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Abdulaziz Ibrahim Alzarea,1 Yusra Habib Khan,1 Sami I Alzarea,2 Abdullah Salah Alanazi,1 Omar Awad Alsaidan,3 Maily J Alrowily,4 Monefah Al-Shammari,5 Ziyad Saeed Almalki,6 Majed A Algarni,7 Tauqeer Hussain Mallhi1 1Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia; 2Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia; 3Department of Pharmaceutics, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi Arabia; 4Department of Radiology, Aljouf Health Cluster, Domat Al-Jandal, Al-Jouf, Saudi Arabia; 5Domat Al-Jandal General Hospital, Aljouf Health Cluster, Domat Al Jandal, Al-Jouf, Saudi Arabia; 6Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; 7Department of Clinical pharmacy, College of pharmacy, Taif university, Taif, Saudi ArabiaCorrespondence: Abdulaziz Ibrahim Alzarea; Tauqeer Hussain Mallhi, Email aizarea@ju.edu.sa; thhussain@ju.edu.saObjective: Chronic diseases hold the potential to worsen the overall health of patients by limiting their functional status, productivity, and capacity to live well, affecting their overall health-related quality of life (HRQoL). The purpose of the study was to assess the HRQoL of individuals with chronic diseases residing in the Al-Jouf region of Saudi Arabia. Furthermore, the current study also sought to ascertain the impact of multimorbidity and the duration of illness on HRQoL.Material and Methods: A cross-sectional study was conducted among the residents of Al-Jouf region for a period of 6 months. A self-administered EuroQoL (EQ-5D-5L) study tool was used. Appropriate statistical analysis was conducted to ascertain the relationship between various variables and HRQoL.Results: A total of 500 out of 562 participants completed the study, with a response rate of 88.97%. Participants had a mean age of 46.15 ± 16.79 years, and the majority were female (n = 299; 59.80%). A mean HRQoL score of 0.82 ± 0.20 was reported, poorest in patients with kidney failure (0.65 ± 0.26) and highest in hepatitis. However, nearly half of the participants had diabetes mellitus type II (n = 205, 39.20%). Patients aged < 30 years (OR: 0.109; p = 0.002), male participants (OR: 0.053; p < 0.001), no disability (OR: 0.143; p = 0.002), and < 2 comorbid diseases (0.84 ± 0.18; p < 0.001) reported better QoL. Additionally, comorbid conditions such as DM, prolong the duration of the overall illness (14.19 ± 7.67 years). Overall, imperfect health (n = 390, 78%) was reported by the study participants.Conclusion: The present study provided preliminary data about the current HRQoL status of individuals with imperfect health and lower HRQoL. In the future, large-scale longitudinal studies are required to investigate the most prevalent chronic diseases, their associations, and change in HRQoL, as there is a dearth of information in the Saudi population.Keywords: HRQoL, EQ-5D-5L, chronic diseases, diabetes mellitus, hypertension, Saudi Arabia, disease outcomes, quality of life

Bashayer Farhan Alruwaili,1 Duaa Fahad Bayyumi,1 Ohud Saud Alruwaili,1 Razan Saud Alsadun,1 Amal Sulaiman Alanazi,2 Amal Hadi,2 Nada Kareem S Alruwaili,3 Ashokkumar Thirunavukkarasu,1 Norah Farhan Aldaghmani,4 Aljawharah Abdulrahman Alrayes4 1Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia; 2Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 3Department of Primary Healthcare, Ministry of Health, Aljouf Health Cluster, Sakaka, Saudi Arabia; 4College of Medicine, Jouf University, Sakaka, Saudi ArabiaCorrespondence: Bashayer Farhan Alruwaili, Department of Family and Community Medicine, College of Medicine, Jouf University, Aljouf, Saudi Arabia, Tel +00966 55 191 3665, Email bfalrwili@ju.edu.saAbstract: In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother’s occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥ 2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.Keywords: childhood obesity, screen time, adolescents, Saudi growth pattern, WHO, CDC

Abdullah Salah Alanazi,1 Shahid Shah,2 Ghulam Abbas,3 Musaddique Hussain,4 Ammara Saleem,5 Haris Khurram,6 Usman Rashid Chand,2 Tauqeer Hussain Mallhi,1 Yusra Habib Khan,1 Kainat Ilyas,2 Savaira Tariq,2 Abdullah Jamil,2 Abdulaziz Ibrahim Alzarea,1 Sami Ibrahim Alzarea7 1Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf Province, Kingdom of Saudi Arabia; 2Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan; 3Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan; 4Faculty of Pharmacy, the Islamia University of Bahawalpur, Bahawalpur, Pakistan; 5Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University Faisalabad, Faisalabad, Pakistan; 6National University of Computer and Emerging Sciences, Chiniot-Faisalabad Campus, Chiniot, Pakistan; 7Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Al-Jouf, Saudi ArabiaCorrespondence: Shahid Shah; Ghulam Abbas, Email Shahid.waris555@gmail.com; ghulamabbas@gcuf.edu.pkPurpose: Patient satisfaction can be used to assess the quality of services provided at pharmacies. Our aim was to determine the level of patient satisfaction with pharmacy services and related factors at community pharmacies located in Punjab, Pakistan.Methods: A questionnaire-based cross-sectional study was conducted from May 2021 to July 2021 by administering the questionnaire to the patients using stratified random sampling method. Survey instrument comprised 4 sections including demographics, satisfaction towards provision of facilities, the provision of information, their accessibility to patients, the relationship between pharmacists and patients and the continuity of care provided. Categorical data were represented by percentages. Descriptive statistics were calculated for satisfaction scores. Simple and multiple logistic regression models were used to find the odds ratios. A p-value of less than 0.05 was considered statistically significant.Results: Response rate of the survey was 92%. Only 30% of patients agreed that the pharmacist was available for counseling on their visit. About 52% agreed that the counseling time provided by pharmacist was enough. Most of the pharmacy patients (61%) trusted the pharmacist regarding any query about medicine and were satisfied with the way the pharmacist resolved issues. Mean satisfaction score of the pharmacy patients was 45.75 with a range of 25 (highly satisfied) to 66 (highly dissatisfied).Conclusion: The provision of community pharmacy services to patients was not satisfactory. Furthermore, the absence of pharmacist in the pharmacy and the lack of provision for counseling time raised concerns.Keywords: pharmacies, pharmacists, community pharmacy services

The peel of Citrus sinensis (L.) Osbeck is a source of essential oils, particularly limonene, which is this plant’s characteristic molecule. The main goal of this study was to test the potential analgesic and anti-inflammatory properties of limonene-rich essential oils derived from the peel of C. sinensis L. (orange) in vivo, as well as their antioxidant activity in vitro. Carrageenan-induced paw edema in Wistar rats and the formalin test in Swiss albino mice were used to examine anti-inflammatory activity. The analgesic activity was assessed using hot plate and acetic acid writhing tests, while the antioxidant activity was assessed using the 1,1-diphenyl-2-picrylhydrazyl and ferric reducing antioxidant power methods. The essential oil (EO) safety was determined using an acute toxicity experiment on mice. The phytochemical analysis confirmed the existence of limonene as the primary molecule (88.94%), and in vivo experiments revealed that the EO had a significant pain and inflammation-relieving effect, especially at the dose of 50 mg/kg, when compared to the used control drugs. The acute toxicity evaluation reported this EO’s safety. This study contributes to the pharmacological valorization of the peel of C. sinensis L., confirming that, in addition to its numerous cosmetic and industrial uses, it may be effective in the treatment of inflammatory and pain-related illnesses.

Mohamed A Abdelgawad,1 Arafa Musa,2 Atiah H Almalki,3,4 Sami I Alzarea,5 Ehab M Mostafa,2 Mostafa M Hegazy,6 Gomaa Mostafa-Hedeab,7 Mohammed M Ghoneim,6,8 Della GT Parambi,1 Rania B Bakr,1 Nayef S Al-Muaikel,9 Abdullah S Alanazi,10,11 Metab Alharbi,12 Waqas Ahmad,13 Syed NA Bukhari,1 Mohammad M Al-Sanea1 1Department of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Aljouf, 72341, Saudi Arabia; 2Department of Pharmacognosy, College of Pharmacy, Jouf University, Sakaka, 72341, Saudi Arabia; 3Department of Pharmaceutical Chemistry, College of Pharmacy, Taif University, Taif, 21944, Saudi Arabia; 4Addiction and Neuroscience Research Unit, Taif University, Taif, 21944, Saudi Arabia; 5Department of Pharmacology, College of Pharmacy, Jouf University, Sakaka, Aljouf, 72341, Saudi Arabia; 6Department of Pharmacognosy, Faculty of Pharmacy, Al-Azhar University, Cairo, 11371, Egypt; 7Department of Pharmacology, Medical College, Jouf University, Sakaka, Aljouf, 72341, Saudi Arabia; 8Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah, 13713, Saudi Arabia; 9Department of Chemistry, College of Science, Jouf University, Sakaka, Aljouf, 72341, Saudi Arabia; 10Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Aljouf, Saudi Arabia; 11Health Sciences Research Unit, Jouf University, Sakaka, Aljouf, Saudi Arabia; 12Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia; 13Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, MalaysiaCorrespondence: Mohamed A AbdelgawadDepartment of Pharmaceutical Chemistry, College of Pharmacy, Jouf University, Sakaka, Aljouf, 72341, Kingdom of Saudi ArabiaTel +966 595435214Email mohamedabdelwahab976@yahoo.comArafa MusaDepartment of Pharmacognosy, College of Pharmacy, Jouf University, Sakaka, Aljouf, 72341, Kingdom of Saudi ArabiaTel +966 558775403Email akmusa@ju.edu.saIntroduction: Epidermal growth factor receptor (EGFR) inhibition is an imperative therapeutic approach targeting various types of cancer including colorectal, lung, breast, and pancreatic cancer types. Moreover, cyclooxygenase-2 (COX-2) is frequently overexpressed in different types of cancers and has a role in the promotion of malignancy, apoptosis inhibition, and metastasis of tumor cells. Combination therapy has been emerged to improve the therapeutic benefit against cancer and curb intrinsic and acquired resistance.Methods: Three semi-synthetic series of compounds (C1-4, P1-4, and G1-4) were prepared and evaluated biologically as potential dual epidermal growth factor receptor (EGFR) and COX-2 inhibitors. The main phenolic constituents of Amaranthus spinosus L. (p-coumaric, caffeic and gallic) acids have been isolated and subsequently subjected to diazo coupling with various amines to get novel three chemical scaffolds with potential anticancer activities.Results: Compounds C4 and G4 showed superior inhibitory activity against EGFR (IC50: 0.9 and 0.5 μM, respectively) and displayed good COX-2 inhibition (IC50: 4.35 and 2.47 μM, respectively). Moreover, the final compounds were further evaluated for their cytotoxic activity against human colon cancer (HT-29), pancreatic cancer (PaCa-2), human malignant melanoma (A375), lung cancer (H-460), and pancreatic ductal cancer (Panc-1) cell lines. Interestingly, compounds C4 and G4 exhibited the highest cytotoxic activity with average IC50 values of 1.5 μM and 2.8 μM against H-460 and Panc-1, respectively. The virtual docking study was conducted to gain proper understandings of the plausible-binding modes of target compounds within EGFR and COX-2 binding sites.Discussion: The NMR of prepared compounds showed characteristic peaks that confirmed the structure of the target compounds. The synthesized benzoxazolyl scaffold containing compounds showed inhibitory activities for both COXs and EGFR which are consistent with the virtual docking study.Keywords: kinase inhibitors, anti-inflammatory, multitarget agents, BRAF, anticancer

Ziyad Saeed Almalki,1 Mohd Faiyaz Khan,1 Saja Almazrou,2 Abdullah Salah Alanazi,3 Mohammed Shahid Iqbal,1 Abdulhadi Alqahtani,4 Saleh Alghamdi,4 Abdullah K Alahmari1 1Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia; 2Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3Clinical Pharmacy Department, College of Pharmacy, Jouf University, Sakaka, Aljouf, Saudi Arabia; 4Clinical Research Department, Research Center, King Fahad Medical City, Riyadh, Saudi ArabiaCorrespondence: Ziyad Saeed AlmalkiDepartment of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi ArabiaTel +966 11 588 6059Fax +966 11 588 6000Email z.almalki@psau.edu.saPurpose: Evidence to date suggests that having chronic conditions increases the probability of severe illness from severe coronavirus disease 2019 (COVID-19). Thus, it is essential to identify the features of those patients. The purpose of this research was to identify the clinical characteristics and outcomes of COVID-19 patients with chronic conditions.Patients and Methods: A retrospective cross-sectional single-center study was conducted using electronic medical records of hospitalized COVID-19 patients between March 1, 2020, and May 20, 2020. Patients’ basic information, laboratory test, clinical data, medications, and outcome data have been extracted and compared among three groups: patients without chronic conditions, patients with one chronic condition, and patients with two or more chronic conditions. Chi-square, Fisher’s exact test, Student’s t-test, and the Mann–Whitney U-test were used.Results: The study population was 458 patients, with an average age of 38.8 years (standard deviation (SD) 12.8). There were 398 (86.9%) males in the study population, most of them with one chronic condition. There were 14 (14.3%) smokers, and the majority of them were among patients with two or more chronic conditions. Longer hospital stay and time in the intensive care unit (ICU), a higher probability of ICU admission, and the need for mechanical ventilation were identified among patients with two or more chronic conditions. Dyspnea, an increased level of platelet counts, and a reduction in hemoglobin levels were discovered among patients with two or more chronic conditions.Conclusion: Patients with more chronic conditions were at higher risk of yielding poor clinical outcomes. Prevention and treatment of infections in these patients merit more attention.Keywords: chronic conditions, clinical features, outcomes, coronavirus disease 2019

Multiple sclerosis (MS) is a disease of the central nervous system (CNS) that is the result of the body's own immune cells being auto-reactive to the myelin regions of the body as if these regions were foreign antigens. This demyelination process is damaging to the electrical conductivity of neurons. The current medicines are only capable of fighting off the symptoms of the disease, but not the disease itself. Specialized stem cells, known as mesenchymal stem cells (MSCs), seem to be the candidate therapy to get rid of MS. MSCs can be isolated from multiple sources of the person's body, and even from the umbilical cord (UC) and placenta of a donor. These cells have anti-inflammatory effects so they can target the overactivity and self-antigen attacks by T cells and macrophages; this immune system overactivity is characteristic of MS. MSCs show the ability to locate into brain lesions when injected and thus can compensate for the loss of the brain function by differentiating into neuronal precursor cells and glial cells. The author has listed tables of clinical trials that have utilized MSCs from different sources, along with the years and the phase of study completed for each trial. The consensus is that these cells work on inhibiting CD4+ and CD8+ T cell activation, T regulatory cells (Tregs), and macrophage switch into the auto-immune phenotype.The best source of MSCs seems to be the UC due to the easiness of extraction, the noninvasive method of collection, their higher expansion ability and more powerful immune-modulating properties compared to other locations in the body. Studies showed there was a significant decline of mRNA expression of several cytokines after the administration of MSCs derived from the UC (UCMSCs). Other researchers were able to repair the defects of Tregs in MS patients by co-culturing Tregs from these patients with UCMSCs, which decreased the production of the pro-inflammatory cytokine IFN γ, and also suggested a strong link between Tregs lack of functionality in MS patients with the pathogenesis of the disease.

Hydrogen (H2) is a clean fuel and key enabler of energy transition into green renewable sources and a method of achieving net-zero emissions by 2050. Underground H2storage (UHS) is a prominent method offering a permanent solution for a low-carbon economy to meet the global energy demand. However, UHS is a complex procedure where containment security, pore-scale scattering, and large-scale storage capacity can be influenced by H2contamination due to mixing with cushion gases and reservoir fluids. The literature lacks comprehensive investigations of existing thermodynamic models in calculating the accurate transport properties of H2-blend mixtures essential to the efficient design of various H2storage processes. This work benchmarks cubic equations of state (EoSs), namely Peng–Robinson (PR) and Soave Redlich–Kwong (SRK) and their modifications by Boston–Mathias (PR-BM) and Schwartzentruber–Renon (SR-RK), for their reliability in predicting the thermophysical properties of binary and ternary H2-blend mixtures, including CH4, C2H6, C3H8, H2S, H2O, CO2, CO, and N2, in addition to Helmholtz-energy-based EoSs (i.e., PC-SAFT and GERG2008). The benchmarked models are regressed against the experimental data for vapor–liquid equilibrium (VLE) that covers a wide range of pressures (0.01 to 101 MPa), temperatures (92 K to 367 K), and mole fractions (0.001 to 0.90) of H2. The novelty of this work is in benchmarking and optimizing the parameters of the mentioned EoSs to study VLE envelopes, densities, and other critical transport properties, such as heat capacity and the Joule–Thomson coefficient of H2mixtures in a wide range of associated conditions. The results highlight the significant effect of the temperature-dependent binary interaction parameters on the calculations of thermophysical properties. The SR-RK EoS demonstrated the highest agreement with VLE data among the cubic EoSs with a low root mean square error and absolute average deviation. The PC-SAFT VLE models demonstrated results comparable to the SR-RK. The sensitivity analysis highlighted the high influence of impurity on changing the thermophysical behavior of H2-blend streams during the H2storage process.

The wind turbine construction aging caused by fatigue components of a wind field over a long period affects the physical structure. Flow controlling methodologies are used to alleviate turbine assembly stress. The flow regulation approach controller is critical in the fatigue load minimization procedure. This paper offers a Predictive controller for Independent pitch control (IPC)-based flow management. Because of the azimuthal position of the blade, the flow dynamics of the blades are vulnerable to cyclic fluctuations. This paper considers the azimuthal angle blade dynamics since there is a significant variation in movements between the bottom and top blades. The suggested controller (which takes into account the wind turbine’s Azimuthal angle characteristics) outperforms the existing controllers in terms of its capacity to forecast the blade’s reaction as it approaches the azimuthal location. The complete replication was effectively done.

Abstract Backgrounds Vaccine acceptance varies across countries, generations, and the perceived personality of individuals. Investigating the knowledge, beliefs, and acceptability of COVID-19 vaccines among individuals is vital to ensuring adequate health system capacity and procedures and promoting the uptake of the vaccines. Results A cross-sectional study was conducted from August 2021 to January 2022 in Saudi Arabia. The study included 281 residents to estimate their acceptance to receive COVID-19 vaccination. Around 70% of the included participants had a moderate to high COVID-19 vaccine acceptance rate during the data collection period. The risk increases to about two folds among undergraduates [OR 1.846 (1.034–3.296), p value = 0.036)] and increases to four folds among non-employed [OR 3.944 (2.310–6.737), p value = 0.001]. About 78% of participants with high and 44% with low COVID-19 vaccine acceptance (p value = 0.001) believed the vaccines were safe and effective. The belief that COVID-19 disease will be controlled within two years increased the risk for low vaccine acceptance by about two folds [OR 1.730 (1.035–2.891), p value = 0.035]. Good knowledge about COVID-19 vaccination significantly affected the acceptance rate (p value = 0.001). Conclusions Several factors affect the intention of individuals to receive vaccines. Therefore, building good knowledge and health literacy through educational intervention programs, especially vaccine safety and effectiveness, is important for successful vaccination campaigns among the general population and ensuring control of the COVID-19 pandemic.

Abstract Background People with spinal cord injury (SCI) frequently develop neuropathic pain (NP) that worsens disability and diminishes rehabilitation efficacy. Chronic NP is presently incurable due to poor understanding of underlying mechanisms. We hypothesized that multilocus neuroinflammation (NIF) might be a driver of SCI NP, and tested it by investigating whether NP coexisted with central NIF, neurotransmission (NTM), neuromodulation (NML) and neuroplasticity (NPL) changes post-SCI. Methods Female Sprague–Dawley rats (230–250 g) with T10 compression or laminectomy were evaluated for physical conditions, coordinated hindlimb functions, neurological reflexes, and mechanical/thermal sensitivity thresholds at 1 day post-injury (p.i.) and weekly thereafter. Eight weeks p.i., central nervous system tissues were histochemically and immunohistochemically characterized for parameters/markers of histopathology and NIF/NTM/NML/NPL. Also analyzed was the correlative relationship between levels of selected biomarkers and thermosensitivity thresholds via statistical linear regression. Results SCI impaired sensorimotor functions, altered reflexes, and produced spontaneous pain signs and hypersensitivity to evoked nociceptive, mechanical, and thermal inputs. Only injured spinal cords exhibited neural lesion, microglia/astrocyte activation, and abnormal expression of proinflammatory cytokines, as well as NIF/NTM/NML/NPL markers. Brains of SCI animals displayed similar pathophysiological signs in the gracile and parabrachial nuclei (GrN and PBN: sensory relay), raphe magnus nucleus and periaqueduct gray (RMN and PAG: pain modulation), basolateral amygdala (BLA: emotional-affective dimension of pain), and hippocampus (HPC: memory/mood/neurogenesis). SCI augmented sensory NTM/NPL (GrN and PBN); increased GAD67 (PAG) level; reduced serotonin (RMN) and fear-off neuronal NTR2 (BLA) expressions; and perturbed neurogenesis (HPC). Conclusion T10 compression caused chronic hyperalgesia that coexisted with NIF/NTM/NML/NPL responses at multilevel neuroaxis centers. The data have provided multidimensional biomarkers as new mechanistic leads to profile SCI NP for therapeutic/therapy development.

High-impact practices (HIPs) have been adopted by many universities around the world to enhance student learning. The aim of this qualitative study was to analyzed how building ePortfolios may impact student learning experience via weekly reflections. A total of 47 senior undergraduate English as a foreign language (EFL) students enrolled in research projects shared reflections about their research experiences via the development of ePortfolios. Data analysis was carried out through deductive coding of the transcribed focus groups and weekly reflections. Findings suggest that the participants used their ePortfolios to improve their writing skills and increase their knowledge. Students were able to track their progress and felt more engaged in learning. They also showed appreciation to the feedback provided by their instructors on their reflections. However, the students shared some challenges they faced while developing their ePortfolios. Despite these challenges, there was a positive impact of ePortfolios on students’ learning experiences. Implications and further directions for research are discussed.

Thekraiat M Al Quran,1 Ziad A Bataineh,2 Abdel-Hameed Al-Mistarehi,1 Anas M Zein Alaabdin,1 Hadeel Allan,1 Anood Al Qura’an,3 Shatha M Weshah,1 Anfal A Alanazi,4 Yousef S Khader1 1Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 2Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Internal Medicine, Jordanian Royal Medical Services, Amman, Jordan; 4Family Medicine Academy, E1-Eastern Health Cluster, Dammam, Saudi ArabiaCorrespondence: Thekraiat M Al Quran, Department of Public Health and Family medicine, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box: 3030, Irbid, 22110, Jordan, Tel +962 7 9014 1425, Email tmalquran@just.edu.joBackground: Dyslipidemia and type 2 diabetes mellitus (T2DM) are growing health problems, particularly in developing countries. This study aimed to determine the prevalence and pattern of dyslipidemia and its associated factors among patients with T2DM.Methods: A cross-sectional study was conducted among patients with T2DM attending Family Medicine Clinics in Jordan between August 2017 and March 2019. The socio-demographics, clinical features, medications, and laboratory findings were collected. These laboratory findings included high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TGs).Results: A total of 870 patients with T2DM were included. The prevalence of dyslipidemia among patients with T2DM was 91.4%. The most common patterns of dyslipidemia were low HDL-C (66.2%), high LDL-C (62.1%), and hypertriglyceridemia (58.2%). Female gender, obesity, and hypertension were associated with diabetic dyslipidemia patterns. T2DM duration and poor glycemic control were associated with high LDL-C and hypercholesterolemia. Hypertriglyceridemia was associated with poor glycemic control and smoking.Conclusion: Dyslipidemia is highly prevalent among patients with T2DM. Evidence –based interventions are needed to prevent and control dyslipidemia among patients with T2DM in Jordan.Keywords: dyslipidemia, diabetes mellitus, cholesterol, triglycerides, prevalence

This study investigated how children's 24-hour (24-h) movement behaviours were affected by SARS-CoV-2 (COVID-19) in the Kingdom of Saudi Arabia. Previous research examined 24-h movement behaviours in Saudi Arabia seven months after the World Health Organization (WHO) declared COVID-19 a global pandemic. This repeat cross-sectional study examined changes in 24-h movement behaviours 12 months after the WHO declaration. The Time 2 survey repeated five months (1 March – 15 May 2021) after Time 1 survey (1 October – 11 November 2020). The survey was distributed to parents of children aged 6–12 years across Saudi Arabia via an online survey. Children were classified as meeting 24-h movement guidelines if they reported uninterrupted sleep for 9–11 ​h per night, ≤ 2 ​h of recreational sedentary screen time (RST) per day and ≥ 60 ​min of moderate-to vigorous-intensity physical activity (MVPA) per day. A total of 1 045 parents from all regions of Saudi Arabia responded (42.4%). Only 1.8% of children met all components of the guidelines, compared to 3.4% in Time 1. In the present study, girls spent more days per week in MVPA ≥ 60 ​min duration than boys (3.0 vs 2.6; p ​= ​0.025), while boys had spent more days per week engaged in activities that strengthened muscle and bone than girls (3.0 vs 2.8; p ​= ​0.019). Healthy levels of physical activity (PA), sedentary behaviour (SB) and sleep further declined in Saudi children five months after the Time 1 survey. These challenges require urgent intervention to ensure children's movement behaviours improve as Saudi Arabia moves out of the COVID-19 pandemic.

Abstract Background Ankle osteoarthritis (OA) is a debilitating health condition that is increasing in prevalence. Currently, there are no evidence-based guidelines for managing ankle OA. One of the current challenges to establishing guidelines is the lack of a widely agreed-upon set of outcome measures that are consistently used in ankle OA research. Without a set of agreed-upon outcome measures, it is difficult to synthesise clinical trial outcomes through meta-analysis—an essential element of evidence-informed practice. In order to develop an appropriate set of outcome measures for ankle OA, it is important first to develop a core domain set. In this protocol, we describe the methodological approach that we will use to develop such a core domain set for ankle OA. Methods We established an international steering committee to guide the development of a core domain set for ankle OA. The core domain set development will follow a multi-staged approach consisting of three phases, involving participation by patients and clinicians/healthcare professionals. In phase 1, a list of candidate domains will be gleaned from (a) a scoping review of outcome measures used in ankle OA research, (b) qualitative interviews with individuals with ankle OA, and (c) qualitative interviews with healthcare professionals with expertise in ankle OA. In phase 2, the steering committee will review and generate a list of candidate domains from those gleaned in phase 1. In phase 3, this list of candidate domains will be considered in a Delphi process to reach a consensus on a core domain set. We anticipated this will involve 3 rounds of surveys. Conclusion This protocol describes the methods that will be used to develop a core domain set of health-related aspects for ankle OA. Importantly, it will include both healthcare professional and patient involvement. This is a prerequisite step to developing a core outcome set for ankle OA that should be reported in all clinical trials for ankle OA. The findings will be widely disseminated across peer-refereed publication(s) and national and international conferences, as well as via relevant professional societies, patient support group organisations, and social media platforms. Project registration This project is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database on 17 March 2021. https://www.comet-initiative.org/Studies/Details/1837 .

Ezeldine K Abdalhabib,1 Badr Alzahrani,1 Muhammad Saboor,2– 4 Alneil Hamza,1 Elyasa M Elfaki,1 Fehaid Alanazi,1 Fawaz O Alenazy,1 Abdulrahman Algarni,5 Ibrahim Khider Ibrahim,6 Hozifa A Mohamed,7 Ayman Hussein Alfeel,8 Nahla Ali Alshaikh3,4 1Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia; 2Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; 3Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 4Medical Research Center (MRC), Jazan University, Jazan, Saudi Arabia; 5Department of Medical Laboratory Technology, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia; 6Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan; 7Department of Molecular Biology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan; 8Department of Medical Laboratory Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab EmiratesCorrespondence: Ayman Hussein Alfeel, Department of Medical Laboratory Sciences, College of Health Sciences, Gulf Medical University, Ajman, United Arab Emirates, Email aymanalfeel@gmail.com Muhammad Saboor, Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates, Tel +971 56 443 2008, Email msaboor@jazanu.edu.saPurpose: Single-nucleotide polymorphism (SNP) in the promoter region of the IL-10 gene can increase susceptibility to tumor development. The current study aimed to explore the genotypic frequency of interleukin-10 (IL-10) rs1800896 polymorphism in newly diagnosed adult patients with acute lymphoblastic leukemia (ALL) and validate whether this SNP is a risk factor for adult ALL.Patients and Methods: This case–control study was based on a subset of newly diagnosed 154 adult patients with ALL recruited from the Radiation and Isotope Center in Khartoum (RICK) and 154 healthy controls from the same geographical area. Genomic DNA was used for the genotyping of rs1800896 polymorphism through allele-specific polymerase chain reaction (PCR) assays.Results: The genotypic frequencies of rs1800896 showed a statistically significant association of AG and AA genotypes with adult ALL (p< 0.001). Combined genotypes AG+GG vs AA also showed a positive association of rs1800896 with adult ALL (OR=4.89). The allelic frequencies of G and A did not show any significant difference in adult patients with ALL compared with the control group. AG rs1800896 genotype showed an increased risk of B and T ALL (OR=2.51 and 4.70, respectively). Age at diagnosis, gender, and immunophenotype (B vs T ALL) did not exhibit any association of rs1800896 with ALL in this patient group.Conclusion: rs1800896 polymorphism is associated with an increased risk of ALL in adult patients irrespective of the age at diagnosis, gender, and immunophenotype of ALL.Keywords: acute lymphoblastic leukemia, polymorphism, IL-10, – 1082 (A>G), rs1800896

Background: Healthcare workers (HCWs) have been highly affected by COVID-19 due to their fundamental duties in diagnosing, caring, and treating the rapidly increasing number of infected patients. Thus, are facing the occupational risk of COVID-19 infection and mortality. Purpose: To investigate the COVID-19 disease clinical characteristic and associated factors among HCWs in Saudi Arabia. Methods: This was a nationwide, retrospective analytical study conducted from 5th of March 2020–21 st of August 2021. All deceased HCWs who were diagnosed with COVID-19 were included in this study. Results: As of August 21, 2021, a total of 305 deaths were recorded due to COVID-19 infection among HCWs in all Saudi healthcare facilities. The case fatality rate was 0.35%. Deaths were highest among physicians (40.0%). Most of deceased HCWs acquired the infection from the community (80%). 71% of deceased HCWs had at least one chronic medical condition. Most of them were admitted to ICU before they passed away (83.6%). Three significant variables predicting ICU admission were presence of one or more comorbidities, hypertension, and chronic respiratory diseases Conclusion: HCWs are at higher risk for exposure to COVID‐19 due to their occupational risk. Our study encourages future research to provide more comprehensive information regarding COVID-19 morbidity and mortality among HCWs.

As solar energy is rapidly being implemented as a renewable energy resource, solar energy integrated systems should be optimally designed by performing a detailed analysis of materials, control systems, and economical aspects. This work aims to develop a theoretical and computational model for the techno-economic analysis of a photovoltaic (PV) system with and without the use of batteries as energy storage devices. A comprehensive literature review was first performed on PV systems with renewable energy integrated systems. Mathematical calculations of PV systems were then performed to develop a theoretical model to assess the technical aspects of PV systems. In addition, theoretical model was developed to calculate the economical assessment of the integrated PV system. Various types of lithium-ion and flow batteries were then discussed and assessed both technically and economically to determine the optimal storage method source. Five cases were analyzed, including the use of no storage solution, two scenarios including lithium-ion batteries, and two cases including flow batteries, using the proposed computational techniques. It was observed that PV system with lithium cobalt oxide battery shows the lowest levelized cost of electricity (3.4 cent/kWh) as compared to other PV system with batteries. The research suggests that integrated system including lithium-ion batteries was determined to be the most feasible and economical. Overall, the resulting detailed analysis of the PV system with energy storage options reflects the applicability of this system in remote areas.

Muhammad Alrwaily,1,2 Fahad Alanazi3 1Division of Physical Therapy, School of Medicine, West Virginia University, Morgantown, WV, 26506-9226, USA; 2Department of Physical Therapy, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 3Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Jouf University, Jouf Region, Saudi ArabiaCorrespondence: Muhammad Alrwaily, Health Sciences Center South, Morgantown, WV, 26506-9226, USA, Tel +1 304-293-0264, Fax +1 304-293-7105, Email muhammad.alrwaily@hsc.wvu.eduBackground: Musculoskeletal disorders (MSDs) are rapidly rising in Saudi Arabia and considered the 3rd reason for hospital visits across the country. Despite their prevalence, the adequacy of knowledge in diagnosing and treating MSDs has not been assessed. The purpose of this study is to assess MSD knowledge amongst healthcare providers (orthopedists, physicians, and physical therapists) and medical and physical therapy students and interns.Methods: In this cross-sectional study, a web-based 25-question MSD test was given to licensed physical therapists, primary care physicians and orthopedists, as well as final-year physical therapy and medical students and interns in Saudi Arabia. Two multivariable linear regression analysis models were used to determine MSD test score differences amongst (1) orthopedists, primary care physicians, and physical therapists and (2) amongst medical and physical therapy students and interns.Results: A total of 680 participants were included (response rate is 22.7%). The overall MSD test score was 48.2%, and the passing rate was 14%. Model 1 showed that orthopedist’s group had a significantly higher mean score on MSD test than physical therapists (t482= 8.12, p < 0.001) and primary care physician (t482= 6.00, p < 0.05). However, primary care physician scores did not significantly differ from physical therapy group (t482= 6.47, p = 0.07). Model 2 showed that medical interns had significantly higher mean score on MSD test than physical therapy students (t240=4.46, p < 0.001), physical therapy interns (t240= 4.7, p < 0.05), and medical students (t240= 2.79, p < 0.05). There was also a significant difference between medical students and physical therapy interns (t240= 2.5, p < 0.05). However, there was no significant difference between medical students and physical therapy students.Conclusion: Except for orthopedists, the MSD knowledge appears inadequate amongst healthcare providers, medical and physical therapy students and interns in Saudi Arabia. To improve knowledge in MSDs, increasing content of MSDs in undergraduate education and postgraduate training is necessary.Keywords: musculoskeletal disorders, competency, education, Saudi Arabia, primary care providers, physical therapists, students, interns

Abstract Resilient modulus (Mr) of subgrade soils is one of the crucial inputs in pavement structural design methods. However, the spatial variability of soil properties and the nature of test protocols, the laboratory determination of Mr has become inexpedient. This paper aims to design an accurate soft computing technique for the prediction of Mr of subgrade soils using the hybrid least square support vector machine (LSSVM) approaches. Six swarm intelligence algorithms, namely particle swarm optimization (PSO), grey wolf optimizer (GWO), symbiotic organisms search (SOS), salp swarm algorithm (SSA), slime mould algorithm (SMA), and Harris hawks optimization (HHO) have been applied and compared to optimize the LSSVM parameters. For this purpose, a literature dataset (891 datasets) of different types of soils has been used to design and evaluate the proposed models. The input variables in all of the proposed models included confining stress, deviator stress, unconfined compressive strength, degree of soil saturation, soil moisture content, optimum moisture content, plasticity index, liquid limit, and percent of soil particles (P #200). The accuracy of the proposed models was assessed by comparing the predicted with the observed of Mr values with respect to different statistical analyses, i.e., root means square error (RMSE) and determination coefficient (R2). For modeling the Mr of subgrade soils, percent passing No. 200 sieve, optimum moisture content, and unconfined compressive strength were found to be the most significant variables. It is observed that the performance of LSSVM-GWO, LSSVM-SOS, and LSSVM-SSA outperforms other models in predicting accurate values of Mr. The (RMSE and R2) of the LSSVM-GWO, LSSVM-SSA, and LSSVM-SOS are (6.79 MPa and 0.940), (6.78 MPa and 0.940), and (6.72 MPa and 0.942), respectively, and hence, LSSVM-SOS can be used for high estimating accuracy of Mr of subgrade soils.

Abstract Background As a precarious clinical condition and a public health problem, heart failure (HF) is associated with a significant burden of morbidity, mortality, and health care costs. As almost all of the published research has been conducted in Western countries, there is a need for culturally relevant studies in Saudi Arabia. This is the first study to investigate health-related quality of life (HRQoL) and its associated factors among Saudi patients with HF in the Qassim region. Methods A cross-sectional study was conducted at the only tertiary care hospital in the Qassim region of Saudi Arabia during the period from November 2020 to July 2021. The participants were interviewed face-to-face by trained interviewers using the standard validated 36-item Short-Form Health Survey (SF-36) questionnaire for HRQoL assessment. The data were analyzed using STATA version 16. Results The participants included 246 HF patients whose mean (SD) age was 56.7 (10.9) years. A majority of the respondents (80%, n = 197) were male, and 49% (n = 121) had an education level of less than secondary school. The median scores were high for the domains of social functioning (100 points) and bodily pain (75 points) and low for role-physical functioning (25 points). In general, the median scores for the physical and mental component summaries were 58.1 and 63.7, respectively. Patients with an education level less than secondary school were more likely to have a low physical component summary score (aOR 3.00, 95% CI 1.46–6.17), while female patients were more likely to have a low mental component summary score (aOR 2.67, 95% CI 1.38–5.16). Conclusions Health-related quality of life was found to be moderate among these HF patients. Periodic HRQoL assessment is recommended for HF patients to minimize their physical and psychological concerns, particularly for patients with low education levels and female patients.

Muslimah N Alsulami,1 Majed H Wakid,2 Mohammed Al-matary,3 Rewaida Abdel-Gaber,4 Wafa Abdullah I Al-Megrin,5 Areej O Bakhraibah,1 Abdullah D Alanazi,6 Hatem A Elshabrawy,7 Asmaa M El-Kady8 1Department of Biology, College of Science, University of Jeddah, Jeddah, 21493, Saudi Arabia; 2Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 3Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 4Department of Zoology, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia; 5Department of Biology, College of Science, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia; 6Department of Biological Sciences, Faculty of Science and Humanities, Shaqra University, Ad-Dawadimi, 11911, Saudi Arabia; 7Department of Molecular and Cellular Biology, College of Osteopathic Medicine, Sam Houston State University, Conroe, TX, 77304, USA; 8Department of Medical Parasitology, Faculty of Medicine, South Valley University, Qena, 83523, EgyptCorrespondence: Asmaa M El-Kady; Hatem A Elshabrawy, Email Asmaa.elkady@med.svu.edu.eg; hatem.elshabrawy@shsu.eduBackground: In Saudi Arabia, more than US$ 0.2 million annual losses are caused by liver condemnations due to fascioliasis. Data obtained from the genetic characterization of Fasciola population sheds light on parasite transmission which could eventually help in development of effective parasite control measures. So, the aim of this study was to investigate the genetic diversity of Fasciola spp. isolated from cattle in Saudi Arabia by sequence analyses of COI gene.Materials and Methods: A total of 325 cows slaughtered at the central municipal abattoir in Jeddah city, Jeddah Province, Saudi Arabia were examined for fascioliasis in the period from 1st of June to 1st of July 2020. DNA was extracted from adult Fasciola worms and used for PCR and DNA sequence using a primer pair targeting COI gene. Analysis of the obtained sequences was done using BLAST search and phylogenetic analysis.Results: Bovine fascioliasis was diagnosed in 18 out of 325 cattle (5.5%). Forty-eight flukes were extracted from infected animals and DNA was successfully amplified from all flukes. Overall 12 different DNA sequences were obtained. BLAST search showed that all obtained sequences were F. hepatica and had > 97% similarity with F. hepatica isolates from Tanzania, Europe and Iran. Phylogenetic analysis of the obtained sequences showed that Fasciola isolates from the current study were clustered in one subclade closely related to isolates from North and South Africa and Italy.Conclusion: Reports on the molecular characterization of Fasciola spp. in Saudi Arabia are limited. In the current study, our findings showed that F. hepatica was the only Fasciola species parasitizing cattle in Jeddah city, Saudi Arabia. Further studies using a large number of samples from different localities in Saudi Arabia are needed to provide data that will help the development of control measures against fascioliasis.Keywords: fascioliasis, cattle, PCR, COI, Saudi Arabia

Background: With the rapid development of the genomic sequence data for the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants Delta (B.1.617.2) and Omicron (B.1.1.529), it is vital to successfully identify mutations within the genome. Objective: The main objective of the study is to investigate the full-length genome mutation analysis of 157 SARS-CoV-2 and its variant Delta and Omicron isolates. This study also provides possible effects at the structural level to understand the role of mutations and new insights into the evolution of COVID-19 and evaluates the differential level analysis in viral genome sequence among different nations. We have also tried to offer a mutation snapshot for these differences that could help in vaccine formulation. This study utilizes a unique and efficient method of targeting the stable genes for the drug discovery approach. Methods: Complete genome sequence information of SARS-CoV-2, Delta, and Omicron from online resources were used to predict structure domain identification, data mining, and screening; employing different bioinformatics tools. BioEdit software was used to perform their genomic alignments across countries and a phylogenetic tree as per the confidence of 500 bootstrapping values was constructed. Heterozygosity ratios were determined in-silico. A minimum spanning network (MSN) of selected populations was determined by Bruvo's distance role-based framework. Results: Out of all 157 different strains of SARS-CoV-2 and its variants, and their complete genome sequences from different countries, Corona nucleoca and DUF5515 were observed to be the most conserved domains. All genomes obtained changes in comparison to the Wuhan-Hu-1 strain, mainly in the TRS region (CUAAAC or ACGAAC). We discovered 596 mutations in all genes, with the highest number (321) found in ORF1ab (QHD43415.1), or TRS site mutations found only in ORF7a (1) and ORF10 (2). The Omicron variant has 30 mutations in the Spike protein and has a higher alpha-helix shape (23.46%) than the Delta version (22.03%). T478 was also discovered to be a prevalent polymorphism in Delta and Omicron variations, as well as genomic gaps ranging from 45 to 65aa. All 157 sequences contained variations and conformed to Nei's Genetic distance. We discovered heterozygosity (Hs) 0.01, mean anticipated Hs 0.32, the genetic diversity index (GDI) 0.01943989, and GD within population 0.01266951. The Hedrick value was 0.52324978, the GD coefficient was 0.52324978, the average Hs was 0.01371452, and the GD coefficient was 0.52324978. Among other countries, Brazil has the highest standard error (SE) rate (1.398), whereas Japan has the highest ratio of Nei's gene diversity (0.01). Conclusions: The study's findings will assist in comprehending the shape and kind of complete genome, their streaming genomic sequences, and mutations in various additions of SARS-CoV-2, as well as its different variant strains like Omicron. These results will provide a scientific basis to design the vaccines and understand the genomic study of these viruses.

This paper introduces a new model for optimal wind distributed generation (WDG) allocation based on mixed integer linear programming (MILP) in todays' smart grids considering on-load tap changing (OLTC) and power factor control (PFC) strategies. The objectives of the proposed optimization model are improving voltage stability and energy loss minimization subject to power flow constraints, line thermal limits, maximum number and size of WDG units, penetration limit, discrete OLTC tap position constraints, and PFC constraints. An efficient voltage phasor-information-based probabilistic voltage stability index (VSI) is extracted to measure the improvement of voltage stability with WDGs. Besides energy losses, reduction index is used to measure the energy loss reduction with the integration of renewable WDGs in the distribution system. An efficient linearized power flow (LPF) model as well as piecewise linearized model of the quadratic terms associated to the PFC constraints are represented to convert the original nonconvex problem into the form of a well-known MILP problem, which guarantees optimal solution and computationally is efficient to be solved using powerful commercial solvers. The effectiveness and validity of proposed model is investigated in compared to the state-of-the-art population-based methods and classical models.

Background: Depression is a mood disease that affects the energy, behavior, and mood of individuals. Depression is associated with an increased risk of chronic disease. Primary healthcare physicians play an important role in the diagnosis and management of depression. We aim to determine the knowledge of primary healthcare physicians on depression. Methods: This is an observational cross-sectional study that was conducted on primary healthcare physicians using a structured validated questionnaire. Statistical analysis was conducted using SPSS 22nd edition. Results: This study included 235 primary healthcare physicians, and the mean ± standard deviation of age was 29 ± 3 years. Males were predominant in the study (62%), and the large majority were residents (94.9%). There were 79.5%, 91.5%, and 27.8% who had good knowledge, a positive attitude, and a good practice, respectively. There was no factor found to affect the knowledge and attitude, whereas only the position of participants was significantly associated with the level of practice (P = 0.027). Conclusion: There were good knowledge and a positive attitude of primary healthcare physicians regarding depression; however, their practice was poor.

Abstract Due to recent advancements in smart city traffic and transport monitoring industry 4.0 applications. Flying Ad‐Hoc Networks (FANETs) ability to cover geographically large areas, makes it a suitable technology to address the challenges faced during remote areas traffic monitoring. The implementation of drone based FANETs have several advantages in remote traffic monitoring, including free air‐to‐air drone assisted communication zone and smart surveillance and security. The drone‐based FANETs can be deployed within minutes without requiring physical infrastructure, making it suitable for mission critical applications in several areas of interests. Here a drone‐based FANETs application for smart city remote traffic monitoring is presented while addressing several challenges including coverage of larger geographical area and data communication links between FANETs nodes. A FANET‐inspired enhanced ACO algorithm that easily coped with drone assisted technology of FANETs is proposed to cover the large areas. Simulation results are presented to compare the proposed technique against different network lifetime and number of received packets. The presented results show that the proposed technique perform better compared to other state‐of‐the‐art techniques.

There are flow research centers on magnetohydrodynamic (MHD) emission of auxiliary liquid in an extended region. The prevailing model is constrained by attractions/infusion and gooey release. The administering model is based on the Koo–Kleinstreuer–Li nanofluid model in the existence of entropy generation. Final requirements of this model are addressed by implementing the shooting strategy, which incorporates a fourth approach for the Runge–Kutta strategy. Into the bargain, the last adds (in standard ordinary differential equations (ODE) divisions) are obtained from the measurable controls partial differential equations, which were represented toward the start of the overseeing model. The varieties for all boundaries are exhibited through graphical arrangements. It is noticed that expanding the substantial volume portion diminishes speed but builds nuclear power dispersion. Likewise, the classification of mathematical qualities on divider heat move rate and skin contact is introduced. Both Reynolds and Brinkman numbers improve the entropy rate of the thermal system resulting in the growth effects of inertial forces and the surface heat dissipation, respectively.

Diabetic nephropathy (DN) is a serious kidney illness characterized by proteinuria, glomerular enlargement, reduced glomerular filtration, and renal fibrosis. DN is the most common cause of end-stage kidney disease, accounting for nearly one-third of all cases of diabetes worldwide. Hyperglycemia is a major factor in the onset and progression of diabetic nephropathy. Many contemporary medicines are derived from plants since they have therapeutic properties and are relatively free of adverse effects. Glycosides, alkaloids, terpenoids, and flavonoids are among the few chemical compounds found in plants that are utilized to treat diabetic nephropathy. The purpose of this review was to consolidate information on the clinical and pharmacological evidence supporting the use of a variety of medicinal plants to treat diabetic nephropathy.

Over the last decade, the increase in the number of vehicles has affected traffic performance, causing traffic congestion. However, intersections, where different flows intersect, are among the primary causes of traffic congestion besides bottlenecks. Bottlenecking in the minor stream is mainly due to the extended queueing, specifically due to minimal gaps in the mainline stream as the intersection’s high priority exists with the major stream. This research aims to control connected and automated vehicles (CAVs) to help generate additional usable gaps for the minor road vehicles to enter the intersection without interrupting the mainline traffic flow. A probability function is developed to estimate the probability of CAVs creating additional usable gaps. The proposed logic is simulated in unsignalized and semi-actuated signalized intersections, and a field investigation is conducted. Simulation results show that the minor road delays and queue length are minimized without causing a significant delay to the mainline. Results show that major road interruptions are reduced at a semi-actuated signal control scenario when CAVs’ penetration increases. It can be observed that deploying CAVs in the road network with the proposed method can positively impact traffic efficiency, where the intersection’s performance and safety are improved.

Background: Trichohepatoenteric syndrome (THES) is a very rare disorder that is characterized by intractable congenital diarrhea, woolly hair, intrauterine growth restriction, facial dysmorphism, and short stature. Our knowledge of THES is limited due to the small number of reported cases. Methods: Thirty patients diagnosed with THES, all molecularly confirmed by whole exome sequencing (WES) to have biallelic variants in TTC37 or SKIV2L, were included in the study. Clinical, biochemical, and nutritional phenotypes and outcome data were collected from all participants. Results: The median age of THES patients was 3.7 years (0.9–23 years). Diarrhea and malnutrition were the most common clinical features (100%). Other common features included hair abnormalities (96%), skin hyperpigmentation (87%), facial dysmorphic abnormalities (73%), psychomotor retardation (57%), and hepatic abnormalities (30%). Twenty-five patients required parenteral nutrition (83%) with a mean duration of 13.34 months, and nearly half were eventually weaned off. Parenteral nutrition was associated with a poor prognosis. The vast majority of cases (89.6%) had biallelic variants in SKIV2L, with biallelic variants in TTC37 accounting for the remaining cases. A total of seven variants were identified in TTC37 (n = 3) and SKIV2L (n = 4). The underlying genotype influenced some phenotypic aspects, especially liver involvement, which was more common in TTC37-related THES. Conclusion: Our data helps define the natural history of THES and provide clinical management guidelines.

Study aim: The aim of the current study is to explore the effect of obesity on spatiotemporal parameters of gait in obese young female students.

Background: Because the emergency department (ED) is such an important element of health care, efficient usage must be taken into account while planning and creating the scope of service for emergency care. Our study's goal is to assess the participants' knowledge and attitude towards ED. Concerns among the general public over the use of emergency rooms (ER). Materials and Methods: A cross-sectional study was carried out among the sample of Saudi Arabia's population of Riyadh City in the year 2020. There were 440 people who responded. The information was gathered with a self-administered questionnaire. Statistical Package for Social Sciences (SPSS) version 23.0 was used to analyze the data. Results: As a result of the findings, 22 symptoms were reported as the cause of ER visits, ranging from acute, urgent, and cold symptoms. Of these, 45.7% of those polled said they visited an ER if they get sick, then seek primary care, online consultation, and community pharmacy, which was 28.2%, 17.5%, and 8.6%, respectively. Around 14.32% of the visitors had a chronic condition, with asthma accounting for 41.3%, diabetes for 23.8%, and hypertension for 11.1%. In terms of the frequency of visits, 66.4% said they visit the emergency care once in every 3–6 months, and 47.7% said they visit once in a month. With a mean score of 16.16 ± 3.02/high in knowledge, the results revealed that the participants possessed a high degree of knowledge, with a significant difference among married group (F = 4.83, P < 0.05 = 0.003), and those from 24 to 29 years of age (F = 3.26, P < 0.05 = 0.012). Conclusions: Because there were characteristics connected to population knowledge, limited hours, and ED overutilization without necessity, the findings of our study could be valuable in understanding the reasons for ED overutilization without necessity. In Riyadh's primary health care centers (PHCCs), there are limited medical resources. Thus, we recommend that the primary health care (PHC) admission process should be improved putting in place a triage mechanism that determines the best location for patient care that is suited.

Background Gestational diabetes mellitus (GDM) is a temporary form of diabetes induced by pregnancy and is potentially harmful to both the mother and fetus The impact of GDM diagnosis on pregnant women needs to be taken into account. This is related to the capacity for self-management of GDM, for which quality evidence is still lacking. Objective to identify several aspects of self-management and self- efficacy for women with GDM. Method Electronic databases were searched for studies related to the self-management, self-efficacy, and glycemic control of women with GDM, from January 2012 to January 2021. The extraction of study features was based on study location, reported research aims, study design, methodology, and the analytical approach, using Endnote Version X7.7.1. The Critical Appraisal Skills Program Qualitative Checklist (CASP) was used to assess quality, as recommended by the Cochrane Qualitative Research Methods Group. Results Ten out of 70 studies were identified as meeting the established criteria and including a diverse population. The synthesis revealed seven major themes: preliminary psychological impact, communicating the diagnosis, knowledge of GDM, self-efficacy and self-management of GDM, risk perception, the burden of GDM, and gaining control. The benefits of a diagnosis were behavioral and were mostly crystalized if a particular level of self-management and self-efficacy was reached and women were able to have specific control over their diet and body weight. On the other hand, women reported that the diagnosis increased their responsibility, as they had to take extra precautions regarding their dietary regimen. Conclusion Self-management and self-efficacy for GDM management are possible, despite the psychological hurdles that most women confront. There is still potential for improvement in terms of developing a healthy lifestyle that not only manages GDM for the best pregnancy result, but also prevents diabetes after pregnancy.

Keratoconus (KC) is an ectatic corneal disorder to frequently characterize by corneal thinning and severe visual impairment, and it continues to be one of the leading indications for corneal transplantation. The etiology is multi-factorial and pathological changes have been observed in the KC corneas. It is still unknown where the disease originates, but the changes in the corneal epithelium are considered to start even before a clinical sign appears. The present study, we investigated the potential role of basement membrane and hemidesmosomes damage whether they are participating a key role on pro-apoptotic protein elevations in the KC corneal epithelium. Samples of corneal epithelium from three KC and three normal subjects were used by Western blot, electron microscopy, immunohistochemistry and fluorescent staining. The histology and ultrastructural changes in the KC corneal sections were illustrated that arises the damage to the bowmen's layer, hemidesmosomes, and basement membrane broken. The basal cells of the corneal epithelium in KC exhibits squamous cells with absence of nuclei compared to the corneal epithelium of normal subjects. The expression of pro-apoptotic proteins Bax, phospho-p53, and cleaved caspase-3 were elevated significantly in the KC cornea when compared to normal corneal tissues extracts. Similarly, immunohistochemistry and triple antibodies staining (Bax, phosphor-p53, and cleaved caspase-3) of KC subjects were demonstrated an identical result as compared to the normal corneal sections. The Nile red/DAPI stain results correspondingly illustrated that KC corneas had less membrane lipid contents, and occurs a fewer progenitor cells than peripheral corneas in the normal subjects. Hence, the collective results indicate the colocalization of pro-apoptotic proteins transduced through basal epithelial cell damage and fragmented basement membrane, which is boost apoptotic induction in the KC corneal epithelium.

Yazed AlRuthia,1,2 Hawazin Alhazzani,1 Ghaida Alhindi,1 Maryam Alarfaj,1 Lama Almutairi,3 Miteb Alanazi,4 Khaulah Alokili,1 Nouf Alanazi,1 Faris Alodaibi,5 Monira Alwhaibi,1 Adel S Bashatah,6 Yousif Asiri,1 Hisham Alsanawi7 1Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 2Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 3Department of Pharmacy, King Abdulaziz University Hospital, Riyadh, Saudi Arabia; 4Department of Pharmacy, King Khalid University Hospital, Riyadh, Saudi Arabia; 5Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 6Department of Nursing Education and Administration, College of Nursing, King Saud University, Riyadh, Saudi Arabia; 7Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Yazed AlRuthiaDepartment of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaTel +996 114677483Fax +966 114677480Email yazeed@ksu.edu.saBackground: Musculoskeletal pain is one of the most complex and debilitating types of pain. Although different pharmacologic treatments are available, very few studies have explored the predictors for opioid analgesics prescription to manage this type of pain.Objective: The aim of this study was to explore the predictors for opioid prescription in patients with acute musculoskeletal pain in Saudi Arabia.Methods: This was a single-center, retrospective chart review of adult patients (≥ 18 yrs.) with an acute nociceptive musculoskeletal pain at a university-affiliated medical center in Riyadh, Saudi Arabia. Cancer patients and those with chronic neuropathic pain were excluded. Patients’ age, gender, number of comorbidities, duration of pain management, number of clinic visits for pain, and Numeric Pain Rating Scale (NPRS) scores at rest and with normal activities were collected. Multiple logistic regression was conducted to examine the relationship between the type of musculoskeletal pain and the prescription of opioid analgesics controlling for NPRS score on activity, age, gender, number of comorbidities, duration of pain treatment, and number of clinic visits for pain.Results: The mean age of the 227 patients, who met the inclusion criteria, was 39 years and 68% of them were male. Sixty-three percent of the patients were prescribed opioid analgesics, and 61% of them had shoulder pain, 29% had back pain, and 10% had lower extremity pain (eg, hip, thigh, lower leg, knee, ankle, and foot pain). Tramadol was the most commonly prescribed opioid analgesic (82%), followed by codeine (13%). Ninety-seven percent of patients who were prescribed non-opioid analgesics had shoulder pain. Patients with shoulder pain had lower odds of receiving opioid analgesics (OR=0.019, P< 0.0001, 95% CI=0.004– 0.081) in comparison to their counterparts who had lower extremity or back pains. Moreover, the higher the pain score on activity was, the higher odds of receiving opioid analgesics (OR=1.317, P< 0.0001, 95% CI=1.029– 1.685).Conclusion: Future studies should explore the impact of different opioid prescribing policies to improve the quality of patient care and reduce the unnecessary prescribing of opioids for patients with non-cancer musculoskeletal pain.Keywords: analgesics, opioid, musculoskeletal pain, shoulder pain, Saudi Arabia

Brugada syndrome is an inherited cardiac channelopathy arising from mutations in voltage-gated cardiac sodium channels. Idiopathic epilepsy portrays a coalescent underlying pathophysiological mechanism pertaining to the premature excitation of neuronal voltage-gated ion channels resulting in the disruption of presynaptic neurons and the unregulated release of excitatory neurotransmitters. The coexistence of epilepsy and Brugada syndrome may be explained by mutations in voltage-gated ion channels, which are coexpressed in cardiac and neural tissue. Moreover, the incidence of sudden unexpected death in epilepsy has been associated with malignant cardiac arrhythmias in the presence of mutations in voltage-gated ion channels. Lamotrigine is an antiepileptic drug that inhibits neuronal voltage-gated sodium channels, thus stabilizing neural impulse propagation and controlling seizure activity in the brain. However, lamotrigine has been shown to inhibit cardiac voltage-gated sodium channels resulting in a potential arrhythmogenic effect and the ability to unmask Brugada syndrome in genetically susceptible individuals. We are reporting a case of a 27-year-old male patient with a background of presumed idiopathic epilepsy who was initiated on lamotrigine therapy resulting in the unmasking of Brugada syndrome and the onset of syncopal episodes. This case provides further evidence for the arrhythmogenic capacity of lamotrigine and highlights the relationship between epilepsy and Brugada syndrome. In this report, we aim to review the current literature regarding the associations between epilepsy and Brugada syndrome and the impact of lamotrigine therapy on such patients.

BackgroundThe use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) in patients with type 2 diabetes mellitus (T2DM) remains limited, especially in those with other compelling indications. Thus, this study aimed to describe the prescribing patterns of GLP-1-RA and SGLT2i in patients with T2DM and to determine the factors that affect the prescribing of these medications.MethodsThis multicenter retrospective cross-sectional study reviewed the electronic health records of adult patients diagnosed with T2DM who received care between January and December 2020. The patients were classified according to their compelling indications into “patients who are more likely” to benefit from SGLT2i or GLP-1 RA and “patients who are less likely” to benefit from them. They were then further categorized depending on whether these medications were prescribed.ResultsA total of 1,220 patients were included; most were female (56.9%). SGLT2i or GLP-1 RA were preferably prescribed in only 19% of the patients for reasons including BMI ≥ 27 kg/m2 (85.6%), uncontrolled T2DM (68.5%), high risk for ASCVD (23.9%), or established ASCVD (14%). The remaining 81.0% were underprescribed these agents. Patients at an older age or with a history of stroke or transient ischemic attack had higher odds of being underprescribed (OR 1.02; 95% CI: 1.01–1.03 and OR 2.86; 95% CI: 1.33–6.15), respectively.ConclusionThe results concur with those of previous studies highlighting the underutilization of GLP-1 RA and SGLT2i in patients with T2DM but also with compelling indications. To optimize the use of GLP-1 RA and SGLT2i for their additional benefits, prescribers need to assess the benefits of using these agents in patients who would likely benefit from them, regardless of DM control.

Objective: Diabetes mellitus is a metabolic syndrome that alters the composition of carbohydrates, proteins and fat content in the body due to decreased insulin secretion. This disrupts the insulin-signaling cascade, resulting in failure in the targeted tissues, such as insulin-stimulated glucose absorption muscle and fat. Natural products such as plants, which are rich in nutrient, offer a wide range of treatments for a number of diseases and infections including diabetes mellitus. Hence, this study investigates the anti-hyperglycemic efficacy of the methanolic leaves extract of Jatropha gossypifolia in experimental diabetic rats. Methods: Phytochemical constitution of J. gossypifolia showed tannin content to be significantly increased in methanolic extract and HPLC analysis also revealed phenolic derivative tannic acid to be main constitution. An intraperitoneal administration of 110 mg/kg body weight (b.w) nicotinamide and 45 mg/kg b.w. streptozotocin was provided to male Wistar albino rats, thus inducing diabetic. Diabetic induced rats treated with methanolic leaves extract of J. gossypifolia at the concentration between 100 and 50 mg/kg for 35 days. Periodic blood glucose level and body weight were measured. Methanolic extract influence was evaluated with q-PCR and western blot analysis on the cellular targets of insulin signaling cascades. Results: The results showed the decrease in blood glucose levels and increased serum insulin level in treated groups was significant (P

Background Influenza vaccine hesitancy is a significant threat to global maneuvers for reducing the burden of seasonal and pandemic influenza. This study estimated the vaccine uptake, barriers, and willingness for influenza vaccines among university students in Saudi Arabia. Methods A cross-sectional survey was conducted among health science (HS) and non-health science (NHS) university students. A 31-item questionnaire was used to ascertain the vaccination rate, barriers, and willingness for the flu vaccine. Results This study included 790 students (mean age: 21.40 ± 1.94 years), 246 (31.1%) from HS and 544 (68.9%) from NHS disciplines. About 70% did not take flu shots before the arrival of the winter. The mean knowledge score was 7.81 ± 1.96, where 20.4%, 67.6%, and 12% of respondents had good, moderate, and poor knowledge regarding flu vaccines. The relative importance index (RII) analysis showed a lack of recommendation from physicians (51.5%, RI ranked: 1) was a top-ranked barrier to vaccine uptake, followed by negative perceptions and accessibility issues. Only 36.6% of the participants were willing to get vaccinated every year, 70% were willing to receive a vaccine on their doctor’s recommendations, and 46% agreed to vaccinate if vaccines were freely available in the university. The knowledge, barriers, and willingness widely varied across students from two disciplines. Conclusions Our analysis underscored low flu vaccine uptake among university students. In addition, the study participants’ knowledge was unsatisfactory, and they were less inclined to receive the flu vaccine in the future. Lack of recommendation from the physicians, negative perceptions towards the flu vaccine, and difficult accessibility were found as significant barriers to the vaccine uptake. A multidimensional approach at educational institutes to cover the knowledge gap and address the barriers curtailing the vaccination rate among students is recommended.

ObjectiveThis study was carried out with an aim to outline the prevalence of coronary artery diseases, its risk of one region of the Saudi Arabia.MethodsA retrospective observational study conducted across five secondary medical centers located in the city of Majmaah. Hospital medical records and ministry of health records were screened over a 6-month period for data on patients admitted for Coronary artery disease (CAD). Data collected included sociodemographic characteristics, medical profile, and laboratory findings.ResultsA total of 327 participants were included in this study with a median age of 64 and the majority being male participants (59.8%). The majority were married, held a primary school degree and earned a salary for living. A large number (82.9%) were hypertensive and diabetic (66.7%) and one-fourth had a previous MI (25.1%). A large number (73.7%) had heart failure with a mean ejection fraction of 44% (SD = 13). The causes of heart failure were mainly ischemic (56.3%) and hypertensive (28.1%). Readmission rates at 30 and 90 days then at 6 and 12 months were 22, 53.8, 68.8, and 75.8%, respectively. The mortality rates at the same time intervals were 5.5, 8.9, 14.1, and 22.9%, respectively. Predictors of readmission are age, CCI, and NYHA class.ConclusionCoronary artery disease is the leading cause of heart failure. End stage CAD can have similar results in terms of readmission and mortality as heart failure. Future research should target patients in different stages of the condition and monitor their comorbidities which may impact the study findings.

The current study explores the rhetoric and stylistic properties of the very first sentence that scholars generate in their research article introductions. The study draws upon a corpus of 502 sentences written in the fields of linguistics and translation, half of which are collected from national low-impact journals affiliated with Gulf universities in the Middle East while the other half are elicited from international high-impact journals. The study shows that half of the authors in high-impact journals as opposed to a quarter of the authors in low-impact journals provide citations to their very first sentence. These preferences are accounted for by the distinction drawn by Swales (1990) between centrality claims and topic generalizations under Move 1. Contra the predictions made by Create A Research Space Model proposed by Swales (1990, 2004), the results show that the authors of high-impact journals are more liberal in starting their introduction with a sentence of Move 2 or 3 type. In contrast, the authors of low-impact journals prefer to begin with a sentence of Move 1 type that is shorter in word count, more metaphorical, less academic as well as full of typos and grammatical errors.

Purpose. To assess the effect of wearing a face mask for a short time on the tear film parameters in normal eye subjects. Methods. Fifty-four normal eye subjects (14 female and 40 male) aged 18–40 years (23.8 ± 4.4 years) were recruited. A standardized patient evaluation of eye dryness was completed first, followed by noninvasive tear break-up time, phenol red thread, and tear ferning tests. A 5-minute gap was allowed between the tests. The subjects were asked to wear a surgical mask for one hour. The measurements were taken both before wearing a face mask and immediately after its removal. Results. Significant (Wilcoxon test) differences were found between the standardized patient evaluation of eye dryness (p=0.002) and the noninvasive tear break-up time scores (p0.05) were found between the phenol red thread scores and tear ferning grades before and after wearing face masks. Strong correlations (Spearman’s rank correlation coefficient, r) were found among the standardized patient evaluation of eye dryness score (r = 0.590; p

According to WHO reports, the emergence of antibiotic resistance together with limited discovery of newer and effective anticancer and antimicrobial chemotherapeutics remained of utmost concern to human health. In addition, the poor solubility, stability, and side effects that lead to inefficiency of current anticancer and antimicrobial therapy encouraged research into new strategies to combat such resilient disease. Various metal nanoparticles (MNPs) such as gold (Au), silver (Ag), and others synthesized from natural or chemical sources have displayed potential biological properties against a wide range of microbial infections caused by multi-drug resistant bacteria. Remarkably, gold nanoparticles (Au-NPs) have gained particular concern, due to their biocompatibility, ease of surface functionalization, and their optical properties. Several studies have been carried out to investigate the antibacterial potentials of Au-NPs and findings showed that these NPs triggers microbial and cancer cell damage as a result of oxidative stress, membrane and DNA damage. In this review, we present a concise description of a broad update on Au-NPs isolated from natural and chemical sources that render it application in biomedical research as therapeutic agents. The review focuses mainly on the anticancer and antimicrobial activities of Au-NPs in conjunction with microorganism being prompted by different biocompatible origin and its future prospects these infectious systems. Finally, we summarize new possibilities for Au-NPs-based biochemical systems as an effective medical nanotechnology based therapeutic.

Soil contamination with cobalt (Co) negatively impacts plant growth and production. To combat Co toxicity, plant growth-promoting microorganisms for improving plant growth are effectively applied. To this end, unclassified haloarchaeal species strain NRS_31 (OL912833), belonging to Haloferax genus, was isolated, identified for the first time, and applied to mitigate the Co phytotoxic effects on maize plants. This study found that high Co levels in soil lead to Co accumulation in maize leaves. Co accumulation in the leaves inhibited maize growth and photosynthetic efficiency, inducing oxidative damage in the tissue. Interestingly, pre-inoculation with haloarchaeal species significantly reduced Co uptake and mitigated the Co toxicity. Induced photosynthesis improved sugar metabolism, allocating more carbon to defend against Co stress. Concomitantly, the biosynthetic key enzymes involved in sucrose (sucrose-P-synthase and invertases) and proline (pyrroline-5- carboxylate synthetase (P5CS), pyrroline-5-carboxylate reductase (P5CR)) biosynthesis significantly increased to maintain plant osmotic potential. In addition to their osmoregulation potential, soluble sugars and proline can contribute to maintaining ROS hemostasis. Maize leaves managed their oxidative homeostasis by increasing the production of antioxidant metabolites (such as phenolics and tocopherols) and increasing the activity of ROS-scavenging enzymes (such as POX, CAT, SOD, and enzymes involved in the AsA/GSH cycle). Inside the plant tissue, to overcome heavy Co toxicity, maize plants increased the synthesis of heavy metal-binding ligands (metallothionein, phytochelatins) and the metal detoxifying enzymes (glutathione S transferase). Overall, the improved ROS homeostasis, osmoregulation, and Co detoxification systems were the basis underlying Co oxidative stress, mitigating haloarchaeal treatment's impact.

A key component of the design and operation of power transmission systems is the optimal power flow (OPF) problem. To solve this problem, several optimization algorithms have been developed. The primary objectives of the program are to minimize fuel costs, reduce emissions, improve voltage profiles, and reduce power losses. OPF is considered one of the most challenging optimization problems due to its nonconvexity and significant computational difficulty. Teaching–learning-based optimization (TLBO) is an optimization algorithm that can be used to solve engineering problems. Although the method has certain advantages, it does have one significant disadvantage: after several iterations, it becomes stuck in the local optimum. The purpose of this paper is to present a novel adaptive Gaussian TLBO (AGTLBO) that solves the problem and improves the performance of conventional TLBO. Validating the performance of the proposed algorithm is undertaken using test systems for IEEE standards 30-bus, 57-bus, and 118-bus. Twelve different scenarios have been tested to evaluate the algorithm. The results show that the proposed AGTLBO is evidently more efficient and effective when compared to other optimization algorithms published in the literature.

Gold nanoparticles (GNPs) are used in proton therapy radio-sensitizers to help increase the dose of radiation to targeted tumors by the emission of secondary electrons. Thus, this study aimed to investigate the link between secondary electron yields produced from a nanoshell of GNPs and dose absorption according to the distance from the center of the nanoparticles by using a Monte Carlo model. Microscopic evaluation was performed by modeling the interactions of secondary electrons in a phase-space file (PSF), where the number of emitted electrons was calculated within a spherical GNP of 15 nm along with the absorbed dose near it. Then, the Geant4-DNA physics list was used to facilitate the tracking of low-energy electrons down to an energy below 50 eV in water. The results show a remarkable change in the number of secondary electrons, which can be compared at concentrations less than and greater than 5 mg/mL, with increased secondary electron production exhibited around NPs within a distance of 10–100 nm from the surface of all nanospheres. It was found that there was a steep dose enhancement drop-off up to a factor of dose enhancement factor (DFE) ≤ 1 within a short distance of 100 nm from the surface of the GNPs, which revealed that the dose enhancement existed locally at nanometer distances from the GNPs. Overall, our results indicate that the physical interactions of protons with GNP clusters should not be considered as being directly responsible for the radio-sensitization effect, but should be regarded as playing a major role in NP properties and concentrations, which has a subsequent impact on local dose enhancement.

Background: Asthma is a chronic inflammatory disease characterized by reversible airway obstruction, hyperresponsiveness, and remodeling. Asthma prevalence has increased significantly globally over the last decade, and it remains incurable to this date. Aims and Objectives: The present study evaluated some of the antiasthmatic medicinal plants to assess their mode of action. Materials and Method: Animal models for milk-induced leukocytosis, milk-induced eosinophilia, mast cell degranulation, clonidine-induced catalepsy, and active paw anaphylaxis were used to assess the pharmacological effects of Ammi visnaga, Medicago sativa, and Urtica dioica. Results: Mice pretreated with diazepam, methanolic extract of M. sativa, and U. dioica exhibited significant (P < 0.05) inhibition in milk-induced leukocytosis. However, only M. sativa showed statistically significant (P < 0.05) results. All plants showed a statistically significant (P < 0.05) tendency to decrease milk-induced eosinophilia. Methanolic extracts of all plants significantly (P < 0.05) protected mast cells against degranulation by clonidine. A. visnaga and U. dioica significantly (P < 0.05) protected mice against clonidine-induced catalepsy. An acute treatment by M. sativa potentiated the catalepsy, while it significantly inhibited the catalepsy (P < 0.05) upon chronic treatment. In the allergic inflammation model, methanolic extracts of all plants under study decreased paw thickness in a statistically significant manner (P < 0.05). Conclusion: All the three plants in this study demonstrated anti-inflammatory and antihistaminic effects, as well as decreased paw thickness, validate anti-allergic properties. A. visnaga showed a mast cell-stabilizing effect. A. visnaga and U. dioica inhibited the histamine-mediated clonidine-induced catalepsy from mast cells which proves the antihistaminic activity of these plants.

The rapid increase in the usage of multimedia content and transmission over the internet demands data securing techniques. In this work, a data encryption technique using a three-dimensional chaotic map and highly nonlinear substitution boxes for the encryption of secret images, followed by a data hiding scheme based on Lah transformation i-e the secret image is first encrypted and then hide in the cover image. For data hiding, integer’s polynomial sequence is generated using addition and multiplication in coefficient form by evaluating pixels of images, secret bits of Lah transformed encrypted image are embedded in the LhTs coefficient of cover image partitioned into the cluster of four bits. To ensure minimum distortion coefficient adjustment is done before the embedding process. To obtain the stego image inverse Lah transformation is applied after the embedding process. The security analysis of the proposed dual layer data security scheme is performed, the result shows that the proposed system bearing strong immunity against various cryptographic attacks.

Cloud service selection and ranking are two different but related important tasks in the realm of cloud computing. Given the rapid growth in the number of available services offered by cloud providers with different quality of service, these tasks are becoming more and more challenging to be managed by the end customers. Furthermore, many services in the cloud are defined over a large set of attributes where the potential customer is interested on only a small subset of them. The other attributes are viewed as irrelevant to the customer selection and ranking strategies. In this work, we show how to employ conditional preferential dependencies in the domain of cloud service selection and ranking. In particular, we use Conditional Preference Networks (CP-nets) as a compact model to represent and reason with customer’s preferences and criteria interdependencies. We show how to select the best service and how to rank, in non-increasing order, a set of services given possibly incomplete information in the customer’s CP-net. Our experimental results prove the feasibility of CP-nets as a mechanism for selecting and ranking hundreds of services defined on hundreds of attributes with complex interdependencies.

In current years many chaos-based Substitution boxes (S-boxes) have been proposed. Recently, an image encryption technique based on multiple chaotic S-box was offered. This encryption method was based on the concept of confusion only produced by the implementation of the S-box. The concept of confusion utilized in the understudy technique can be smashed by using just one chosen-plaintext attack and a chosen-ciphertext attack. This article presents a detailed structure of two types of cryptographic attacks on the diffusion-based encryption scheme. The proposed attacks are successfully performed to retrieve the key with very little execution time by using just one chosen image which indicates the vulnerability of multiple chaotic S-boxes-based cryptosystems. The retrieved data is passed through some statistical analysis such as correlation, histogram, and entropy to check the correctness of recovered data.