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PPHN is a common cause of neonatal respiratory failure and is still a serious condition that is associated with high mortality. Objectives: To analyze the clinical characteristics and outcomes of SARS-CoV-2 infection in neonates with PPHN to identify neonatal cases at risk to develop severe illness. Methods: For this systematic review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and searched Medline, Embase, CINAHL, and PubMed for studies on the development of COVID-19 in neonates with PPHN, published from 1 December 2019 to 29 February 2024, with an English language restriction. Results: Of the 2406 papers that were identified, 21 articles were included in the systematic review. Studies involving thirty-six neonates with PPHN and infected with SARS-CoV-2 were analyzed (twenty-nine survived, six died, and one is still hospitalized). The main causes of PPHN in neonates who had COVID-19 were neonatal respiratory distress syndrome (NRDS) (41.7%), meconium-stained amniotic fluid (MSAF) (16.7%), preterm premature rupture of membranes (PPROM) (11.1%), hypoxic ischemic encephalopathy (HIE) (5.5%), pneumonia (5.5%), and idiopathic (2.8%). Most of those neonates were male (33.3%), belonged to Indian ethnicity (50%), and were delivered via caesarean section (44.4%). COVID-19 in cases with PPHN commonly occurred in neonates born with a pregnancy range from 32 to <37 weeks (moderate to late preterm) (36.1%). The maternal severity of COVID-19 was reported to be severe in three cases only (8.3%); however, SARS-CoV-2 infection in neonates with PPHN was either severe (44.4%) or critical (22.2%). Most of these neonates experienced acute respiratory distress syndrome (ARDS) (58.3%). Early and late multisystem inflammatory syndrome in neonates (MIS-N) were reported in 50% and 11.1%, respectively. A high proportion of neonates were admitted to the intensive care unit (ICU) (58.3%) or needed mechanical ventilation (MV) (47.2%). Neonates with concurrent PPHN and SARS-CoV-2 infection who died had worse severity of COVID-19 [i.e., severity of COVID-19 was critical in 10% (neonates with PPHN who survived group) vs. 83.3% (neonates with PPHN who died group); p = 0.026]. Neonates with PPHN and COVID-19 had a higher relative risk of death if they received more antibiotics (RR 4.14, 95% CI 0.64–6.88) and if their COVID-19 was defined as critical (RR 2.84, 95% CI 0.86–9.39). Male neonates with PPHN and COVID-19 (RR 2.60, 95% CI 0.30–1.17) and those requiring prolonged invasive positive pressure ventilation (RR 2.22, 95% CI 0.64–7.73) also showed an increased relative risk for death. Conclusions: COVID-19 in neonates with PPHN is challenging and may be associated with increased mortality, severity, ICU admission, ARDS, MIS-N, and MV usage. The results should be interpreted with caution owing to the small number of studies and substantial heterogeneity and indicate a need for future research in this area. Due to its benefits, testing for SARS-CoV-2 should be encouraged for newborns with symptoms consistent with COVID-19, especially in neonates with a history of SARS-CoV-2 exposure. Effective protection measures should be implemented during delivery and post-delivery care as necessary. [ABSTRACT FROM AUTHOR]

Background: GLP-1 receptor agonists (GLP-1RA) are used in the management of type II diabetes mellitus or obesity, although its role in patients with type I diabetes mellitus (T1DM) has been debated. This study aimed to investigate the efficacy and safety of GLP-1RA in patients with T1DM using real-world data. Methods: This multicenter, retrospective study was conducted at three tertiary medical centers in Riyadh, Saudi Arabia. The study followed up patients (>16 years old) with T1DM treated with insulin followed by GLP-1RA add-on therapy. The efficacy outcomes included changes in HbA1c, body weight, and insulin requirements from baseline to each follow-up visit. The main safety outcomes assessed included hypoglycemic events and gastrointestinal (GI) adverse events. Results: The study included 144 patients with a mean age of 33.0 ± 10.1 years. Semaglutide was the most used GLP-1RA (63.9%) followed by liraglutide (34.0%). From baseline to 3-month follow-up, HbA1c (mean difference (MD) = −0.8%; p = 0.0053), weight (MD = −2.4 kg; p = 0.0253), and daily basal insulin dose (MD = −2.1 units; p = 0.0349) were significantly reduced. Likewise, HbA1c (MD = −0.5%; p = 0.0004), weight (MD = −3.6 kg; p < 0.0001), and daily basal insulin (MD = −2.4 units; p = 0.0282) were significantly reduced at the 4–6-month follow-up. The significant reductions in HbA1c, weight, and daily basal insulin levels were consistent for up to 18-month follow-up. Only one patient had a major hypoglycemic event, whereas 8.3% of the patients had GI adverse events. Conclusions: Overall, significant improvements in glycemic control, weight loss, and insulin requirements were observed with the use of GLP-1RA in patients with T1DM, with a limited number of GI adverse events. [ABSTRACT FROM AUTHOR]

The present investigation was designed to assess how administering biocontrol agents (BCAs) made from the nematophagous endophytic fungus MR20 (Purpureocillium lilacinum) or a mixture of endophytic plant growth-promoting bacteria MR12 (Pseudomonas fluorescens), and MR25 (Serratia marcescens), could enhance tomato growth and resistance to Meloidogyne incognita under in vivo conditions. The three strains' cell-free culture filtrates showed a strong nematocidal impact (P < 0.05) on M. incognita infective second-stage juveniles (J2s). The highest mortality rates by the three BCAs were at concentrations of 80%, followed by 60%, 40%, and 20%. The in vitro hatching of free eggs was found to be considerably (P < 0.05) reduced as the concentrations of the endophytic bacteria MR12, and MR25 were increased in the order 1 × 105, 1 × 106, 1 × 107, 0.5 × 108, to 1 × 108 colony forming units (CFU)/mL, and the maximum nematicidal activity in killing M. incognita free eggs occurred at 1 × 108 CFU/mL. A statistically significant (P < 0.05) reduction in the percentage of M. incognita-free eggs retrieved was seen in vitro when various concentrations of the endophytic fungus MR20 were applied compared to the negative control (distilled water). The endophytic fungus MR20 had the highest nematicidal activity against M. incognita free eggs at a concentration of 3 × 106 CFU/mL. The application of P. lilacinum or a combination of P. fluorescens and S. marcescens to tomato plants in the presence of M. incognita under greenhouse conditions resulted in a significant increase (P < 0.05) in root and shoot fresh weight, number of leaves, weight of leaves, and stem diameter when compared to the positive control treatment that contained only M. incognita. Treatment with P. lilacinum was more effective (P < 0.05) than P. fluorescens and S. marcescens in reducing egg masses per root, J2s per 100 g of soil, egg masses per 100 g of soil, J2s + eggs of M. incognita per 100 g of soil, reproduction factor, and reduction percentage after 60 days under greenhouse conditions. Nevertheless, the reduction of M. incognita gall size categorization (> 4 mm, 2–4 mm, and < 2 mm) was more effectively achieved by treatment with P. fluorescens and S. marcescens than by treatment with P. lilacinum. Under in vivo conditions, the tested P. lilacinum or a mixture of P. fluorescens and S. marcescens effectively controlled nematode population densities below the economic threshold. [ABSTRACT FROM AUTHOR]

Background: Dental anxiety is marked by intense and irrational fear of dental procedures affecting millions of individuals worldwide. The purpose of this study was to investigate the relationship between dental anxiety, its influencing factors, and the preferred management techniques among adults seeking dental care in Riyadh. Methods: A cross-sectional questionnaire study was carried out among 1734 patients who visited dental clinics in Riyadh. A self-administered questionnaire was developed and validated, comprising 28 closed-ended questions; it demonstrated good reliability and internal consistency (Cohen's kappa coefficient = 0.90, Cronbach's alpha coefficient = 0.86), it contained pre-validated Modified Dental Anxiety Scale to quantitatively assess the level of dental anxiety. Data analysis involved descriptive analysis, Chi-square test, Pearson correlation coefficient and multiple linear regression. Results: Majority (59.2%) of participants reported moderate anxiety, while 10.9% experienced high anxiety which was significantly linked to factors such as fear of pain (37.8%) and anaesthetic needles (25.8%). Topical anaesthetic gel (64.5%), pre-treatment explanations (78.9%), and conducive clinic environment (79.4%) were perceived as effective anxiety alleviators. A negative correlation existed between dental anxiety and preferred management techniques. Dental anxiety had significant association between gender (β = 0.910) and age (β = 0.263). Conclusion: This study revealed that majority of participants had moderate dental anxiety, linked significantly to influencing factors like frequency and purpose of dental visits and past dental experiences. The study also found the preferred anxiety management methods among participants which included topical anaesthetic gel, pre-treatment explanations, and a comfortable clinic environment. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Illness uncertainty was found to be associated with the development of depressive and anxiety symptoms among patients with type 1 diabetes and chronic illness in general. However, the moderating effect of illness uncertainty was not examined in sufficient depth. The current study evaluates how the path from diabetes distress to depression and anxiety is mediated by illness uncertainty, ambiguity, symptoms and course predictability, and illness complexity. Method: Descriptive cross-sectional survey of a large-scale sample of patients living with type one diabetes in Saudi Arabia. We utilized structural equation modelling mediation analysis to examine the effect of illness uncertainty and its subcategories (illness-related ambiguity, symptoms and course predictability, and illness complexity) on depressive and anxiety symptoms. Results: The current survey analyzed data pertaining to (n = 536) type one diabetes patients. Mean Mishel Uncertainty of Illness Scale score was 80.8 points (Cronbach's α = 0.91) signifying moderate uncertainty among our patients. Diabetes-related uncertainty was associated with marriage (t = 3.337, P = 0.0009937), diabetes complications (t = 5.257, P < 0.00001), pain (r = 0.2247, P < 0.00001), and children count (correlation coefficient r = 0.195, P < 0.00001). The prevalence of depression was (n = 367, 68.5%) and for anxiety was (n = 173, 30.3%). Illness uncertainty correlated with depressive (r = 0.2484, P < 0.00001) and anxiety (r = 0.2548, P < 0.00001) symptoms' scores. Illness uncertainty exerted a partial moderating effect on both anxiety (β = 0.060, P < 0.001) and depressive symptoms (β =0.056, P < 0.001). We observed a partial moderating effect for diabetes-related ambiguity and diabetes-related symptom unpredictability in terms of depressive and anxiety symptoms. However, for diabetes-related course unpredictability, the moderating effect was significant only for anxiety. Diabetes-related complexity did not exert a significant moderating effect on either depressive or anxiety symptoms. Discussion: We confirmed high levels of depression and anxiety among patients with type one diabetes in Saudi Arabia. Our findings suggest that illness uncertainty affects both diabetes-related distress and depression constructs and is likely to be affected by them. [ABSTRACT FROM AUTHOR]

Adding organic soil amendments can improve the physical and hydrological properties of soil, subsequently enhancing fertility for better crop production. In this study, spent Arabica and Columbian coffee wastes and their respective biochars were evaluated as soil amendments to improve the physical and hydrological properties of loamy sand soil and enhance maize (Zea mays L.) crop growth. Spent Arabica coffee (AC) and Columbian coffee (CC) wastes were collected and transformed into biochar through pyrolysis process at 550 °C with a residence time of 3 h and pyrolysis rate of 5 °C per minute. The AC and CC derived biochar were termed as ABC and CBC, respectively. The produced soil amendments were applied to soil at 0% (control), 1%, 3%, and 5% in a column setup. The moisture characteristics, including water infiltration, evaporation, and water retention, were investigated. Thereafter, the prepared amendments were applied to loamy sand soils at 0% (control), 1%, 3%, and 5% (w/w) application rates. Maize growth was then observed for a period of 30 days under greenhouse conditions. Results of the column trials showed that ABC and CBC applied at 5% reduced the cumulative water evaporation by 57%–66% and cumulative infiltration by 124%–181% compared to control. Likewise, 5% application of ABC and CBC resulted in 101 to 130% higher water retention in loamy sand soil. Results of the greenhouse experiment showed that 5% application of ABC and CBC amendments resulted in root biomass of 2.12 and 2.38 g, respectively, as compared to 0.51 g in control treatment. Similar treatments resulted in shoot biomass of 9.70 and 9.93 g respectively, as compared to 7.37 g in control. Likewise, 5% application of CBC and ABC increase plant height from 15.71 to 30.94 cm in ABC and 33.23 cm in CBC. Overall, 5% application of coffee waste-derived biochars significantly reduced water evaporation and infiltration, while increasing soil water retention and maize plant height, root biomass, and shoot biomass. Therefore, spent coffee waste-derived biochar could effectively be employed to improve physical and hydrological properties of loamy sand soils for better crop productivity. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Patient satisfaction is the subjective evaluation of a patient's cognitive and emotional responses. This reflects their expectations regarding the ideal healthcare to be provided. This study aims to assess the satisfaction level of the attendees to the family medicine staff clinics at King Saud Medical City, Riyadh. Materials and Methods: A descriptive cross-sectional study recruited 378 participants. An adapted and piloted questionnaire was used to gather the data. The questionnaire enquires about the communication skills of the receptionist, the triage nurse, and the assigned physician. It included questions regarding the structure of the clinics. Results: Females represent the majority of about 255 (67.5%). About 2/3 of the respondents were within the age group of 18-34 years, 245 (64.8%). A high level of satisfaction was reported by the participants regarding the professionalism, kindness, interest of the staff member, and waiting time. Gender, marital status, and age group have no significant effect on the satisfaction level; the P value was uniformly more than 0.05. Conclusion: The result of this study identified high satisfaction responses regarding the communication skills of the receptionist, triage nurse, and physicians. The overall evaluation of the experience during staff clinic visits was satisfactory. Periodic evaluation of these attributes and other indicators that promote patient-centered care should be undertaken to improve the overall quality of care. [ABSTRACT FROM AUTHOR]

This article critically analyzes the ethical and legal implications of adopting predictive analytics by the French administrative justice system. It raises a key question: Is it wise to integrate artificial intelligence into the administrative justice system, considering its potential benefits, despite the associated risks, ethical dilemmas, and legal challenges? The research employs a method based on an extensive literature review, a qualitative analysis of the adoption by the French administrative justice of predictive analytics tools, and a critical evaluation of the benefits and issues these tools bring. The study finds that AI can make the administrative justice system more efficient, reduce backlogs, and enhance the consistency and predictability of judicial decisions. However, the study also identifies important risks and serious ethical and legal issues associated with integrating AI tools into the justice system. Especially, AI utilization can lead to the dehumanization of justice and poses real risks to the independence and impartiality of justice. While AI can offer significant benefits to all the stakeholders of the administrative justice system, its integration must be approached with caution. A progressive and responsible approach to AI adoption is necessary to avoid compromising judicial integrity and upholding fundamental justice values. [ABSTRACT FROM AUTHOR]

Emergency Medical Services (EMS) are crucial for immediate medical assistance during life-threatening situations. However, insufficient public awareness about EMS services can impede their effectiveness. This study aimed to assess EMS knowledge and trust among the population of Eastern Saudi Arabia while identifying factors contributing to low awareness. A cross-sectional study was conducted in Eastern Saudi Arabia from September 2022 to September 2023. The study included participants aged 18 to 60 from diverse backgrounds. Using a convenience sampling approach, data was collected using a validated questionnaire covering demographics, hypothetical scenarios, EMS knowledge, and trust in EMS. We conducted the Chi-square tests and logistic regression using Jamovi software, with significance levels set at p < 0.05. Our study yielded 435 participants; 55% were males. Gender-based analysis showed significant differences in responses regarding first aid provision and EMS services (P < 0.001). Expectations for EMS response times also varied by gender (P = 0.01). Knowledge-based analysis revealed that age and education significantly influenced EMS knowledge (P < 0.001). Respondents with EMS knowledge were more likely to know how to provide first aid, understand the importance of emergency number 112, and trust EMS (P < 0.001). Trust-based analysis showed age and education-related differences in EMS trust (P < 0.001). Respondents with EMS knowledge and awareness of emergency numbers displayed higher trust in EMS (P < 0.001). This study underscores the need for enhanced public awareness of EMS services in Eastern Saudi Arabia. Age, education, and gender emerged as critical factors affecting EMS knowledge and trust. Bridging this awareness gap necessitates tailored educational campaigns and continuous monitoring. Policymakers should prioritise EMS awareness within broader healthcare strategies, contributing to improved public health outcomes and community well-being. [ABSTRACT FROM AUTHOR]

The immense volume of online content linked to digital libraries has given emergence to the advancement of screening and recommendation systems. A recommendation system is vitally important in both academic institutions and elibraries to assist professors, instructors, students, and researchers in finding appropriate sources of information. Distributed or collaborative screening is the most common method used in current recommendation systems. However, collaborative approaches cannot promote library repositories, including unrated or unpurchased electronic information. Thus, this paper deals with the automated classification and recommendation of a multiclass corpus found in virtual repositories (cloud databases). In various stages, Neuro-Fuzzy (NF) and Support Vector Machine (SVM) techniques are used as the base classifiers for the categorization of the essential subjects (contents). Later, a high-level ensemble learning strategy is utilized to recommend appropriate subjects from the available multiclass corpus. The methods use a CoC (Coherence of Content)-based inference mechanism to extract and filter the critical components before beginning the recommendation process. Experiments demonstrated that a recommended approach based on detailed conceptual descriptions instead of a handful of phrases/words might help academic and research communities to find relevant sources. Observing the results over a period of months shows that the suggested method increases user comfort, proving the system's acceptability to users in this way. In addition, compared to previous models, the accuracy in categorizing the requisite subjects is more than 97.16 per cent. [ABSTRACT FROM AUTHOR]

Copyright of An-Najah University Journal for Research, B: Humanities is the property of An-Najah National University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Supracondylar humeral fractures are among the most common pediatric fractures that require surgical intervention when displaced. Recent attention has been directed towards the utilization of serial radiographs in the post-operative period and their effect on decision-making. This study aimed to determine the usefulness of postoperative radiographs early post-operatively, with the goal of determining the optimal frequency for these radiographs. Methods: Pediatric patients who sustained a supracondylar humeral fracture and underwent operative intervention over a 15-year period were included in this study. Data were collected, including the baseline characteristics of the patients, fractures, and operative interventions. In addition, the time until healing, the total number of X-rays before K-wire removal, and postoperative function were evaluated. Results: A total of 122 pediatric patients were included, with a mean age of 5.33 ± 2.93 years. Most fractures were Gartland Type III (74.6%). Most fractures healed at 4 (36.1%) and 3 weeks (35.2%) after surgery. Of the cohort, 94.3% underwent four different x-rays before wire removal, with 4.9% requiring revision surgery. All revision cases were Gartland type 3, and for all cases, the decision to revise was made within three weeks of surgery. Conclusion: Routine post-fixation radiography should not be performed for surgically treated supracondylar humeral fractures before healing. An exception is the Gartland type 3 fracture, for which earlier imaging may be indicated. [ABSTRACT FROM AUTHOR]

Purpose: Rheumatoid arthritis (RA) doubles the morbidity of cardiovascular disease (CVD) and leads to a 50% increase in mortality compared to the general population. This study aims to estimate the CVD incidence among RA patients in Saudi Arabia (SA), vital for assessing CVD burdens within this group. Patients and Methods: This retrospective study took place at two centers in the Eastern Province of SA, including all adult RA patients who visited the rheumatology clinic from 2016 to 2021 and were prescribed disease-modifying antirheumatic drugs (DMARDs). CVD incidence was determined by the diagnosis of ischemic heart disease (IHD), stroke/transient ischemic attack (TIA), venous thromboembolism (VTE), heart failure (HF), and arrhythmia post-RA diagnosis. Additional data collected included demographics, CVD risk factors, comorbidities, RA-related factors, and medication usage. Results: The study comprised 651 patients, 80.5% of whom were females with an average age of 51. The overall CVD incidence was 11.2 per 1000 person-years, with males experiencing five times more incidents than females. The prevalence of CVD risk factors included 18.7% with hypertension, 7.8% with hyperlipidemia, 18.9% with diabetes, and 42.9% with obesity. Significant predictors of CVD were male gender and RA duration, with adjusted odds ratios (aOR) of 3.17 (95% CI 1.10 to 9.14, P=0.033) and 64.81 (95% CI 3.68 to 1140.6, P=0.004), respectively. Conclusion: This unique study from SA examined the CVD incidence in RA patients, identifying long disease duration and male gender as significant predictors. Effective reduction of CVD risk in RA patients requires aggressive management of modifiable risk factors and regular risk assessments. [ABSTRACT FROM AUTHOR]

Copyright of Critique of Law: Independent Legal Studies / Krytyka Prawa: Niezalezne Studia nad Prawem is the property of Akademia Leona Kozminskiego and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Grafting high-yielding tomato varieties onto stress-tolerant rootstocks can mitigate the adverse effects of saline water irrigation on plant tomato productivity in arid regions like Saudi Arabia. This study investigates the efficacy of grafting tomatoes onto both novel and commercial rootstocks to enhance salinity tolerance and its impact on growth, physiological parameters, and yield in a soilless culture system. The experiment involved two water quality levels, 2 (S1) and 4 (S2) dS m−1, two growth media types, volcanic rock (M1) and sand (M2), and six grafting treatments: Tone Guitar F1 non-grafted (G1) (commercial scion), grafted onto itself (G2), Tone Guitar F1* Maxifort F1 (G3) (commercial rootstock), and grafting the scion onto three novel rootstocks, X-218 (G4), X-238 (G5), and Alawamiya365 (G6). Growth, physiology, photosynthetic pigments, and yield improved with lower salinity (2 dS m−1) in volcanic rock and with the grafting treatments (G2–G6) compared to the non-grafted treatment (G1). The best results were achieved with the S1M1G5 treatment, where yield increased by 53% compared to the lowest yield in non-grafted plants grown in sand under higher salinity (S2M2G1). All studied traits were adversely affected under high salinity (S2) in sandy media, with the G1 treatment resulting in the lowest values for these traits. [ABSTRACT FROM AUTHOR]

Enhancing saline water productivity in arid regions is essential for sustainable agriculture. Adding biochar can improve the quantity and quality of tomato yield under higher levels of salinity and lower levels of irrigation. The experiment aimed to evaluate the effects of biochar on enhancing tomato fruit quality and yield under salinity and drought stress. The experiment combines two treatments for irrigation water quality (0.9 and 2.3 dS m−1), four irrigation levels (40, 60, 80, and 100%) of crop evapotranspiration (ETc), and the addition of 5% of biochar to treated soil (BC5%) and untreated soil (BC0%). The results showed that the decrease in the water quality and irrigation levels negatively impacted the yield and properties of tomato fruit, while 5% of biochar application positively improved the yield. Adding biochar decreased the tomato yield by 29.33% and 42.51% under lower-saline-irrigation water than the control, negatively affecting the fruit's physical parameters and mineral content. In contrast, adding biochar and irrigating with saline water at 60% of ETc improved the firmness and quality characteristics of the fruit by 56.60%, 67.19, 99.75, and 73.57% for vitamin C (VC), total titratable acidity (TA), total soluble solids (TSS), and total sugars (TS), respectively, compared to the control, and also reduced the sodium content of the fruits under all irrigation levels compared to untreated plants by biochar. Generally, biochar with saline water under deficit irrigation with 80 and 60% of ETc could be an excellent strategy to enhance the qualitative characteristics of tomato fruits and save approximately 20–40% of the applied water. [ABSTRACT FROM AUTHOR]

Wheat is one of the most important cereal crops in Egypt and all over the world. Its productivity is adversely affected by drought due to deficient irrigation to provide nutrients required for plant growth. In a field experiment, silicon foliar applications at concentrations of 0, 200, and 400 mg L−1 were performed at different irrigation rates ranging from 1000 to 4000 m3 ha−1 to assess water irrigation productivity and wheat crop yield in a calcareous soil under arid climate conditions. Increased irrigation rates led to a significant increase in soil nutrient dynamics, as well as in the number and weight of grains per spike, leaf area index, grain yield, straw yield, and biological yield, with the exception of the weight of 1000 grains. Spraying with sodium silicate had a significant impact on grain yield and harvest index but did not significantly impact the other traits. Furthermore, the interaction between irrigation and silicate application rates showed significance only for grain yield, the number of spikes/m2, and the harvest index. Applying three times irrigation could produce the highest nutrient retention, wheat yield, and water irrigation productivity. No significance was observed between 3000 m3 ha−1 and 4000 m3 ha−1 irrigation, indicating a saving of 25% of applied irrigation water. It can be concluded that applying irrigation at 3000 m3 ha−1 could be a supplemental irrigation strategy. High wheat grain yield can be achieved under deficit irrigation (3000 m3 ha−1) on the northwestern coast of Egypt with an arid climate by spraying crops with sodium silicate at a rate of 400 mg L−1. [ABSTRACT FROM AUTHOR]

Snakebite envenoming is a neglected tropical disease that causes >100,000 deaths and >400,000 cases of morbidity annually. Despite the use of mouse models, severe local envenoming, defined by morbidity-causing local tissue necrosis, remains poorly understood, and human-tissue responses are ill-defined. Here, for the first time, an ex vivo, non-perfused human skin model was used to investigate temporal histopathological and immunological changes following subcutaneous injections of venoms from medically important African vipers (Echis ocellatus and Bitis arietans) and cobras (Naja nigricollis and N. haje). Histological analysis of venom-injected ex vivo human skin biopsies revealed morphological changes in the epidermis (ballooning degeneration, erosion, and ulceration) comparable to clinical signs of local envenoming. Immunostaining of these biopsies confirmed cell apoptosis consistent with the onset of necrosis. RNA sequencing, multiplex bead arrays, and ELISAs demonstrated that venom-injected human skin biopsies exhibited higher rates of transcription and expression of chemokines (CXCL5, MIP1-ALPHA, RANTES, MCP-1, and MIG), cytokines (IL-1β, IL-1RA, G-CSF/CSF-3, and GM-CSF), and growth factors (VEGF-A, FGF, and HGF) in comparison to non-injected biopsies. To investigate the efficacy of antivenom, SAIMR Echis monovalent or SAIMR polyvalent antivenom was injected one hour following E. ocellatus or N. nigricollis venom treatment, respectively, and although antivenom did not prevent venom-induced dermal tissue damage, it did reduce all pro-inflammatory chemokines, cytokines, and growth factors to normal levels after 48 h. This ex vivo skin model could be useful for studies evaluating the progression of local envenoming and the efficacy of snakebite treatments. [ABSTRACT FROM AUTHOR]

Drought is a crucial environmental stress that tremendously impacts maize production, particularly under abrupt climate changes. Consequently, breeding drought-tolerant and high-yielding maize hybrids has become decisive in sustaining its production and ensuring global food security under the global fast-growing population. The present study aimed to explore drought tolerance and agronomic performance of newly developed maize inbred lines and their hybrids. Ten newly developed maize inbred lines were crossed with two high-yielding testers using a line × tester mating design. The developed twenty hybrids alongside two high-yielding commercial hybrids were evaluated under water-deficit (5411 m3/ha) and well-watered (7990 m3/ha) conditions in dry summer climate conditions. Highly significant variations were detected among the evaluated hybrids for all studied agronomic traits under well-watered and water-deficit conditions. The inbred lines L10 and L6 were particularly notable, demonstrating the most significant negative general combining ability (GCA) effects for earliness, which is crucial for stress avoidance in both environmental settings. Inbred lines L11, L7, L6, and L1 also showed the highest positive and most significant GCA effects for key yield traits, indicating their potential as parents in breeding programs. The crosses L-10×T-1 and L-6×T-2 were outstanding for their heterotic effects on earliness in days to tasseling and silking. Similarly, the crosses L-4×T-2 and L-1×T-1 excelled in plant and ear heights under both irrigation regimes. The hybrids L-1×T-2 and L-7×T-1 demonstrated superior heterosis for chlorophyll content, number of rows per ear, and overall grain yield. Additionally, hybrids L-11×T-1 and L-11×T-2 exhibited remarkable heterotic effects for the number of grains per row, number of rows per ear, 100-kernel weight, and grain yield, highlighting their potential in breeding for productivity. Based on drought tolerance indices and cluster analysis, the cross combinations L-11×T-1, L-11×T-2, L-7×T-1, and L-1×T-2 were classified as the most drought-tolerant crosses. The principal component analysis highlighted traits such as days to tasseling, days to silking, chlorophyll content, plant height, ear height, number of grains per row, number of rows per ear, and 100-kernel weight can be taken as selection criteria for improving grain yield in maize breeding programs under limited water conditions. Based on the summarized results, the identified genetic materials could be considered promising under both conditions and hold potential for future breeding programs. [ABSTRACT FROM AUTHOR]

Background: Many studies across the globe have observed the significant effect of sleep disturbance on the academic achievement of medical students. Objective: This research was conducted to define the prevalence of sleep disturbance and to discover the consequences and management of this condition among undergraduate pharmacy students of Mohammed Al‑Mana College for Medical Sciences (MACHS). Methods: We conducted a questionnaire-based online survey among different levels of MACHS pharmacy students. Results: A total of 165 students participated in the study, of whom 132 (80%) were females and 33 (20%) were males. Most of the participants, 142 (86.06%), were staying with their parents, whereas few of them were staying alone (23; 13.94%). While a handful of them, 29 (17.58%), did not have their bedrooms, most of them had their bedrooms (136; 82.42%). When asked about drinking caffeine-rich products in the afternoon or at night, most of them responded “sometimes” (78; 47.27%), followed by the category “always” (61; 36.97%), “rarely” (15; 9.09%), and then the category of students who responded “not at all” (11; 6.67%). Overall, 35 (21.21%) of the study participants had a smoking habit, 72 (43.63%) tried to treat their sleep disturbance, whereas 42 (25.45%) were getting treatment for insomnia. Conclusion: Most pharmacy students at MACH College, especially females, have sleep problems. Mostly, the prevalence is common during exam periods, and it mildly affects their grade point average. [ABSTRACT FROM AUTHOR]

This study delves into the intricate realm of recognizing handwritten Arabic characters, specifically targeting children's script. Given the inherent complexities of the Arabic script, encompassing semi-cursive styles, distinct character forms based on position, and the inclusion of diacritical marks, the domain demands specialized attention. While prior research has largely concentrated on adult handwriting, the spotlight here is on children's handwritten Arabic characters, an area marked by its distinct challenges, such as variations in writing quality and increased distortions. To this end, we introduce a novel dataset, "Dhad", refined for enhanced quality and quantity. Our investigation employs a tri-fold experimental approach, encompassing the exploration of pre-trained deep learning models (i.e., MobileNet, ResNet50, and DenseNet121), custom-designed Convolutional Neural Network (CNN) architecture, and traditional classifiers (i.e., Support Vector Machine (SVM), Random Forest (RF), and Multilayer Perceptron (MLP)), leveraging deep visual features. The results illuminate the efficacy of fine-tuned pre-existing models, the potential of custom CNN designs, and the intricacies associated with disjointed classification paradigms. The pre-trained model MobileNet achieved the best test accuracy of 93.59% on the Dhad dataset. Additionally, as a conceptual proposal, we introduce the idea of a computer application designed specifically for children aged 7–12, aimed at improving Arabic handwriting skills. Our concluding reflections emphasize the need for nuanced dataset curation, advanced model architectures, and cohesive training strategies to navigate the multifaceted challenges of Arabic character recognition. [ABSTRACT FROM AUTHOR]

The operative mechanisms and advantageous synergies existing between the rhizobiome and the wild plant species Abutilon fruticosum were studied. Within the purview of this scientific study, the reservoir of genes in the rhizobiome, encoding the most highly enriched enzymes, was dominantly constituted by members of phylum Thaumarchaeota within the archaeal kingdom, phylum Proteobacteria within the bacterial kingdom, and the phylum Streptophyta within the eukaryotic kingdom. The ensemble of enzymes encoded through plant exudation exhibited affiliations with 15 crosstalking KEGG (Kyoto Encyclopaedia of Genes and Genomes) pathways. The ultimate goal underlying root exudation, as surmised from the present investigation, was the biosynthesis of saccharides, amino acids, and nucleic acids, which are imperative for the sustenance, propagation, or reproduction of microbial consortia. The symbiotic companionship existing between the wild plant and its associated rhizobiome amplifies the resilience of the microbial community against adverse abiotic stresses, achieved through the orchestration of ABA (abscisic acid) signaling and its cascading downstream effects. Emergent from the process of exudation are pivotal bioactive compounds including ATP, D-ribose, pyruvate, glucose, glutamine, and thiamine diphosphate. In conclusion, we hypothesize that future efforts to enhance the growth and productivity of commercially important crop plants under both favorable and unfavorable environmental conditions may focus on manipulating plant rhizobiomes. [ABSTRACT FROM AUTHOR]

This article, published in the Arab Journal of Interventional Radiology, presents a systematic review and meta-analysis on the need for left subclavian artery revascularization in thoracic endovascular aortic repair. The study found that revascularization was associated with reduced risks of stroke, spinal cord ischemia, and arm ischemia. However, there was no significant reduction in paraplegia or mortality. The risk of endoleak was comparable in both groups, but the risk of reintervention was higher in the revascularization group. The study provides important indications for revascularization and predictors of complications, which can inform clinical decision-making and future research. [Extracted from the article]

Slipped capital femoral epiphysis (SCFE) is a common adolescent hip disorder that can lead to complex proximal femur deformities and devastating consequences such as avascular necrosis, femoroacetabular impingement syndrome and early-onset osteoarthritis. Existing surgical techniques are often insufficient to fully address the constellation of multiplanar deformities in patients with severe SCFE. Therefore, the McMaster Osteotomy, a novel intertrochanteric proximal femur osteotomy, was developed to improve anatomic correction and hip mechanics in patients with chronic SCFE. The McMaster Osteotomy was implemented in two patients (A: 16-year-old male, B: 17-year-old female) with proximal femur deformities due to chronic SCFE. Surgical planning was facilitated with a 3D-printed pelvic model generated from a CT scan of a patient with the SCFE deformity. Patient B also underwent concurrent arthroscopic osteochondroplasty and labral repair. Pre- and post-operative function and radiographic measurements were recorded. Post-operatively, patient A's neck-shaft angle improved from 125° to 136°, Southwick angle from 52° to 33°, neck length from 66 mm to 80 mm and hip internal rotation from 5° to 25°. Patient B's post-operative neck-shaft angle improved from 122° to 136°, Southwick angle from 25° to 15°, neck length from 76 mm to 84 mm, hip internal rotation from 5° to 20° and alpha angle from 87.6° to 44.3°. Both patients are pain-free and have obtained full union of their osteotomies. The McMaster Osteotomy is a versatile technique that can produce a more anatomic reconstruction of hip anatomy and restoration of abductor mechanics. As an extracapsular technique, the risk of femoral head avascular necrosis is minimized. [ABSTRACT FROM AUTHOR]

Due to the increasing impact of worldwide environmental changes, temperature stress has become a major factor resulting in crop yield losses. The discovery of temperature‐stress‐responsive protein‐coding genes has made significant progress in understanding plants' complex stress response systems involving microRNAs (miRNAs). The miRNAs are triggered by heat or cold, thus confirming their significant functional role in cold or heat tolerance. Such dependable recommendations significantly broaden our understanding of the regulatory role of miRNAs in plant stress responses. This article presents novel perspectives on the substantial roles of plant miRNAs in responding to and acclimatizing to heat and cold stress. It comprehensively elaborates on miRNAs responsive to temperature stress, their regulatory mechanisms, and their targeted functions in plants. Additionally, the article investigates how miRNAs contribute to safeguarding plant reproductive tissues, mitigating damage caused by reactive oxygen species, modulating heat shock proteins, transcription factors, and phytohormones in the context of temperature stress. The conclusion outlines potential avenues for future research, highlighting the utilization of miRNAs and their regulatory functions to develop economically vital crops with enhanced tolerance to temperature stress, thereby ensuring future food security. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the impact of ownership by large shareholders (blockholders) on corporate cash holdings. The study further investigates heterogeneity in the relationship between blockholder ownership and corporate cash holdings. Design/methodology/approach: Building on the precautionary and agency motives of corporate cash holdings, the study focuses on publicly listed firms from 22 European countries for the period from 2006 to 2015. Multiple pooled ordinary least square and fixed effects regression models are employed to examine the relationship between blockholder ownership and firms' cash holdings. Findings: This study documents a positive relationship between blockholder ownership and corporate cash holdings which indicates the role of blockholders in influencing firms' cash holdings policies. However, further analyses show that the effect of blockholding on cash holdings depends on the type of blockholder. While the relationship is still positive between cash holdings and ownership by strategic blockholders, it turns negative for the ownership by institutional blockholders. Research limitations/implications: This study provides evidence for the important role played by firms' ownership structures, and especially blockholding, in shaping firms' cash holdings decisions. The findings are therefore of great value for investors, firms' management and board and policy makers. Originality/value: This paper contributes to the literature by providing an explanation of the contradictory results documented in the literature on the impact of blockholders on corporate cash holdings. This study, to the best of the author's knowledge, is the first to examine the effect of blockholder ownership on cash holdings by distinguishing between different types of blockholder. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to evaluate the outcome of THA done in patients with sickle cell disease at a single center, and compare with rest of the world before we could recommend routine THA in SCD patients. Methods: In 92 patients, 117 THAs were performed in sickle cell patients. Seventy-six (76) patients had homozygous hemoglobin (Hgb SS) disease, whereas sixteen had sickle cell trait (Hgb AS). Patients with Grade III Ficat and above avascular necrosis of the head of femur (ANFH) with cementless porous-coated proximal femur fixation were included in this analysis. Harris hip score was modified (MHHS) and used for assessment of improvement and visual analog scale score (VAS), for pain assessment. Result: VAS improved from average pre-operative mean of 7 (7–9) to 2.5 (1–5). The average pre-operative MHHS was 44 (32–63), and it improved to 79 (71–88) in the final mean follow-up of 12.4 (4–18) years. Nine patients (9.7%) had complications and revision surgery was required in seven (5.9%) for aseptic loosening. Conclusion: Our analysis shows that THA in sickle cell disease is safe with average 12 years of follow-up, indicating that surgery in these young patients (≤ 25 years) is safe and should not be delayed. [ABSTRACT FROM AUTHOR]

Actinobacteria are ubiquitous Gram-positive filamentous bacteria that are well-known for their ability to control plant diseases through mechanisms such as the production of antibacterial and antifungal antibiotics, induction of plant resistance, parasitism, and even simple competition for resources. For their potential as nematode biocontrol agents, streptomycete actinobacteria have received the greatest attention. The current study aimed to isolate chitinase-producing streptomycete actinobacteria from eggplant rhizospheres with the potential to be used as biocontrol agents for the root-knot nematode Meloidogyne incognita. Twenty-four different strains of streptomycete actinobacteria were isolated and tested for chitinase production. Only five high chitinase-producing isolates were chosen for further experiments and were identified as ST01; Streptomyces levis, ST07; S. enissocaesilis, ST10; S. plicatus, ST15; S. rochei, and ST16; S. sparsus. The isolates were identified using cultural, morphological, biochemical, physiological and chemotaxonomical characteristics as well as16S rRNA gene sequencing. The phylogenetic analyses indicated that the actinobacteria isolates in this study belonged to the genus Streptomyces. The in vitro tests compared the culture filtrates of five isolates at three different concentrations (5, 10, and 20%) for their ability to reduce nematode numbers and the percentage of eggs hatching of M. incognita. When exposed to higher concentrations (20%) for longer periods of time (up to 72 h), second stage juveniles (J2) of M. incognita had a higher mortality rate. The Streptomyces strains, ST15, ST10, ST16, ST01, and ST07, significantly (P < 0.05) reduced egg hatching by 86.8, 85.4, 78.9, 77.8, and 68.1%, respectively. In addition, these five isolates were tested under greenhouse conditions to control M. incognita on eggplants. In both the presence and absence of M. incognita, the treatment of strain ST15 was the most effective and significantly (P < 0.05) increased the length, fresh weight, and dry weight of eggplant roots and shoots, total chlorophyll and carotenoids contents compared to the control and to the other strains (ST10, ST16, ST01, and ST07). Strain ST15 significantly (P < 0.05) reduced the number of galls, number of eggs, number of egg masses and the population of M. incognita in soil compared to the control and to the other strains. Malonaldehyde, hydrogen peroxide concentration, and the antioxidant enzyme (superoxide dismutase, peroxidase, and catalase) activity were all significantly (P < 0.05) decreased in eggplant tissues after treatment with strain ST15, compared to infected control. Based on our research, we have concluded that chitinase-producing Streptomyces strains, and specifically St15, have the potential to be used as significant biocontrol agents against the root-knot nematode M. incognita and as promotor of eggplant performance. [ABSTRACT FROM AUTHOR]

Background: Physicians are more likely to examine children than dentists; thus, they may have a significant role in detecting oral and dentofacial problems. This study aimed to determine the rate and comprehensiveness of examinations, the rate and quality of referral practices, and the predictors of referral practice of physicians regarding orthodontic problems among children.Methods: In a multi-center cross-sectional study, a total of 518 physicians in Saudi Arabia were subjected to an e-questionnaire of four sections: (1) Physicians' demographic and work-related characteristics; (2) Physicians' comprehensiveness of oral and orthodontic examinations; (3) Physicians' referral practices to orthodontists and reasons considered for referral; and (4) Physicians' sources of orthodontic education. Logistic regression analysis was applied to identify the significant predictors of referral practice. The significance was set at p < 0.05.Results: Most physicians reported partial oral (78.5%) and orthodontic (72.2%) examinations, while the full examination was reported by only 12% and 2.5% of physicians, respectively. Referral to orthodontists was practiced by most of the physicians (83.8%), yet for the majority of them, the quality of referral was poor (40.3%) or fair (46.1%), with only 13.6% who practiced quality referral. Dental development issues (53.3%) and functional issues (51.5%) were reported as the main reasons for referral, followed by family/patient request (42.9%), dental alignment (42.5%), oral respiratory issues (32.4%), and finally jaw relation (26.1%). Referral practice was predicted by the comprehensive oral (OR = 2.37, p = 0.007) and orthodontic (OR = 4.26, p < 0.001) examinations, number of patients seen by the physician (OR = 1.58, p = 0.007), and level of training (OR = 1.88, p = 0.03).Conclusion: Although most physicians reported high rates of examination and referral practices on orthodontic problems among children in Saudi Arabia, only a small portion showed comprehensive examinations and quality referral practice. Including dental courses in medical curricula and improving oral and orthodontic examination guidelines for physicians are recommended. [ABSTRACT FROM AUTHOR]

Option of defect is an important theory regulated in Omani Civil Law. It gives the injured party in bilateral contracts an option to rescind the contract if they find a defect in the subject matter of the contract. This theory is deemed a legal basis to refuse objects of sale by tender. In particular, it is useful when a guarantee that is given to the governmental body is insufficient to cover damages, due to bad performance of the contract. This article discusses how the option of defect is applied to sale by tender in Omani law. [ABSTRACT FROM AUTHOR]

This study examines the influences of financial compensations (whether direct or indirect) and role stress on tourism employees' job satisfaction in the Kingdom of Saudi Arabia (KSA). This is because job satisfaction has become a major concern for service organisations, which rely on employees for fulfilling their business goals. To achieve this purpose, a pre-tested questionnaire survey has been self-distributed to a sample of tourism employees in KSA. The results of statistical data analysis showed a positive relationship between financial compensations and job satisfaction. Both direct and indirect financial compensations have positive influences on job satisfaction of tourism employees. Unlike the results of most pervious research studies, the results showed that role stress has a significant positive influence on job satisfaction of tourism employees. The results of follow up interviews with a sample of respondents showed that most respondents were expatriates or foreign employees, who had expectations of high role stress before they undertake their tourism job role outside their country. They found the level of role stress generate their creativity and make a differentiation for them among other tourism employees. This leads employees to prove their ability at work hence, employee seeks to accomplish many tasks at the same time in order to get an attention of their managers/employers and ensure that they win the job for the next year by renewing their contract. Thus, such employees get thanks and appreciation by the manager/employer and is reflected in their job satisfaction. The study confirmed positive significant influence of both types of financial compensation and role stress on job satisfaction. It concludes that condition of employment should have special consideration when examining factors affecting employees' attitudes, i.e. job satisfaction. [ABSTRACT FROM AUTHOR]

Background. Chronic kidney disease (CKD) is often associated with multiple comorbidities including diabetes mellitus, and each has its own complications and impact after cardiac surgery including coronary revascularization. The objective of this work was to study the impact of CKD on clinical outcomes after coronary artery bypass grafting (CABG) and to compare outcomes in patients with different grades of renal functions. We retrospectively reviewed all patients who underwent CABG from January 2016 to August 2020 at our tertiary care hospital using electronic medical records. Results. The study included 410 patients with a median age of 60 years, and 28.6% of them had CKD and hospital mortality of 2.7%. About 71.4% of the patients had GFR > 60 mL/min per 1.73 m2, 18.1% had early CKD (GFR 30–60), 2.7% had late CKD (GFR < 30), and 7.8% of them had end-stage renal disease (ESRD) requiring dialysis. The CKD group had significantly more frequent hospital mortality (p = 0.04), acute cerebrovascular stroke (p = 0.03), acute kidney injury (AKI) (p < 0.001), longer ICU stay (p = 0.002), post-ICU stay (p = 0.001), and sternotomy wound debridement (p = 0.03) compared to the non-CKD group. The frequencies of new need for dialysis were 2.4% vs. 14.9% vs. 45.5% (p < 0.001) in the patients with GFR > 60 mL/min per 1.73 m2, early CKD, and late CKD, respectively. Acute cerebral stroke (OR: 10.29, 95% CI: 1.82–58.08, and p = 0.008), new need for dialysis (OR: 25.617, 95% CI: 13.78–85.47, and p < 0.001), and emergency surgery (OR: 3.1, 95% CI: 1.82–12.37, and p = 0.036) were the independent predictors of hospital mortality after CABG. The patients with CKD had an increased risk of strokes (HR: 2.14, 95% CI: 1.20–3.81, and p = 0.01) but insignificant mortality increase (HR: 1.44, 95% CI: 0.42–4.92, and p = 0.56) during follow-up. Conclusion. The patients with CKD, especially the late grade, had worse postoperative early and late outcomes compared to non-CKD patients after CABG. Patients with dialysis-independent CKD had increased risks of needing dialysis, hospital mortality, and permanent dialysis after CABG. [ABSTRACT FROM AUTHOR]

Child abuse and neglect (CAN) have significant consequences for children's health and well-being. Dentists play an important role in identifying and reporting CAN cases. This study aimed to assess knowledge and attitudes toward CAN among dental students. A cross-sectional study was conducted among dental students, comparing second-year (preclinical) and fifth-year (clinical) students, both male and female, in the College of Dentistry at King Saud University during the first semester of the 2022/2023 academic year, using a questionnaire with 23 multiple-choice questions and an electronic link. The results revealed that most dental students (96%) were aware of CAN, with social media being the most utilized source of information (85%). However, the dental college was noticed as the least utilized source (50%). Most dental students recognize the significance of CAN in dentistry and expressed an intense interest in learning how to effectively deal with such cases. Only a small proportion, 16%, of dental students reported experiencing incidents of CAN in their clinical practice. In general, there were statistically significant differences between preclinical and clinical students, but there were no significant differences in awareness between female and male students when the source of information and role in dealing with CAN were taken into consideration. Both preclinical and clinical dental students were aware of CAN, although there were concerns about their ability to cope with it. The results emphasize the importance of comprehensive education and training programs across the dental curriculum about CAN. [ABSTRACT FROM AUTHOR]

As it is important for the Blood transfusion to be extremely safe, some measures have to be taken long safeguarded the blood supply from the major transfusion transmissible diseases (TTIs). The risk of transfusion-transmitted infection (TTI) rises with the number of donors exposed, and the effects of TTI are frequently more severe in immune compromised people. TTIs (hepatitis B virus [HBV], HIV, and hepatitis C virus [HCV]) are examples of typical transfusion-transmitted infectious agents. As a result of the gradual application of nucleic acid-amplification technology (NAT) screening for HIV, HCV, and HBV, the residual risk of infected window-period donations has been minimized. Nonetheless, infections emerge far more frequently than is commonly acknowledged, needing ongoing surveillance and individual assessment of transfusion-associated risk. Although there is a constant need to monitor present dangers owing to established TTI, the ongoing issues in blood safety are mostly related to surveillance for developing agents, as well as the creation of quick reaction systems when such agents are detected. [ABSTRACT FROM AUTHOR]

A metagenomic whole genome shotgun sequencing approach was used for rhizospheric soil micribiome of the wild plant Abutilon fruticosum in order to detect antibiotic resistance genes (ARGs) along with their antibiotic resistance mechanisms and to detect potential risk of these ARGs to human health upon transfer to clinical isolates. The study emphasized the potential risk to human health of such human pathogenic or commensal bacteria, being transferred via food chain or horizontally transferred to human clinical isolates. The top highly abundant rhizospheric soil non-redundant ARGs that are prevalent in bacterial human pathogens or colonizers (commensal) included mtrA, soxR, vanRO, golS, rbpA, kdpE, rpoB2, arr-1, efrA and ileS genes. Human pathogenic/colonizer bacteria existing in this soil rhizosphere included members of genera Mycobacterium, Vibrio, Klebsiella, Stenotrophomonas, Pseudomonas, Nocardia, Salmonella, Escherichia, Citrobacter, Serratia, Shigella, Cronobacter and Bifidobacterium. These bacteria belong to phyla Actinobacteria and Proteobacteria. The most highly abundant resistance mechanisms included antibiotic efflux pump, antibiotic target alteration, antibiotic target protection and antibiotic inactivation. antimicrobial resistance (AMR) families of the resistance mechanism of antibiotic efflux pump included resistance-nodulation-cell division (RND) antibiotic efflux pump (for mtrA, soxR and golS genes), major facilitator superfamily (MFS) antibiotic efflux pump (for soxR gene), the two-component regulatory kdpDE system (for kdpE gene) and ATP-binding cassette (ABC) antibiotic efflux pump (for efrA gene). AMR families of the resistance mechanism of antibiotic target alteration included glycopeptide resistance gene cluster (for vanRO gene), rifamycin-resistant beta-subunit of RNA polymerase (for rpoB2 gene) and antibiotic-resistant isoleucyl-tRNA synthetase (for ileS gene). AMR families of the resistance mechanism of antibiotic target protection included bacterial RNA polymerase-binding protein (for RbpA gene), while those of the resistance mechanism of antibiotic inactivation included rifampin ADP-ribosyltransferase (for arr-1 gene). Better agricultural and food transport practices are required especially for edible plant parts or those used in folkloric medicine. Key points: Risk of transfer of rhizosphere resistome of A. fruticosum to human gut was explored The most common resistance mechanism in this resistome is antibiotic efflux pump Rhizobiome is a source of new antibiotics with feasible therapeutic interventions [ABSTRACT FROM AUTHOR]

The aim of this study is to examine the ability of Saudi Arabian pediatricians and family physicians to conduct clinical screening for (DDH) by estimating their clinical knowledge and skills and analyzing the gaps therein to determine whether there is potential to launch a national screening protocol for DDH in Saudi Arabia.Methods: This is a multicenter cross-sectional study from three major regions in Saudi Arabia (Central, Eastern and Western provinces). The assessed aspects are risk factors, age of screening, incidence in Saudi Arabia, physical signs and diagnostic markers, and treatment, along with their 'clinical knowledge and skills' score.Results: Half of the participants were pediatricians, while the rest were family physicians. More than a third of the participants were considered to have adequate knowledge, ie, above the mean score. Dimensions with the most significant knowledge gaps included the incidence of DDH in Saudi Arabia, adverse effects of swaddling, and the management of a high-risk infants presenting with a negative physical examination. Additionally, there were relatively low rates of awareness regarding positive risk factors as well as a generally poor ability to identify physical signs. Clinical knowledge and skill levels were significantly lower among family physicians.Conclusion: Pediatricians and family physicians in Saudi Arabia still need further training to improve their clinical skills for DDH screening. The proper administration of training programs could eventually enable the gradual implementation of a national systematic screening program. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested that drug pricing could contribute to drug shortages; however, there is limited quantitative assessment of this potential causal association. This retrospective database analysis aimed to investigate the association between drug prices and drug shortage incidents in Saudi Arabia. Methods: This was a retrospective database analysis study. Drugs with shortage notifications sent to the Saudi Food and Drug Authority (SFDA) between January 2017 and December 2020 were included. Each drug's foreign-to-Saudi price ratio (FTSPR) was calculated by dividing the mean international price by the Saudi price. Drugs were categorized into three groups based on their FTSPR: Group 1 (FTSPR > 1), Group 2 (FTSPR = 1), and Group 3 (FTSPR < 1). The primary outcome was the ratio of mean counts (mCR) between the three groups, with Group 3 serving as the control group. The analysis was adjusted for the measured confounders using a negative binomial regression model. Results: A total of 900 drugs were included in the study, with 348 in Group 1, 345 in Group 2, and 209 in Group 3. The mean count in Group 1 was higher compared to Group 3 (mCR: 1.88; 95% confidence interval [CI] 1.24 to 2.83), while the mean counts between Group 2 and Group 3 were comparable (mCR: 1.39; 95% CI 0.92 to 2.09). Conclusions: Our findings indicate an association between drug shortage incidents and higher prices of drugs outside Saudi Arabia. Further studies are needed to explore this causal relationship in different contexts. [ABSTRACT FROM AUTHOR]

Irrigation water quality is important to sustain agricultural productivity. The primary irrigation water sources in Al-Ahsa Oasis, KSA, are groundwater wells, mixed with treated wastewater and agricultural drainage. This study sought to evaluate irrigation water quality in Al-Ahsa Oasis with the aid of using irrigation water quality indices (IWQIs). One hundred and forty-eight different water samples were collected from various irrigation water resources throughout Al-Ahsa Oasis. The investigated physiochemical characteristics include pH, temperature, TDS, EC, turbidity, free chlorine, total hardness, cations (Na, K, Ca, Mg), anions (Cl, CO3, HCO3, SO4), organic matter indices (DO, BOD, COD), and nutrients (NH4, NO3, PO4). The IWQIs used in this study include salinity hazard, sodium adsorption ratio (SAR), Kelly's ratio (KR), soluble sodium percentage (SSP), Permeability index (PI), residual sodium carbonate (RSC), and magnesium hazard (MH). The results indicated that treated wastewater mixed with groundwater is acceptable for irrigation. Spatial variations in irrigation water quality throughout Al-Ahsa are associated with water resources. For instance, groundwater mixed with agricultural drainage has the highest values of TDS, cations, and anions, whereas the lowest values were reported for treated wastewater, reflecting the good efficiency of wastewater treatment plants. The IWQI results revealed that 4.1% and 62.1% of the investigated irrigation water samples were considered good (class III) and satisfactory (class IV) for irrigation, respectively, whereas 33.8% of the collected water samples fall within the severe irrigation restrictions. Moreover, 79.7% of the investigated water samples were classified to have high to very high salinity hazards (C3, C4) and medium to high sodium hazards (S2, S3). Regular monitoring and assessment of treated water quality and wastewater treatment plant efficiency are important factors in achieving the sustainability of treated wastewater reuse in irrigation and consequently food security. [ABSTRACT FROM AUTHOR]

This study aims to explore the current practice of pediatric hip spica table application among hospitals in the GCC countries and report comprehensive data that help surgeons enhance their practice.Methods: This is a cross-sectional study on pediatric orthopedic surgeons using a self-administered Online Questionnaire. The respondents were grouped as those using locally customized tables, where further information about the material and characteristics were collected, and those using company manufactured tables. Both groups answered analytical questions related to their current practice of hip spica tables.Results: Sixty-three surgeons completed the survey. More than half the physicians in this study are using locally customized spica tables (n= 41, 65%). Compared to company-manufactured tables, locally customized tables were associated with a higher rate of difficulties when taking an X-ray, when the patient weighs more than 50.0 kg, and with anesthesia, although not statistically significant.Conclusion: Obtaining a good quality spica table at a suitable price is a primary obstacle pediatric orthopedic surgeons face. This study shows no statistically significant difference between locally customized and company-manufactured tables regarding the outcomes and that spica tables have room for development to optimize their utilization. [ABSTRACT FROM AUTHOR]

In the Middle East, particularly in Saudi Arabia, the offering of a meat dish to guests is a deeply embedded cultural tradition, and a meat-based diet is the standard in Saudi Arabia. Thus, the rise of veganism and vegetarianism within Saudi Arabia is surprising and worthy of attention, as is understanding the perceptions and motivations behind this phenomenon, particularly as they relate to food and sustainability. This research was designed to investigate this emerging phenomenon and to identify key differences in dietarian identity between Saudi vegetarians and vegans using Rosenfeld and Burrow's Dietarian Identity Questionnaire. Among other results, the vegan group scored significantly higher on the prosocial motivation construct, suggesting the desire to help society as a whole is a stronger motivating factor for vegans. As well, the vegan cohort scored higher in the personal motivation category. From an environmental and public health perspective, understanding the key factors motivating individuals to adopt a vegetarian or vegan diet in a meat-based culture like Saudi Arabia can be used to encourage others to pursue more healthy and sustainable food behaviors. [ABSTRACT FROM AUTHOR]

The use of saline water under drought conditions is critical for sustainable agricultural development in arid regions. Biochar is used as a soil amendment to enhance soil properties such as water-holding capacity and the source of nutrition elements of plants. Therefore, the experiment was conducted to evaluate the effects of biochar application on the morpho-physiological traits and yield of tomatoes under combined salinity and drought stress in greenhouses. There were 16 treatments consist two water quality fresh and saline (0.9 and 2.3 dS m−1), three deficit irrigation levels (DI) 80, 60, and 40% addition 100% of Evapotranspiration (ETc), and biochar application by rate 5% (BC5%) (w/w) and untreated soil (BC0%). The results indicated that the salinity and water deficit negatively affected morphological, physiological, and yield traits. In contrast, the application of biochar improved all traits. The interaction between biochar and saline water leads to decreased vegetative growth indices, leaf gas exchange, the relative water content of leaves (LRWC), photosynthetic pigments, and yield, especially with the water supply deficit (60 and 40% ETc), where the yield decreased by 42.48% under the highest water deficit at 40% ETc compared to the control. The addition of biochar with freshwater led to a significantly increased vegetative growth, physiological traits, yield, water use efficiency (WUE), and less proline content under all various water treatments compared to untreated soil. In general, biochar combined with DI and freshwater could improve morpho-physiological attributes, sustain the growth of tomato plants, and increase productivity in arid and semi-arid regions. [ABSTRACT FROM AUTHOR]

Organizational sustainability supports the financial, social, and cultural well-being of organizations and their surrounding communities. However, few studies have examined organizational sustainability in Saudi Arabia or its link to information technology. This study used self-reported data from a large sample of employees at various Saudi government institutions to conclude that these institutions moderately implemented organizational sustainability. Correlation and regression analyses demonstrated weak associations between various types of organizational sustainability and dimensions of information system success, where user satisfaction with information systems is the strongest positive predictor of perceived organizational sustainability. Organizational sustainability is still emerging in the public sector, and further research is needed to identify predictors of its success. [ABSTRACT FROM AUTHOR]

Objectives: The operating room (OR) is considered the highest source of cost and earnings. Therefore, measuring OR efficiency, which means how time and resources are allocated precisely for their intended purposes in the operating room is crucial. Both overestimation and underestimation negatively impact OR efficiency Therefore, hospitals defined metrics to Measuring OR Effeciency. Many studies have discussed OR efficiency and how surgery scheduling accuracy plays a vital role in increasing OR efficiency. This study aims to evaluate OR efficiency using surgery duration accuracy. Methods: This retrospective, quantitative study was conducted at King Abdulaziz Medical City. We extracted data on 97,397 surgeries from 2017 to 2021 from the OR database. The accuracy of surgery duration was identified by calculating the duration of each surgery in minutes by subtracting the time of leaving the OR from the time of entering the OR. Based on the scheduled duration, the calculated durations were categorized as either underestimation or overestimation. Descriptive and bivariate analyses (Chi-square test) were performed using the Statistical Package for the Social Sciences (SPSS) software. Results: Sixty percent out of the 97,397 surgeries performed were overestimated compared to the time scheduled by the surgeons. Patient characteristics, surgical division, and anesthesia type showed statistically significant differences (p < 0.05) in their OR estimation. Conclusion: Significant proportion of procedures have overestimated. This finding provides insight into the need for improvement. Recommendations: It is recommended to enhance the surgical scheduling method using machine learning (ML) models to include patient characteristics, department, anesthesia type, and even the performing surgeon increases the accuracy of duration estimation. Then, evaluate the performance of an ML model in future studies. [ABSTRACT FROM AUTHOR]

The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)– and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)–compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects. [ABSTRACT FROM AUTHOR]

Spinal infections comprise a large spectrum of clinical manifestations with multiple etiologies. Therefore, early detection and management are imperative to reduce morbidity and potential mortality associated with such conditions. Treatment modalities include using antibiotics based on the etiological agent and the neurosurgical team's possible intervention involvement. We present the case of a 52-yearold male patient who presented with lower back pain and was diagnosed with MRSA spondylodiscitis confirmed radiologically with MRI spine on a background of recent admission with MRSA line sepsis that was confirmed microbiologically through blood cultures. The patient was treated conservatively with a prolonged course of antibiotics and was followed up routinely to monitor response to treatment. Our case report describes MRSA spondylodiscitis clinical manifestation, diagnostic tests, treatment plan, and long-term outcome. [ABSTRACT FROM AUTHOR]

Annular rupture occurs in approximately 1% of transcatheter aortic valve replacement cases. Annular rupture often requires surgical management and is associated with high mortality. Repair of annular rupture in patients with previous coronary artery bypass grafting (CABG) is undercharacterized and poses a unique challenge given the increased difficulty and complexity from both an emergent and reoperative case. An 80-year-old male with previous CABG experienced annular rupture post-transcatheter aortic valve replacement requiring urgent surgical management. This case illustrates the successful repair of a rare and high-risk complication describing the approach utilized in correcting annular rupture in a patient with previous CABG. Damage to the base of the main blood vessel supplying blood to the body (the aortic annulus) after transcatheter aortic valve replacement (TAVR), a minimally invasive procedure to replace a narrowed aortic valve that fails to open properly, is rare. Annular rupture, a term used for injuries that occur in the region of the base of the aorta during TAVR, often needs surgical management. It also carries a high risk of death. Repair of annular rupture in patients with previous coronary bypass surgery, a surgery used to treat coronary heart disease, a condition where blood vessels of the heart become narrowed due to a buildup of fatty material within their walls, is not well described and poses a unique challenge. An 80-year-old male with previous bypass surgery had an annular rupture after TAVR requiring urgent surgery. This case illustrates the successful repair of a rare and high-risk complication. This case report also describes the approach for correcting this complication in a patient with previous bypass surgery. [ABSTRACT FROM AUTHOR]

Predicting the direction and magnitude of change in soil dynamics caused by invasive plant species has proven to be difficult because these changes are often reported to be species- and habitat-specific. This study was conducted to determine changes in three soil properties, eight soil ions, and seven soil microelements under established stands of four invasive plants, Prosopis juliflora, Ipomoea carnea, Leucaena leucocephala, and Opuntia ficus-indica. Soil properties, ions, and microelements were measured in sites invaded by these four species in southwest Saudi Arabia, and these values were compared to the results for the same 18 parameters from adjacent sites with native vegetation. Because this study was conducted in an arid ecosystem, we predict that these four invasive plants will significantly alter the soil properties, ions, and microelements in the areas they invaded. While the soils of sites with the four invasive plant species generally had higher values for soil properties and ions compared to sites with native vegetation, in most instances these differences were not statistically significant. However, the soils within sites invaded by I. carnea, L. leucocephala, and P. juliflora had statistically significant differences for some soil parameters. For sites invaded by O. puntia ficus-indica, no soil properties, ions, or microelements were significantly different compared to adjacent sites with native vegetation. Sites invaded by the four plant species generally exhibited differences in the 11 soil properties, but in no instance were these differences statistically significant. All three soil properties and one soil ion (Ca) were significantly different across the four stands of native vegetation. For the seven soil microelements, significantly different values were detected for Co and Ni, but only among stands of the four invasive plant species. These results indicate that the four invasive plant species altered soil properties, ions, and microelements, but for most of the parameters we assessed, not significantly. Our results do not support our initial prediction, but are in general agreement with previous published findings, which indicate that the effects of invasive plants on soil dynamics vary idiosyncratically among invasive species and among invaded habitats. [ABSTRACT FROM AUTHOR]

Many studies have focused on how leaf litter depth affects seed germination and seedling growth because the seedling stage is the most vulnerable portion of a plant's life cycle. Invasive plants with the most severe ecological consequences are those that modify ecosystems, and this can occur through the formation of thick litter layers which can suppress the emergence, survival, and recruitment of native plant seedlings; in addition, in some cases, these litter layers can suppress invasive plant seedling recruitment. Prosopis juliflora is a thorny shrub that is native to arid and semi-arid portions of North America, parts of South America, and the Caribbean. It has invaded millions of hectares around the world, including Saudi Arabia. The objective of this study is to evaluate whether P. juliflora leaf litter reduces the recruitment of its own seedlings under greenhouse and field conditions in Saudi Arabia. In both the greenhouse and the field, the number of days to first emergence increased and germination percentage decreased with increasing litter depth. With the 1, 2, and 4 cm litter depth treatments, the number of viable seeds generally decreased, with no emergence, germination, or viable seeds detected for the 8 cm litter depth treatment. Results of this study reveal that increasing the depth of P. juliflora leaf litter suppresses the survival and recruitment of its own seedlings. Future search should assess the actual mechanisms through which P. juliflora seeds are suppressed, the role of allelopathic compounds in this process, and whether viable seeds are dormant and will persist in the soil seed bank. [ABSTRACT FROM AUTHOR]

Focusing on the role of the institutional investment horizon as a monitoring mechanism that enhances companies' sustainability reporting reliability, this study investigates the association between long-term ownership and companies' decisions to assure their sustainability report. Further, the study examines the moderating effect of the quality of governance on this association. Consistent with the critical mass theory, the study argues that long-term ownership should reach a certain threshold to have an influence on companies' assurance decisions. The study's results support the argument and find that long-term ownership is positively and significantly associated with companies' assurance decisions, and the association is positive and significant only for a high level of long-term ownership in comparison to low- and medium-level long-term ownership. Moreover, the study finds that the association between long-term ownership and assurance is negatively moderated by the quality of governance at both the company and country levels. [ABSTRACT FROM AUTHOR]