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Heavy metal stress poses a significant threat to the productivity of agricultural systems and human health. Silicon (Si) is widely reported to be very effective against the different heavy metal stresses in crops. According to reports, it can help plants that are under cadmium (Cd) and nickel (Ni) stress. The presented work investigated how silicon interacted in Cd- and Ni-stressed wheat and mitigated metal toxicity. A pot experiment was carried out in which wheat crop was irrigated with Cd- and Ni-contaminated water. Application of Cd and Ni-contaminated water to wheat significantly reduced the root and shoot growth parameters and physiological and biochemical factors while increasing the antioxidant enzymatic activity and bioaccumulation of Cd and Ni metal in shoot and root as compared to the control. Application of Si led to an improvement in physiological parameters, i.e., greenness of leaves, i.e., SPAD values (17% and 26%), membrane stability (26% and 25%), and growth parameters i.e., root surface area (42% and 23%), root length (81% and 79%), root dry weight (456% and 190%), root volume (64% and 32%), shoot length (41% and 35%), shoot dry weight of shoot (111% and 117%), and overall grain weight (62% and 72%) under Cd and Ni stress, respectively. It increased the activity of antioxidant activity (max. up to 20%) whereas decreased the metal bioaccumulation of Cd and Ni in the roots and shoot (max. up to 62%) of wheat. It was concluded that the application of Si potentially increases antioxidant activity and metal chelation resulting in decreased oxidative damage and reducing the effect of Cd and Ni stress on wheat which improves growth and physiological parameters as well as inhibits Cd and Ni inclusion in food chain under Cd and Ni toxicity reducing health risks associated with these metals., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Without intervention, cardiac arrhythmias pose a risk of fatality. However, timely intervention can be challenging in environments where transporting a large, heavy defibrillator is impractical, or emergency surgery to implant cardiac stimulation devices is not feasible. Here, we introduce an injectable cardiac stimulator, a syringe loaded with a nanoparticle solution comprising a conductive polymer and a monomer that, upon injection, forms a conductive structure around the heart for cardiac stimulation. Following treatment, the electrode is cleared from the body, eliminating the need for surgical extraction. The mixture adheres to the beating heart in vivo without disrupting its normal rhythm. The electrofunctionalized injectable cardiac stimulator demonstrates a tissue-compatible Young's modulus of 21 kPa and a high conductivity of 55 S/cm. The injected electrode facilitates electrocardiogram measurements, regulates heartbeat in vivo, and rectifies arrhythmia. Conductive functionality is maintained for five consecutive days, and no toxicity is observed at the organism, organ, or cellular levels., (© 2024. The Author(s).)

Background: Problem-based learning (PBL) is a method of learning that has been adopted in different curricula of different disciplines for more than 30 years; the assessment of the students in PBL sessions in medical schools is fundamental to ensure students' attainment of the expected outcomes of conducting PBL sessions and in providing the students with the feedback that help them to develop and encourage their learning. This study investigated the inter-rater reliability of the tutor assessment in assessing medical students' performance in their PBL tutorial sessions., Materials and Methods: This study was conducted in the College of Medicine (COM), in the academic year 2021-2022. The study involved ten raters (tutors) of two genders who assessed 33 students in three separate PBL tutorial sessions. The PBL sessions were prerecorded and shown to the 10 raters for their assessment of PBL sessions., Results: This study showed that male raters gave higher scores to students compared with female raters. In addition, this investigation showed low inter-rater reliability and poor agreement among the raters in assessing students' performance in PBL tutorial sessions., Conclusion: This study suggests that PBL tutor assessment should be reviewed and evaluated; this should be performed with consideration of using assessment domains and criteria of performance. Thus, we recommend that 360-degree assessment including tutor, self, and peer assessment should be used to provide effective feedback to students in PBL tutorial sessions., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

The existing approaches on continual learning (CL) call for a lot of samples in their training processes. Such approaches are impractical for many real-world problems having limited samples because of the overfitting problem. This article proposes a few-shot CL approach, termed flat-to-wide approach (FLOWER), where a flat-to-wide learning process finding the flat-wide minima is proposed to address the catastrophic forgetting (CF) problem. The issue of data scarcity is overcome with a data augmentation approach making use of a ball-generator concept to restrict the sampling space into the smallest enclosing ball. Our numerical studies demonstrate the advantage of FLOWER achieving significantly improved performances over prior arts notably in the small base tasks. For further study, source codes of FLOWER, competitor algorithms, and experimental logs are shared publicly in https://github.com/anwarmaxsum/FLOWER.

Bangladesh is currently experiencing significant infrastructural development in road networking system through the construction or reconstruction of multiple roads and highways. Consequently, there is a rise in traffic intensity on roads and highways, along with a significant contamination of adjacent agricultural soils with heavy metals. The purpose of this study was to evaluate the ecological risk, health risk and the abundance of seven heavy metals (Cu, Mn, Pb, Cd, Cr, As, and Ni) in three distance gradients (0, 300, and 500 m) of agricultural soil along the Dhaka-Chattogram highway. The concentration of heavy metals was measured with an Atomic Absorption Spectrophotometer (AAS) on a total of 36 soil samples that were taken from 12 different sampling sites. Based on the findings, Cd had a high contamination factor for all distance gradients, whereas Cr had a moderate contamination factor in 67% of the study areas. According to the Pollution Load Index (PLI), Cd, Cr, and Pb were the predominant pollutants. Principal component analysis (PCA) result shows these metals mainly came from anthropogenic sources. The considerable positive correlations between Cu-Pb, Cu-Cd, Pb-Cd, and Cr-Ni all pointed to shared anthropogenic origins. As per Potential Ecological Risk Assessment (PERI) analysis, Pb, Cd, Cr, and Ni each contribute significantly and pose a moderate threat. The Target Hazard Quotient (THQ) values for all pathways of exposure to Pb and Cr in soils were more than 1, which would pose a significant risk to human health in the following order: THQ adult female  > THQ adult male  > THQ children . This study will help to evaluate the human health risk and develop a better understanding of the heavy metal abundance scenario in the agricultural fields adjacent to this highway., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The inflammation plays a role in the pathophysiology of type-2 diabetes progression, and the mechanism remains unclear. The systemic immune-inflammation index (SII) is a novel inflammatory marker for type 2 diabetes patients and integrates multiple indicators in complete blood counts and routine blood tests., Aim: Since there is no international diagnostic standard for dry eye disease (DED), this study uses low-cost inflammatory blood biomarkers to investigate the correlation between SII and DM2-DED and determine the diagnosis indices of other biomarkers in DM2-DED., Methodology: A case-control retrospective analysis of totel patients n  = 293 randomly selected and categorized into four groups: DED, DM2, DM2-DED, and healthy subjects. Demographic and blood biomarker variables were classified as categorical and continuous variables. The platelet-to-lymphocyte ratio (PLR), lymphocytes-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio (NLR), and SII were calculated platelet count multiply by NLR and analyzed for their correlation for all groups., Results: Focusing on DM2-DED patients was more common in females, 59.6%, than in males, 40.2%. The mean ages were 60.7 ± 11.85 years, a statistically significant difference with all groups. In the study group DM2-DED, there was an increase in all blood markers compared to all remaining groups except PLR. Only neutrophil, hemoglobin A1c (HbA1c), and fasting blood sugar levels were statistically significant differences in DM2-DED patients ( p  > 0.001, p  < 0.001, and p  < 0.001, respectively) compared to all groups. There was a positive correlation between HbA1c and PLR, HbA1c and NLR, and HbA1c and SII ( r  = 0.037, p  = 0.705; r  = 0.031, p  = 0.754; and r  = 0.066, p  < 0.501, respectively) in the DM2-DED group., Conclusion: This study demonstrated that elevated SII values were linked to elevated HbA1c in DM2-DED patients. The potential of SII and HbA1c as early diagnostic indicators for ocular problems associated with diabetes mellitus is highlighted by their favorable connection in diagnosing DM2-DED., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background: Palliative care teams provide support to patients and their caregivers during terminal illness, which requires interprofessional collaboration. One of the foundational skills is to assist patients with decision-making. This can be facilitated through interprofessional shared decision-making (IP-SDM). So far, IP-SDM education frameworks have only been used to a limited extent in the area of palliative care., Aim: This study aims to explore perceptions and practices of faculty members, health professionals, and students toward IP-SDM education in palliative care and to indicate associated factors to implement an IP-SDM in undergraduate health professions education in palliative care settings., Methods: We used a cross-sectional study design in which the data was obtained via an online self-administered questionnaire adapted from existing validated tools. The questionnaire was distributed to faculty members and health professionals (n = 125) and students (n = 334) at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The sampling technique was a non-probability convenience sampling. Bivariate statistics, such as independent sample t -tests, one-way ANOVA, correlation coefficient, and linear multiple regression were conducted., Findings: The response rate was 54% (85 faculty members and health professionals and 164 students). Perceptions on IP-SDM did not differ between participants. From those who had previous experience with IP-SDM, the mean practices score was slightly higher for faculty members and health professionals (M = 83.1, SD = 15.9) than for students (M = 74.1, SD = 11.5), which was significant (p < 0.05). Factors such as gender, age, discipline, nationality, level of education, years of study, and previous experience that were associated with perceptions and practices were varied among participants., Conclusion: The findings show high levels of perception with low levels of practice of IP-SDM in palliative care. Other factors that could be associated with the topic should be addressed in further studies., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Sultan et al.)

Background: Receiving a cancer diagnosis can be extremely stressful for patients, as it is a life-threatening disease. However, when this topic is discussed or researched, the psychological state of cancer patients is often ignored or forgotten. The study aimed to measure the levels of hopelessness and social support among cancer patients. It also aimed to assess the relationship between different demographic variables, hopelessness, and social support of these patients., Methods: The study followed a cross-sectional quantitative design. The setting included Princess Norah Oncology Center, at King Abdul-Aziz Medical City, Jeddah.   A convenience sampling technique including 300 cancer patients was followed. Data collection included a demographic questionnaire, the Beck Hopelessness Scale (BHS), and the Multidimensional Scale of Perceived Social Support (MSPSS).  Ethical principles of anonymity and confidentiality were followed., Results: The total number of respondents was 300, with 50% being male and 50% being female. The mean age of patients was 52.6±14.83 years. The most prevalent types of cancer were breast cancer (21.4%), colorectal (15.2%), and lymphoma (12.1%) respectively. Most of the patients were married (71.3%). The mean value of the BHS was 4.5, whereas the mean value of the MSPSS was 67.7. Moreover, the type of cancer showed a significant association between family support and total social support. In colorectal cancer patients, the total social support (71.2 ± 20.1) and family support (26.2 ± 5.0) provided was the highest followed by leukemia (70.3 ± 15.5 and 25.2 ± 5.1) and breast cancer (68.3-± 20.3. and 24.3 ± 6.8)., Conclusion: The findings of the present study suggest that the levels of hopelessness in cancer patients are moderate, and the levels of social support received by participants are high. In addition, the relationship between the levels of hopelessness and the levels of social support received is inversely proportional.

Soil contaminated with heavy metals cause serious threat to the soil quality, biota, and human. The removal or stabilization of heavy metals through plants is an environment friendly approach. The aim of study was to assess the potential of Celosia argentea L. for the phytoremediation of heavy metals contaminated soil. Soil was spiked with different levels (0, 100, 200, 300, and 400 mg/kg) of chromium (Cr), copper (Cu), lead (Pb), and Zn (Zn). Experiment was carried out in greenhouse and impact of heavy metals was evaluated on plant by assessing the germination rate and plant growth. To evaluate either plant has potential to extract/stabilize the heavy metals, concentration in roots and shoot, translocation factor (TF), bioconcentration factor (BCF), and bioaccumulation factor (BAF) were determined. Application of heavy metals significantly affected the germination rate and minimum (26.6%) was observed in Cr spiked soil (400 mg/kg). Moreover, the biomass of C. argentea was also affected by the application of heavy metals. However, the concentration of heavy metals in roots and shoots were low. The BCF and BAF of C. argentea was lower than 1 except at lower levels of Pb and Zn, but the TF was greater than 1. The TF showed that plants have capability to transfer heavy metals to shoots once they are taken up by roots. However, based on the BCF and concentrations of heavy metals in shoots, it is evident that plant could play important role in the phytostabilization of heavy metals polluted soil., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: As a result of the failure of embryogenic kidney formation, a condition can occur where not a single kidney appears and this phenomenon is known as unilateral renal agenesis (URA). Both aplastic and dysplastic kidney are different from renal agenesis, atrophy and renal hypoplasia. However, from this case report it can be seen that there are similarities, both radiologically and macroscopically, between cases of unilateral renal aplasia and renal agenesis., Case Presentation: A 2 year old Javanese boy came to the health facility with complaints of recurrent fever and urinary tract symptoms such as dysuria and straining. Computerized Tomography (CT) scan of the abdomen and urography showed agenesis of the left kidney and a probable spina bifida. Cystourethrography examination was done and showed grade 5 voiding, then retrograde pyelography was performed with the diagnosis of unilateral renal agenesis was made because there was no visible left side collecting system even though there was a duplication in the left ureter. The next examination was carried out by histopathology and immunohistochemistry after resection of the left side of the ureter and the diagnosis increasingly pointed towards renal aplasia after primitive renal structures were found., Conclusions: Renal agenesis and aplastic kidney are difficult to differentiate macroscopically and radiologically. Nevertheless, from this case report, we try to provide some interesting points to differentiate cases of unilateral renal agenesis from Renal Dysplasia which presents as unilateral renal aplasia., (© 2024. The Author(s).)

Infectious diseases are a part of everyday life, and acute respiratory diseases are the most common. Many agents carrying out respiratory infections are transmitted as bioaerosols through the air, usually, particulate matter containing living organisms. The purpose of the study is to conduct a systematic review and meta-analysis to assess the likelihood that people exposed to bioaerosols may experience severe respiratory diseases. Nine digital databases and bibliographies were assessed for papers conducted between January 1960 and April 2021. A total of 35 health and exposure studies were included from 825 studies for the systematic review, while only 17 contented the meta-inclusion analysis's criteria. This systematic review found higher bacterial bioaerosol concentrations in poultry farms, waste dumpsites, composting plants, and paper industries. The meta-analysis's Standard Mean Difference (SMD) measurement indicates a substantially positive association between bioaerosol exposure and respiratory disease outcomes in targeted populations. The value is 0.955 [95% CI, range 0.673-1.238; p < 0.001]. As per the Risk of Bias (ROB) findings, most of findings (30 out of 35 [85.71%]) were judged to have low ROB. From the random effect probit model, the total relative risk is 1.477 (95% CI, range 0.987-2.211), indicating a higher risk of respiratory diseases from bioaerosol exposure than the control groups. The total risk difference is 0.121 (95% CI, -0.0229 to 0.264), which means intervention groups may have a higher risk of respiratory diseases from continuous bioaerosol exposure than the control groups. The dose-response relationship revealed a strong positive linear coefficient correlation between bacterial & fungal bioaerosol exposure to respiratory health. Based on self-reported outcomes in those studies, The systematic review and meta-analysis stated that bioaerosol exposure had an effect on pulmonary health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Pesticides and fungicides are extremely useful to hinder the attacks of pests and fungi to secure crops, vegetables, fruits and other plants but due to their endocrine disrupting and carcinogenic risks in humans and animals through their continued addition in water resources they are extremely important to monitor carefully. In this investigation we synthesized silver nanoparticles (AgNPs) via the reducing action of sodium borohydride in the presence of secnidazole (SEC) as capping agent under various optimized parameters such as the concentration of NaBH 4 , silver nitrate (AgNO 3 ), SEC and pH. These SEC-AgNPs were characterized through various techniques including ultra-violet visible (UV-Vis) spectroscopy, Fourier transform infra-red (FTIR) spectroscopy, field emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), dynamic light scattering (DLS) and zeta-potential analysis (ZPA) in order to investigate their diverse properties. As prepared SEC-AgNPs were proved as extremely sensitive for trace level sensing of fungicide carbendazim (CARB) in the range of 0.5-22 µM with limit of detection (LOD) equal to 0.021 µM and R 2 value of 0.9964. SEC-AgNPs were tested for CARB sensing under the presence of several pesticides with negligible interference thus verifying its exclusive selectivity for the targeted analyte. This SEC-AgNPs was further applied to find out the concentration of CARB in real samples of tap water and human blood plasma with reference to standard addition method., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Diabetes mellitus, recognized by elevated glucose level in the body fluids is commonly caused by less insulin production or its action. To overcome the complications of diabetes, chemical drugs are never preferred over herbal medicines. Present study was designed to find out the anti-diabetic and health-promoting effects of ethanolic leaf extracts of Cucumis melo and Citrullus lanatus in induced-diabetic albino rats. Thirty male albino rats were bought from the animal house of the university and divided randomly into five feeding groups (n=6). Diabetes was induced in rats of groups A, B, C & D by a single dose of intra-peritoneal injection of streptozotocin (55 mg/Kg), whereas, the rats of group E were considered as control. The rats of groups A, B & C were fed basal diet supplemented with plant extracts (150mg/Kg body weight), whereas; only basal diet was offered to rats of groups D & E. After 28 days of the experiment, blood was collected for biochemical analysis. Results revealed that body weight, glucose, AST, ALB, GGT, HDL, cholesterol, triglyceride, urea and creatinine level differed significantly among treatment groups. It was therefore concluded that ethanolic leaf extracts of Cucumis melo and Citrullus lanatus can be used separately or in combination for the management of diabetes.

Background: 2020 Coronavirus disease 2019 (COVID-19) has become a global health crisis, so hand alcohol-based sanitizers have become essential to preventive measures. Previous studies reported that hand sanitizers could kill bacteria and viruses; however, using them excessively can lead to health problems if misused. In light of sanitizer overuse, the availability of various products and qualities in the market, and the absence of data on skin problems, we conducted a survey study about the impact of commonly used sanitizers on skin health, particularly on hands. The study aimed to determine the prevalence and the correlation between hand sanitizer and skin health during the COVID-19 pandemic at the National Guard Institute- Jeddah, Saudi Arabia., Methods: A cross-sectional study was conducted using a self-administered online questionnaire by sending an invitation link to students and employees of the National Guard Institute- Jeddah, Saudi Arabia, in 2021. A chi-squared test was used to obtain differences concerning awareness of hand sanitizer use/type and hand skin health., Results: In the total 216 participants, there were considerably more skin conditions reported by women (62.5%) and respondents ages 31-40 (36.6%). For the types of hand sanitizers, 89.8%, 40.9%, 30.2%, 4.7%, and 6% were recorded: gel, spray, wipes, foam, and others, respectively, and the survey applicants were filled by 60.6% of non-medical workers. According to the survey, 32.9% of participants experienced a hand crack, which was the most common hand side effect. The handwashing frequency was reported between 3 to 7 times per day during the COVID-19 pandemic, and 9.3% of participants used hand sanitizers more than 10 times daily., Conclusion: It was found that during the pandemic, skin changes were common among the NGHA population and healthcare workers. Consequently, the adverse health effects of these hand sanitizers on human health may result in multiple infections and toxicity. The present study provides appropriate knowledge on the types and ingredients of hand sanitizers as essential factors for skin health, preventing health risks during this pandemic., (© 2024 The Authors. Skin Research and Technology published by John Wiley & Sons Ltd.)

Permethrin is a pyrethroid pesticide and insect repellent that prevents mosquito-borne infections like dengue and malaria in tropical areas. This work describes a new colorimetric sensor based on metronidazole-stabilized silver nanoparticles (MTZ-AgNPs) for the first rapid, sensitive, and selective permethrin detection. The MTZ-AgNPs-based colorimetric sensor has a limit of detection (LOD) of 0.0104 µM and a limit of quantification (LOQ) of 0.0348 µM, respectively. The sensor is further integrated with smartphone and microfluidic fabrication of paper-based analytical devices (µPADs) for real-time and on-site detection of permethrin. Under optimal settings, no potential environmental contaminants interfere with permethrin detection, confirming its high selectivity. Finally, the practical applicability of sensors is confirmed in real tomato and apple extract samples. The US environmental protection agency's recommended UPLC method validated the detection efficiency of the proposed colorimetric sensor. The % recoveries from UPLC and MTZ-AgNPs suggest that the present sensor can quantitatively analyze permethrin in real samples., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Discrimination by some healthcare providers toward people living with HIV/AIDS has been documented. Differences in cultural backgrounds make it harder for future doctors, who need a lot of knowledge and a positive attitude to treat patients. In conservative countries like Saudi Arabia, not enough is known about how much medical interns know about HIV and how they feel about people living with HIV/AIDS., Methods: From April to September 2021, this cross-sectional study use non-probability random sampling and utilized a self-administered questionnaire to collected the data from 346 medical interns who had graduated from five different medical schools., Results: Most of the subjects correctly identified the main transmission routes, such as unprotected sex (94.57%), blood and body fluid exchange (94.19%), and sharing needles or syringes (91.47%). But they did not know what the most common co-infections were for HIV patients or how to protect themselves after exposure. This paper showed that medical interns have some stigmatizing behaviors toward patients living with HIV, as 31.1% and 22.9% agreed, respectively, that they would feel more sympathetic toward people who get AIDS from blood transfusions compared to IV drug users (IDU)., Conclusion: Medical interns also showed some positive attitudes, as more than half of the sample (56.2%) would not isolate beds for people living with HIV/AIDS. The study's conclusion is that HIV education and training programs should be added for medical interns, which might have a significant positive impact on their attitude., Competing Interests: The authors declare no conflicts of interest., (© 2023 Malli et al.)

Bioelectronics can potentially complement classical therapies in nonchronic treatments, such as immunotherapy and cancer. In addition to functionality, minimally invasive implantation methods and bioresorbable materials are central to nonchronic treatments. The latter avoids the need for surgical removal after disease relief. Self-organizing substrate-free organic electrodes meet these criteria and integrate seamlessly into dynamic biological systems in ways difficult for classical rigid solid-state electronics. Here we place bioresorbable electrodes with a brain-matched shear modulus-made from water-dispersed nanoparticles in the brain-in the targeted area using a capillary thinner than a human hair. Thereafter, we show that an optional auxiliary module grows dendrites from the installed conductive structure to seamlessly embed neurons and modify the electrode's volume properties. We demonstrate that these soft electrodes set off a controlled cellular response in the brain when relaying external stimuli and that the biocompatible materials show no tissue damage after bioresorption. These findings encourage further investigation of temporary organic bioelectronics for nonchronic treatments assembled in vivo., (© 2023. The Author(s).)

An accurate classification of upper limb movements using electroencephalogram (EEG) signals is gaining significant importance in recent years due to the prevalence of brain-computer interfaces. The upper limbs in the human body are crucial since different skeletal segments combine to make a range of motions that helps us in our trivial daily tasks. Decoding EEG-based upper limb movements can be of great help to people with spinal cord injury (SCI) or other neuro-muscular diseases such as amyotrophic lateral sclerosis (ALS), primary lateral sclerosis, and periodic paralysis. This can manifest in a loss of sensory and motor function, which could make a person reliant on others to provide care in day-to-day activities. We can detect and classify upper limb movement activities, whether they be executed or imagined using an EEG-based brain-computer interface (BCI). Toward this goal, we focus our attention on decoding movement execution (ME) of the upper limb in this study. For this purpose, we utilize a publicly available EEG dataset that contains EEG signal recordings from fifteen subjects acquired using a 61-channel EEG device. We propose a method to classify four ME classes for different subjects using spectrograms of the EEG data through pre-trained deep learning (DL) models. Our proposed method of using EEG spectrograms for the classification of ME has shown significant results, where the highest average classification accuracy (for four ME classes) obtained is 87.36%, with one subject achieving the best classification accuracy of 97.03%.Clinical relevance- This research shows that movement execution of upper limbs is classified with significant accuracy by employing a spectrogram of the EEG signals and a pre-trained deep learning model which is fine-tuned for the downstream task.

Background: Online medical education is critical for public health literacy and physician efficacy, but it must be trustworthy. Although it has the potential to be a useful resource for medical education, users must be able to identify reliable content., Objective: To assess the scientific quality of Arabic-language video content related to erectile dysfunction that is available on YouTube to learn what information our patients can handle online., Materials and Methods: A comprehensive search of the YouTube database was carried out to identify videos related to erectile dysfunction published in Arabic. The search was conducted using the following keywords: "Erectile dysfunction", "Sexual dysfunction" and "Impotence". Without a time, limit, the search was carried out until January 1, 2023. The quality assessment of the videos was done using the Kappa score., Results: The videos in our sample had up to one million views (average 2,627,485.6), and the kappa index was 0.86 (p <0.001). Of these videos, 16% were considered scientific evidence-based (SEB), and 84% were considered not scientific evidence-based (NSEB) (p <0.001). The NSEB group addressed details concerning natural remedies, the Psychosocial sphere, and lifestyle, whereas the SEB group tended to be more concerned with physiopathology, etiology, endothelial dysfunction, diagnosis, psychosocial treatment, oral treatment, injections, or prosthesis., Conclusion: On social media, misleading or incorrect information about erectile dysfunction is widely disseminated. This research may support urological and technical oversight and emphasizes guiding patients to the best men's health options., Competing Interests: The authors report no conflicts of interest in this work., (© 2023 Alzahrani et al.)

We report the functionalization and deplanarization of truxenes using pnictaalkene fragments. Selective introduction of one, two, or three Mes*-Pn fragments provides up to three fully reversible reductions based on the Pn=C fragments. The incorporation of the unsaturated heteroelement fragment as well as the contortion of the truxene core result in significantly red-shifted absorption spectra and interesting opto-electronic properties which are studied by electrochemistry and spectro-electrochemistry. Incorporation of arsaalkene (As=C) motifs gives significantly milder reduction potentials and red-shifted absorption, while phosphaalkene decorated truxene P3 can be functionalized using Au(I)Cl coordination. Furthermore, solubility is markedly increased upon incorporation of the Pn-Mes* fragments which renders these materials suitable for solution processing., (© 2023 The Authors. Chemistry - A European Journal published by Wiley-VCH GmbH.)

Background: Due to the 2019 Coronavirus disease (COVID-19) precaution, educational systems and learners' practices from all specialties have been negatively affected, especially university students. COVID-19 has a massive effect on the practice of allied health students. The students' hospital exposure has been severely affected by the cancelation of the clinical practice. This study aims to investigate the effect of COVID-19 pandemic on the clinical practice of respiratory therapy students in different universities around Jeddah, Saudi Arabia., Methods: Analytical cross-sectional online questionnaire was distributed from August 2021 to November 2021 to respiratory therapy students. The study's sampling technique was non-probability consecutive, and the calculated sample size was 183 participants. The survey contained questions to identify the clinical exposure of the participants. The participants included RT students in their clinical training years from King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz University, and Batterjee Medical College in Jeddah. The survey evaluated the effects of the pandemic on students' clinical practice, confidence and clinical preparation, and education., Results: A total of 187 respiratory therapy students completed the questionnaire. The results revealed that 145 (77.5%) of respiratory therapy students agreed that the pandemic had disrupted their clinical practice. The percentage of respiratory therapy students who felt that they were less confident and less prepared for the next academic year due to practical session cancellation was 141 (75.4%). Out of the total students, 135 (72.2%) students reported difficulty in connecting the clinical and theoretical part because of the pandemic., Conclusion: The majority of respiratory therapy students from the three universities similarly reported that the pandemic disrupted their practice and interfered with their ability to connect between clinical and theoretical part. Moreover, it had affected their confidence and preparedness for the next year., (© 2023. The Author(s).)

Background: Diffuse large B cell lymphoma (DLBCL) is the most commonly diagnosed subtype of non-Hodgkin's lymphoma (NHL). R-CHOP has significantly improved clinical outcomes in patients with DLBCL, however, its indication in the prevention of CNS relapse and recurrence is still inconsistent. Moreover, prophylactic methotrexate and/or cytarabine have been used prophylactically for DLBCL patients is at high risk of CNS relapse and to treat CNS DLBCL, however, their efficacy remains unclear., Methods: The aim of our retrospective study was to determine the incidence of CNS in-volvement in patients with DLBCL and to describe its risk factors and survival outcomes., Results: A total of 406 patients with DLBCL were identified, and 17 (4.2%) of DLBCL patients had CNS involvement i.e. 9 (2.2 %) at diagnosis and 8 (~2%) at relapse. The patients were younger, had advanced stage, high CNS-IPI, and had extra nodal involvement. Seven out of the 17 patients who survived received chemotherapy and a prophylactic methotrexate. Considering the CNS-IPI, of the 146 patients with high CNS-IPI at presentation, 18 received the prophylactic HDMTX and 3 (16.7%) of them had CNS relapse. Two (1.6%) out of 128 who did not receive the prophylactic HDMTX had CNS relapse. On the other hand, of the 223 patients with intermediate CNS-IPI, 25 received the prophylactic HDMTX and 2 (8%) of them had CNS relapse and in 198 patients who did not receive the prophylactic HDMTX, 2 (1.01%) had CNS relapse. The 5-year progression-free survival and overall survival rates for the entire cohort were 73% and 84%, respectively. The median OS for those who had CNS involvement was 17 months and the 2-year OS was 40%., Conclusion: CNS involvement in DLBCL has a poor prognosis, thus, aggressive CNS-directed therapy should be considered, especially in young patients.

Background: Self-emulsifying drug-delivery systems (SEDDSs) are designed to improve the oral bioavailability of poorly water-soluble drugs. This study aimed at formulating and characterization of SEDDS-based tablets for simvastatin using castor and olive oils as solvents and Tween 60 as surfactant., Methods: The liquids were adsorbed on microcrystalline cellulose, and all developed formulations were compressed using 10.5 mm shallow concave round punches., Results: The resulting tablets were evaluated for different quality-control parameters at pre- and postcompression levels. Simvastatin showed better solubility in a mixture of oils and Tween 60 (10:1). All the developed formulations showed lower self-emulsification time (˂200 seconds) and higher cloud point (˃60°C). They were free of physical defects and had drug content within the acceptable range (98.5%-101%). The crushing strength of all formulations was in the range of 58-96 N, and the results of the friability test were within the range of USP (≤1). Disintegration time was within the official limits (NMT 15 min), and complete drug release was achieved within 30 min., Conclusion: Using commonly available excipients and machinery, SEDDS-based tablets with better dissolution profile and bioavailability can be prepared by direct compression. These S-SEDDSs could be a better alternative to conventional tablets of simvastatin., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 Bashir et al.)

Background: Authentic leadership (AL) is an interesting topic in the organizational behavior literature that has attracted the attention of researchers since the last decade., Objectives: This research examines the employee-centered aspect among AL, trust, happiness at work and individual performance through a sequential mediating approach., Method: Data was collected from 435 healthcare professionals working in various hospitals in Pakistan. AL-independent variables were measured and the trust mediating variables were assessed through a questionnaire. The level of happiness at work and IP-dependent variables were measured through a survey., Results: The results revealed a significant and positive effect of AL on the individual performance that is connected both directly and indirectly through mediating effects of trust and happiness at work. Furthermore, the results showed that AL created a trustworthy atmosphere among the workers that enhanced employee's happiness at work and, subsequently, improved their job performance and motivation., Conclusion: This research delivers new and important results as, one the one hand, it depends on the sequential mediating effects of constructs whereas, on the other hand, it integrates four important variables in one model. Theoretical and practical implications along with future recommendations were presented for organizational management.

Introduction: Antibiotic resistance (ABR) is defined as bacteria's resistance to therapy despite therapeutic levels of antibiotics. It is a global health concern. Data on the antibiotic prescription practice of physicians, in general, are limited in Saudi Arabia. Therefore, we aim to assess the knowledge, attitude, and practice of antibiotic prescription between surgical and non-surgical residents at King Abdulaziz Medical City (KAMC)., Methods: A cross-sectional study was conducted at KAMC in Jeddah, Saudi Arabia, from September 2019, until March 2020. The questionnaire contained demographic information and 31 questions based on the studied variables: knowledge (17), attitude (4), and practice (10)., Results: The response rate was 83 %. Male to female response rates were 54 % and 46 %, respectively. The majority of respondents (72 %) were non-surgical residents. Positive practice skills showed that 55 % of all healthcare residents always used practice guidelines for antibiotic prescription in their daily work (P-value < 0.001). Most residents (50 %) sometimes used delayed prescriptions. Non-surgical residents discussed ABR with patients more than surgical residents (P-value = 0.028). Lack of patient interest was the common cause for not discussing ABR with patients (42 %). Non-surgical residents had significantly more training on antibiotic prescription (p-value = 0.001). The fear of infection spread due to not prescribing an antibiotic was significantly higher in non-surgical residents (P-value < 0.001). Non-surgical residents (76 %) took a past medical history of antibiotic consumption more than surgical residents (24 %) (P-value = 0.003). Antibiotic prescription for residents was not influenced by advertisements (91 %). The most common resistant organisms reported by residents were insignificant between the two groups. The results also showed that the residents' common choice of antibiotics was not statistically different between surgical and non-surgical residents in most antibiotic classes., Conclusions: We found that practice guidelines, formal training, and taking patients' past medical histories were significantly higher among non-surgical residents. In contrast, surgical residents were prescribing more antibiotics due to the fear of the spread of the infection. Proper training is essential for all healthcare residents to overcome differences among different specialties., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s).)

Background: Herbal medicines, derived from medicinal plants, are among the most popular alternative remedies around the globe. In Saudi Arabia, herbal medicines are extensively used by public as part of the culture as well as religious norms. Therefore, this study aimed to evaluate knowledge, attitudes, and practices regarding herbal medicines among the general population in Saudi Arabia., Methods: A descriptive cross-sectional survey study was conducted on the general population of Jeddah city with the help of a validated and self-administered questionnaire. Sample size was calculated to be 450 with subjects between 20 and 60 years of either gender. Descriptive and inferential statistical analysis was performed using SPSS., Results: Results of our data showed that 173 (42.2%) of the total participants used herbal medicines, however, significant association was found between female gender and the usage of herbal medicines (p < 0.001). Approximately, more than half (56.0%) of the respondents agreed that herbal medicines could be used to promote health and treat illnesses, and 45% respondents agreed that herbal medicines are safe. 153 (37.4%) of the participants opined that herbal medicines could be taken with conventional or allopathic medicine. The data also showed a significant (p < 0.05) association between knowledge about the source of herbal medicine and gender where females were found to have more knowledge compared to males. Moreover, a significantly higher number of chronic disease patients were using herbal medicines compared to individuals with no medical problems (p < 0.001). Strikingly, majority (n = 204; 49.9%) of the respondents used herbal medicines as a first choice when sick, while a good number (n = 172; 42.1%) of respondents did not consult doctors before taking herbal medicines., Conclusion: The use of herbal medicines is common among the general population of Jeddah. Although most of the participants believed that the herbal medicines are safe and do not require consultation, there is a dire need to increase awareness as well as to establish effective strategies to evaluate the safety, efficacy and quality of the herbal medicines for propitious consequences of this commonly used entity in the local society., (© 2022. The Author(s).)

Objective: Gliomas are immune system suppressive tumors, and the role of vitamin D is pivotal in the immune system. This study aimed to observe if there is any significant association between the serum levels of 25-hydroxyvitamin D with hematological indices and anthropometric measurements., Methods: A total of 75 glioma patients were included, and the information was collected on gender, age group, area, socioeconomic status, intake of vitamin D and calcium in food and supplements, skin color, sunlight exposure, body mass index, and muscle strength. A nonparametric Kendall's tau-b correlation test was performed to find a correlation between 25-hydroxyvitamin D levels and blood counts, body mass index, and muscle strength., Results: The majority of patients (72%) were having low lymphocytes followed by high granulocytes and high white blood cells. The majority were having low levels of both 25-hydroxyvitamin D (84%) and calcium (73%). Patients were mainly from urban areas, and the majority belonged to middle-class families having sedentary lifestyles. The majority of patients were not taking vitamin D supplements. An insufficient amount of sunlight exposure was found in most of them. The majority of the patients were although had normal weight but weak muscle strength (74.6%). An insignificant correlation was found between 25-hydroxyvitamin D levels with the hematological indices or anthropometric measurements in brain tumor patients., Conclusion: Vitamin D is a powerful immune modulator, and there is a great need for sufficient amounts of sunlight exposure and vitamin D-enriched diets to prevent cancer.

Obesity is an important risk factor for diabetes mellitus (DM) which is a major global health problem. Electro-mechanical dysfunction has been extensively described in diabetic heart and cardiovascular complications are an important cause of mortality and morbidity in diabetic patients., Objectives: To examine the effects of Isoprenaline (ISO) in obesity and diabesity on ventricular myocyte shortening and Ca 2+ transport in Zucker fatty (ZF), Zucker diabetic fatty (ZDF) in comparison to Zucker lean (ZL) rats., Methods: Myocyte shortening and intracellular Ca 2+ were investigated with video imaging and fluorescence photometry, respectively., Results: The amplitude of Isoprenaline stimulated shortening was significantly (p < 0.05) decreased in ZDF and ZF compared to ZL myocytes. The amplitude of Isoprenaline stimulated Ca 2+ transient was also significantly (p < 0.05) reduced in ZF compared to ZL and modestly reduced in ZDF compared to ZL myocytes. Mean Isoprenaline stimulated time to peak along with time to half relaxation of shortening were unchanged in ZDF and ZF compared to ZL myocytes. Mean Isoprenaline stimulated time to peak Ca 2+ transient was significantly shortened in ZF compared to ZL myocytes. Time to half decay of the Ca 2+ transient was considerably prolonged in ZDF compared to ZL myocytes. Amplitude of Isoprenaline stimulated caffeine-evoked Ca 2+ transients were significantly reduced in ZDF and ZF in comparison to ZL myocytes., Conclusion: Isoprenaline was less effective at generating an increase in the amplitude of shortening in ZDF and ZF in comparison to ZL myocytes and defects in Ca 2+ signaling, and in particular SR Ca 2+ transport, might partly underlie these abnormalities., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: In the Middle East, where most of the higher learning institutions still focus on the teacher-centred approach, implementation of this pedagogical model is an enormous task for educators. This study was designed to assess the role that the flipped classroom modality plays in the knowledge retention of medical students with a background in traditional methods of teaching and learning., Methods: This study employed a mixed study design among a sample of 3rd year medical students (n=193) in the neurosciences course block. The students were divided into two groups: experimental and control. A post-test, a questionnaire, and semi-structured interviews as research instruments were used to collect data in this study., Results: The results revealed a significant mean difference between the post-test scores in traditional (4.1±0.98) and flipped classroom (3.6±1.03) with a p-value=0.01, while no mean difference was found between male and female students (3.9±1.04, 3.9±1.02, p-value=0.77). The students appreciated the flipped classroom modality that helped with information sharing, interaction with peers and learning from others' experiences. Correspondingly, the four main characteristics of flipped classroom emerged from the thematic analysis: (1) positive perceptions of the flipped classroom, (2) challenges of the flipped classroom, (3) the effects of personal characteristics, and (4) lack of administration support., Conclusion: The performance of students was better in the traditional class than in the flipped classroom, particularly in the cognitive areas that deal with the interpretation and application of knowledge. The students taking responsibility for their own learning in this new modality and the short duration of the study might have had some influence on the study results. Future in-depth studies are recommended.

In light of the outbreak caused by the COVID-19 and its impact on the physical and mental wellbeing, we explored the consequences of this pandemic on the mental health among pre-professional health sciences students and their awareness regarding the virus. A descriptive observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah and Riyadh campuses. Data was collected from 770 participants using an online questionnaire, and statistical analysis was performed using SPSS. The majority of the participants (87.5%) considered governmental authorities as their main source of information, and therefore, they were up to date on the general information regarding COVID-19. For findings on mental health, it was found that 61.9% were exhibiting variant degrees of depression, as well as 50% expressing signs of extremely severe anxiety. However, 50.9% of the participants expressed no signs of stress during this pandemic. An association was found between gender and mental health showing females to have higher tendencies to express signs of extremely severe depression, anxiety, and stress. An association was also found between parents' marital status and anxiety. Analysis revealed that participants with separated parents were the least among the participants to show no signs of anxiety, as well as reporting the highest numbers in the "extremely severe" anxiety category. With the increased awareness and higher than normal levels of the investigated mental illnesses, we advise that proper action should be considered to address this issue., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

There has been an increasing demand for psychiatric care in recent decades, and "telepsychiatry" was developed to meet these demands. It is a type of telemedicine in which they provide many medical services virtually, such as therapy, counseling, and medication management. Telepsychiatry has numerous advantages, including lower costs, reduced stigma, and improved continuity of care. To the best of our knowledge, no previous studies in the western region of Saudi Arabia addressed patients satisfaction with telepsychiatry. This cross-sectional study aims to assess patient satisfaction in telepsychiatry in terms of accessibility and timeliness, appropriateness, effectiveness, and safety, and to see whether patient satisfaction affects their decision to use the service again in the future. A cross-sectional study was conducted using a prestructured survey on the basis of the Client Satisfaction Questionnaire-18, which is a validated questionnaire used to assess patients' satisfaction with the services provided to them. From January 2021 to July 2021, all male and female psychiatric patients over the age of 18 years who had psychiatric virtual appointments were included in this study. This study included 182 patients, of whom 106 were female. Patients were generally satisfied with the telepsychiatry services; 56.6%, 81.9%, 86.8%, and 91.2% of the participants were satisfied with the access and timeliness, appropriateness, effectiveness, and safety, respectively, and a total of 58.3% either strongly agree or agree of the overall satisfaction level. Depression and anxiety disorders were the most common psychiatric diseases. The statistical analysis revealed no significant relationships between patients' satisfaction and demographic characteristics. Telepsychiatry has been evaluated to meet the growing demand for psychiatric care; it also has significant advantages. Patients had an overall positive satisfaction level toward telepsychiatry service, and so the results of this study support the continuity of using telepsychiatry in the future. Further research area could include a comparison between patients' and providers' satisfaction levels with telepsychiatry., Competing Interests: All authors have no conflicts of interest to declare. The authors have no funding and conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Introduction: Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, there have been some reports regarding the impact of COVID-19 on male psychosexual health. Aims and Objectives: To assess the severity of stress during COVID-19 and to determine the association of stress levels with partner relationships and sexual activity. Methodology: A cross-sectional study was conducted in Saudi Arabia through social media platforms via an online questionnaire between 1 December 2020 and 31 January 2021 among 871 participants after a pilot study among 20 participants, of which 497 were included in the study. Stress levels were assessed using the Arabic version of the Depression, Anxiety, and Stress Scale (DASS-21). Statistical analysis was conducted using SPSS version 20.0. Responses were presented as frequencies and percentages, and associations were studied using the Chi-squared test/Fisher’s exact test. A value of p ≤ 0.05 was considered significant. Results: A total of 497 participants who had been infected with COVID-19 completed the survey. In total, it was found that 203 (40.8%) had severe stress scores (severe and extremely severe scores merged), while 131 (26.4%) had moderate stress scores. About 84 (16.9%) participants agreed that their sexual desire decreased, 91 (18.1%) confirmed their sexual intercourse frequency decreased, and sexual satisfaction decreased in 76 (15.3%). A significant positive correlation was found in that those who disagreed with having a good sexual relationship tended to have severe stress (p < 0.001). Conclusion: There were increased levels of stress during the lockdown period, which impacted psychosexual health.

Purpose: This study aimed to assess the burnout among faculty members of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, during the COVID-19 pandemic and investigate their adaptations to online teaching., Patients and Methods: The study utilized a survey research design, and a validated questionnaire was e-mailed to faculty members. The Maslach Burnout Inventory - Educators Survey was used to assess burnout in three domains (emotional exhaustion, depersonalization, and personal accomplishment), in addition to their adaptations to online teaching., Results: A total of 112 faculty members completed the survey with a response rate of 25%. Females comprised 50.9% of the sample. Burnout assessment among faculty showed moderate emotional exhaustion and personal accomplishment. In contrast, the level of depersonalization was low. When assessing the impact of the shift to online education during the pandemic, 87.5% of the respondents reported increased confidence in online teaching and learning effectiveness., Conclusion: Faculty members at KSAU-HS reported moderate emotional exhaustion. Fortunately, this had a moderate impact on students' intellectual development and well-being. Most of the faculty feedback supported online teaching during the pandemic., Competing Interests: The authors report no conflicts of interest in this work., (© 2022 Turkistani et al.)

The participation of numerous physicochemical and biological functions maintains the evolution and expansion of the remarkable nature. Due to its vast applicability in several engineering disciplines, naturally occurring bio-mineralization or microbially induced calcium carbonate (MICP) precipitation is attracting more interest. Cave bacteria contribute to the precipitation of calcium carbonate (CaCO 3 ). In the present study, soil sediments were collected from Kashmir cave, KPK, Pakistan, and plated on B4 specific nutrients limited medium for bacterial isolation and the viable bacterial count was calculated. Three bacterial strains named GSN-11, TFSN-14, and TFSN-15 were capable of precipitating CaCO 3 . These bacterial isolates were identified through 16S rRNA gene sequencing and strain GSN-11 was identified as Bacillus toyonensis, TFSN-14 as Paracoccus limosus and TFSN-15 as Brevundimonas diminuta. Enhanced CaCO 3 precipitation potential of these bacteria strains was observed at 25°C and pH 5. The precipitated CaCO 3 was confirmed by scanning electron microscopy, X-ray powder diffraction, and Fourier transform infra-red spectroscopy. The findings showed that the precipitates were dominated by calcite, aragonite, and nanosize vaterite. Current research suggests that precipitation of CaCO 3 by proteolytic cave bacteria is widespread in Kashmir cave and these bacterial communities can actively contribute to the formation of CaCO 3 by enhancing the pH of the microenvironment. RESEARCH HIGHLIGHTS: Kashmir cave inhabit potentially active bacteria in terms of biogeochemical processes. Cave bacteria significantly precipitated CaCO 3 . Calcite, aragonite, and nanosize vaterite were dominant in precipitates., (© 2022 Wiley Periodicals LLC.)

Over the last few years, the number of Rohingya refugees in Bangladesh has increased exponentially. On arrival, they experience poor mental health and psychological well-being. This commentary explores the risk factors and contemporary challenges that deteriorate Rohingyas' psychological well-being in Bangladesh. The onslaught of Covid-19 compounds the pre-existing psychological health conditions of the Rohingyas living in cramped and flimsy camps. The recent relocation to Bhashan Char may likely trigger tensions and eventually exacerbates their existing psychological well-being. The relocation to Bhashan Char has presumably happened against their volition. Meanwhile, the Myanmar military's coup has added additional fear about their bleak future of a safe and dignified return from Bangladesh to Myanmar. All these have contributed to the worsening of their existing psychological well-being. In order to subside their psychological health challenges, this commentary suggests: (a) the immediate execution of 'National Deployment and Vaccination Plan for Covid-19 Vaccines and initiation of vaccine rollout among the refugees; and (b) involving Rohingyas in economic activities and making them a self-reliant and economically empowered community. We suggest that safe and dignified repatriation is the only solution to the challenges they have been going through in Bangladesh and to preserve their psychological well-being., (© 2022 John Wiley & Sons Ltd.)

The addition of palbociclib (a cyclin-dependent kinase 4/6 inhibitor) to endocrine therapy (ET) has been shown to significantly improve progression-free survival (PFS) and overall survival (OS) among patients with hormone receptor-positive (HR + ) advanced breast cancer. The current study presents the local experience of using palbociclib at two cancer centers in Saudi Arabia. Electronic data of patients with metastatic HR + and human epidermal growth factor receptor 2-negative breast cancer who progressed after prior ET and received at least one cycle of palbociclib plus ET, were retrospectively reviewed. A total of 97 patients were identified, and their data were included in the analysis. The median age of the patients was 55 years. Patients were heavily pretreated in the metastatic setting (55% received systemic chemotherapy and 49% received two or more lines of prior ET). In total, 29 (30%) and 50 (52%) patients achieved an objective response and clinical benefit, respectively. The median follow-up time was 31.0 months [95% confidence interval (CI), 16.9-44.9] and the median PFS time was 16.3 months (95% CI, 11.4-21.2), with 58% of patients remaining progression-free at 12 months. Upon multivariate regression analysis, liver involvement was the only significant independent variable that predicted a greater risk of progression or death (hazard ratio, 2.32; 95% CI, 1.22-4.40; P=0.010). The median OS time was 19.6 months (95% CI, 18.1-20.9), with 12- and 24-month OS rates of 75 and 30%, respectively. Overall, real-world data showed that administration of palbociclib in combination with ET in patients with advanced HR + breast cancer achieved a favorable outcome that was comparable to that reported in clinical trials., Competing Interests: The authors declare that they have no competing interests., (Copyright: © Al-Foheidi et al.)

Background: Human papillomavirus (HPV) infection is the major risk factor for cervical cancer (CC) in women of reproductive age. Despite advances in treatment and prevention of CC by HPV vaccination, very few women utilize them because of a lack of awareness about HPV., Materials and Methods: We conducted this cross-sectional study among Health Professions Students (HPS) at King Saud Bin Abdul Aziz University for Health Sciences, Jeddah. Data were collected using a predesigned and validated study questionnaire to assess the knowledge, attitude, and perception of HPS toward HPV., Results: A total of 580 HPS responded to the survey; 128 (22.1%) were male, while 452 (77.9%) were female with the mean age ± standard deviation 20.36 ± 1.74 years. There was no significant difference between males and females related to screening of HPV and CC (82.8%; 82.3%). A minority (30.3%) of participants thought that HPV infection leads to CC, while 38.3% did not know about it. Furthermore, knowledge about HPV screening and vaccination was poor., Conclusions: Students from the college of medicine had more knowledge and awareness about HPV (34.9%, P < 0.001). Thus, it is important to implement effective education programs, curricular activities, and awareness campaigns for health professions to augment the learning process effectively., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Education and Health Promotion.)

The study was planned to evaluate the inter, and intra population genetic variation in general protein banding pattern in Oestrus ovis larvae, by using 10% sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE). The larvae were collected from slaughtered goats head from five different locations (AAS, PN, LA, GM, and BC) of Karachi, Pakistan. The data obtained was subjected to POPGENE (Population Genetic Analysis) software for analysis. The polymorphic loci within populations ranged from 45.45% to 90.91%. Polymorphic loci observed in all populations were 90.91%. The expected heterozygosity observed was 0.182 ± 0.096 in all populations. The chi-square test showed 5 out of 11 loci at H-W equilibrium. The overall fixation index (FST) value was 0.108, showing that the likelihood of subpopulations being differentiated from one another is about 11 percent. The gene flow value (Nm = 2.065) was higher, showing that genes flow occurs between populations. The values of genetic identity were greater, and genetic distance were smaller among all the populations, which means that all the populations were more alike and closer to each other. It was concluded that there was no sympatric and parapatric population differentiation observed among all the population of O. ovis and the populations of the five different locations were not genetically and reproductively isolated from each other., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Introduction: Approximately 9.2 million refugees live in Asia, with most originating from Afghanistan and Myanmar, and half of them are women, girls, and children. Humanitarian crises disrupt the existing health-care system, limiting access to sexual and reproductive health (SRH) services. This review explores the SRH status of Afghan and Rohingya refugee women of reproductive age in Asia and their needs and experiences in accessing these services and commodities., Materials and Methods: We used the PRISMA checklist and searched for qualitative and quantitative peer-reviewed studies from five online bibliographic databases, SCOPUS, EMBASE (Ovid), MEDLINE (Ovid), CINAHL, and PROQUEST, from January 2000 to April 2021. Content analysis was undertaken following the minimum initial service package objectives., Results: Fifteen studies were included in this review from four countries: Bangladesh (5), Pakistan (5), Iran (4), and Malaysia (1). Approximately 50.91% of Rohingya and 54% of Afghan refugee women used contraceptives. About 56.6% of Afghan refugee mothers experienced pregnancy-related complications, one-third received antenatal care, and low birth weight was 2.6 times higher among infants born to Afghan refugee mothers than to Pakistani-born mothers. One out of five Rohingya women received delivery-related care. Approximately 72% of Rohingya and 79.8% of Afghan refugee women had experienced gender-based violence, and 56.5% of Rohingya women engaged in unwanted sexual intercourse with their husbands., Conclusion: Social norms, stigma, cultural values, distrust of providers, inadequate staff, and prohibition by family members limit their access to SRH services and influence their needs, knowledge, and perceptions regarding SRH., Competing Interests: None

A comprehensive understanding of the quality of life (QoL) is essential to establish long-term survivor care plans. The present study was aimed at the assessment of QoL of BC survivors with special emphasis on post-treatment physical, emotional, social, and spiritual challenges. We have assessed the QoL of 250 female BC survivors of all age groups through demographic factors. Volunteer BC survivors were registered in the present study who had got treatment from the Institute of Nuclear Medicine and Oncology (INMOL) hospital and Mayo hospital Lahore. An informed consent form was signed by each participant. The physical, psychological, and spiritual well-being was evaluated by a questionnaire filled with the help of respondents. The average age of BC survivors was 52 ± 7.8 years. Most of them (83%) complained of fatigue during daily life activities, 75.1% body pain or headache, 77.1% had problems with appetite, 63.2% reported weight loss, 77.1% had sleep problems, and 90.5% were feeling general weakness. Only 16.2% were satisfied with their physical health and 2% were not satisfied with their medication. Psychologically, 74.4% were feeling different levels of anxiety, only 10% of them were hoping to achieve a desired life. Age group 21 to 40 years reported better physical health, those with 40-50 years of age and family history of BC have shown better mental strength. The physical and psychological health of survivors from rural areas was comparatively better than those from urban areas. The BC survivor women have to face several physical, psychological and social challenges. The majorities of them complain of anxiety, body pain, fatigue, sleep problems, general weakness, and fear about the future. Our findings suggest the need for psychological support, physical activity a comprehensive post-diagnosis and post-treatment physical and mental health assistance plan for all BC survivors. Implications for Cancer Survivors. Survivors of breast cancer experience various challenges including anxiety, sleep problems, body pain, fatigue, and fear about the future. The psychological, physical and social factors make a great difference in their quality of life., (© 2021. The Author(s).)

Highly stable, small-sized and evenly distributed solid mercury nanoparticles capped with ibuprofen (Ibu-HgNPs) were prepared via reduction with hydrazine and capped with ibuprofen as a stabilizing agent. Characterization of Ibu-HgNPs was carried out by UV-Vis spectrophotometry and transmission electron microscopy (TEM). The prepared Ibu-HgNPs were immobilized onto a glassy carbon electrode (GCE) and used for the first time as the sensing element for voltammetric determination of low concentrations of acrylamide (AA) in aqueous solutions. Various parameters such as the type of supporting electrolyte, voltammetric mode, frequency, deposition time, stirring rate and initial potential were optimized to obtain the highest peak current of AA. The sensor delivered the best results in combination with the square wave voltammetry (SWV) mode, with good repeatability (relative standard deviation (RSD) of 25 repetitions was 1.4% for 1000 ppb AA). The study further revealed that Ibu-HgNPs are strongly adhered to GCE and hence do not contaminate the environment even after several runs. The newly developed AA sensor provides linear calibration dependence in the range of 100-1300 ppb with an R 2 value of 0.996 and limit of detection (LOD) of 8.5 ppb. Negligible interference was confirmed from several organic compounds, cations and anions. The developed sensor was successfully applied for AA determination in various types of environmental real water samples to prove its practical usefulness and applicability.

Mange mites represent a serious problem in livestock farming due to their worse effect on animals health, reducing milk and meat production. The status of mange mites prevalence was unknown from the livestock present in Malakand Division, Pakistan. Hence, the present study was conducted to determine the prevalence and risk factors assessment of mange mites in livestock of Malakand Division, Pakistan. Villages and livestock herds were visited for data collection and sampling for one year from September 2017 to August 2018. The diagnosis of mange infestation was carried out from skin scrapings collected from symptomatic animals. A total of 1437 animals were screened (240 sheep, 658 cows, 340 buffalos, 199 goats) from selected localities of the Malakand Division. The overall prevalence was 2.37%, with the highest prevalence in buffalos (5.0%) and lowest (0.42%) in sheep (p < 0.05). The locality also significantly affect the prevalence of mange mites in livestock, with a higher percentage (8.14%) in the Ouch area. The prevalence was higher in winter (3.78%) than in summer (1.07%). The prevalence was high (p < 0.05) in young animals (≤1 year) (4.7%) as compared to adults (>1 year) (1.15%). Gender was also a significant risk factor for mange infestation. The infestation was higher in females (2.85%) as compared to males (0.64%) (p < 0.05). Herd size of less than ten animals had a significantly high prevalence rate (3.69%) compared to >10 animals (1.89%). Animals having an infection history >15 days infected more than animals having infection history ≤15 days. This study documented for the first-time epidemiology of mange mites in livestock of Malakand Division, Pakistan. Further studies involving molecular characterization of mange mites will increase our understanding on the spread of mange mites in Malakand Division livestock., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Introduction: Spinal intramedullary dermoid is very rare, accounting for <1% of intraspinal tumors. It can be congenital or acquired. They usually present in 2nd or 3rd decade of life in adults. It may or may not associated with spinal dysraphism. It is asymptomatic in most cases, manifest acutely if it ruptures. Long segment involvement of spinal intramedullary tumor in adult without the history of trauma makes this case unique. Fat suppression imaging helps to distinguish adipose tissue from lesions causing hematomyelia in patients presented with intramedullary hyperintensity in both T1 & T2 sequences of MRI spine., Case Presentation: We report here a rare case of 30 years old male who presented to us with sudden urinary retention followed by rapidly progressive quadriparesis and paresthesia in his right arm. In MRI, spinal intramedullary tumor was noted from medulla till D5 vertebra. We performed subtotal excision of tumor and sample sent for histopathology which proved it to be intramedullary spinal dermoid cyst., Conclusion: Long segment involvement of spinal intramedullary dermoid cyst in adult without history of trauma makes this case different. Fat suppression imaging must be done in patients with intramedullary hyperintensity in both T1 and T2 sequences of MRI spine. Early diagnosis and appropriate management will be helpful in reducing morbidity., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: In recent years, consumption of E-cigarettes has increased dramatically. Several studies have focused on the prevalence of E-cigarettes among specific groups of people, using it as a substitute to traditional cigarettes, or the participant knowledge regarding risks. This research was aimed on E-cigarettes' prevalence and its association to several factors in the general population of Western Saudi Arabia., Design and Methods: Using an observational cross-sectional study, data were collected from (n=465) above 18 years old smokers during the survey at public attractions. A validated self-administered questionnaire acquired from previous studies was employed to insure the suitability for the general population of Jeddah Saudi Arabia. Sample size was calculated via Raosoft@ and adults of either gender were included in the study. Descriptive or inferential statistical analysis was performed using SPSS., Results: The preponderance of e-cigarette smokers used entertainment as the reason for smoking, with an average of (33.9%). Although one reason for e-cigarette consumption was to cease traditional smoking, results showed an average of (49.4%), which is the majority of those who attempted to cease traditional smoking via e-cigarette, did not succeed in quitting traditional smoking. This study also demonstrated that participant that believed that e-cigarette is beneficial had a higher chance to cease conventional smoking than who did not (32.1% versus 14.6%) which is significant (p<0.001)., Conclusions: In conclusion, this study estimated the prevalence of e-cigarette consumption among the population of Jeddah, Saudi Arabia along with assessment of elements which help increase the overall e-cigarette consumption in Jeddah.

Pakistan, an agricultural country, raises 146.5 million commercial and domestic poultry birds, which generate around 544,831 tons of waste per year. This waste finds its final disposal in agricultural land as soil fertilizer or disposal site amendment. The usage of poultry litter for this purpose is uncontrolled, which results in environmental degradation such as emission of greenhouse gases, e.g., methane. However, alternative options such as thermochemical conversion of poultry litter can offer better solutions where this waste can be used as a low-cost carbon source for the synthesis of Multiwalled Carbon Nanotubes (MWCNTs). In this study, efforts were made to utilize this cheap and plentiful carbon source for the synthesis of CNTs in the presence of Ni/Mo/MgO as a catalyst, through pyrolysis. For a better yield of carbon product, the optimum ratio for the catalysts (Ni/Mo/MgO) was found to be 4:0.2:1. Furthermore, the process parameters were also optimized for better carbon yield. A good yield of CNTs resulted from a pyrolysis time of 12 min, a temperature of 825 °C, and a catalyst weight of 100 mg. The structure and morphology of the produced nanotubes were confirmed through X-ray Diffractometer (X-RD) and Scanning Electron Microscopy (SEM). The environmental application of the nanotubes was tested in a synthetic chromium solution in the lab using a batch experiment. Different experimental conditions (pH, adsorbent dosage, and contact time) were optimized to improve the adsorption of Cr (VI) by carbon nanotubes and a UV-Visible spectrophotometer was used at 540 nm to measure the absorbance of Cr (VI). The results showed that up to 81.83% of Cr (VI) removal was achieved by using 8 mg of CNTs at pH 3 with 400 rpm at 180 min of contact time. Thus, it was concluded that poultry litter can be a useful source for the synthesis of MWCNTs and thereby removal of Cr (VI) from industrial tanneries' wastewater.

Background & Objective: Persistent pulmonary hypertension of the newborn (PPHN) is described as severe respiratory failure along with hypoxaemia. PPHN is known to be linked with high morbidity and mortality around the world. This study was planned to determine the postnatal causes and assess the severity of persistent pulmonary hypertension of newborn in babies presenting to the Children's Hospital, Multan., Methods: This observational study was conducted at the Department of Paediatric Cardiology, The Children Hospital &Institute of Child Health, Multan, Pakistan from July to December 2019. A total of 122 confirmed cases of PPHN admitted having gestational age above 34 weeks were enrolled. Demographic data of the newborns was recorded along with maternal medical history, pregnancy status and postnatal causes of PPHN. Severity of PPHN was also recorded., Results: Out of a total of 122 cases of PPHN, 81 (66.3%) were male. Majority, 78 (64.0%) had gestational age above 37 weeks. Mode of delivery as cesarean section was noted in 70 (57.4%). Meconium aspiration syndrome 52 (42.6%), birth asphyxia 48 (39.3%), respiratory distress syndrome 23 (18.8%) and sepsis 33 (27.0%) were found to be the commonest causes of PPHN. Severe PPHN was found to be the most frequent, noted among 63 (51.6%) while Moderate PPHN was observed in 40 (32.8%) and Mild PPHN in 19 (15.6%). Morality was noted among 26 (21.3%) of cases., Conclusion: Meconium aspiration syndrome, birth asphyxia and respiratory distress syndrome were the commonest postnatal causes of PPHN. Severe PPHN was found to be the most frequent form of PPHN., Competing Interests: Conflict of Interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Background: Medical students even though being aware of the importance of well-balanced nutrition do tend to have laxity in practicing it themselves leading to poor nutrition. The aim of this study was to compare the awareness and knowledge of dietary habits among medical and non-medical students., Methods: This cross-sectional study was carried out in two universities in the Jeddah province, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and King Abdulaziz University (KAU), Jeddah over 6 months. A self-administered online questionnaire was employed to assess the knowledge and attitude of the dietary habits among the students., Results: The number of students who responded positively to the survey was 386, the mean age was 21.5 ± 2.10. 310 (80.3%) of which were males while 76 (19.7%) were females by a ratio of 4.07:1. Most of the participants were single (95.9%); 238 (87.6%) participants lived with their family and 272 (70.5%) participants were in the college of medicine. Among the medical students, 41.9% did exercise "sometimes," 57.4% identified breakfast as an important meal of the day, and 14.7% were smokers., Conclusion: In our study, we found that the medical students were having a higher level of awareness about the dietary and lifestyle habits but it was not reflected in their practice which needed to be taken care of., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)

Hazardous industrial wastes negatively impact the environment by creating issues for aquatic as well as human's life. This study investigates the treatment of hazardous industrial wastewater using cost-effective graphite adsorbent along with electrochemical regeneration integrated with renewable solar energy. The synthetic industrial effluent containing crystal violet dye was treated using an adsorbent (Nyex™ 1000) having a surface area of 1.0 m 2  g -1 . The efficiency of removing solute was found to be more than 90%. The adsorbent regeneration efficiency was achieved at 99.5% by passing a charge of 100 C g -1 at current density of 10 mA cm -2 for 1 h. Solar energy was integrated with electrochemical reactor for the regeneration of adsorbent to make the system cost-effective and self-sustainable. PRACTITIONER POINTS: Industrial hazardous wastewater treatment with a cost-effective graphite integrated adsorbent. Development of renewable solar energy-integrated with electrochemical system for regeneration. Regeneration efficiency of adsorbent Nyex™ 1000 was achieved around 99.5% with integrated system. Sustainable system was introduced to incorporate with renewable energy for waste water treatment., (© 2021 Water Environment Federation.)