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Introduction: Therapeutic inertia in type 2 diabetes, defined as a failure to intensify treatment despite poor glycemic control, can arise due to a variety of factors, despite evidence linking improved glycemic control with reductions in diabetes-related complications. The present study aimed to evaluate the health and economic burden of therapeutic inertia in people with type 2 diabetes in Saudi Arabia. Methods: The IQVIA Core Diabetes Model (v.9.0) was used to evaluate outcomes. Baseline cohort characteristics were sourced from Saudi-specific data, with baseline glycated hemoglobin (HbA1c) tested at 8.0%, 9.0%, and 10.0%. Modeled subjects were brought to an HbA1c target of 7.0% immediately or after delays of 1–5 years across time horizons of 3–50 years. Outcomes were discounted annually at 3.0%. Costs were accounted from a societal perspective and expressed in 2023 Saudi Arabian Riyals (SAR). Results: Immediate glycemic control was associated with improved or equal life expectancy and quality-adjusted life expectancy and cost savings in all scenarios compared with delays in achieving target HbA1c. Combined cost savings ranged from SAR 411 (EUR 102) per person with a baseline HbA1c of 8.0% versus a 1-year delay over a 3-year time horizon, to SAR 21,422 (EUR 5291) per person with a baseline HbA1c of 10.0% versus a 5-year delay over a 50-year time horizon. Discounted life expectancy and quality-adjusted life expectancy were projected to improve by up to 0.4 years and 0.5 quality-adjusted life years (QALYs), respectively, with immediate glycemic control. Conclusion: Therapeutic inertia was associated with a substantial health and economic burden in Saudi Arabia. Interventions and initiatives that can help to reduce therapeutic inertia are likely to improve health outcomes and reduce healthcare expenditure. [ABSTRACT FROM AUTHOR]

This report describes the case of a 62-year-old male patient in Saudi Arabia who developed a diverticular pouch in his oral cavity. Diverticula are rare conditions that appear as protrusions or pouches within the digestive tract's inner lining. The condition can occur in different parts of the digestive system, but the colon is the most affected part. As part of the patient's symptoms, he presented with dysphagia, weight loss, and globus sensations. Multiple diagnostic tests, including ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI), did not identify the diverticula. Barium and upper gastrointestinal studies were the diagnostic tests that provided accurate diagnoses where several diverticula were discovered during the videofluoroscopic swallow study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES). Surgical intervention was recommended by the multidisciplinary team; however, the patient rejected this treatment option. This report highlights the necessity for instrumental swallowing diagnostic evaluation in the workup of the infrequent etiologies of dysphagia and suggests a gap in the current knowledge, prompting further studies on the etiology, incidence, and optimum management of upper gastrointestinal (GI) tract diverticular disease. [ABSTRACT FROM AUTHOR]

In recent years, social media has become much more popular to use to express people's feelings in different forms. Social media such as X (i.e., Twitter) provides a huge amount of data to be analyzed by using sentiment analysis tools to examine the sentiment of people in an understandable way. Many works study sentiment analysis by taking in consideration the spatial and temporal dimensions to provide the most precise analysis of these data and to better understand people's opinions. But there is a need to facilitate and speed up the searching process to allow the user to find the sentiment analysis of recent top-k tweets in a specified location including the temporal aspect. This work comes with the aim of providing a general framework of data indexing and search query to simplify the search process and to get the results in an efficient way. The proposed query extends the fundamental spatial distance query, commonly used in spatial-temporal data analysis. This query, coupled with sentiment analysis, operates on an indexed dataset, classifying temporal data as positive, negative, or neutral. The proposed query demonstrates over a tenfold improvement in query time compared to the baseline index with various parameters such as top-k, query distance, and the number of query keywords. [ABSTRACT FROM AUTHOR]

Human activity recognition (HAR) is a crucial task in various applications, including healthcare, fitness, and the military. Deep learning models have revolutionized HAR, however, their computational complexity, particularly those involving BiLSTMs, poses significant challenges for deployment on resource-constrained devices like smartphones. While BiLSTMs effectively capture long-term dependencies by processing inputs bidirectionally, their high parameter count and computational demands hinder practical applications in real-time HAR. This study investigates the approximation of the computationally intensive BiLSTM component in a HAR model by using a combination of alternative model components and data flipping augmentation. The proposed modifications to an existing hybrid model architecture replace the BiLSTM with standard and residual LSTM, along with convolutional networks, supplemented by data flipping augmentation to replicate the context awareness typically provided by BiLSTM networks. The results demonstrate that the residual LSTM (ResLSTM) model achieves superior performance while maintaining a lower computational complexity compared to the traditional BiLSTM model. Specifically, on the UCI-HAR dataset, the ResLSTM model attains an accuracy of 96.34% with 576,702 parameters, outperforming the BiLSTM model's accuracy of 95.22% with 849,534 parameters. On the WISDM dataset, the ResLSTM achieves an accuracy of 97.20% with 192,238 parameters, compared to the BiLSTM's 97.23% accuracy with 283,182 parameters, demonstrating a more efficient architecture with minimal performance trade-off. For the KU-HAR dataset, the ResLSTM model achieves an accuracy of 97.05% with 386,038 parameters, showing comparable performance to the BiLSTM model's 98.63% accuracy with 569,462 parameters, but with significantly fewer parameters. [ABSTRACT FROM AUTHOR]

A 40-year-old female presented with right mandibular swelling. A panoramic radiograph showed a unilocular radiolucency from the mandibular angle to tooth #46. Biopsy confirmed a schwannoma. Surgical resection was performed via a submandibular approach with a reconstruction plate. Teeth 46 and 47 were extracted. Surgery was complication-free, and histopathology confirmed the tumor's benign nature. The patient was discharged on the second postoperative day. At the 1-year follow-up, she had no paresthesia, normal mouth opening, and full mandibular motion. The reconstruction plate was intact. This case adds to the limited literature on intraosseous schwannomas, emphasizing early detection, thorough radiological assessment, and meticulous surgical planning. [ABSTRACT FROM AUTHOR]

The utilization of recycled materials in concrete technology has gained significant attention in recent years, promoting sustainability and resource conservation. This paper investigates the behavior of lightweight self-compacting concrete (LWSCC) with recycled tire steel fibers (RTSFs). The effects of RTSFs on the flowability of the composite material and its density were assessed. The mechanical properties of the developed material were examined and beam tests were performed, aiming to assess its feasibility for structural applications. The compressive and tensile strengths were determined to evaluate the mechanical properties of the developed concrete mixtures. The beam tests were conducted to assess the flexural behavior of the beam specimens. Three different steel fiber contents of 0, 0.5, and 1% volumetric fractions of concrete were used in this study. The test results indicate that incorporating the fibers did not negatively impact the flowability and density of the LWSCC mixtures. In addition, the use of RTSFs enhanced the tensile strength of the developed concrete mixtures, where fibrous concrete showed increases in the splitting tensile strength in the range of 38 to 76% over that of non-fibrous concrete. On the other hand, the compressive strength of the mixtures was not affected. The test beams with RTSFs exhibited improved flexural performance in terms of delaying and controlling cracking, enhancing ultimate load, and increasing ductility. Compared with the control non-fibrous beam, the increases in the cracking load, ultimate load, and ductility index were up to 63.8, 9.3, and 16%, respectively. The test results of the beams were compared with theoretical predictions, and good agreement was found. [ABSTRACT FROM AUTHOR]

Background: Test anxiety (TA) is described as a set of psychological and behavioral responses that occur when a person is concerned about the possibility of unfavorable results or failing on an exam. Based on multiple studies, medical education is known for its rigorous curricula, continuous high academic demands, frequent assessments, practical instruction, and mentorship, all of which contribute to a stressful atmosphere that results in elevated rates of depression, anxiety during exams, subpar academic achievement, and a higher number of medical student dropouts. This study aimed to measure the prevalence of test anxiety and predisposing factors among students at Unaizah College of Medicine. Results: Our study revealed that 45.4% of responders reported having low anxiety, while 33.2% of them reported having moderate anxiety. A lower but statistically significant percentage (21.5%) expressed high levels of anxiety. Regarding the factors contributing to exam anxiety in medical students such as social support, it was found that the students with poor social support exhibited significant odds of severe test anxiety. Remarkably, there was a decreased likelihood of experiencing severe anxiety when studying all the night before the exam. Conclusion: Research results have the potential to impact institutional policies concerning medical students' well-being. Colleges can create supportive environments that address the factors causing test anxiety and promote mental health and academic success. [ABSTRACT FROM AUTHOR]

Sentiment analysis is a critical component in understanding customer opinions and reactions. This study explores the application of sentiment analysis using Python on the Amazon Fine Food Reviews dataset to classify customer reviews as positive or negative, enabling businesses to gain valuable insight into customer sentiments. This study used and compared the efficiency of Logistic Regression, Support Vector Machines, Random Forest, XGBoost, LSTM, and ALBERT. The comparison results showed that the LSTM and ALBERT classifiers stand out with remarkable accuracy (96%) and substantial support for positive and negative reviews. On the other hand, although the Random Forest classifier had similar accuracy (96%), it exhibited lower support for positive and negative sentiments. [ABSTRACT FROM AUTHOR]

Seven-wire prestressing strands are commonly used to pretension concrete bridge members. While the industry standard is 12.7-mm (0.5-in.) or 15.2-mm (0.6-in.) diameter strand, interest in developing greater pretensioning forces has resulted in the proposed use of 17.8-mm (0.7-in.) strands. This paper reports an experimental program aimed at characterizing the bond properties of 17.8-mm seven-wire prestressing strand and contrasting these with 9.5-mm (3/8-in.), 12.7-mm (1/2-in.), and 15.2-mm (−0.6-in) strands. The geometric and material properties of the strands are reported, and the evaluation of bond performance is assessed by standard test methods. Beam-end bond tests of both straight and 90° hooked strands are presented. The results of in situ transfer length determined from full-scale girders are also presented. Finally, finite-element analyses aimed at evaluating the influence of the Hoyer effect and strand spacing are presented. In all the tests, bond performance of 17.8-mm strand was found to be adequate and appropriately represented by existing AASHTO transfer and development length equations. The potential for utilizing the embedment of hooked strands into cast-in-place end diaphragms to increase the strand stress that may be developed near girder ends is proposed. From the in situ determination of transfer length, the mean and fifth percentile transfer lengths (determined with 95% confidence) of 0.7-in. strands were determined to be 30.4db (db is the strand diameter) and 53.4db, respectively, both less than the 60db prescribed by AASHTO. Additionally, the conventional 51-mm (2-in.) minimum center-to-center strand spacing appears to be adequate for 17.8-mm strands in terms of release stresses. No local cracking or other deleterious effects associated with strand spacing were observed. It is shown numerically that the lower Hoyer effect strand dilation and larger circumference result in marginally lower crack-inducing circumferential stresses. Although the current AASHTO determination of transfer and development length appears to overestimate these values for all strand diameters including 17.8-mm strands, the overestimation of transfer length underestimates concrete tensile stresses at prestress transfer in the area affected by the transfer length. This may result in unanticipated cracking. To address this, a two-tier approach is proposed: (1) using a reduced transfer length—40db is proposed—to check tensile stresses at prestress release; and (2) using the longer development length—using a transfer length component of 60db—to determine the load-carrying capacity of a prestressed concrete member. [ABSTRACT FROM AUTHOR]

Introduction: Respiratory syncytial virus (RSV) represents a considerable burden on the healthcare system and hospital resources. This study explored the impact of universal immunoprophylaxis with long-acting monoclonal antibody (nirsevimab) during infants' first RSV season on RSV-induced health events and related costs in the Kingdom of Saudi Arabia (KSA). Methods: The burden of RSV-induced health events and related costs under the current standard of practice (SoP) and the impact of universal immunoprophylaxis with nirsevimab was estimated using a static decision-analytic model in a cohort of infants experiencing their first RSV season in the KSA. The model estimated hospital admissions (including pediatric intensive care unit [PICU] admissions and mechanical ventilation [MV]), emergency room (ER) visits, primary care (PC) visits, long-term sequelae, and RSV mortality. Results: The model estimated that under the current SoP, RSV results in 17,179–19,607 hospitalizations (including 2932–3625 PICU and 172–525 MV admissions), 57,654–191,115 ER visits, 219,053–219,970 PC visits, 14 deaths, 12,884–14,705 cases of recurrent wheezing, and a total cost of SAR 480–619 million. Universal nirsevimab immunoprophylaxis was estimated to avert 58% of hospitalizations (58% PICU admissions, 58% MV episodes), 53% of ER visits, 53% of PC visits, 58% of episodes of recurrent wheezing, 8 deaths, and result in savings of SAR 274–343 million in total healthcare cost. Conclusion: Compared with current SoP, an nirsevimab immunoprophylaxis strategy in the KSA for all infants during their first RSV season was estimated to dramatically decrease healthcare resource use, and economic burden associated with RSV. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to significant changes in healthcare practices, including increased antibiotic usage. This study aimed to investigate the impact of the pandemic on the prevalence of extended-spectrum β-lactamase (ESBL) production and carbapenem resistance among key bacterial species causing urinary tract infections (UTIs). Conducted at King Fahad Medical City in Riyadh from January 2018 to December 2022, the study analyzed urine samples from 9697 UTI patients. Patients were categorized into 'pre-COVID-19' and 'during COVID-19' groups. Bacterial isolates were identified, and antimicrobial susceptibility testing was performed following guidelines. ESBL production was detected using the Double-Disc Synergy Test. Escherichia coli and Klebsiella pneumoniae were the main pathogens. During the pandemic, ESBL production decreased in E. coli by 1.9% and in K. pneumoniae by 6.0%. Carbapenem resistance also declined, with E. coli displaying a 1.2% reduction and K. pneumoniae and Pseudomonas aeruginosa displaying 10.7% and 7.9% reductions, respectively. Notably, logistic regression analysis revealed that the odds of ESBL presence were 10% lower during the COVID-19 pandemic (OR 0.91; 95% CI 0.83–0.99; p = 0.040), and there was a significant reduction in the odds of carbapenem resistance (OR 0.43; 95% CI 0.37–0.51; p < 0.001). This study reveals a significant decrease in ESBL production and carbapenem resistance among UTI pathogens during the COVID-19 pandemic, hinting at the impact of modified antibiotic and healthcare approaches. It emphasizes the need for persistent antimicrobial resistance surveillance and policy adaptation to address resistance challenges, offering key directions for future public health actions. [ABSTRACT FROM AUTHOR]

Burn prevention programs can effectively reduce morbidity and mortality rates. In this article, we present the findings of our investigation of the knowledge, attitudes, and practices of the Saudi Arabian population regarding electrical burns. Our study was a cross-sectional online survey that used a five-part questionnaire to assess the participant's demographic information, knowledge of electrical burns, attitudes toward electrical injuries, and practices related to electrical burns and their prevention. Overall, 2314 individuals responded to the survey (males: 41.2%; females: 58.8%). A total of 839 participants (36%) had a personal or family history of electrical burns. Approximately ≥90% of the responses to questions on electrical burn-related knowledge were correct; relatively less responses to questions on the extent of tissue damage from electrical burns and arcs were correct (74% and 29%, respectively). Only 54% of the respondents knew that applying first aid to the burn-affected areas at home could lead to a better outcome; 27% and 19% did not know the correct answer and thought that this would not lead to a better outcome, respectively. The most common source of information was school or college (38.9%), followed by social media (20.8%) and internet websites (16.3%). Enhancing community awareness and practices related to electrical burns is a cost-effective and straightforward strategy to prevent the morbidity and mortality associated with electrical injuries. [ABSTRACT FROM AUTHOR]

INTRODUCTION The FDA's 'The Real Cost' tobacco prevention campaign aimed to counter tobacco marketing efforts directed toward children and youths. Our objectives were to explore the associations between exposure to the FDA's campaign and cigarette risk perception among the US adolescent population, and between exposure and cigarette smoking curiosity among adolescents who never smoked cigarettes. METHODS We analyzed 3 cycles of National Youth Tobacco Survey (NYTS 2018-2020, n=53738). Multivariable logistic regression models were fitted to measure the relationship between campaign exposure and cigarettes risk perception (among all), as well as the relationship between campaign exposure and cigarette curiosity (among cigarette never smokers). RESULTS Majority of youths have reported exposure to the campaign 63% between 2018-2020. The odds of youths perceiving cigarettes as risky were 1.6 times higher among exposed compared to those not exposed (adjusted odds ratio, AOR=1.60; 95% CI: 1.43-1.79). There were some racial disparities in risk perceptions among Hispanics and Non-Hispanic Blacks across exposure groups. Exposure was associated with higher cigarettes curiosity odds among Hispanic youths who never smoked (AOR=1.26; 95% CI: 1.10-1.44) compared to their Non-Hispanic White peers. CONCLUSIONS The FDA's 'The Real Cost' campaign had exposure levels deemed essential for population-level perceptions change. Exposure was associated with youths having higher risk perceptions about the negative health outcomes related to cigarette smoking. However, students that never smoked were more curious about smoking with campaign exposure. Therefore, future health communication plans should consider both the potential benefits and possible unintended consequences prior to launching such campaigns. [ABSTRACT FROM AUTHOR]

Human errors (HEs) are common problems in manual assembly processes, impacting product quality and resulting in additional costs. Based on expert judgments, this study aims to identify the most significant factors affecting HEs in manual assembly processes and explore the cause-and-effect relationships among those factors. In order to achieve this objective, a proposed model is constructed using two types of Multi-Criteria Decision-Making (MCDM) techniques. Firstly, using two rounds of the fuzzy Delphi method (FDM), twenty-seven factors with an influence score of 0.7 or higher were found to have a major impact on HEs during manual assembly processes, with at least a 75% consensus among experts. After that, the twenty-seven factors affecting HEs were given to experts in a third round to analyze the cause-and-effect relationships among those factors using the fuzzy decision-making trial and evaluation laboratory (DEMATEL) method. In MCDM techniques, symmetry refers to an important property that can be used to find relationships between variables. It is based on the principle that the relative importance or preference between two variables should remain the same regardless of their positions or roles. Therefore, symmetry is a factor that MCDM approaches take into account to ensure that the relationships between variables are accurately represented, leading to more reliable decision-making outcomes. The reliability and normality of the surveying data were examined using the SPSS 22.0 software program. The study results revealed that training level, poor workplace layout, a lack of necessary tools, and experience were the major factors affecting HEs as root causes. Moreover, a failure to address the error-causing problem, unintentional unsafe acts, fatigue, and poor error visual perception were found to be effect (dependent) factors. The findings of this study can help organizations make better-informed decisions on how to reduce worker errors and interest in the factors that contribute to assembly errors and provide a good basis for reaching the quality of final assembled parts. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to describe patient characteristics and medication adherence among medication access mobile application users and nonusers. Methods: This was a cross-sectional study of a randomly selected sample of patients who refilled their medications either through the mobile application 'MNG-HA Care' or by phone call to a government-funded multispecialty hospital in Riyadh, Saudi Arabia. Data were collected through an online survey and filed either via WhatsApp or by phone call. Medication adherence was assessed using the five-item Medication Adherence Report Scale (MARS-5). Results: A total of 280 respondents were recruited, and their mean age was 48.8 years (standard deviation (SD): 17.8). More than 75% of application users and nonusers were younger (18–64 years) and lived in urban areas, 58% were male, 37.5% held a bachelor's degree, and 40% were unemployed. The number of respondents who accessed the mobile application (mobile application users) was 212, and 64.2% of them were adherent to their medications. Sixty-eight of the respondents used a phone call for refills (mobile application nonusers), and 77.9% of them were adherent to their medications. The most common self-reported reasons for using the application were to book an appointment and to request a medication refill. The most common self-reported reasons for not using the application were respondents' lack of knowledge about the availability of the application and preference for speaking directly to the health care provider. Adjusted multivariate logistic regression analysis revealed that medication adherence was not associated with application use (Odds Ratio (OR): 0.65; 95% CI: 0.33–1.29). However, male patients had significantly higher adherence than females (OR 2.68, 95% CI 1.31 to 5.51), and employed patients had significantly lower adherence than unemployed patients (OR 0.37, 95% CI 0.17 to 0.81). Conclusions: Providing patients with access to their medication list through a mobile application alone did not significantly impact medication adherence. Further research is needed to explore the potential benefits of incorporating additional features, such as medication instructions and reminders within mobile applications, to improve medication adherence. [ABSTRACT FROM AUTHOR]

Background: Celiac serology can be transiently elevated in patients with type 1 diabetes mellitus (T1DM) and normalized despite gluten consumption. This study aimed to identify the frequency and predictive factors of spontaneous normalization of anti-tissue transglutaminase (anti-TTG-IgA) antibodies in these patients. Methods: The charts of all patients (≤18 years) with T1DM were retrospectively reviewed from 2012 to 2021 at a tertiary care center in Riyadh, Saudi Arabia. The following data were collected: clinical characteristics of the participants, anti-TTG-IgA-immunoglobulin (Ig) A antibody, and histological findings. The outcome of positive anti-TTG-IgA-IgA in patients with T1DM and the predictive factors for spontaneous normalization were investigated. Results: Of the 1,006 patients with T1DM, 138 (13.7%) had elevated anti-TTG-IgA antibodies, celiac disease was diagnosed in 58/138 (42%) patients, spontaneous normalization of anti-TTG-IgA was observed in 65 (47.1%) patients, and fluctuating anti-TTG-IgA antibodies were seen in 15 (10.9%) patients. The patients with anti-TTG-IgA levels at 3–10 times the upper normal limits (UNL), and those with levels ≥10 times UNL were less likely to have spontaneous normalization of anti-TTG-IgA compared to patients with levels at 1–3 times UNL (hazard ratio [HR] = 0.28, 95% confidence interval [Cl] = 0.13–0.61, P = 0.001, and HR = 0.03, 95% Cl = 0.00–0.19, P < 0.001, respectively). Conclusion: Asymptomatic patients with T1DM with mild elevation of anti-TTG-IgA need not be rushed for invasive endoscopy or exposed to an un-needed gluten-free diet but should rather have a regular follow-up of their celiac serology. [ABSTRACT FROM AUTHOR]

Background: Anthropometry facilitates the evaluation of risks associated with reduced macular pigment optical density (MPOD). Objectives: To investigate the predictors and anthropometric indices associated with MPOD in healthy adult in Arab population. Design: This is a cross-sectional study. Methods: The MPOD was measured at 0.5° from fovea using a heterochromatic flicker photometer. Healthy participants aged between 20 and 40 years were recruited. The study evaluated the following data of the participants: height, weight, body mass index, body fat percentage, basal metabolic rate, visceral fat level, muscle mass, bone mineral content, and percentage of protein and body water. The correlation between MPOD with anthropometrics and demographic data was evaluated using Spearman's correlation test. The differences among genders were investigated using the Mann–Whitney U test. The smoking effect on MPOD was analyzed using the Friedman test. Results: In all, 143 participants were recruited. The median ± interquartile range was calculated for age (23 ± 4 years), visual acuity (0.00 ± 0.00 logMAR), and MPOD (0.41 ± 0.18). The average MPOD was higher in males than in females but it was not statistically significant (p > 0.05); on the other hand, they were statistically significantly different in most of the anthropometric data. A significant relationship was found between MPOD and percentage of body fat, protein, and body water (r = 0.30, p < 0.05). The observed median MPOD value was higher in this study than that found in previous studies in white populations, but lower than that found in studies investigating Asian populations. Conclusion: One of the most important risk factors of age-related macular degeneration is associated with a relative absence of macular pigment. This study brought into focus percentage of protein and body water for further studies as well as the well-established links with body fat and obesity. Unknown predictors of MPOD remain uncovered. The study also provided first report on normative values of MPOD for Arab population and confirmed the differences from other ethnicities. [ABSTRACT FROM AUTHOR]

Purpose: This work aimed to utilize virtual reality (VR) in dental radiographic anatomical interpretation in junior dental students and test if it can enhance student learning, engagement, and performance. Methods: VR software for panoramic anatomy was developed. Sixty‐nine first‐year dental students were divided into a control group (lecture‐based) and an experimental group (VR) to learn panoramic radiographic anatomy. Both groups were then tested on knowledge via a 20‐question quiz. Student feedback on VR experience was collected via an online survey. Results: There was a statistically significant difference between lecture‐based and VR students in the correct identification of anatomical landmarks. Lecture‐based students scored higher in identifying the ear lobe, hyoid bone, condylar neck, and external oblique ridge, whereas VR students scored higher in identifying zygoma (Chi‐squared test, p < 0.005). The VR group reported high evaluation on all perception items of the online feedback survey on their experience (Student t‐test, p < 0.005). Conclusions: Lecture‐based students generally showed better performance in panoramic radiographic anatomy. Several structures were not correctly identified in both groups of novice students. The positive feedback of VR experience encourages future implementation in education to augment conventional methods of radiographic anatomy in dentistry with considerations to repeated exposures throughout undergraduate dental education. [ABSTRACT FROM AUTHOR]

Excessive use of natural resources and environmental concerns are key issues motivating the recycling of waste materials in the construction industry to minimize landfill problems. Free cement binders such alkali-activated binders have emerged as a prospective alternative to ordinary Portland cement, wherein diverse industrial, agriculture, and by-product waste materials have been converted as valuable spin-offs. Annually, tens of millions tons of red brick wastes are generated, which leads to several environmental problems. Thus, waste red brick powder (WRBP) was used as binder or a fine aggregate (silica sand) substitute to prepare some new types of alkali-activated mortars (AAMs). These mortars contained ground blast furnace slag (GGBFS) and metakaolin (MK) with various levels of WRBP (0, 15, 30, and 45%) as a substitute for silica sand. The prepared AAMs were cured at 300 °C, 600 °C, and ambient temperature. All the specimens were tested to determine the effects of various WRBP contents on the workability, strengths, and microstructures of the designed AAMs. The workability of the fresh AAMs was considerably dropped due to the incorporation of WRBP as binary binder or fine aggregate replacement. In addition, AAM containing 15% of WRBP as GGBFS and MK replacement displayed a significant improvement (by 30.7%) in the strength performance. However, the increasing content of WRBP to 30% and 45% significantly led to a decrease in compressive strength from 49.9 MPa to 44.7 and 34.2 MPa, respectively. Overall, the mortars' strength was increased with the increase in WRBP contents from 0 to 45% as sand substitute. Conversely, the mortars strength was reduced with the increase in curing temperatures. The microstructure analyses of the studied mortars revealed an appreciable enhancement of the geopolymerization process, gels formulation, and surface morphology, leading to an improvement in their compressive and flexural strength characteristics. It was asserted that high-performance mortars with customized engineering properties can be designed via the inclusion of WRBP into alkali-activated MK-GGBFS mixes. [ABSTRACT FROM AUTHOR]

The synthesis of advanced materials at high pressures has been an area of growing research interest for several decades. This article is the third in a three-part series that reviews Laser Materials Processing Within Diamond Anvil Cells (L-DACs). Part III focuses on the practice of Laser Reactive Synthesis Within Diamond Anvil Cells (LRS-DAC). During LRS-DAC processing, chemicals are precompressed within diamond anvil cells, then microscale chemical reactions are induced by focused laser beams. The method is distinguished from the well-known Laser-Heated Diamond Anvil Cell (LH-DAC) technique (see Part I) through the existence of chemical precursors (reactants), end-products, and quantifiable changes in chemical composition upon reaction. LRS-DAC processing provides at least three new degrees of freedom in the search for advanced materials (beyond adjusting static pressures and temperatures), namely: laser-excitation/cleavage of chemical bonds, time-dependent reaction kinetics via pulsed lasers, and pressure-dependent chemical kinetics. All of these broaden the synthetic phase space considerably. Through LRS-DAC experimentation, it is possible to obtain increased understanding of high-pressure chemical kinetics—and even the nature of chemical bonding itself. Here, LRS-DAC experimental methods are reviewed, along with the underlying chemistry/physics of high-pressure microchemical reactions. A chronology of key events influencing the development of LRS-DAC systems is provided, together with a summary of novel materials synthesised, and unusual chemical reactions observed. Current gaps in knowledge and emerging opportunities for further research are also suggested. [ABSTRACT FROM AUTHOR]

Expatriates, or migrant workers, are employees who work outside their home country and reside in a foreign country for the purpose of work. They are often subject to job fraud, employment contract violations, and poor working conditions. These calamities are mainly due to language barriers, limited legal protection, and feeling inferior in their host countries. Many reports have indicated that minimum working and living standards for expatriates are not as adequately enforced as those for domestic employees. These issues may be elevated with the presence of an employment contract framework, which would enable better enforcement and wider visibility for both workers and employers. Thus, we propose a blockchain-powered framework to represent expatriate employment contracts as digital assets managed by smart contracts. It enables employers to create contracts to which employees agree in a decentralized, tamper-proof, transparent, and traceable manner. This framework facilitates auditability, tracking, and enhanced visibility of expatriate employment contracts and job history verification for both workers and employers. We provide a prototype implementation using the Hyperledger Fabric platform and analyze the framework qualitatively from scalability, efficiency, security, and privacy perspectives. [ABSTRACT FROM AUTHOR]

Introduction: Saudi Arabia has a high prevalence of obesity, which increases the risk of individuals experiencing multiple chronic complications. Only a few publications highlight the healthcare costs of obesity-related complications (ORCs) in Saudi Arabia. Methods: A micro-costing approach was used to estimate the healthcare costs associated with 10 ORCs. Experienced clinicians in public and private practice across different geographical regions in Saudi Arabia were asked to estimate healthcare resource use associated with each ORC, and estimated unit costs were obtained from hospital administrators. Estimated overall annual costs per patient were calculated as a weighted average of separate public and private sector costs. Results: Individuals in Saudi Arabia with any single ORC incurred overall average annual healthcare costs of 2165–7558 US dollars (USD). Heart failure, chronic kidney disease, dyslipidemia, and type 2 diabetes (T2D) were the most costly complications, mainly driven by monitoring and/or pharmacological treatment costs. In contrast, asthma, hypertension, and angina were the least costly complications. Costs in private healthcare were higher than in public healthcare; the largest differences (2359–2793 USD) were noted for dyslipidemia, T2D, and osteoarthritis, mainly explained by differences in pharmacological treatment costs. Conclusions: These data suggest that ORCs result in a considerable financial burden to the healthcare system, and highlight the substantial cost savings that could be achieved by preventing or delaying the occurrence of ORCs in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: Obesity and its complications are associated with morbidity, mortality and high economic cost in Saudi Arabia. Estimating this impact at the population level and potential benefits to be gained from obesity reduction is vital to underpin policy initiatives to prevent disease risks. Methods: We combined data in an adapted version of the value of weight loss simulation model, to predict reductions in complication rates and cost savings achievable with 15% weight loss in Saudi Arabia over 10 years. To obtain model inputs, we conducted a systematic literature review (SLR) to identify data on the prevalence of obesity and its complications in Saudi Arabia, and surveyed specialist physicians and hospital administrators in public (governmental) and private healthcare sectors. We used combinations of age, sex, obesity and type 2 diabetes (T2D) rates in Saudi Arabia to sample a United Kingdom (UK) cohort, creating a synthetic Saudi Arabia cohort expected to be representative of the population. Results: The synthetic Saudi Arabia cohort reflected expected comorbidity prevalences in the population, with a higher estimated prevalence of T2D, hypertension and dyslipidaemia than the UK cohort in all age groups. For 100,000 people with body mass index 30–50 kg/m2, it was estimated that 15% weight loss would lead to a 53.9% reduction in obstructive sleep apnoea, a 37.4% reduction in T2D and an 18.8% reduction in asthma. Estimated overall cost savings amounted to 1.026 billion Saudi Arabian Riyals; the largest contributors were reductions in T2D (30% of total cost savings for year 10), dyslipidaemia (26%) and hypertension (19%). Conclusions: Sustained weight loss could significantly alleviate the burden of obesity-related complications in Saudi Arabia. Adopting obesity reduction as a major policy aim, and ensuring access to support and treatment should form an important part of the transformation of the healthcare system, as set out under 'Vision 2030'. [ABSTRACT FROM AUTHOR]

To constructively ameliorate and enhance traffic safety measures in Saudi Arabia, a prolific number of AI (Artificial Intelligence) traffic surveillance technologies have emerged, including Saher, throughout the past years. However, rapidly detecting a vehicle incident can play a cardinal role in ameliorating the response speed of incident management, which in turn minimizes road injuries that have been induced by the accident's occurrence. To attain a permeating effect in increasing the entailed demand for road traffic security and safety, this paper presents a real-time traffic incident detection and alert system that is based on a computer vision approach. The proposed framework consists of three models, each of which is integrated within a prototype interface to fully visualize the system's overall architecture. To begin, the vehicle detection and tracking model utilized the YOLOv5 object detector with the DeepSORT tracker to detect and track the vehicles' movements by allocating a unique identification number (ID) to each vehicle. This model attained a mean average precision (mAP) of 99.2%. Second, a traffic accident and severity classification model attained a mAP of 83.3% while utilizing the YOLOv5 algorithm to accurately detect and classify an accident's severity level, sending an immediate alert message to the nearest hospital if a severe accident has taken place. Finally, the ResNet152 algorithm was utilized to detect the ignition of a fire following the accident's occurrence; this model achieved an accuracy rate of 98.9%, with an automated alert being sent to the fire station if this perilous event occurred. This study employed an innovative parallel computing technique for reducing the overall complexity and inference time of the AI-based system to run the proposed system in a concurrent and parallel manner. [ABSTRACT FROM AUTHOR]

The Kingdom of Saudi Arabia (KSA) has embarked on a Health Sector Transformation Program as part of the Kingdom's Vision 2030 initiatives with the facilitation of access to healthcare services for the millions in KSA with diabetes an essential part of the Program. Decision-making tools, such as budget impact models, are required to consider the addition of new medications like oral semaglutide that have multifaceted health benefits and address barriers related to therapeutic inertia to reduce diabetes-related complications. To determine the financial impact of the introduction of oral semaglutide as a treatment option for people with type 2 diabetes mellitus (T2DM) in KSA. From the public payer's perspective, the budget impact model estimates the costs before and after the introduction of oral semaglutide over a 5-year time horizon. The budget impact of introducing oral semaglutide (primary comparator) compared with three different classes of diabetes medicines: glucagon-like peptide-1 receptor agonists (GLP-1), sodium-glucose transport protein 2 inhibitors (SGLT 2i) and dipeptidyl peptidase 4 inhibitors (DDP-4i) have been calculated based on the projected market shares. The model includes the cost of care through the incorporation of health outcomes that have an impact on the national payer's budget in Saudi Riyals (SAR). The budget impact over the five-year time horizon indicates a medication cost increase (17,424,788 SAR), and cost offsets which include a difference in diabetes management costs (-3,625,287 SAR), CV complications costs (-810,733 SAR) and weight loss savings of 453,936 SAR. The cumulative total cost difference is 12,427,858 SAR (0.66%). The introduction of oral semaglutide 14 mg as a second-line treatment option after metformin is indicated as budget-neutral to slightly budget-inflating for the public pharmaceutical formulary of KSA. The price difference is offset by positive health outcomes and costs. This conclusion was confirmed through a probabilistic sensitivity analysis. [ABSTRACT FROM AUTHOR]

Saudi Arabia's Vision 2030 aims to reform health care across the Kingdom, with health technology assessment being adopted as one tool promising to improve the efficiency with which resources are used. An understanding of the opportunity costs of reimbursement decisions is key to fulfilling this promise and can be used to inform a cost-effectiveness threshold. This paper is the first to provide a range of estimates of this using existing evidence extrapolated to the context of Saudi Arabia. We use four approaches to estimate the marginal cost per unit of health produced by the healthcare system; drawing from existing evidence provided by a cross-country analysis, two alternative estimates from the UK context, and based on extrapolating a UK estimate using evidence on the income elasticity of the value of health. Consequences of estimation error are explored. Based on the four approaches, we find a range of SAR 42,046 per QALY gained (48% of GDP per capita) to SAR 215,120 per QALY gained (246% of GDP per capita). Calculated potential central estimates from the average of estimated health gains based on each source gives a range of SAR 50,000–75,000. The results are in line with estimates from the emerging literature from across the world. A cost-effectiveness threshold reflecting health opportunity costs can aid decision-making. Applying a cost-effectiveness threshold based on the range SAR 50,000 to 75,000 per QALY gained would ensure that resource allocation decisions in healthcare can in be informed in a way that accounts for health opportunity costs. A limitation is that it is not based on a within-country study for Saudi Arabia, which represents a promising line of future work. Healthcare in Saudi Arabia is undergoing wide-ranging reform through Saudi Arabia's Vision 2030. One aim of these reforms is to ensure that money spent on healthcare generates the most improvement in population health possible. To do this requires understanding the trade-offs that exist: funding one pharmaceutical drug means that same money is not available to fund another pharmaceutical drug. This is relevant whether the new drug would be funded from within the existing budget for healthcare or from an expansion of it. If the drugs apply to the same patient population and have the same price, the question is simply, "which one generates more health?" In reality, we need to compare pharmaceutical drugs for different diseases, patient populations, and at a range of potential prices to understand whether the drug in question would generate more health per riyal spent than what is currently funded by the healthcare system. This paper provides the first estimates of the amount of health, measured in terms of quality adjusted life years (QALYs), generated by the Saudi Arabian healthcare system. We find that the healthcare system generates health at a rate of one QALY produced for every 50,000–75,000 riyals spent (58–86% of GDP per capita). Using the range we estimate to inform cost-effectiveness threshold can aid decision-making. [ABSTRACT FROM AUTHOR]

The field of high-pressure materials research has grown steadily over the last seven decades, with many remarkable discoveries having been made. This work is part II of a three-part series summarising recent progress in laser material processing within diamond anvil cells (L-DACs); this article focuses on the practice of laser-driven dynamic compression within diamond anvil cells (i.e., LDC–DAC experimentation). In this case, materials are initially pre-compressed within diamond anvil cells, then further dynamically compressed through the use of a high-power pulsed laser, often with the intent to isentropically compress, rather than to heat samples. The LDC–DAC approach provides a novel route to much higher dynamic pressures (approaching 1 TPa), as compared to conventional static compression within a single-stage DAC (<300 GPa) and provides a route to mapping Hugoniot curves. Recent proliferation of low-cost, high-power laser sources has led to increased research activity in LDC–DAC materials processing over the last two decades. Through LDC–DAC experiments, a greater understanding of the properties/structure of cold- and warm-dense matter has been obtained, and novel material phases have been realised. In this article, LDC–DAC experimental methods are reviewed, together with the underlying physics of laser dynamic compression in confined spaces. In addition, a chronology of important events in the development of LDC–DAC processing is provided, and emerging trends, gaps in knowledge, and suggestions for further work are considered. [ABSTRACT FROM AUTHOR]

Laser-heated diamond anvil cell (LH-DAC) experimentation has emerged as a leading technique for materials processing at extreme pressures and temperatures. LH-DAC systems are often employed to better characterise the structure and properties of materials in applications ranging from condensed matter physics to geophysical research to planetary science. This article reviews LH-DAC and related laser-based characterisation, as the first part of a series within the broader context of all high-pressure laser-induced material processing. In part I of this review, a synopsis of laser-heated diamond anvil cell experimental methods, developmental history, fundamental physicochemical processes, and emerging research trends are provided. Important examples of minerals/materials modified during LH-DAC investigations (since their inception) are also tabulated, including key phase transformations, material syntheses, laser parameters, and process conditions—as a reference for the reader and as a guide for directing future research efforts. Note that laser-dynamic-compression within diamond anvil cells (LDC-DAC experimentation) and laser-induced reactive chemical synthesis within diamond anvil cells (LRS-DAC experimentation) are treated separately, as Parts II and III of this review. [ABSTRACT FROM AUTHOR]

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Purpose: Compared to the complete extraction of impacted third molars that are in close proximity to the mandibular canal, the coronectomy procedure is used as an alternative, owing to its minimal risk of damaging the Inferior alveolar nerve. Despite clear coronectomy concepts mentioned in the literature, the procedure is debatable. This study aimed to assess the knowledge and attitude towards the coronectomy procedure among dentists in Saudi Arabia. Patients and Methods: The 16 close-ended questionnaire was distributed electronically to 377 dentists over the country. It included the demographic data and the options given to their patients with complicated impacted third molars, and the number of coronectomy they have performed. The retrieved data were exported and transferred to the SPSS software program for analysis. The Chi-squared and Fisher's exact tests were used as appropriate for comparisons. A P-value < 0.05 was considered significant. Results: Only 54 (15%) participants performed coronectomy procedure, and only 28.3% of the participants advised their patients to do coronectomy. Nearly two-thirds of the participants (71.9%) were aware of coronectomy procedures, with no significant differences (P> 0.05) between the groups. About 68.9% of the participants agreed that coronectomy aims to protect inferior alveolar nerve damage. More than 60% of participants believed that coronectomy is a reliable technique, while 40.6% of participants claimed that they were capable of deciding whether to do coronectomy or extraction. No significant differences were found between the groups concerning most of the study variables (P> 0.05). Conclusion: Knowledge of Saudi dentists towards coronectomy is good, while their attitude is still low. More learning strategies about coronectomy should be implemented. [ABSTRACT FROM AUTHOR]

Background and Objective: Patient self-management education has been a major factor in the intervention and management of chronic diseases as it engages and empowers patients to control and/or prevent complications of chronic diseases. The objective of this study was to develop and validate a framework standard for diabetic patient's self-management education. Methods: A quantified qualitative research method was applied to design and validate a patient self-management framework. Previously published 26 international diabetes management standards and guidelines were reviewed, analyzed, tabulated, and coded into three categories; systems, constructs, and themes. The resulting matrix with coding criteria was validated by a 3-session focus group for consensus, verification, and re-verification of the model. Co-researchers reviewed and reclassified the focus group re-verification data with >90% reliability. Results: The framework consisted of main three domains: the health system with four constructs and 96 items; the delivery system with five constructs and 139 items; and the system of decision, support, supervision, monitoring, and evaluation with 6 constructs and 32 items. Results are reported for the 3 focus group sessions and the co-researchers' review. It resulted in a modification of <30% of the original framework (N of items = 277 - 203 = 74 [26.7%]). Conclusion: A focus group methodology was effectively used to design and validate an appropriate patient self-management education framework. A valid framework of standards and guidelines for type 2 diabetes mellitus self-management was developed and validated to reflect the diabetic patients' needs. An outcome measurement tool would be developed based on the framework to assess the effectiveness of patient self-management outcomes in Saudi Arabian society. [ABSTRACT FROM AUTHOR]

This research analyzes the content of preschool children's drawings as they reflect on aspects of their preschool environment that they missed most during COVID-19 pandemic-related school closures in Saudi Arabia. Children participated in collaboration with their mothers, who directed and collected their drawings. The participants were limited to a group of 41 children between 3–7 years old. The results revealed that most of their drawings were of people, followed by the school environment; the playground was the most prominent area drawn representing the physical environment. Other categories, from the most to the least drawn, include nature, daily scheduled activities, writing activities, food items, and methods of transportation. Through drawings, children showed their most important needs in the preschool environment, which provides some insight into what educators should plan for when children to return to school. [ABSTRACT FROM AUTHOR]

Context: The prevalence of overweight and obesity in Saudi Arabia has been rising. Although the health burden of excess weight is well established, little is known about the economic burden. Aims: To assess the economic burden—both direct medical costs and the value of absenteeism and presenteeism—resulting from overweight and obesity in Saudi Arabia. Settings and design: The cost of overweight and obesity in Saudi Arabia was estimated from a societal perspective using an epidemiologic approach. Methods and materials: Data were obtained from previously published studies and secondary databases. Statistical analysis used: Overweight/obesity-attributable costs were calculated for six major noncommunicable diseases; sensitivity analyses were conducted for key model parameters. Results: The impact of overweight and obesity for these diseases is found to directly cost a total of $3.8 billion, equal to 4.3 percent of total health expenditures in Saudi Arabia in 2019. Estimated overweight and obesity–attributable absenteeism and presenteeism costs a total of $15.5 billion, equal to 0.9 percent of GDP in 2019. Conclusions: Even when limited to six diseases and a subset of total indirect costs, results indicate that overweight and obesity are a significant economic burden in Saudi Arabia. Future studies should identify strategies to reduce the health and economic burden resulting from excess weight in Saudi Arabia. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused many countries around the globe to put strict policies and measures in place in an attempt to control the rapid spread of the virus. These measures have affected economic activities and have impacted a broad range of businesses, such as international traveling, restaurants, and shopping malls. As COVID-19 vaccination efforts progress, countries are starting to relax international travel constraints and permit passengers from certain destinations to cross the border. Moreover, travelers from those destinations are likely required to provide certificates of vaccination results or negative COVID-19 tests before crossing the borders. Implementing these travel guidelines requires sharing information between countries, such as the number of COVID-19 cases and vaccination certificates for travelers. In this paper, we introduce SPIN, a framework leveraging a permissioned blockchain for sharing COVID-19 information between countries. This includes public data, such as the number of vaccinated people, and private data, such as vaccination certificates for individuals. Additionally, we employ cancelable fingerprint templates to authenticate private information about travelers. We analyze the framework from scalability, efficiency, security, and privacy perspectives. To validate our framework, we provide a prototype implementation using the Hyperledger Fabric platform. [ABSTRACT FROM AUTHOR]

Introduction : Patients treated with orthodontics show short root due to apical root resorption. Aim: The aim of the study was to compare the external apical root resorption (EARR) of endodontically treated teeth before and after orthodontic movements using clear aligner therapy. Materials and Methods: The study group comprised 22 class I adult healthy patients with a mean age of (28 ± 8.2) years treated with clear aligner therapy. Thirty-four endodontically treated teeth (maxillary incisors and molars) were measured for the extent of the EARR in panoramic radiographs at the beginning and at the end of clear aligner therapy. Root resorption was measured using an electrical digital caliper (Mitutoyo Manufacturing Co. Ltd., Tokyo, Japan) on the dental panoramic radiographs from the mesial cusps of the first molar tooth to the apex of the root, and from the incisal edge to the apex of the root for the central incisors. Results and Discussion: All the endodontically treated teeth demonstrated reduction in pretreatment root length. Less than one percent of EARR was found in 4 teeth, and 1%–4.9% of the EARR was observed in 23 teeth. Six teeth showed EARR of 5–7.9 while only one tooth EARR in the range of 8–10. A pretreatment versus posttreatment comparison of median root lengths of #16, #26, #36, and #46 showed a statistically significant difference (P < 0.05). The mean differences of root lengths after clear aligner therapy among different teeth showed no significant difference (P = 0.981). Conclusion: All the endodontically treated teeth showed minimal external root resorption after orthodontic treatment with a clear aligner. [ABSTRACT FROM AUTHOR]

Background: Medical training programs candidate's interview is an integral part of the residency matching process. During the coronavirus disease 2019 (COVID-19) pandemic, conducting these interviews was challenging due to infection prevention restrains (social distancing, namely) and travel restrictions. E-interviews were implemented by the Saudi Commission for Healthcare Specialties (SCFHS) since the matching cycle of March 2020 to hold the interviews in a safer virtual environment while maintaining the same matching quality and standards. Aim: This study was conducted to assess the medical training residency program applicants' satisfaction, stress, and other perspectives for the (SCFHS) March 2020 Matching-cycle conducted through an urgently implemented E-interviews process. Method: A cross-sectional, nationwide survey (Additional file 1) was sent to 4153 residency-nominated applicants to the (SCFHS) March 2020 cycle. Results: Among the 510 candidates who responded, 62.2% applied for medical specialties, 20.2% applied for surgical specialties, and 17.6% applied for critical care and emergency specialties. Most respondents (61.2%) never had previous experience with web-based video conferences. Most respondents (80.2%) used the Zoom application to conduct the current E-interviews, whereas only 15.9% used the FaceTime application. 63.3% of the respondents preferred E-interviews over in-person interviews, and 60.6% rated their experience as very good or excellent. 75.7% of the respondents agreed that all their residency program queries were adequately addressed during the E-interviews. At the same time, 52.2% of them agreed that E-interviews allowed them to represent themselves accurately. 28.2% felt no stress at all with their E-interviews experience, while 41.2% felt little stressed and only 8.2% felt highly stressed. The factors that were independently and inversely associated with applicants' level of stress with E-interviews experience were their ability to represent themselves during the interviews (p = 0.001), cost-savings (p < 0.001), their overall rating of the E-interviews quality (p = 0.007) and the speed of the internet connection (p < 0.006). Conclusion: Videoconferencing was implemented on an urgent basis during the COVID-19 pandemic in the medical residency application process in Saudi Arabia. It was perceived as an adequate and promising tool to replace in-person interviews in the future. Applicants' satisfaction was mainly driven by good organization, cost-saving, and their ability to present themselves. Future studies to enhance this experience are warranted. [ABSTRACT FROM AUTHOR]

Background: Basic understanding of medical errors and medical complications is essential to ensure patient safety. Our aim in this study was to assess whether patients have sufficient knowledge of medical errors and medical complications and to identify the factors that influence their knowledge. Methods: A cross-sectional study was conducted with 400 patients with a scheduled appointment at King Abdulaziz Medical City from 2019 to 2020. A self-administered validated questionnaire was developed by the coinvestigators. The first section focused on demographic information, and the second contained 17 scenarios to assess the knowledge of the patients. The data were analyzed with Chi-square test and logistic regression. Results: The sample size realized as 346 (n = 346), with the majority (n = 198, 57%) female, and the mean age 39.5 ± 11 years. The mean scores for the medical errors and complications were 5.5 ± 2.10 and 4.8 ± 2.3, respectively. The participants with secondary education were less likely to have sufficient knowledge of both medical complications (OR 0.52, P = 0.016) and errors (OR 0.52, P = 0.016). In terms of age, the older participants, the 38–47 year age group, were less likely to be knowledgeable about medical complications compared to the younger age groups (OR 0.92, P = 0.046). Conclusion: The patients had a higher level of knowledge about medical errors compared to medical complications. The level of education and the employment status significantly predicted the knowledge of both medical errors and complications. [ABSTRACT FROM AUTHOR]

Background: Induction therapy with IL-2 receptor antagonist (IL2-RA) is recommended as a first-line agent in low immunological risk kidney transplant recipients. However, the role of IL2-RA in the setting of tacrolimus-based immunosuppression has not been fully investigated.Aims: To compare different induction therapeutic strategies with 2 doses of basiliximab vs. no induction in low immunologic risk kidney transplant recipients as per KFSHRC protocol.Methods: Prospective, randomized, double blind, non-inferiority, controlled clinical trial EXPECTED OUTCOMES: 1. Primary outcomes: Biopsy-proven acute rejection within first year following transplant 2.Secondary Outcomes: a. Patient and graft survival at 1 year b. eGFR at 6 months and at 12 months c. Emergence of de novo donor-specific antibodies (DSAs) TRIAL REGISTRATION: The study has been prospectively registered at clinicaltrials.gov (NTC: 04404127). Registered on 27 May 2020. [ABSTRACT FROM AUTHOR]

COVID-19 has emerged as the world's biggest challenge that has not only threatened human lives but also had an immense impact on the economy, safety and religious practices. The situation has worsened due to the lack of proper guidelines for fighting the sudden unexpected outbreaks. The world was not prepared for this situation. This review highlights some important steps the Middle East countries is taking and their impact on controlling the COVID-19 outbreak. We also discuss some hypothetical predictions for the coming months. [ABSTRACT FROM AUTHOR]

Polygraph is a tool to quantify application anomalies attributed to violating atomicity, isolation, and linearizability properties of transactions. It is a plug-n-play framework that includes visualization tools to empower an experimentalist to (a) quickly incorporate Polygraph into an existing application or benchmark and (b) quantify the number of anomalies. We demonstrate Polygraph using existing benchmarks, including TPC-C, SEATS, TATP, YCSB, and BG. We highlight Polygraph as an on-line tool by showing it scales for almost all benchmarks to process their transaction log records faster than their rate of production. [ABSTRACT FROM AUTHOR]