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Background: Parkinson’s disease (PD) is a disabling neurodegenerative movement disorder. Most PD patients are looked after by caregivers who are close to them regardless of their relationship. Caregivers may experience a notable impact on their mental health as they dedicate a significant amount of time to the patient while observing the progression of the disease.Objective: The aim of this study was to evaluate the level of burden, depression, anxiety, and stress among caregivers of PD patients.Methods: We conducted a cross-sectional analysis between July and September 2023 among caregivers of PD patients following in the Movement Disorders Clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, and through the Saudi Parkinson’s Society. The data collection was done anonymously through an electronic self-administered questionnaire. Caregiver burden was assessed by using the validated Arabic version of the Zarit Burden Interview (ZBI) scale, and the Depression Anxiety Stress Scale (DASS) was used to assess the presence and level of anxiety and depression.Results: There were 118 caregivers (53.39% female, 33.9% aged between 35– 45 years, and 73.73% were sons/daughters) caring for 118 patients (57.63%, male, 38.98% aged between 66– 76). The ZBI score was highest among sibling caregivers. Moreover, burden scores were higher among those who provided care more frequently than others.Conclusions: Our study revealed that PD caregivers face a high risk of care burden, especially those who are siblings and spend longer periods in patient care. Additionally, female caregivers reported higher rates of depression, anxiety, and stress.

Parkinson’s disease (PD) is a disabling neurodegenerative movement disorder. Most PD patients are looked after by caregivers who are close to them regardless of their relationship. Caregivers may experience a notable impact on their mental health as they dedicate a significant amount of time to the patient while observing the progression of the disease. The aim of this study was to evaluate the level of burden, depression, anxiety, and stress among caregivers of PD patients. We conducted a cross-sectional analysis between July and September 2023 among caregivers of PD patients following in the Movement Disorders Clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, and through the Saudi Parkinson’s Society. The data collection was done anonymously through an electronic self-administered questionnaire. Caregiver burden was assessed by using the validated Arabic version of the Zarit Burden Interview (ZBI) scale, and the Depression Anxiety Stress Scale (DASS) was used to assess the presence and level of anxiety and depression. There were 118 caregivers (53.39% female, 33.9% aged between 35– 45 years, and 73.73% were sons/daughters) caring for 118 patients (57.63%, male, 38.98% aged between 66– 76). The ZBI score was highest among sibling caregivers. Moreover, burden scores were higher among those who provided care more frequently than others. Our study revealed that PD caregivers face a high risk of care burden, especially those who are siblings and spend longer periods in patient care. Additionally, female caregivers reported higher rates of depression, anxiety, and stress. Parkinson’s disease (PD) is a serious condition that affects movement, and most PD patients are cared for by someone close to them, such as a family member. This caregiving can significantly impact the mental health of the caregiver, who often spends a lot of time caring for the patient and witnessing the disease’s progression. We studied caregivers of PD patients at the Movement Disorders Clinic at King Khalid University Hospital and through the Saudi Parkinson’s Society from July to September 2023. Caregivers completed an anonymous electronic questionnaire, and we measured caregiver burden using the Zarit Burden Interview (ZBI) and assessed anxiety and depression using the Depression Anxiety Stress Scale (DASS). Our study included 118 caregivers (53.39% female, most aged 35– 45 years, and 73.73% were sons or daughters) caring for 118 PD patients (57.63% male, most aged 66– 76 years). Caregivers who were siblings or cared for the patient daily had higher burden scores, and female caregivers had higher levels of depression, anxiety, and stress compared to males. Our study revealed that PD caregivers face a high risk of care burden, especially those who are siblings and spend longer periods in patient care, and that female caregivers exhibited an elevated risk of experiencing depression, anxiety, or stress.

Background: Adrenalectomy for pheochromocytoma (PHEO) is challenging because of the high risk of intraoperative hemodynamic instability (HDI). This study aimed to compare the incidence and risk factors of intraoperative HDI between laparoscopic left adrenalectomy (LLA) and laparoscopic right adrenalectomy (LRA). Methods: We retrospectively analyzed two hundred and seventy-one patients aged > 18 years with unilateral benign PHEO of any size who underwent transperitoneal laparoscopic adrenalectomy at our hospitals between September 2016 and September 2023. Patients were divided into LRA (N= 122) and LLA (N= 149) groups. Univariate and multivariate logistic regression analyses were used to predict intraoperative HDI. In multivariate analysis for the prediction of HDI, right-sided PHEO, PHEO size, preoperative comorbidities, and preoperative systolic blood pressure were included. Results: Intraoperative HDI was significantly higher in the LRA group than in the LLA (27% vs. 9.4%, p< 0.001). In the multivariate regression analysis, right-sided tumours showed a higher risk of intraoperative HDI (odds ratio [OR] 5.625, 95% confidence interval [CI], 1.147–27.577, p= 0.033). The tumor size (OR 11.019, 95% CI 3.996–30.38, p< 0.001), presence of preoperative comorbidities [diabetes mellitus, hypertension, and coronary heart disease] (OR 7.918, 95% CI 1.323–47.412, p= 0.023), and preoperative systolic blood pressure (OR 1.265, 95% CI 1.07–1.495, p= 0.006) were associated with a higher risk of HDI in both LRA and LLA, with no superiority of one side over the other. Conclusion: LRA was associated with a significantly higher intraoperative HDI than LLA. Right-sided PHEO was a risk factor for intraoperative HDI.

The quasi-potential flow in a doubly linked airfoil wing with a sharp trailing edge can be solved using a high-order boundary-element method (BEM). A bicubic Hermite spline interpolation is used to express the unknown, with node derivatives given by finite difference method. The revolutionary traits apply to bleeding-edge settings; specifically, challenges relating to the three-dimensional problem of multiply connected domains are investigated. Numerical validation examples were utilized to assess the implemented BEM approach.

Purpose: English as a foreign langauge (EFL) students find it difficult to apply the theoretical knowledge they acquire on translation in the practical world. Therefore, this study explored if training in pretranslation techniques (PTTs) (syntactic parsing) as suggested by Almanna (2018) could improve the translation proficiency of Yemeni EFL students. Moreover, the study also assessed which of the PTTs the intervention helped to develop. Design/methodology/approach: The study adopted a primarily experimental pre- and posttests research design, and the sample comprised of an intake class with 16 students enrolled in the fourth year, Bachelor in Education (B.Ed), Hadhramout University. Six participants were also interviewed to gather the students' perceptions on using PTTs. Findings: Results showed that students' performance in translation developed significantly (Sig. = 0.002). All the six PTTs showed development, though subject, tense and aspect developed more significantly (Sig. = 0.034, 0.002, 0.001 respectively). Finally, the study reported students' positive perceptions on the importance of using PTTs before doing any translation tasks. Originality/value: One of the recurrent errors that can be noticed in Yemeni EFL students' production is their inability to transfer the grammatical elements of sentences from L1 (Arabic) into L2 (English) or the visa versa. The researchers thought though translation is more than the syntactic transmission of one language into another, analyzing the elements of sentences using syntactic and semantic parsing can help students to produce acceptable texts in the target language. These claims would be proved or refuted after analyzing the experiment result of the present study.

This study explores the sustainability reporting (SR) and assurance market in the Gulf Cooperation Council (GCC) region from the Big 4 auditors' perspectives and investigates the drivers and barriers of SR and assurance in the GCC region. We have interviewed ten representatives of auditing firms (i.e., members of Big 4) in the GCC region. The results of study reveal the immaturity of the SR and assurance market in the region but are hopeful for the future contingent upon certain factors. In addition, the voluntary nature of SR, the cost of reporting and assurance, and religious concerns among others are primary barriers in front of the eagerness of firms to adopt SR and its assurance. Reputation building and accessing international markets among others are the main motivations for the adoption of SR and assurance. The interviewees have firmly expressed that there is no direct relationship between SR assurance and financial report audit.

Internet of Things (IoT) devices are crucial in different industries because they provide high‐functioning services to the IoT network connectivity. The IoT devices collect sensitive data, which comes under potential risk while transmitting data from one location to another. The data transmission is performed using various communication protocols that give security to the data. The intermediate attacks such as jamming, collision, flooding, worm‐hole, black‐hole and so forth create several security‐related issues. These intermediate attacks affect data privacy, trust, user identity, which completely affects the IoT device performance. So, this article introduces the near field communication (NFC) protocol with the Otway Rees protocol for making the secure communication process. In IoT applications based on short‐range communication, intermediate attacker issues have been reduced by combining NFC protocol features with Otway Rees protocol features. The NFC protocol provides baseline security trustworthiness while making the communication in the IoT environment cost‐effective. IoT communication is protected while cost‐effective using the security model, ensuring data integrity and confidentiality. In addition to this, the user and servers are authenticated for every session, which provides data security. Moreover, the discussed system is implemented using the NS2 simulation tool, ensuring security and trust with minimum complexity. Even in abnormal traffic conditions, our proposed method resulted in data transmission speeds (up to 289 Kb/s), and this feature can improve processing times. The loT devices collect sensitive data, which comes under potential risk while transmitting data from one location to another. The data transmission is performed using various communication protocols that give security to the data. The intermediate attacks such as jamming, collision, flooding, worm‐hole, black‐hole and so forth create several security‐related issues. These intermediate attacks affect data privacy, trust, user identity, which completely affects the loT device performance. So, this article introduces the near field communication (NFC) protocol with the Otway Rees protocol for making the secure communication process.

Objective:The aim of this study was to reach a consensus on an updated version of the recommendations for the diagnosis and Treat-to-Target management of osteoporosis that is effective and safe for individuals with chronic kidney disease (CKD) G4-G5D/kidney transplant. Methods:Delphi process was implemented (3 rounds) to establish a consensus on 10 clinical domains: (1) study targets, (2) risk factors, (3) diagnosis, (4) case stratification, (5) treatment targets, (6) investigations, (7) medical management, (8) monitoring, (9) management of special groups, (10) fracture liaison service. After each round, statements were retired, modified, or added in view of the experts’ suggestions, and the percent agreement was calculated. Statements receiving rates of 7–9 by more than 75% of experts’ votes were considered as achieving consensus. Results:The surveys were sent to an expert panel (n= 26), of whom 23 participated in the three rounds (2 were international experts and 21 were national). Most of the participants were rheumatologists (87%), followed by nephrologists (8.7%), and geriatric physicians (4.3%). Eighteen recommendations, categorized into 10 domains, were obtained. Agreement with the recommendations (rank 7–9) ranged from 80 to 100%. Consensus was reached on the wording of all 10 clinical domains identified by the scientific committee. An algorithm for the management of osteoporosis in CKD has been suggested. Conclusion:A panel of international and national experts established a consensus regarding the management of osteoporosis in CKD patients. The developed recommendations provide a comprehensive approach to assessing and managing osteoporosis for all healthcare professionals involved in its management.

Trabecular bone score (TBS) is a grayscale textural assessment resulting from a computed evaluation of pixel gray-level variations in previously obtained lumbar spine DXA images. It is an index of bone microarchitecture correlated with parameters of bone strength. Higher values of TBS indicate a better microarchitecture, whereas lower values indicate a degraded microarchitecture. TBS can be used alongside Fracture Risk Assessment tool “FRAX” and bone mineral density (BMD) to enhance the assessment of fracture risk and to inform treatment initiation and monitoring. A systematic review was carried out aiming to update the evidence on the clinical use of the TBS in the management of both primary and secondary osteoporosis. Results revealed that in both primary and secondary osteoporosis, TBS enhances the prediction of fracture risk, and when adjust with BMD and clinical risk factors, it is able to inform the decision-making process regarding initiating osteoporosis therapy and the choice of anti-osteoporosis medication. Evidence also implies that TBS provides valuable adjunctive information in monitoring osteoporosis therapy. In conclusion, this work provides an up-to-date evidence-based review and recommendations which informs the utility of trabecular bone score in standard clinical practice.

Purpose: To assess the relationship between the triad of obesity, fracture risk factors, and osteoporosis and its impact on fragility fractures. Results: Osteoporosis was least prevalent (p< 0.001) among the obese patients in comparison to overweight and normal body mass index patients. On the other hand, history of risk of falling as well as history of fall(s) in the last year, sarcopenia, and functional disability were significantly more prevalent (< 0.01, 0.05, and 0.05 respectively) among the obese patient cohort. Conclusion: Obesity was found to be associated with higher bone mineral density of the hip, lumbar spine, and distal forearm. This was significantly different in post-menopausal women, but not in men. Covariates such as sarcopenia, falls risk, and functional disability play an important factor in making the patient at high risk and prone to develop a fragility fracture.

Background: Gender differences in the diagnosis and treatment of osteoporosis is a relatively common phenomenon, particularly amongst those patients under 80 years of age presenting with fragility fractures. The clinical implications of these findings are that strategies, which tend to focus on osteoporosis management in women, should also pay enough attention to osteoporosis in men. However, there have been questions whether there is a gender difference when setting intervention thresholds for osteoporosis management. This work was carried out aiming to determine the fracture probabilities calculated by FRAX at which therapeutic intervention in older men and women can be considered. Results: Assessment of fracture risk probability thresholds in men revealed that for hip fractures, ROC was 0.754 (95% CI: 0.69–0.817). The sensitivity was 80.5% for threshold probabilities of 2.5%. For the major osteoporosis fracture, ROC was 0.828 (95% CI: 0.694–0.963). The sensitivity was 87.5% for threshold probabilities of 10%. Assessment of fracture risk probability threshold in women ROC was 0.760 (95% CI: 0.691–0.83). The sensitivity was 76.1% for threshold probabilities of 3%. For major osteoporosis fracture, ROC was 0.848 (95% CI: 0.784–0.912). The sensitivity was 87.3% for threshold probabilities of 15%. Conclusion: Operational aspects of osteoporosis management should consider gender specific fracture thresholds. Interventional thresholds were found to be different in men compared to women. This helps to optimise fracture prevention in older men.

Background: The aim of this work is to set up the standards for performing musculoskeletal ultrasound scans and reporting as an additional procedure in the rheumatology setting. We used two rounds of the Delphi approach to get the consensus on a musculoskeletal ultrasound reporting. Results: Fifteen expert panels had completed the two rounds of surveys. After the end of round two, eighteen recommendations distributed upon eight domains were released. The percentage of the agreement on the recommendations was 93.3 to 100 %. All eighteen key questions were answered at the end of the second round with agreement. Conclusion: A musculoskeletal ultrasound report template has been developed by this study, based on outcomes of a Delphi process, by an international participants’ panel. All domains met the 80% voting threshold set in this work. The reporting template can be used for both clinical research as well as standard practice to provide guidance and standardize the musculoskeletal ultrasound reporting.

•Surfactant properties play an important role in regulating the wetting behavior.•Cationic surfactants show higher wetting capabilities than anionic surfactants with similar sizes.•Surfactants with larger molecular sizes exhibit lower wetting capability.•Parameters like apparent contact angle and solution surface tension are not reliable for predicting the wetting behavior of MD.

This study examined how the relationship between information asymmetry and earnings management was affected by audit quality as an example of emerging markets using a sample of Jordanian industrial firms listed on the Amman stock exchange from 2015 to 2019. Fixed effect model is used to examine study hypotheses. The findings indicate that information asymmetry positively affected earnings management. Moreover, the results revealed that audit quality negatively affected the relationship between information asymmetry and earnings management, meaning that audit quality can reduce the level of information asymmetry and mitigate earnings management. This study will contribute to corporate governance and auditing literature among Jordanian firms by providing beneficial information for regulators, investors and other stakeholders about how audit quality can restrict information asymmetry and reduce earnings management. This study will be of value to firms seeking to reduce earnings management and enhance financial reporting quality by decreasing information asymmetry.

Ethanol has been a commonly used sclerosant for low-flow vascular malformations, but it carries a high risk of complications. Bleomycin has been recently introduced as a potentially effective treatment. The aim of this study was to evaluate the safety and efficacy of bleomycin intralesional injection for the treatment of low-flow vascular malformations and determine the different factors affecting the outcome.

Purpose: Weight reduction can effectively improve nonalcoholic fatty liver disease (NAFLD), which is a constant companion of severe obesity. This study aimed to determine the effect of one-anastomosis gastric bypass (OAGB) on pathological liver changes in severely obese cases with NAFLD. Methods: The present prospective research comprised 67 subjects with morbid obesity scheduled for OAGB during the period from February 2015 to August 2018. Clinical, biological, and histologic data were evaluated pre and 15 months postoperatively. Results: Fifteen months after surgery, a considerable reduction was noted in the grades of fat deposition, liver cell ballooning, and lobular inflammatory changes, in addition to the total NAS score. Fifteen months after surgery, nonalcoholic steatohepatitis (NASH) disappeared in 42% of the patients. A significant regression of fibrosis stage occurred after surgery in 79.1% of patients (p< 0.001). After surgery, patients had substantial reductions in aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, HbA1c, total cholesterol, and Low-density lipoprotein (p< 0.001, for all comparisons). Diabetes mellitus, hypertension, and dyslipidemia resolved in 54%, 59%, and 69% of the patients, respectively. Conclusion: OAGB resolved NASH from nearly 42% of patients and reduced the histological features of NAFLD 15 months after surgery. Bariatric procedures might be adopted as a therapeutic modality in severely obese cases with NAFLD after the failure of lifestyle modifications.

Estrus synchronization and manipulation are a tool that has been used by producers to provide uniform lamb and kid meat production and dairy sheep and goat milk production, to concentrate work and labor cost, and to plan for the lambing and kidding time. Breeders can also use estrus synchronization to stimulate ewes and does to exhibit estrus and ovulate outside of the breeding season, although both the ovulation rate and pregnancy rate may be decreased. To increase the ovulation rate outside of the breeding season, a variety of estrus synchronization methods have been used.

Corrosion is one of the serious problems in oil and gas industry. So far, many inhibitors have been used to control or reduce corrosion. Nowadays, nano-materials have been employed as inhibitors as well due to their excellent properties such as high surface area, excellent inhibition efficiency, low cost, and minimum toxicity. In the current work, nano-ferrite materials have been used as inhibitors to reduce the corrosion of carbon steel in oil environment (crude oil obtained from Iraqi Majnoon oil field). The anti-corrosion properties of the nickel and zinc ferrite on carbon steel in Iraqi oil media have been evaluated. The nano materials of nickel Ferrities (NiFe2O4) zinc Ferrities (ZnFe2O4) and Zn-Ni doped Ferities (Zn0.6. Ni0.4Fe2O4) were selected as additive ferrites. It has been found that nano-nickel and zinc ferrites could act as an effective corrosion inhibitor for the metal carbon steel. An average reduction of about 38% in the corrosion rate has been achieved when using Zn-Ni doped Ferities (Zn0.6. Ni0.4Fe2O4) with the crude oil as a corrosive environment.

Background: Kawasaki disease (KD) is an acute, self-limited febrile disease of unidentified cause that mostly affects children less than 5 years of age. This work aimed to provide an appropriate Egyptian evidence-based consensus on clinical practice recommendations for the management of Kawasaki disease. The main objective of this study, which employed the Delphi method, was to reach a consensus among experts on a treat-to-target management approach for KD. Results: The expert panel was confined to an online survey (n=26), and all the expert completed the three rounds. At the conclusion of round 3, a total of 17 recommendation items were gathered, which were divided into two sections. The range of respondents (ranks 7–9) who agreed with the recommendations was 92.3 to 100%. All 17 clinical standards identified by the scientific committee were written in the same way. There have been algorithms proposed for managing various KD conditions. Conclusion: The developed evidence-based consensus recommendations for the diagnosis and management of KD represent an up-to-date document that focuses on clinical management questions which are generally posed to health care professionals involved in the management of KD. This guideline was developed considering experience with and availability of treatment and diagnostic options in Egypt.

Purpose: (1) This was a multi-center, cross-sectional, observational study. Both old men and postmenopausal women over 50 years old who were admitted with an osteoporotic fracture (whether hip fracture or major osteoporosis) were consecutively recruited for this work and managed under the Fracture Liaison Service. All the patients were assessed for their sarcopenia risk (SARC-F), fracture risk (FRAX), and fall risk (FRAS) as well as functional disability (HAQ). The aim was to assess the prevalence of sarcopenia risk among older adult Egyptians presenting with fragility fractures. (2) To identify the relation between sarcopenia risk with the risk of falling as well as sustaining a fragility fracture. Results: Two hundred and thirty-six patients (69 males, 167 females) were included in this work. The mean age was 70.1 (SD = 9.2) years. The prevalence of sarcopenia was 69.7%. The sarcopenia risk score was positively correlated with the FRAX score (p= 0.01). The prevalence of high sarcopenia risk was 78% of the patients presenting with a high 10-year probability of major osteoporosis fracture as well as a 10-year probability of hip fracture. The sarcopenia risk score was positively correlated with the increased fall risk (p= 0.01) as scored by the FRAS scale. There was a significant relation (p< 0.05) between the functional disability score and the SARC-F score. This was persistent when assessed in relation to fall risk. Conclusion: This study highlighted the high sarcopenia risk in the patients presenting with fragility fractures. Identification of patients at increased risk of sarcopenia should be a component of the standard practice.