casualty incidents and disasters requires a well-planned and integrated effort by all involved professionals, particularly those who are working in healthcare, who are equipped with unique knowledge and skills for emergencies. This study aims to investigate and evaluate the level of knowledge and skills related to mass casualty and disaster management in a cohort of healthcare professionals.MethodsA cross-sectional brief study was conducted using a validated and anonymous questionnaire, with a sample of 134 employees at a clinical hospital in Lublin, Poland.ResultsThe findings of this study may indicate a need for standardization of training for hospitals employees. It also suggests a knowledge gap between different professional groups, which calls for adjusting such general training, to at least, the weakest group, while special tasks and mission can be given to other groups within the training occasion.ConclusionPre-Training gap ...
    The United States has continued to face severe health coverage and spending challenges that have been attributed to a fragmented multi-payer and fee-for-service delivery system which has become even more exposed by the COVID-19 pandemic.... more
    The United States has continued to face severe health coverage and spending challenges that have been attributed to a fragmented multi-payer and fee-for-service delivery system which has become even more exposed by the COVID-19 pandemic. Legislators and healthcare professionals have tried to answer the challenges faced by the U.S. health system through the introduction of several state and federal proposals for a “Medicare-for-all” like system, which have failed to be adopted likely due to the lack of consideration for free-market economic values. Looking to existing models abroad can provide the U.S. with different ways to understand how to achieve the benefits of single-payer models with universal coverage while maintaining the integrity of free-market values. The health systems in wealthy, industrialized countries are closely referenced in this article because of the variation of methods in which each achieves a single-payer/universal coverage model as well as the contrast in the...
    This research initiates a comprehensive evaluation of safety awareness among emergency medical service (EMS) practitioners in Riyadh, Saudi Arabia, an area experiencing substantial academic and regulatory transformation. By employing the... more
    This research initiates a comprehensive evaluation of safety awareness among emergency medical service (EMS) practitioners in Riyadh, Saudi Arabia, an area experiencing substantial academic and regulatory transformation. By employing the Safety Attitudes Questionnaire, the study explores safety awareness across various EMS domains, unveiling a significant consistency that is unaffected by the work environment, professional tenure, or gender. Importantly, there are no significant disparities in safety awareness between hospital-based EMS practitioners and their pre-hospital counterparts, regardless of their tenure or gender. The findings highlight a homogenous safety awareness landscape among Riyadh’s EMS practitioners, suggesting strategies to sustain and strengthen patient safety culture irrespective of workspace, experience, or gender. This research not only presents these key findings but also advocates for sustainable resilience in healthcare delivery. It emphasizes the need for...
    Objective: In numerous countries, emergency medical services (EMS) students receive curriculum training in effective patient–provider communication, but most of this training assumes patients have intact communication capabilities,... more
    Objective: In numerous countries, emergency medical services (EMS) students receive curriculum training in effective patient–provider communication, but most of this training assumes patients have intact communication capabilities, leading to a lack of preparedness to interact with patients, who have communication disorders. In such cases, first responders could end up delivering suboptimal care or possibly wrong procedures that could harm the disabled person. Method: A quasi-experimental design (pretest–posttest) was used to assess the knowledge of EMS students both before and after a translation workshop on how to deal with patients who have hearing and communication disorders during emergencies. Comparisons between pretest and posttest scores were examined using the Wilcoxon signed rank test. The level of knowledge scores was compared before and after the workshop. Results: The results indicated that EMS students’ scores improved after the workshop. There was a 0.763 increase in the average score of knowledge level. The results of this study show that knowledge translation workshops are a useful intervention to enhance the level of knowledge among EMS students when interacting with hearing and communication patients. Conclusions: Our results show that such training workshops lead to better performance. Communication is a vital element in a medical encounter between health care providers and patients at all levels of health care but specifically in the prehospital arena. Insufficient or lack of communication with a vulnerable population, who may suffer from various disabilities, has a significant impact on the outcome of treatment or emergency management.
    Background: The Coronavirus Disease 2019 (COVID-19) outbreak has affected all regions and countries with varying impacts based on infection rates and the associated fatalities. This study aimed to assess knowledge, attitude, and practices... more
    Background: The Coronavirus Disease 2019 (COVID-19) outbreak has affected all regions and countries with varying impacts based on infection rates and the associated fatalities. This study aimed to assess knowledge, attitude, and practices (KAP) toward the COVID-19 pandemic among Saudi Arabians. Methods: The study utilized a cross-sectional research design. Web-based questionnaires’ link was sent via emails and social media and sample was 5483 respondents. Purposive sampling ensured only those participants that met the inclusion criteria. Validity and reliability were checked. Results: Most respondents, 67.9%, were aged between 18 and 35 years and highest level of education university. The findings based on the study objectives indicated a high level of knowledge about COVID-19, which indicated early detection can improve treatment by 4701 (85.7%), the disease can be treated at home 84.6%, the disease can be prevented and avoided when precautions are taken 96.8%. Moreover, 37.2% of t...
    Background and objectives: An overcrowded emergency department (ED) cannot meet the patients' growing demand. This situation harms employees' performance and, alternatively, causes anxiety and dissatisfaction among patients since... more
    Background and objectives: An overcrowded emergency department (ED) cannot meet the patients' growing demand. This situation harms employees' performance and, alternatively, causes anxiety and dissatisfaction among patients since the quality of healthcare outcomes fall below their expectations. This study aimed at improving and validating a scale for assessing patient satisfaction in the ED. Methods: In this study, 134 participants from Wadi Al-Dawasir General Hospital were enrolled using a convenient sampling technique. A cross-sectional survey was conducted using 5-point Likert scales. Results: All tested hypotheses showed statistical significance (P < 0.05). Our results show that male employees were more satisfied compared with their female counterparts. Furthermore, Saudi employees were more satisfied with the health services than non-Saudi ones. Conclusion: The findings of this study brought to the fore that patients and their families were satisfied with the healthc...
    Background Limited effective interventions exist in the emergency department (ED) for COVID-19 patients with respiratory failure. One of the promising interventions is the prone position, which has been proven to improve oxygenation in... more
    Background Limited effective interventions exist in the emergency department (ED) for COVID-19 patients with respiratory failure. One of the promising interventions is the prone position, which has been proven to improve oxygenation in ICU settings. Here, we aimed to describe and assess the utility of the prone position in awake non-intubated adult patients in EDs during the COVID-19 pandemic. Methods We conducted a prospective cohort study of hypoxic COVID-19 adult patients who presented to our emergency department. We collected the data from June to the end of August 2020, including vital signs and physiological and clinical parameters before and after completing the four-hour prone position protocol. The main outcomes assessed were improvement in oxygenation, respiratory rate, respiratory distress score, ICU admission, and intubation. Oxygenation was calculated based on the standard pulse oximeter saturation [SpO2]/fractional concentration of oxygen in inspired air (FiO2). Results The study included 49 patients (81.63% men; mean age, 53.37 ± 11 years). The mean oxygen saturation during the triage was 84.49% ± 7.98 on room air. After completing of the four-hour prone protocol, the mean SpO2/FiO2 ratio increased from 1.62 ± 0.78 to 1.99 ± 0.75 (p < 0.0001). The respiratory rate decreased from 32.45 ± 5.24 to 26.29 ± 5.40 (p < 0.0001). Respiratory distress scores decreased after changing patients’ positions (p < 0.0001). Twenty-four patients (48.9%) were admitted to the ICU, 6 patients were intubated (12.2%), and 7 (14.3%) died in the hospital. Conclusion After applying the prone position in the ED, significant and immediate improvement was observed in oxygenation, respiratory rate, respiratory distress, and carbon dioxide levels. A linear relationship between the level of improvement in oxygenation and reduction in ICU admission was observed. However, further studies recommended to assess the advantage of the procedure in terms of ICU admission, intubation, or mortality.
    Flood early warning (FEW) is a vital component of disaster risk management and is particularly important for saving lives, developing a sustainable agro-based economy, economic stability, and the overall development of the people of... more
    Flood early warning (FEW) is a vital component of disaster risk management and is particularly important for saving lives, developing a sustainable agro-based economy, economic stability, and the overall development of the people of Bangladesh as well as others. This study was conducted in a northern, flood-prone area of Bangladesh to investigate the potential of incorporating volunteers of the community to the Union Councils (UCs) to disseminate FEW alongside the top-down approach. Several studies have found that despite having a sophisticated flood forecasting technology, local communities are not reaping the benefits of it, as the existing dissemination system is inaccessible to most local people. Since risk communication takes place in a social context, this study investigated and thereby proposed that volunteerism, as a form of social capital or communal virtue, can potentially assist the community-based disaster management (CBDM) institutions in enhancing their capacity to rea...
    The Hajj is a recurring annual mass gathering event with over three million attendants taking place at the same site for six days. During such events, major incidents and disasters can occur. It is crucial that Emergency Medical Services... more
    The Hajj is a recurring annual mass gathering event with over three million attendants taking place at the same site for six days. During such events, major incidents and disasters can occur. It is crucial that Emergency Medical Services providers are sufficiently trained regarding disaster preparedness to respond appropriately. EMS-providers of the Saudi Red Crescent Authority who worked during the Hajj in 2016 were asked to complete a web-based survey, utilizing predetermined responses with 5-point Likert scale responses. Seven hundred respondents identified real disasters as the most common source of information about disaster preparedness and also indicated that a disaster management course was the most desired course for improving knowledge. The study has also highlighted a list of Life Support Courses providers feel should be offered as part of a disaster response training package. These findings highlight the importance of continuing education, which may be obtained through s...
    Road traffic crashes represent a substantial global public health issue. In Saudi Arabia, which is the focus area of this research, road traffic crashes kill over 130,000 people annually, accounting for almost 5% of deaths in that... more
    Road traffic crashes represent a substantial global public health issue. In Saudi Arabia, which is the focus area of this research, road traffic crashes kill over 130,000 people annually, accounting for almost 5% of deaths in that country. A cross-sectional study with 316 participants holding a valid Saudi driver’s license was conducted via the internet from December 2019 to March 2020 to collect information about the prevalence of risky driving habits among Saudi drivers. The sample was predominantly men and aged between 20 and 39, which is representative of the population of drivers in Saudi Arabia. Drivers generally reported engaging in safe behaviors, although they did state that they drove above the legal speed limit, drove aggressively around slow drivers, and became distracted while driving with some frequency. Multivariate analyses suggested men took more risks than women and younger drivers took more risks than older ones. We conclude that the behavior among drivers in Saud...
    The coronavirus 2019 (COVID-19) pandemic has a direct and indirect effect on the different healthcare systems around the world. In this study, we aim to describe the impact on the utilization of emergency medical services (EMS) in Saudi... more
    The coronavirus 2019 (COVID-19) pandemic has a direct and indirect effect on the different healthcare systems around the world. In this study, we aim to describe the impact on the utilization of emergency medical services (EMS) in Saudi Arabia during the COVID-19 pandemic. We studied cumulative data from emergency calls collected from the SRCA. Data were separated into three periods: before COVID-19 (1 January–29 February 2020), during COVID-19 (1 March–23 April 2020), and during the Holy Month of Ramadan (24 April–23 May 2020). A marked increase of cases was handled during the COVID-19 period compared to the number before pandemic. Increases in all types of cases, except for those related to trauma, occurred during COVID-19, with all regions experiencing increased call volumes during COVID-19 compared with before pandemic. Demand for EMS significantly increased throughout Saudi Arabia during the pandemic period. Use of the mobile application ASAFNY to request an ambulance almost do...
    This study used a descriptive cross-sectional methodology to measure healthcare workers’ knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data... more
    This study used a descriptive cross-sectional methodology to measure healthcare workers’ knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data using a convenience sampling technique through multiple social media platforms. A total of 227 participants were included in this study: 52% of them were aged between 26 to 34 years, 74% were residents from Riyadh, and 52.4% worked in nursing divisions. A significant number of respondents (73.2%) had positive perceptions towards their hospitals’ ability to provide an effective response to a flood, 89% were willing to report to work following a flood, and 90% of participants reported the need to develop both guidelines and training for flood disaster preparedness. Preparation and successful flood mitigation in the hospital setting requires staff that have both knowledge and training in emergency management. One way to obtain such readiness is throug...
    Nursing graduates are required to have both excellent theoretical and practical skills that should be used during stressful emergency interventions. Since the received knowledge should be practiced to gain skills and trained to achieve... more
    Nursing graduates are required to have both excellent theoretical and practical skills that should be used during stressful emergency interventions. Since the received knowledge should be practiced to gain skills and trained to achieve competences, simulation exercises can be beneficial to even reduce the stress that each individual may face during emergency management of patients. A total of 146 first-year nursing students participated in the study, including 124 women and 22 men aged between 19 and 50 years, with a mean age of 32 years. The objective method estimated psychophysiological parameters (serum cortisol). Objective and subjective methods were used. The subjective method assessed stress experienced by students based on the standardized Stress Appraisal Questionnaire Version B for dispositional assessment. The study was conducted in the Monoprofile Medical Simulation Centre at the University of Economics and Innovation in Lublin, Poland and was approved by the University R...