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In this paper, we compute the throughput of wireless communications using Reconfigurable Intelligent Surfaces (RIS) when the source harvests energy using a solar panel. Harvesting duration is also optimized to enhance the performance of wireless communications when RIS is used. We derive the statistics of the Signal to Noise Ratio (SNR). We show that the SNR is the product of a Gaussian and a chisquare random variables (r.v.). We consider solar energy harvesting for Rayleigh channels. [ABSTRACT FROM AUTHOR]

Preventive Maintenance (PM) is a periodic maintenance strategy that has great results for devices in extending their lives, increasing productivity, and, most importantly, helping to avoid unexpected breakdowns and their costly consequences. Preventive maintenance scheduling (PMS) is determining the time for carrying out PM, and it represents a sensitive issue in terms of impact on production if the time for the PM process is not optimally distributed. This study employs hybrid heuristic methods, integrating Genetic Algorithm (GA) and Tabu Search (TS), to address the PMS problem. Notably, the search for an optimal solution remained elusive with GA alone until the inclusion of TS. The resultant optimal solution is achieved swiftly, surpassing the time benchmarks set by conventional methods like integer programming and nonlinear integer programming. A comparison with a published article that used metaheuristics was also applied in order to evaluate the effectiveness of the proposed hybrid approach in terms of solution quality and convergence speed. Moreover, sensitivity analysis underscores the robustness and efficacy of the hybrid approach, consistently yielding optimal solutions across diverse scenarios. The schedule created exceeds standards set by waterworks experts, yielding significant water and electricity surpluses—16.6% and 12.1%, respectively—while simultaneously matching or surpassing total production levels. This method can be used for power plants in private or public sectors to generate an optimal PMS, save money, and avoid water or electricity cuts. In summary, this hybrid approach offers an efficient and effective solution for optimizing PMS, presenting opportunities for enhancement across various industries. [ABSTRACT FROM AUTHOR]

Given the prevalence of handwritten documents in human interactions, optical character recognition (OCR) for documents holds immense practical value. OCR is a field that empowers the translation of various document types and images into data that can be analyzed, edited, and searched. In handwritten recognition techniques, symmetry can be crucial to improving accuracy. It can be used as a preprocessing step to normalize the input data, making it easier for the recognition algorithm to identify and classify characters accurately. This review paper aims to summarize the research conducted on character recognition for handwritten documents and offer insights into future research directions. Within this review, the research articles focused on handwritten OCR were gathered, synthesized, and examined, along with closely related topics, published between 2019 and the first quarter of 2024. Well-established electronic databases and a predefined review protocol were utilized for article selection. The articles were identified through keyword, forward, and backward reference searches to comprehensively cover all relevant literature. Following a rigorous selection process, 116 articles were included in this systematic literature review. This review article presents cutting-edge achievements and techniques in OCR and underscores areas where further research is needed. [ABSTRACT FROM AUTHOR]

Artificial intelligence has been used effectively in medical diagnosis. The objective of this project is to examine the application of a collective AI model using weighted fusion of predicted probabilities from different AI architectures to diagnose various retinal conditions based on optical coherence tomography (OCT). A publicly available Noor dataset, comprising 16,822, images from 554 retinal OCT scans of 441 patients, was used to predict a diverse spectrum of age-related macular degeneration (AMD) stages: normal, drusen, or choroidal neovascularization. These predictions were compared with predictions from ResNet, EfficientNet, and Attention models, respectively, using precision, recall, F1 score, and confusion matric and receiver operating characteristics curves. Our collective model demonstrated superior accuracy in classifying AMD compared to individual ResNet, EfficientNet, and Attention models, showcasing the effectiveness of using trainable weights in the ensemble fusion process, where these weights dynamically adapt during training rather than being fixed values. Specifically, our ensemble model achieved an accuracy of 91.88%, precision of 92.54%, recall of 92.01%, and F1 score of 92.03%, outperforming individual models. Our model also highlights the refinement process undertaken through a thorough examination of initially misclassified cases, leading to significant improvements in the model's accuracy rate to 97%. This study also underscores the potential of AI as a valuable tool in ophthalmology. The proposed ensemble model, combining different mechanisms highlights the benefits of model fusion for complex medical image analysis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Congenital Diaphragmatic Hernia (CDH) is a severe congenital anomaly with significant morbidity and mortality. It can be isolated or can be associated with other congenital anomalies, including broncho-pulmonary sequestration (BPS). The association of CDH with BPS (CDH+BPS) is uncommon but has been previously reported, and it can complicate the course of the disease in patients with CDH. We report two cases of CDH+BPS that were recently treated at our CDH-Qatar (CDH-Q) program. METHODS: We reviewed CDH-Q program registry to search for CDH+BPS and extracted the data for the identified cases. We also reviewed the previously published literature available on PubMed for similar cases. RESULTS: Out of 53 cases of CDH referred to CDH-Q from January 2018 to December 2022, two cases of CDH+BPS were identified, with an estimated prevalence of 3.8% of this association in our CDH population. Both cases were born at term. Case 1 was diagnosed with CDH+BPS postnatally, while case 2 was diagnosed with CDH antenatally but BPS was diagnosed after birth. Both cases underwent a surgical repair of the CDH with resection of the associated BPS, and the histopathology of the resected lung tissue confirmed the presence of BPS in both. Both cases survived to discharge. CONCLUSION: The association of CDH+BPS is uncommon; however, it can have significant consequences on the management and the prognosis of patients with CDH. Reporting these cases is important to provide a better understanding of this association and its impact on CDH patients. [ABSTRACT FROM AUTHOR]

Introduction: Attention-deficit hyperactivity disorder (ADHD) and eating disorders (ED) can coexist. The goal of the current study is to establish if the risk of EDs among participants with ADHD changes as they age. Materials and Methods: A longitudinal follow-up study was designed to determine variables of interest to participants during childhood and adolescence. Data were collected at baseline in 2019 (T1) and later in 2023 (T2). Data collection included demographics, anthropometrics, and risk of ED using a validated tool, which is the eating attitudes test-26 (EAT-26). Results: The mean age of participants was 13 years at baseline, and 13% were female. About 41% were on methylphenidate as a psychostimulant during T1, and this was reduced to 23%, P < 0.001, effect size (ES) = 0.5. The risk for ED was 29.51% at T1, with a mean EAT-26 score of 15 ± 7. The risk for ED was 36% at T2 with a mean EAT-26 score of 17 ± 6. Conclusions: Adolescents with ADHD had a greater prevalence rate of EDs when compared to their childhood baselines. Screening and intervention are therefore essential to reduce the risk of long-term disordered eating in this population. [ABSTRACT FROM AUTHOR]

Background: Abu Dhabi, a part of the United Arab Emirates, is situated in an arid region where water scarcity is a significant concern. The residential sector in Abu Dhabi consumes a large portion of the available water resources, leading to a critical need for effective water management strategies. This study aims to understand the relationship between water tariffs and water consumption in the residential sector in Abu Dhabi. It employs an integrated fuzzy logic model, a form of artificial intelligence, to assess the impact of water tariffs on water consumption. The model includes variables such as water tariffs, the level of water awareness, the level of water behavior, and the level of technology use. The objective of these variables is to evaluate their impact on the water-saving index, which represents the ratio of daily water consumption per capita in Abu Dhabi to the global average. Results: The findings of this study, based on a survey measuring the level of water awareness, behavior, and technology use, revealed a potential strategy for reducing water consumption in Abu Dhabi's residential sector. It was observed that increasing water tariffs, while maintaining current levels of water awareness, behavior, and technology use, could lead to a reduction in water consumption. However, it was also found that the impact of further tariff increases on water conservation diminishes after a certain threshold, indicating the necessity of a balanced approach in tariff adjustment. Interestingly, the study also highlights that Abu Dhabi residents demonstrate high levels of water behavior and technology use, indicating a positive trend toward water conservation. Conclusions: This study emphasizes the importance of increasing water awareness among Abu Dhabi residents as a means to foster sustainable water consumption practices. While water tariffs can contribute to reductions in water consumption, the effects tend to decrease beyond a certain point. Therefore, a comprehensive approach involving water tariffs, increased water awareness, and the adoption of water-saving technologies may be the most effective strategy for water conservation. The insights from this study extend beyond Abu Dhabi and offer valuable guidance for addressing water conservation challenges worldwide. It highlights the importance of adopting a multi-faceted approach in water management, and the potential for such strategies to have international relevance in the pursuit of sustainable water consumption. [ABSTRACT FROM AUTHOR]

The optimal operation of any electrical power system is considered a crucial aspect in modern day optimization. The optimal power flow problem is widely known as an effective tool to plan the operation of these systems. However, due to the nonlinearity of variables such as generation cost and power losses, computation is difficult with conventional optimization methods. Therefore, various metaheuristic algorithms are implemented to solve the Optimal Power Flow (OPF) problem and overcome the possible drawback of conventional methods. This systematic review will explore various popular metaheuristic techniques that are employed to solve the optimal power flow problem such as Artificial Bee Colony (ABC), Ant Colony Optimization (ACO), Particle Swarm Optimization (PSO), and Genetic Algorithm (GA) along with various newly introduced and emerging optimization techniques. Diverse techniques were reviewed for optimizing the OPF problem, however, deployment of artificial bee colony optimization algorithm has proved its popularity due to its fast computational speed and rate of convergence as compared to the previously established algorithms based on the reported qualitative data from existing studies. Furthermore, the qualitative data analyzed presented a higher frequency of studies adopting artificial bee colony optimization algorithm, presenting accurate results in critical power system aspects such as generation cost, real power losses, and total emissions. Additionally, this research provides the pathway for future research in improving the performance of metaheuristics when applied to the optimal power flow problem. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to find out how much pharmacists know and have used ChatGPT in their practice. We investigated the advantages and disadvantages of utilizing ChatGPT in a pharmacy context, the amount of training necessary to use it proficiently, and the influence on patient care using a survey. Methods: This cross-sectional study was carried out between May and June 2023 to assess the potential and problems that pharmacists observed while integrating chatbots powered by AI (ChatGPT) in pharmacy practice. The correlation between perceived benefits and concerns was evaluated using Spearman's rho correlation due to the data's non-normal distribution.Any pharmacists licensed by the Jordanian Pharmacists Association were included in the study. A convenient sampling technique was used to choose the participants, and the study questionnaire was distributed utilizing an online medium (Facebook and WhatsApp). Anyone who expressed interest in taking part was given a link to the study's instructions so they may read them before giving their electronic consent and accessing the survey. Results: The potential advantages of ChatGPT in the pharmacy practice were widely acknowledged by the participants. The majority of participants (69.9%) concurred that educational material about pharmacy items or therapeutic areas can be provided using ChatGPT, with 66.9% of respondents believing that ChatGPT is a machine learning algorithm. Concerns about the accuracy of AI-generated responses were also prevalent. More than half of the participants (55.7%) raised the possibility that AI systems such as ChatGPT could pick up on and replicate prejudices and discriminatory patterns from the data they were trained on. Analysis shows a statistically significant positive link, albeit a minor one, between the perceived advantages of ChatGPT and its drawbacks (r = 0.255, p < 0.001). However, concerns were strongly correlated with knowledge of ChatGPT. In contrast to those who were either unsure or had not heard of ChatGPT (64.2%), individuals who had heard of it were more likely to have strong concerns (79.8%) (p = 0.002). Finally, the results show a statistically significant association between the frequency of ChatGPT use and positive perceptions of the tool (p < 0.001). Conclusions: Although ChatGPT has shown promise in health and pharmaceutical practice, its application should be rigorously regulated by evidence-based law. According to the study's findings, pharmacists support the use of ChatGPT in pharmacy practice but have concerns about its use due to ethical reasons, legal problems, privacy concerns, worries about the accuracy of the data generated, data learning, and bias risk. [ABSTRACT FROM AUTHOR]

Preoperative assessment of hemoglobin concentration in blood is important to diagnose anemia. The primary aim of this prospective diagnostic test accuracy study was to monitor non-invasive spectrophotometric hemoglobin (SpHb, g/dL) concentrations among adults prior to elective surgery and to investigate the correlation and agreement of SpHb with laboratory hemoglobin (Hb, g/dl). A secondary aim was to identify the anemia cut-off values for SpHb based on the World Health Organization (WHO) definitions for anemia. This study included 151 consecutive patients (age ≥ 18 year) presenting for preoperative evaluation prior to scheduled elective general or orthopedic surgery. Results identified the mean ± SD of SpHb at 11.43 ± 2.01 g/dL, which underestimated the mean laboratory Hb (12.64 ± 2.29 g/dL, p < 0.001). A bias mean difference (SpHb–Hb) of −1.21 g/dL, with a SD of 1.76, was reported. This bias (SpHb–Hb) was inversely correlated with the mean Hb concentrations. A positive correlation existed between SpHb and Hb, with a good degree of reliability and a significant Intra Class Correlation (ICC). SpHb diagnosed anemia in 32.3% and 60.3% of males and females, respectively. The SpHb cut-off values to identify anemia were 11.3 and 10.2 g/dL for males and females, respectively, with a sensitivity of 83.3% for males and only 62.9% for females. The specificity for males and females were 81% and 91.3%, respectively. SpHb sensitivity allows for anemia diagnosis among males, but not females. However, the specificity allows SpHb to rule out anemia for both. [ABSTRACT FROM AUTHOR]

The management of failing kidney allograft and transition of care to general nephrologists (GN) remain a complex process. The Kidney Pancreas Community of Practice (KPCOP) Failing Allograft Workgroup designed and distributed a survey to GN between May and September 2021. Participants were invited via mail and email invitations. There were 103 respondents with primarily adult nephrology practices, of whom 41% had an academic affiliation. More than 60% reported listing for a second kidney as the most important concern in caring for patients with a failing allograft, followed by immunosuppression management (46%) and risk of mortality (38%), while resistant anemia was considered less of a concern. For the initial approach to immunosuppression reduction, 60% stop antimetabolites first, and 26% defer to the transplant nephrologist. Communicating with transplant centers about immunosuppression cessation was reported to occur always by 60%, and sometimes by 29%, while 12% reported making the decision independently. Nephrologists with academic appointments communicate with transplant providers more than private nephrologists (74% vs. 49%, p = 0.015). There are heterogeneous approaches to the care of patients with a failing allograft. Efforts to strengthen transitions of care and to develop practical practice guidelines are needed to improve the outcomes of this vulnerable population. [ABSTRACT FROM AUTHOR]

The preliminary test results of a novel robotic hand rehabilitation device aimed at treatment for the loss of motor abilities in the fingers and thumb due to stroke are presented. This device has been developed in collaboration with physiotherapists who regularly treat individuals who have suffered from a stroke. The device was tested on healthy adults to ensure comfort, user accessibility, and repeatability for various hand sizes in preparation for obtaining permission from regulatory bodies and implementing the design in a full clinical trial. Trials were conducted with 52 healthy individuals ranging in age from 19 to 93 with an average age of 58. A comfort survey and force data ANOVA were performed to measure hand motions and ensure the repeatability and accessibility of the system. Readings from the force sensor (p < 0.05) showed no significant difference between repetitions for each participant. All subjects considered the device comfortable. The device scored a mean comfort value of 8.5/10 on all comfort surveys and received the approval of all physiotherapists involved. The device has satisfied all design specifications, and the positive results of the participants suggest that it can be considered safe and reliable. It can therefore be moved forward for clinical trials with post-stroke users. [ABSTRACT FROM AUTHOR]

Simple Summary: Lung cancer is one of the most common cancers in the world, and despite improvements in treatment, it remains a significant health burden. B7-H3 is a member of the B7 immune checkpoint family of membrane proteins and shows increased expression in lung cancers; however, the functional consequences of this to cancer cell signalling remain unclear. Here, we show that B7-H3 forms a complex with the metabolic enzyme IMPDH2, and this protects cancer cells from oxidative stress and resulting apoptosis triggered by chemotherapy. The removal of B7-H3 from cancer cells in 2D results in sensitisation to chemotherapeutic stress and reduces cell viability in an IMPDH2-dependent manner. However, the loss of B7-H3 in 3D spheroid models results in enhanced IMPDH2-dependent spheroid growth, likely due to the weakening of cell–cell adhesion. These findings demonstrate that B7-H3 functionally contributes to metabolic signalling in lung cancer cells in the absence of immune cell interactions. Lung cancer is one of the most common cancers worldwide, and despite improvements in treatment regimens, patient prognosis remains poor. Lung adenocarcinomas develop from the lung epithelia and understanding how specific genetic and environmental factors lead to oncogenic transformation in these cells is of great importance to define the pathways that contribute to tumorigenesis. The recent rise in the use of immunotherapy to treat different cancers has prompted the exploration of immune modulators in tumour cells that may provide new targets to manipulate this process. Of these, the B7 family of cell surface receptors, which includes PD-1, is of particular interest due to its role in modulating immune cell responses within the tumour microenvironment. B7-H3 (CD276) is one family member that is upregulated in many cancer types and suggested to contribute to tumour–immune interactions. However, the function and ligand(s) for this receptor in normal lung epithelia and the mechanisms through which the overexpression of B7-H3 regulate cancer progression in the absence of immune cell interactions remain unclear. Here, we present evidence that B7-H3 is associated with one of the key rate-limiting metabolic enzymes IMPDH2, and the localisation of this complex is altered in human lung cancer cells that express high levels of B7-H3. Mechanistically, the IMPDH2:B7-H3 complex provides a protective role in cancer cells to escape oxidative stress triggered by chemotherapy, thus leading to cell survival. We further demonstrate that the loss of B7-H3 in cancer cells has no effect on growth or migration in 2D but promotes the expansion of 3D spheroids in an IMPDH2-dependent manner. These findings provide new insights into the B7-H3 function in the metabolic homeostasis of normal and transformed lung cancer cells, and whilst this molecule remains an interesting target for immunotherapy, these findings caution against the use of anti-B7-H3 therapies in certain clinical settings. [ABSTRACT FROM AUTHOR]

The management of failing kidney allograft and transition of care to general nephrologists (GN) remain a complex process. The Kidney Pancreas Community of Practice (KPCOP) Failing Allograft Workgroup designed and distributed a survey to GN between May and September 2021. Participants were invited via mail and email invitations. There were 103 respondents with primarily adult nephrology practices, of whom 41% had an academic affiliation. More than 60% reported listing for a second kidney as the most important concern in caring for patients with a failing allograft, followed by immunosuppression management (46%) and risk of mortality (38%), while resistant anemia was considered less of a concern. For the initial approach to immunosuppression reduction, 60% stop antimetabolites first, and 26% defer to the transplant nephrologist. Communicating with transplant centers about immunosuppression cessation was reported to occur always by 60%, and sometimes by 29%, while 12% reported making the decision independently. Nephrologists with academic appointments communicate with transplant providers more than private nephrologists (74% vs. 49%, p = 0.015). There are heterogeneous approaches to the care of patients with a failing allograft. Efforts to strengthen transitions of care and to develop practical practice guidelines are needed to improve the outcomes of this vulnerable population. [ABSTRACT FROM AUTHOR]

Introduction: This study evaluates undergraduate pharmacy students' and examiners’ perceptions of implementing OSCE exam. Methods: A sample of 185 undergraduate pharmacy students (138 from Zarqa University and 47 from Yarmouk University) and 20 examiners were invited to complete a quantitative survey and qualitative focus group discussion, respectively. Results: 103 out of 185 (56%, response rate) undergraduate pharmacy students completed the quantitative survey, with 11 examiners out of 20 (55%) agreeing to participate in the examiners' focus group discussion. Most pharmacy students agreed that OSCE exam was a practical and useful experience (74.8%) and should be part of the assessment in other pharmacy courses (61.2%). However, less than a quarter thought that OSCE exam was not fair (17.5%), very intimidating (20.4%), and needed more time (29.1%). Examiners were generally in favour of OSCE exam being well-organised and well-administered despite the need for a large place to conduct and a good number of pharmacy staff to implement. Conclusion: Pharmacy students and examiners agreed that OSCE exam is an excellent and preferable clinical assessment tool. This study provides a scheme to evaluate OSCE exam as a clinical assessment tool and would help policy-makers gain more insight into the impact of implementing OSCE exam on students' clinical knowledge and communicational skills development and learning process. [ABSTRACT FROM AUTHOR]

Fuzzy techniques are approximations used to model phenomena or decisions for which mathematical precision is impractical or impossible. In this work, we have developed a new approach to modeling visual performance using fuzzy techniques. Fuzzy techniques allow us to include variables that are not included in the current visual performance model. We also introduce the term critical contrast, which we define as the contrast at which a change in the rating of visual performance occurs. The comparison between our fuzzy relative visual performance model and the relative visual performance model shows close agreement for most conditions. A digital tool was also developed and is available for use. This will make the proposed metric simple to use and implement. [ABSTRACT FROM AUTHOR]

Road safety audit (RSA) is a method used to proactively identify safety risks in road projects from planning, design, and construction stages. The effectiveness of the implementation of RSAs varies across the globe. This paper provides an understanding of road safety auditor's opinions and attitudes by using data collected from an online questionnaire filled by 408 road safety experts with varying demographic and technical backgrounds. Results demonstrated that majority of respondents agreed that RSA is an effective tool to improve road safety. Compared to high-income countries, respondents from low- and middle-income countries had less knowledge about RSA and less access to RSA guidelines. The results also indicate that many road safety auditors have a misunderstanding of the independence requirement for conducting RSA. The results of this paper can be used to inform and develop improved guidance to improve RSA generally and promote RSA as an effective road safety engineering tool. [ABSTRACT FROM AUTHOR]

Bu araştırma, çağımızda yaygınlaşan yeni tıbbi vakaları sunmaya, odaklanan temel bir soruna dayanmaktadır, ve bu meseleler ilgili dini hükümleri açıklaması, Günümüzde toplumda bu tür vakaların yaygınlığı göz ardı edilemez İnsanlar da bu meselelerde fıkhın hükmünü soruyorlar. Bunun için bu meselelerin sınırlandırılması sonra açıklanması ve Fıkıh alimlerinin görüşleri ile karşılatırması gerekir. Bu araştırmada betimsel yöntemden yararlandım Özel gruplarda ekstrapolasyon ve sınıflandırmadan sonra içerdiği terminolojik kavramları açıkladığım yer Her yeni tıbbi durum, Sonra her yeni tıbbi vakanın özgünlüğünü açıklamak için karşılaştırmalı yaklaşım. Taşıyıcı annelik ve tüp bebek gibi alternatif çocuk sahibi olma yolları bu problemlerden bazılarını teşkil eder. Fıkıh alimlerinin görüşleri doğrultusunda, aile ve doğumla ilgili konuların İslami kaidelere uygun olup olmadığı meselesi güncel fıkhi problemler kapsamındadır. Bu araştırmada tüp bebek, taşıyıcı annelik, süt bankası, sperm bankası, rahim nakli, kordon bağlatma (vazektomi), gebeliğin ilk kırk gününde ve sonrasında kürtaj, engelli bebeği aldırmak gibi meseleler incelenecektir. Bu meselelerin dini hükümleri, Arap dünyasında saygın kabul edilen bilginler ve kurumların (Yusuf el karadavi, Vehbe Zuhayli, Muhammed Saîd Ramazân el-Bûtî, Muhammed salih el münajcid ve Bekir ibn abdullah ve Abdullah el tayyar, Mecmaül fıkhil islami, İslam Question And Answer, İslam Web. görüşlerinden istifade edilerek özetlenecektir ve Bunun caiz mi yoksa haram mı olduğu ve bununla ilgili içtihat kontrolleri ile ilgili hukuki hükmün bir açıklama. [ABSTRACT FROM AUTHOR]

The design and detailed assembly of a dual 3D printer that combines both Fused Deposition Modelling (FDM) and Masked Stereolithography Apparatus (MSLA) technologies is presented. Combining two different 3D printing modes in one machine minimizes the required desk space, offers a larger printing area, and reduces total cost as compared to owning two different 3D printers. The FDM printing section in the proposed design utilizes the Core-XY and CHT nozzle to achieve fast travel and extrusion speeds. The MSLA printing section includes a standard UV light array and a mono screen to control printing speed and stability. All the mechanical parts of the FDM printer section are positioned above or outside of the printing plate, forming the top half of the dual printer. On the other hand, all the mechanical parts for the MSLA printer section such as the UV light source, controller motherboard and resin vat are placed underneath the build plate, therefore constituting the bottom half of the dual printer. Thus, the build plates of the FDM and MSLA portions serve as the main division between the two sides. The proposed dual printer is an opensource machine to help users find replacement parts and apply upgrades easily, as well as reduce the overall cost of manufacturing. The proposed dual printer aims to utilize the best of both worlds; the utility and versatility of an FDM printer and the print quality of an MSLA printer, all in a small, cost-effective compact package. [ABSTRACT FROM AUTHOR]

The aryl hydrocarbon receptor (AhR) has been implicated in regulating skeletal progenitor cells and the activity of bone-forming osteoblasts and bone-resorbing osteoclasts, thereby impacting bone mass and the risk of skeletal fractures. The AhR also plays an important role in the immune system within the skeletal niche a nd in the differentiation of mesenchymal stem cells into other cell lineages including chondrocytes and adipocytes. This transcription factor responds to environmental pollutants which can act as AhR ligands, initiating or interfering with various signaling cascades to mediate downstream effects, and also responds to endogenous ligands including tryptophan metabolites. This review comprehensively describes the reported roles of the AhR in skeletal cell biology, focusing on mesenchymal stem cells, osteoblasts, and osteoclasts, and discusses how AhR exhibits sexually dimorphic effects in bone. The molecular mechanisms mediating AhR's downstream effects are highlighted to emphasize the potential importance of targeting this signaling cascade in skeletal disorders. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder which mainly affects small joints, occurs most commonly in middle‐aged adults, and can be fatal in severe cases. The exact etiology of RA remains unknown. However, uncontrolled expression of pro‐inflammatory cytokines and chemokines can contribute to the pathogenesis of RA. Aim: In the current study, we assessed the potential of serum concentrations of interleukin (IL)‐1β, IL‐6, tumor necrosis factor (TNF)‐α, IL‐8, and C‐C motif chemokine ligand (CCL)5 as early predictive markers for RA. Methods: In addition to clinical examination, blood samples were collected from 100 Saudi patients recently diagnosed with early RA for basic and serological tests, including rheumatoid factor (RF), C‐reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Sera of 32 healthy individuals were used as controls. Specific enzyme‐linked immunosorbent assay was used to quantify the serum IL‐1β, IL‐6, TNF‐α, IL‐8, and CCL5 levels in the samples. Results: Our results indicated that RF, CRP, and ESR levels were higher in RA patients compared to controls. Furthermore, serum levels of IL‐1β, IL‐6, IL‐8, and CCL5, but not TNF‐α, significantly increased in RA patients compared to controls. Conclusion: Overall, the findings suggested that IL‐1β, IL‐6, IL‐8, and CCL5 can be used as biomarkers in the early diagnosis of RA. [ABSTRACT FROM AUTHOR]

In this paper, we propose the use of Intelligent Reflecting Surfaces (IRS) between the secondary source and K secondary users. The secondary source transmits the combination of K symbols dedicated to K secondary Non Orthogonal Multiple Access (NOMA) users. A set I i of IRS reflectors are dedicated to user U i so that all reflections are in phase at U i . We derive the throughput when the secondary source harvests energy using n r antennas and transmits with an adaptive transmit power to generate low interference at primary destination. We show that the use of IRS with 32 reflectors per user offers up to 45 and 50 dB gain with respect to NOMA and Orthogonal Multiple Access (OMA) without IRS. [ABSTRACT FROM AUTHOR]

Concrete is a heterogeneous material that consists of cement, aggregates, and water as basic constituents. Several cementitious materials and additives are added with different volumetric ratios to improve the strength and durability requirements of concrete. Consequently, performance of concrete when exposed to elevated temperature is greatly affected by the concrete type. Moreover, post-fire properties of concrete are influenced by the constituents of each concrete type. Heating rate, days of curing, type of curing, cooling method, and constituents of the mix are some of the factors that impact the post-fire behavior of concrete structures. In this paper, an extensive review was conducted and focused on the effect of concrete constituents on the overall behavior of concrete when exposed to elevated temperature. It was evident that utilizing fibers can improve the tensile capacity of concrete after exposure to higher temperatures. However, there is an increased risk of spalling due to the induced internal stresses. In addition, supplementary cementitious materials such as metakaolin and silica fume enhanced concrete strength, the latter proving to be the most effective. In terms of the heating process, it was clear that several constituents, such as silica fume or fly ash, that decrease absorption affect overall workability, increase the compressive strength of concrete, and can yield an increase in the strength of concrete at 200 °C. Most of the concrete types show a moderate and steady decrease in the strength up until 400 °C. However, the decrease is more rapid until the concrete reaches 800 °C or 1000 °C at which it spalls or cannot take any applied load. This review highlighted the need for more research and codes' provisions to account for different types of concrete constituents and advanced construction materials technology. [ABSTRACT FROM AUTHOR]

Study Objectives: This systematic review and meta-analysis was conducted to identify the neurological sequelae and consequences in patients infected with coronavirus disease 19 (COVID-19), as well as to explore the impact of COVID-19 infection on the central nervous system, and the contributing risk factors to the neurological sequelae associated with the disease. Methodology: The World Health Organization COVID-19 database, which included data from 31 multiple databases, was used in February 2021. Exclusion of noncohort studies was conducted as well as the exclusion of studies with pediatric age groups (<18 years of age). There was an English language restriction. The random-effect models meta-analysis model was used with the DerSimonian and Laird methodology. Results: Nineteen papers, involving a total of 45,181 participants, were judged relevant and contributed to the systematic review and meta-analysis of neurological sequelae in patients with COVID-19. The overall event rate of any given neurological sequelae among all studies was 7.6% (95% confidence interval [CI], 3.0%-17.6%). Meta-regression showed an increase of overall neurological sequelae in relation to age, as well as an increased occurrence in females. Stroke had an event rate of 1.8% (95% CI, 0.9%-3.3%). Headache had an event rate of 6.7% (95% CI, 1.9%-20.7%). Delirium had an event rate of 25.2% (95% CI, 13.9%-41.4%). Intracerebral hemorrhage (ICH) had an event rate of 1.0% (95% CI, 0.4%-2.8%). Conclusions: The prevalence of stroke and ICH was higher than that of the global prevalence. Delirium showed a similar prevalence to the global prevalence. Headache was found to have a lower prevalence compared to the global prevalence. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: This study provided a platform for electronic prescribing design features that may facilitate antimicrobial stewardship. This study aimed to identify software features within electronic prescribing systems and to assign priorities to these software features according to the opinions of the infection specialist health care professionals. Also, to identify any differences in priorities according to a professional group and experience in using electronic prescribing and communicate research findings to policy-makers and electronic prescribing manufacturers. Methods: The study was conducted in a large (600-bed) governmental tertiary and teaching hospital in Amman, Jordan. The survey was delivered by hand to antimicrobial prescribers (internists, surgeons, paediatricians, infectious diseases specialists, and critical care specialists) and non-prescribers (medical interns, clinical pharmacists, nurses, and other allied health care professionals) who filled out the survey face to face. The delivery of the survey started on March 15, 2020, and was closed on April 7, 2020. Results: Responses were received from 210 individuals. Interns represented more than one-third of respondents (n= 79, 37.6%), with 15.7% were internal medicine physicians. Among the healthcare professionals, around 44.7% (n= 94) are considered prescribers to antimicrobials, while others are considered non-prescribers (n= 116, 55.2%). The majority of respondents (n= 205, 97.6%) reported using an electronic prescribing and electronic health record system for part or all in their hospital, with 35.7% (n= 75) of them reported using these systems for more than one year. The prompt prescribing feature having the highest assigned priority was the allergy checker (n= 193, 91.9%) followed by the dose checker (n= 192, 91.4%). Conclusion: This study demonstrates the first attempt to describe views of healthcare professionals in Jordan about the potential significance of prescribing prompt and active prescription surveillance software features on clinical, microbiological and process outcomes to support antimicrobial stewardship. Findings from this study reveal considerable demand for additional software features expressed by the healthcare professionals charged with promoting rational use of antimicrobials and a consensus of anticipated positive impact on patient safety and efficiency outcomes. [ABSTRACT FROM AUTHOR]

In this paper, we derive a tight lower bound of the detection probability of the energy detector when intelligent reflecting surface (IRS) are used. The secondary source uses the energy detector to detect primary source activity. There is IRS between primary source and secondary source. The secondary sources compute the energy of the received signal from primary source and reflected on IRS. The proposed spectrum sensing algorithm using IRS offers 15, 21, 27, 33 dB gain with respect to conventional sensing without IRS for a number of reflectors K = 8 , 16 , 32 , 64 . We also used IRS for data communication between primary source and destination as well as the communication between secondary nodes. The proposed primary and secondary networks of cognitive radio network (CRN) using IRS offer 23, 29, 36, 43, 49 and 56 dB gain with respect to conventional CRN without IRS for a number of reflectors K = 8 , 16 , 32 , 64 , 128 , 256 . We show that the use of N = 20 , 10 , 5 symbols in energy detection offers up to 8.5, 7.7 and 4.7 dB gain with respect to a single symbol. We plot the miss detection probability P md versus the false alarm probability P f . For K = 16 reflectors, average SNR per bit E b / N 0 = - 10 dB and P f = 0.01 , P md = 210 - 3 , 710 - 3 , 2. 510 - 2 when N = 20 , 10 , 5 symbols are used in energy detection, whereas P md = 0.45 when a single symbol is used. [ABSTRACT FROM AUTHOR]

This study attempts to widen our understanding of how manipulating pressured online task planning affects L2 oral fluency. The principal aim of this study is to investigate the effect of reducing time pressure on L2 learners' oral speech production while performing video-based narrative tasks in terms of fluency. The study adopted a video-based narrative task to elicit spoken data from forty secondary school students. Online planning was operationalised through slowing down the video clip in the + online planning condition. Measures of breakdown and repair fluency were adopted to capture learners' oral fluency. The findings revealed that online planning had a positive effect on L2 oral fluency regarding the number of filled pauses. Whereas it had a negative impact on fluency regarding mean length of silent pauses. No effect was found regarding number of silent pauses and disfluencies. The results will be discussed and pedagogic implications will be proposed. [ABSTRACT FROM AUTHOR]

Objective  Feeding intolerance (FI) is a common presentation of necrotizing enterocolitis (NEC) and sepsis. NEC and sepsis are associated with hematological changes, but these changes alone are not reliable biomarkers for early diagnosis. This study examined whether the combination of hematological indices and FI can be used as an early diagnostic tool for NEC or sepsis. Study Design  This retrospective cohort study included infants born at <1,500 g or <30 weeks who had symptoms of FI. The exclusion criteria were congenital or chromosomal disorders, thrombocytopenia or platelet transfusion before the onset of FI, and history of bowel resection. We compared the hematological indices from infants with pathologic FI (due to NEC or sepsis) to infants with benign FI. Results  During the study period, 211 infants developed FI; 185 met the inclusion criteria. Infants with pathologic FI (n  = 90, 37 cases with NEC and 53 with sepsis) had lower birth gestational age and weight compared with 95 infants with benign FI (n  = 95). Pathologic FI was associated with lower platelet count (median 152 × 10 3 /μL vs. 285 × 10 3 /μL, p  < 0.001) and higher immature-to-total neutrophil (I/T) ratio (median 0.23 vs. 0.04, p  < 0.001) at the onset of FI. Pathologic FI was also associated with a decrease in baseline platelets compared with an increase in benign FI. For diagnosis of pathologic FI, a decrease ≥10% in platelets from baseline had a sensitivity and specificity of 0.64 and 0.73, respectively, I/T ratio ≥0.1 had a sensitivity and specificity of 0.71 and 0.78, respectively, and the combination of both parameters had a sensitivity and specificity of 0.50 and 0.97, respectively. Conclusion  FI caused by NEC or sepsis was associated with a decrease in platelets from baseline, and a lower platelet level and higher I/T ratio at the onset of FI. These findings can help clinicians in the management of preterm infants with FI. Key Points FI is a common presentation of NEC and sepsis in preterm infants. FI due to NEC or sepsis is associated with changes in platelets and I/T ratio. These changes could be useful as early markers for diagnosis. [ABSTRACT FROM AUTHOR]

Background: Excessive use of social media sites and applications was reported to be associated with depressive symptoms. We determined the association between social media use and depressive symptoms among adults in Riyadh and correlated the results with other studies. Methods: A cross-sectional study was performed using a self-administered survey questionnaire distributed to participants aged 13 years old and above. The Patient Health Questionnaire 9 (PHQ-9) was used as a screening tool to measure depression. Positive and negative affective experiences were also assessed. Results: A total of 467 participants with a mean age of 27.0 ± 10.9 years were surveyed; 269 (57.6%) were males, and 198 (42.4%) were females. The mean of the total PHQ-9 score was 8.7 ± 5.8. There were 17 patients (3.6%) with no depression, 103 (22.1%) with minimal depression, 160 (34.3%) with mild depression, 113 (24.2%) with moderate depression, 47 (10.1%) with moderately severe depression, and 27 (5.8%) with severe depression. Females significantly had experienced moderate to severe depression compared to males (P = 0.040, OR = 1.48). One hundred eighty-seven respondents (40.0%) had moderate to severe depression on the three dimensions of social networking sites (SNSs) usage. The PHQ-9 score was positively significantly correlated with all three dimensions of the use of SNSs. The negative affective experiences ranked high among other affective experiences with depression, the highest mean of all the scales (5.8 ± 1.4). The positive affective experiences scored low, with contentment scoring the lowest (3.7 ± 1.9). Conclusion: A high percentage of moderate to severe depression and negative affective experiences, including anger and happiness, exists among individuals who excessively use and spend a lot more time using SNSs. A greater tendency toward depression occurs among females. Although the data from this study are self-reported, there is a need for health practitioners and family physicians to identify early signs of depression that warrants early intervention to address to mitigate and prevent the potentially harmful consequences that might happen in the future. [ABSTRACT FROM AUTHOR]

Objectives: Cancer is a leading cause of disabling morbidities and death worldwide. Although there are various strategies for the management of cancer, the severe adverse effects negatively impact the patient's quality of life. In addition, the development of resistance limits the efficacy of many chemotherapeutics. Many natural agents are capable of reducing the adverse effects associated with chemotherapy and improving the therapeutic outcome. Tangeretin, a polymethoxy flavone, is one of the promising natural anticancer agents. Key findings: Tangeretin not only targets various malignancies but also synergizes chemotherapeutic agents and reverses cancer resistance. Hence, the application of tangeretin as an adjuvant in cancer chemotherapy would be a promising strategy. Summary: This work critically highlighted the proposed anticancer activity of tangeretin and discussed its potential combination with various chemotherapeutic agents. Additionally, it shed light on tangeretin chemical derivatives with improved pharmacokinetic and pharmacodynamic activity. Finally, this review described flavonoid biosynthetic pathways and how bioengineering can be employed to enhance the production yield of tangeretin. Thus, this work paves the way for the rational clinical utilization of tangeretin as a safe and effective adjuvant in chemotherapeutic protocols. [ABSTRACT FROM AUTHOR]

This study attempts to widen our understanding of how manipulating pressured online task planning affects L2 oral fluency. The principal aim of this study is to investigate the effect of reducing time pressure on L2 learners’ oral speech production while performing video-based narrative tasks in terms of fluency. The study adopted a video-based narrative task to elicit spoken data from forty secondary school students. Online planning was operationalised through slowing down the video clip in the + online planning condition. Measures of breakdown and repair fluency were adopted to capture learners’ oral fluency. The findings revealed that online planning had a positive effect on L2 oral fluency regarding the number of filled pauses. Whereas it had a negative impact on fluency regarding mean length of silent pauses. No effect was found regarding number of silent pauses and disfluencies. The results will be discussed and pedagogic implications will be proposed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Information regarding acute exacerbation (AE) in patients with interstitial lung disease (ILD) is limited. OBJECTIVES: The objective of the study was to elucidate the clinical features and outcome of AE among ILD patients. METHODS: We retrospectively analyzed the data of 667 consecutive ILD (nonidiopathic pulmonary fibrosis [IPF] ILD, n = 463; IPF, n = 204) patients. ILD patients meeting the 2016 definition of AE-IPF were identified. Information analyzed included pulmonary function tests, 6-min walk tests, and right heart catheterization data, among others. Cox regression models were used to identify independent predictors of survival. RESULTS: AE was identified in non-IPF ILD (n = 113) and IPF (n = 74). Compared with AE-IPF patients, non-IPF ILD patients with AE were of younger age, predominantly women, and primarily nonsmokers (all, P < 0.0001). The estimated survival probabilities at 1, 3, and 5 years were 88%, 75%, and 70%, respectively, in the ILD without AE group; 80%, 57%, and 50%, respectively, in the non-IPF ILD with AE group; and 53%, 38%, and 28%, respectively, in the AE-IPF group (P < 0.0001 by log-rank analysis). Age, body mass index, IPF diagnosis, AE, diffusion capacity of the lung for carbon monoxide <35% predicted, 6-min walk distance <300 meters, and cardiac index were independent predictors of survival in the ILD cohort. CONCLUSIONS: Non-IPF ILD patients with AE have distinct clinical features compared to AE-IPF patients. Importantly, AE is one of many independent risk factors associated with worsened outcomes regardless of the underlying ILD type. [ABSTRACT FROM AUTHOR]

BACKGROUND: Diagnosing primary Sjogren's syndrome (pSS)-associated interstitial lung disease (ILD) is complex and can be very challenging. In addition, information about the prognostic factors is limited. AIMS: We aimed to determine the clinical characteristics and prognostic factors that impact pSS-ILD survival. METHODS: This retrospective review included 84 consecutive patients diagnosed with pSS-ILD. The information analyzed included the clinical characteristics, laboratory findings, and physiological and hemodynamic data. Prognostic factors were identified using a Cox proportional hazards regression model. RESULTS: The mean age was 60.5 years, and 61.9% were females. The mean time between the onset of symptoms and diagnosis was 21 months (range, 1–98 months). Minor salivary gland biopsy (MSGB) was positive for pSS in 92.3% of the cohort. Fifty percent of the patients had negative autoimmune serology related to pSS. Based on the available hemodynamic data, 40% had pulmonary hypertension (PH), and 20% had severe PH. During follow-up, acute exacerbation was noted in 38% of the cohort. The 5-year survival rate for all patients was 56%. Male sex, usual interstitial pneumonia pattern, and a reduced forced vital capacity were independent predictors of mortality in the pSS-ILD patients. CONCLUSIONS: A significant delay between the onset of symptoms and diagnosis was noted in our cohort. Importantly, our study highlights the importance of MSGB and emphasizes that clinicians should not rely solely on serological tests to diagnose pSS in ILD patients. The overall survival was poor, and more efforts are needed to diagnose pSS-ILD at an early stage and refer patients to experienced centers. [ABSTRACT FROM AUTHOR]

This study aims to assess the Jordanian pharmacy students' attitudes and perceptions toward providing rational pharmaceutical care. The study was conducted by administering an anonymous online survey (Standard Pharmaceutical Care Attitude Survey; PCAS) to pharmacy students at five public universities in Jordan. Descriptive statistics were used to describe participants response on the questionnaire items and one-way ANOVA were used for inferential statistics. A total of 884 responses met the eligibility criteria. The majority of participants (n=614, 69.5%) reported that they have been introduced to the pharmaceutical care concept in their program. The majority of participants reported positive attitudes toward the professional duty and benefit of pharmaceutical, more negatives attitudes were reported toward the return on effort. Participants who had a clerkship experience had significantly more positive attitudes toward six items of the PCAS. In conclusion, pharmacy students in Jordan have positive attitudes toward providing rational pharmaceutical care. The majority, however, perceived pharmaceutical care to be time-consuming and not worth the additional workload that it places on pharmacists. This study highlights opportunities to achieve more positive attitudes by mandating pharmaceutical care courses in pharmacy schools in Jordan and exposing students to real-world scenarios. [ABSTRACT FROM AUTHOR]

Background: High numbers of violence incidents against physicians are reported annually in both developing and developed countries. In Jordan, studies conducted on healthcare workers involved small number of physicians and showed higher percentages of violence exposure when compared to other investigations from the Middle East. This is a large study aiming to comprehensively analyze the phenomenon in the physicians' community to optimize future strategies countering it. Methods: The study has a cross sectional, questionnaire-based design. It targeted 969 doctors from different types of healthcare Jordanian institutions in Amman, between May to July, 2019. The questionnaire was designed to evaluate properties of reported abuse cases in terms of abusers, timing, and type of abuse, in addition to the consequences of this abuse. Results: Prevalence of exposure to violence in the last year among doctors was 63.1% (611 doctors). 423 (67.2%) of male doctors had an experience of being abused during the last 12 months, compared to 188 (55.3%) of females (p< 0.001). Governmental centers showed the highest prevalence. Among 356 doctors working in governmental medical centers, 268 (75.3%) reported being abused (p< 0.001), and they were more abused verbally (63.5%) and physically (10.4%) compared to other medical sectors (p <0.001). The mean score of how worried doctors are regarding violence at their workplace from 1 to 5 was 3.1 ± 1.3, and only 129 (13.3%) believed that they are protected by law. Conclusions: The study emphasized on the higher rate of violence against physicians in the governmental sector, in addition to the negative effect of abuse on their performance. Moreover, male physicians had higher incidence of workplace abuse. Therefore, strategies that ease and promote the real application of anti-violence policies should become our future target. [ABSTRACT FROM AUTHOR]

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a common subtype of interstitial lung disease (ILD). Information about the associated comorbidities and predictors of survival among Saudi patients with IPF is limited. AIMS: The aim of the study was to determine the clinical characteristics, associated comorbidities, and prognostic factors that impact IPF survival. METHODS: Consecutive IPF patients diagnosed in our ILD center were included. The information analyzed included demographics, physiological parameters, and associated comorbidities, among others. Cox regression models were used to identify independent predictors of survival. RESULTS: The data of 212 patients with IPF were available for the analysis. The mean age was 66.4 years, and 70.8% were male. The mean time between the onset of symptoms and diagnosis was 11.6 months (range: 1–48 months). Common comorbid conditions noted in the IPF cohort included pulmonary hypertension (49.6%), diabetes mellitus (43.2%), hypertension (42.2%), osteoporosis (40.4%), and gastroesophageal reflux disease (32.1%). Acute exacerbation (AE) was noted in 21.2% of the IPF patients. AE, final saturation <85%, walking distance <300 m, and antifibrotic therapy were independent predictors of survival. CONCLUSIONS: In our IPF cohort, we found that there was a significant delay between the onset of symptoms and diagnosis. Moreover, we identified multiple comorbidities associated with IPF, which increases the burden on both IPF patients and clinicians. Importantly, AE and the use of antifibrotic therapy were independent predictors of survival. It is of paramount importance for clinicians to diagnose IPF at an early stage, refer patients to experienced centers, recognize comorbidities, and initiate antifibrotic therapy regardless of the underlying disease severity. [ABSTRACT FROM AUTHOR]

BACKGROUND: There is a paucity of information regarding prognostic factors associated with reduced survival in interstitial lung disease (ILD) patients without pulmonary hypertension (PH). AIMS: The aim of this study was to determine physiological and hemodynamic parameters that impact survival among ILD patients without PH based on right heart catheterization (RHC). METHODS: Consecutive ILD patients who underwent RHC (n = 169) at one center were included. The information analyzed included demographics and physiological and hemodynamic parameters. Cox regression models were used to identify independent predictors of survival. RESULTS: The mean age was 55.0 years, and 49.7% of the patients were females. Thirty-three patients died, and two underwent transplantation. Patients with predicted diffusion capacity of the lung for carbon monoxide <35%, walking distance <300 m, and 6-min walk test (6MWT) final oxygen saturation measured by pulse oximetry (SpO2) <85% were significantly associated with an increased mortality risk (P = 0.022, P < 0.0001, and P = 0.049, respectively; all by log-rank analysis). Advanced age, idiopathic pulmonary fibrosis diagnosis, reduced forced vital capacity, and low cardiac index were independent predictors of increased mortality in the ILD cohort. CONCLUSIONS: Our study demonstrates that parameters obtained from baseline pulmonary function tests and 6MWTs are important determinants of survival in ILD patients without PH. Importantly, cardiac index was the only hemodynamic variable independently associated with survival. Thus, in the absence of PH, when ILD patients perform poorly during the 6MWT manifested as reduced walking distance and desaturation at the end of the test, cardiovascular impairment must be ruled out. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Estimated complementary and alternative medicine (CAM) usage in Saudi Arabia is 70%. The Saudi Food and Drug Authority, National Center for Complementary and Alternative Medicine (NCCAM) regulates the license-based practices of various CAM modalities including procedures, herbs, and devices. As an aid to help primary care physicians for understanding CAM practices among general population, this study aimed to explore the prevalence of CAM along with its most common modality, and to understand attitude and practices among patients attending primary care center in Riyadh (Saudi Arabia). Methods: A prospective cross-sectional study was conducted among 403 literate patients aged more than 18 years, coming to the primary care center for regular check-up from 1st April 2019 to 1st April 2020 Saudi Arabia. Data was collected using self-administered questionnaire. Results: Around 44.5% participants had practiced one method of alternative medicine in their life. Majority of participants who attended primary care centers belonged to the age group of 18–39 years (71.1%). The most common used method of alternative medicine was honey healing. More than half of the study participants had heard about the CAM from their family and friends. Nearly 45.7% had stated that the CAM cannot be used without consulting a medical professional. Nearly 3/4th population used it for treating up to 3 ailments. Conclusion: Use of alternative medicine was found to be prevalent in Riyadh. Family and friends were recognized as gatekeepers for propagating information about CAM usage in the society. Primary healthcare physicians need to be trained on prevalent practices of CAM to understand the societal needs. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe a method that has been set up to schedule preventive maintenance (PM) tasks for power and water plants with all constraints such as production and maintenance. Design/methodology/approach: The proposed methodology relies on the zero-one integer programming model that finds the maximum number of power and water units available in separate generating units. To verify this, the model was implemented and tested as a case study in Kuwait for the Cogeneration Station. Findings: An effective solution can be achieved for scheduling the PM tasks and production at the power and water cogeneration plant. Practical implications: The proposed model offers a practical method to schedule PM of power and water units, which are expensive equipment. Originality/value: This proposed model is an effective decision-making tool that provides an ideal solution for preventive maintenance scheduling problems for power and water units in a cogeneration plant, effectively and complies with all constraints. [ABSTRACT FROM AUTHOR]

Objective: To explore the medication adherence in type 2 diabetes mellitus in Majmaah, Kingdom of Saudi Arabia and to find possible role of socio-demographic factors in determining adherence to medication among patients with type 2 diabetes mellitus. Study Design: Cross-sectional analytical study. Place and Duration of Study: The data was collected from patients with type 2 diabetes mellitus in public places such as shopping areas and restaurants in Majmaah, from Feb 2018 to May 2018. Methodology: A total of 137 patients with type 2 diabetes mellitus who fulfilled the inclusion criteria were recruited in the study. Adherence to medication was assessed by using the four item Modified Morisky mediction adherence scale (MMAS). Results: The frequency of high adherence was only 10 (7.3%). Moderate adherence was 62 (45.3%), and low adherence was 65 (47.4%). There was no statically significant correlation between patients’ age, gender, educational level, the employment status, duration of disease since diagnosis and adherence rate. Majority of the patients 40 (60.6%) responded that complexity of treatment and forget fullness 54 (56.8.3%) are the main factors contributing to low adherence. Fewer visits to the clinic is also a reason for low adherence to treatment either patients foget to take an appointment, or they intentionally miss due to the long clinic waiting time 50 (58.1%) and 51 (60.7%) respectively. Conclusion: Adherence to diabetes medication was found to be low. No statically significant association with scodemographic factors and level of adherence were noted. The factors contributing to low adherence were complexity of treatment, forgetfulness and failure to keeping the appointment due to long clinic waiting time. [ABSTRACT FROM AUTHOR]

Introduction: Carpal Tunnel Syndrome (CTS) presents with symptoms like numbness, tingling, and weakness along the median nerve pathway. Risk factors include prolonged wrist positions, repetitive muscle contractions, and exposure to vibrations. Aim: To determine the prevalence of CTS among healthcare practitioners at vaccine facilities in Saudi Arabia. Materials and Methods: A cross-sectional study on a total of 150 healthcare practitioners (aged 25-30 years) working in vaccination centres in Riyadh, Saudi Arabia were recruited. The study was conducted from November 2021 to March 2022. The authors collected demographic data, Body Mass Index (BMI) and work shift information, and administered two validated questionnaires, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and the Duruoz Hand Index (DHI). CTS symptoms were diagnosed using Phalen's and Arm Raising Test (ART). Results: Of the 150 practitioners (aged 25-45 years), predominantly in the 25-30 age group, n=65 (44.0%) tested positive on the Phalen's test, and n=65 (43.5%) on the ART. Females had higher BCTSQ scores, while DHI scores were similar across genders. Spearman's correlation analysis showed positive correlations between BCTSQ and DHI, and a moderate negative correlation between ART and DHI. Logistic regression analysed factors affecting the likelihood of CTS diagnosed by ART and Phalen's Test. Higher BCTSQ and DHI scores increased the likelihood of CTS (ART: BCTSQ OR=0.843, DHI OR=1.064; Phalen's Test: BCTSQ OR=0.830, DHI OR=1.069). Conclusion: During the Coronavirus Disease-2019 (COVID-19) pandemic, the prevalence of CTS among healthcare practitioners at vaccine centres in Riyadh, Saudi Arabia reached up to 43-44%. The present study highlights that day shift workers face a higher risk of CTS compared to night shift workers, likely due to heavier daytime workloads. This underscores the need for ergonomic interventions and workload management, especially during high-demand periods like the vaccination campaign, to safeguard healthcare workers' health and productivity. [ABSTRACT FROM AUTHOR]

In this paper, we derive the detection probability of cooperative spectrum sensing using the energy detector with multiple branches and multihops in each branch. The primary signal passes through L i hops in the ith branch. Two cooperation protocols are considered. In the first one, the fusion center combines the signal of all branches, and it is known as all-participating relaying. It requires multiples channels for branch transmissions to avoid interferences. In the second one, only the branches with the highest SNR are activated. The results are valid for any number of hops and branches. We also consider situations where the direct link is available or not. We have studied the evolution of the detection probability with respect to the signal-to-noise ratio for a constant false alarm rate. [ABSTRACT FROM AUTHOR]

Purpose: There is no such thing as a truly centralized or decentralized management system. With regard to universities, most of the key areas in universities are centralized, e.g. finance, personnel, curriculum, management and quality. These key areas will exhibit a higher impact on learning and research by maintaining the appropriate balance between centralization and decentralization approaches. The purpose of this paper is to study the key features of balanced management implemented within the internal quality assurance system at the University of Bahrain. Areas of such balance will be explained while showing the pros and cons of each management approach. Design/methodology/approach: In this paper, both quantitative and qualitative surveys were used to study this balanced approach. Findings: The centralization approach at the university maintained systematic compliance through the development of policies and procedures, quality structure and a clear framework for quality enhancement. Centralization ensured consistency in quality, programmes and activities. It also maintained diffusion of innovation, for example, sharing and transferring the knowledge of international accreditation practices to other colleges. The balance of the centralized with the decentralized management approach provided additional advantages. For example, the management shared the vision of decentralization to raise the level of responsibility and accountability. The management provided an acceptable level of authority to take on spot decisions; hence, building expertise at the decentralized levels. However, this would require support and capacity building to ensure directly responsible persons, who can take on spot decisions. The ownership of the self-improvement cycles was implemented at the level of the departments and colleges. Practical implications: This study showed that this balanced management had a great influence to maximize the benefits of the internal quality assurance (IQA) system, as it showed that 71.4 and 67.3 per cent of the academic and administrative staff, respectively, found that the IQA system was effective. Originality/value: This balanced approach would guide the universities to enhance its quality system by organizing its structure, processes and systems in a harmonized nature. [ABSTRACT FROM AUTHOR]

Graphical abstract Synthesis, crystal structure data and biological evaluation of four novel NHC∗-Ag(I)-Benzoate and four novel Triphenyl Phosphine Ag(I)-Benzoate complexes against Methicillin-Resistant Staphylococcus aureus (MRSA) , Escherichia coli , Candida parapsilosis and Candida albicans , with antifungal data indicating several complexes can complete with medicinal grade antifungal agents. Highlights • Synthesis of four novel triphenylphosphino-silver(I) benzoate complexes through simple benchtop methods. • Synthesis of four novel NHC∗-silver(I) benzoate complexes through in-situ free carbene generation. • Biological evaluation of the eight novel complexes against Methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli to determine antibiotic activity, resulting in an MIC 50 comparable to previous antibiotic candidate SBC3. • Biological evaluation of the eight novel complexes against Candida parapsilosis and Candida albicans resulting in all NHC∗-silver(I) benzoate complexes showing better activity against C. parapsilosis than the clinical standard Caspofungin. Abstract The rising threat of Antimicrobial Resistance (AMR) requires a novel approach to the treatment of infectious diseases. Covalently bonded silver, which has known antibacterial and antifungal properties and multiple mechanisms of action, may provide a treatment strategy when used alone or in combination with already known antimicrobial compounds. Here we describe the synthesis of eight novel silver(I) complexes, which were screened for in vitro activity against two pathogenic bacterial strains, Methicillin-resistant Staphylococcus aureus (MRSA) and Escherichia coli (E. coli), and against two pathogenic fungal strains, Candida albicans and Candida parapsilosis. Complexes 5 – 8 were synthesized by reacting triphenylphosphine in relative equivalents with the relevant silver benzoates (1 , 2 & 4), whilst complexes 9 – 12 were synthesized by generation of a free carbene NHC∗ (1,3-dibenzyl-4,5-diphenyl-imidazol-2-ylidene) and reacting this with the silver benzoates 1 – 4 , under Schlenk conditions. Complexes 9 – 12 showed the strongest antimicrobial activity, resulting in 50% inhibition of growth against MRSA and C. parapsilosis at concentrations of 12.5 and 3.25 µg/mL, respectively. [ABSTRACT FROM AUTHOR]

Originally published affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan. Corrected affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy, Zarqa University, Zarqa, Jordan. [Extracted from the article]

Background: The financial management of community pharmacies is a critical aspect of healthcare delivery, as pharmacists often operate as healthcare providers and business managers. Understanding pharmacists' awareness, perceptions, and practices related to financial indicators is essential for effective pharmacy management. There is a paucity of research addressing this issue regionally and locally. Objectives: This study aimed to investigate the perceptions and utilization of financial indicators among community pharmacists in Jordan and identify demographic and contextual factors influencing their financial practices. Methods: A cross-sectional study was conducted, surveying 353 community pharmacists from various regions of Jordan. The developed and validated survey assessed demographic characteristics, utilizations of financial indicators, and perceptions of their significance. Pharmacists were queried about their financial practices, including the use of various financial indicators. Descriptive and analytical statistics were used to portray the study's findings. Results: The study included a diverse group of community pharmacists in terms of demographic characteristics. Most pharmacists exhibited awareness of financial indicators, with a higher awareness of profitability and liquidity indicators. Pharmacists generally had positive perceptions of the importance of these indicators in daily practice. High agreement was observed in financial practices, including following up on payables and receivables, monitoring changes in monthly revenue, and preparing income statements. There was significant variation in the utilization and perception of financial indicators based on factors such as pharmacy ownership, province, foundation age, and practical experience. Conclusion: The findings indicate a positive correlation between utilization and perception, emphasizing the importance of raising awareness of financial indicators among pharmacists. The study also highlights the significance of tailored financial training programs for pharmacists at different stages of their careers and the importance of regional context in financial practices. Understanding these variations can lead to more effective financial management and improved healthcare services in community pharmacies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the Intracytoplasmic Sperm Injection (ICSI) cycle outcome for azoospermic in non-obstructive azoospermia (NOA) compared to obstructive azoospermia (OA) patients undergoing TESA procedures. Setting: IVF Unit, Prince Sultan Military Medical City, Riyadh, KSA. Design: A Retrospective Study. Method: The data of couples that underwent ICSI with fresh sperm retrieval using TESA and reached the stage of embryo transfer were documented from November 2012 to March 2015. A total of 85 patients were included in this study. Personal characteristics, laboratory data, TESA data, stimulation parameter and pregnancy outcome were documented. Result: Fifty-six males had OA and 29 had NOA. Female characteristics including age, FSH, BMI and the parity were similar. Male characteristics including age, smoking, and TESA motility and count were similar. Cycle characteristics including cycle number, protocol type, stimulation drug and duration, and estradiol and progesterone on the day of human chorionic gonadotropin (hCG) trigger were similar. Stimulation outcome including the number of collected, mature, and fertilized oocytes, embryo transferred, the day of embryo transfer and number of grade 1 embryo were similar. There was significantly better quality oocytes and higher number of frozen embryos in NOA group, P-value=0.03 and 0.04, respectively. Pregnancy, implantation, and miscarriage rate were also similar with no significant difference between both groups. Conclusion: ICSI cycle outcome for azoospermic patients in NOA compared to OA undergoing TESA procedure was similar in both groups and no factors were affected the final cycle outcome. [ABSTRACT FROM AUTHOR]

In this paper, we employ the new iterative method to investigate two prominent nonlinear partial differential equations, namely the modified Camassa–Holm (mCH) equation and the modified Degasperis–Procesi (mDP) equation, both within the framework of the Caputo operator. The mCH and mDP equations are fundamental in studying wave propagation and soliton dynamics, exhibiting complex behavior and intriguing mathematical structures. The new iterative method (NIM), a powerful numerical technique, is utilized to obtain analytical and numerical solutions for these equations, offering insights into their dynamic properties and behavior. Through systematic analysis and computation, we unveil the unique features of the mCH and the mDP equations, shedding light on their applicability in various scientific and engineering domains. This research contributes to the ongoing exploration of nonlinear wave equations and their solutions, emphasizing the versatility of the new iterative method in tackling complex mathematical problems. Numerical results and comparative analyses are presented to validate the effectiveness of the new iterative method in solving these equations, highlighting its potential for broader applications in mathematical modeling and analysis. [ABSTRACT FROM AUTHOR]