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This qualitative study reports on the experiences of international students enrolled in a Health Professional Education program at a large Australia university. International students have long contributed to Australia's economy. However, the sustainability of international students' contributions to Australia's economy is questionable. Challenges for international students have been widely reported in Australia. Students enrolled in Health Professional Education having unique challenges of their own. In total, 19 semi-structured interviews were conducted in 2020 and the data were thematically analysed. The findings uncovered numerous challenges for international students and those unique to international students enrolled in health- related degrees. Although all identified challenges may not be feasible to address, this study highlights recommendations for strategies that could be implemented by universities and policy makers to reduce challenges and to enhance graduate outcomes for this student population.

Solar water pumping system may be a competitive application for remote and luxurious areas where power costs a lot. One may argue that solar photovoltaic water pumping systems not only comprises an environmentally friendly solution, but also contributes substantially to the satisfaction of remote communities’ water consumption needs. Therefore, the study aimed to manage pump for sprinkler irrigation system operated by solar power in small area of turf. The required hydraulic experiment and measurements were conducted using Direct-coupled photovoltaic pumping system to operating sprinkler irrigation network at the experimental farm of soil and water Research Department, Nuclear Research Center, located at Inshas, Sharkia Governorate, Atomic Energy Authority, Egypt. The essential idea to operate the sprinkler irrigation system and fulfill the water needs of turf area was to use a locally assembled pump-set to match the photovoltaic generator unsteady output. Results indicated that, solar radiation increased during summer (April and July), so the electric power, pump discharge, pressure head, Hydraulic horsepower (hp) and Photovoltaic conversion efficiency are affected as solar radiation changed. Four mathematical equations has been derived to illustrate the relationship between solar radiation and electric power, pump discharge pressure head , water hp and Photovoltaic conversion efficiency (PVCE) during the day hours.

Abstract Clinical reasoning (CR) is an essential cognitive skill that medical students should learn early in their training. However, medical students find learning CR challenging. This study aimed to explore medical students’ perceptions and experiences during CR training. A qualitative study design was employed, collecting data from 26 undergraduate medical students via semi-structured interviews. After teaching a case-based scenario using a "Patient Note Form" (PNF), participants were interviewed with three open-ended questions to evaluate their CR learning experiences. Data was analyzed using inductive thematic analysis. Three themes emerged regarding CR learning during the pediatric rotation: ‘Favorable Experience,’ ‘Challenges,’ and ‘Helpful Practices’. Students generally reported positive learning experiences, satisfaction, and recognition of the exercises’ benefits and strengths. However, they also identified challenges such as knowledge gaps and difficulties in data processing that hindered their CR processes. A solid knowledge base is seen helpful to expedite efficient diagnostic hypothesis generation. So, students expressed satisfaction with their CR learning experience, found it favorable, and believed it would aid their future professional development. Given the importance of CR and the challenges students encounter in mastering it, further research to develop innovative teaching and assessment methods is warranted.

The Red Sea-Gulf of Suez-Cairo-Alexandria Clysmic-Trend in northern Egypt is the main earthquake zone in the country, with a moderate-to-high seismic hazard and a history of significant earthquakes caused by rifting and active faulting. To improve our understanding of the tectonic and seismic processes in this area, more comprehensive imaging of the crustal structure is required. This can be achieved by increasing the number of receiver functions (RFs) recorded by the seismic stations in northern Egypt and the southeastern Mediterranean. Data handling and processing should also be automated to increase process efficiency. In this study, we developed a capsule neural network for automated selection of RFs. The model was trained on a dataset containing RFs (both selected and unselected) from five broadband stations in northern Egypt. Stations SLM, SIWA, KOT, NBNS, and NKL are located in the unstable shelf region of Egypt, where limited knowledge of the deep crustal structure is available. The proposed capsule neural network achieved an average precision of 80% on the test set. The automated selection of RFs using a capsule neural network has the potential to significantly improve the efficiency and accuracy of RF analysis, as demonstrated by the stacking test. This could lead to a better understanding of crustal structure and tectonic processes in northern Egypt and the southeastern Mediterranean.

Lipomas are the most common soft tissue tumors, accounting for half of all soft tissue masses. However, intravascular lipomas (IVLs) are rare. IVLs have been described in case reports in the various major veins. They are often asymptomatic and found incidentally. Given the risk of malignancy, as liposarcomas are the second most common soft tissue sarcoma in adults and account for 1 % of all malignancies, histological differentiation is important, and surgical excision remains the mainstay of treatment in the literature. We present the case of a 61-year-old male who presented with left chest pain that radiated to his left shoulder and arm. On further evaluation, the patient endorsed left-hand swelling and weakness and increased prominence of veins in the left upper extremity. He underwent a CT scan that showed a hypodense mass with fat attenuation in the left innominate vein extending extra-vascularly and into the left internal jugular vein, measuring 2.3 × 2.0 × 5.2 cm. Successful surgical excision and reconstruction of the innominate vein with reimplantation of the left internal jugular vein was performed through median sternotomy and left cervical incision. The postoperative course was unremarkable, and the patient recovered well. The clinical presentation of an intravascular lipoma in a large caliber vessel can be subtle and nonspecific. This case report characterizes this rare vascular tumor and includes a contemporary literature review, summarizing the diagnosis and treatment options.

IntroductionAlthough COVID-19 vaccines have been recommended for children and adolescents since 2021, suboptimal vaccination uptake has been documented. No previous systematic review/meta-analysis (SRMA) investigated parents' willingness to administer COVID-19 vaccines for their children in Saudi Arabia. Accordingly, this SRMA aimed to estimate parents' willingness to immunize their children with COVID-19 vaccines in Saudi Arabia and to identify reasons and determinants influencing parents' decisions.MethodsThis SRMA adhered to the PRISMA guidelines and the protocol was registered on PROSPERO (ID: CRD42023492760). An extensive systematic search was performed across electronic databases including Pub Med, Pub Med Central, ISI Web of science, Web of Science Core Collection, Medline, KCI-Korean Journal Database, ProQuest, and SciELO, to identify relevant studies published from January 1, 2020 to October 30, 2023. A random-effects model was utilized to estimate the pooled effects considering the expected variability across studies. Heterogeneity, risk of bias, publication bias and quality of studies were considered and evaluated by relevant appropriate tests to ensure robust results.ResultsTwenty-five studies with 30,844 parents were included. The overall pooled rate of parents who intended to immunize their children with COVID-19 vaccines was 48.0% (95% CI: 41.0-54.0%) with high heterogeneity (I2 = 99.42%). The main reason for parents to vaccinate children was to protect child, family and community from COVID-19. Perceived efficacy/safety of vaccines were the most significant determinants associated with parents' willingness to vaccinate children.ConclusionThis was the first SRMA from Saudi Arabia which emphasized the priority to focus on vaccine-related factors as main/key strategy of COVID-19 vaccines' drivers to convince parents in a logical way based on accurate cumulative and emerging scientific data about efficacy and safety of COVID-19 vaccines to optimize their uptake by children/adolescents. This SRMA can provide valuable insights for development of evidence-based policies to improve parental willingness to vaccinate children, which is crucial for controlling SARS-CoV-2 spread and promoting herd immunity in the community particularly if the virus continues to pose a major threat.

Background Globally, the most common causes of blindness in adults are cataracts, glaucoma, age-related macular degeneration, and diabetic retinopathy. Inadequate knowledge of these conditions leads to lag in medical advice requisition, losing the opportunity for prevention and early intervention with an increased rate of disease complications. Aim This study aimed to detect the level of public awareness about common eye problems in Egypt to help build strategies to prevent complications related to these eye problems. Patients and methods This is a prospective cross-sectional analytical study that used a pre-tested e-questionnaire to collect data from the study participants during the period from September 2022 to June 2023 at Kasr Alainy School of Medicine, Cairo, Egypt. A Google form was created, and participants were invited through social media. It included four sections: socio-demographic characteristics, medical history of study participants, knowledge about common ocular diseases, and sources of gaining knowledge. Results The study included 802 participants, 54.2% of them were females, more than 55% of them were between the ages of 18–30 years, and 74.4% were university graduates. Awareness of cataracts, glaucoma, corneal opacity, diabetic retinopathy, and age-related macular degeneration was reported in 45.7, 34.8, 38.3, 80, and 77.5% of the study participants, respectively. Physicians and social media were the most common efficient sources of gaining knowledge. Higher education and working in a medical profession, especially physicians and pharmacists were associated with higher knowledge scores. Conclusion Low levels of knowledge of most of the blinding conditions among the study participants raise the importance of adopting health education programs by our healthcare systems taking into consideration that physicians and social media were among the most convenient routes to reach the targeted population.

By early April 2002, a severe outbreak of a disease was reported in sheep and goats in Al-Hasa province, Hofuf township (lat. 25o N, long. 47o E) of the eastern region of Saudi Arabia. The involved flock was composed of 70 adult sheep and goats. The onset of the disease was sudden. The clinical manifestations were high fever (41oC), lachrymation, nasal discharge, salivation, profuse diarrhea, followed by recumbency and death. The course of the disease in the affected animals took three to four days. Thirty out of seventy animals in the herd were affected (43% morbidity rate). The case mortality rate was 100%. A virus was isolated in Vero cell culture and was reacted in cross virus neutralization tests, using reference hyperimmune sera against peste des petits ruminants (PPR) and rinderpest virus. The virus was eventually identified as the PPR virus. The epidemiology of the disease in Saudi Arabia and the Arabian peninsula is discussed.

This paper presents a novel approach for simulating and optimizing production costing systems using linear programming. The proposed method employs a linear programming algorithm to simulate the behavior of production costs and to derive optimal solutions, including cost minimization, resource maximization, and economic returns. This approach has been implemented as a standard platform computer application, which automatically processes the costing system to reflect real-world behavior accurately. The developed application was tested on a university college costing system. The results demonstrated that the approach effectively simulates production costing systems and provides comprehensive reports and results, such as optimal costs, efficient resource utilization, and profit calculations. All processes are stored automatically in a database, supported by a full user interface with forms for ease of use. This approach is valuable for controlling costs and aiding decision-making processes. The versatility and efficiency of the linear programming model, particularly in handling large datasets and linear relationships, make it a powerful tool in various sectors.

Responsible for approximately 35% of all trauma-related deaths in the United States, thoracic trauma is one of the leading causes of death among trauma patients. Furthermore, traumatic rib fractures represent the most frequently encountered injury following thoracic trauma with mortality rates ranging from 8% among the elderly to 13% for patients with a flail chest. This manuscript reviews the history of SSRF as well as the contributions of the pioneering surgeons who championed this treatment. Rib fractures are a marker for severe injury as indicated by a recent National Trauma Data Bank (NTDB) retrospective analysis of 564,798 patients with one or more rib fractures. Approximately half of these patients were found to have multiple injuries with worse outcomes observed in patients with polytrauma and flail chest [1]. In addition, age, male gender, injury severity score (ISS), Glasgow Coma Scale (GCS), preexistent comorbidities, and number of rib fractures are independently associated with significantly higher rates of morbidity and mortality [1, 2]. Recently, studies have demonstrated surgical stabilization of rib fractures (SSRF) improves outcomes for ventilated as well as non-ventilated patients with flail chest, elderly patients, and select patients with multiple rib fractures without a flail injury or non-flail fracture pattern [2-6]. SSRF applies orthopedic principles of reduction and fixation to restore the architecture of the thoracic skeleton and re-establish normal respiratory physiology and minimize pain [7]. There has been a recent increase in prevalence of SSRF operations, however, SSRF is not a new technique, and progress has been anything but mundane or linear [3, 6]. This manuscript reviews the history of SSRF (Figure 1) as well as the contributions of the pioneering surgeons who championed this treatment. This review was conducted utilizing multiple national experts and a thorough literature review of related SSRF was performed. The sources chosen are considered by the authors to be highly influential and include the first publication for each distinctive method of SSRF.

BackgroundThe need for chest X-rays (CXR) following large-bore chest tube removal has been questioned; however, the utility of CXRs following removal of small-bore pigtail chest tubes is unknown. We hypothesized that CXRs obtained following removal of pigtail chest tubes would not change management.MethodsPatients

BackgroundThere is little information on the effects of Pseudomonas infection on outcomes in perforated appendicitis. As Pseudomonas is not covered by many empiric appendicitis antibiotic regiments, we hypothesized that children with Pseudomonas would have worse outcomes.MethodsPatients

BackgroundWe determined whether in vitro potency assays inform which placental mesenchymal stromal cell (PMSC) lines produce high rates of ambulation following in utero treatment of myelomeningocele in an ovine model.MethodsPMSC lines were created following explant culture of three early-gestation human placentas. In vitro neuroprotection was assessed with a neuronal apoptosis model. In vivo, myelomeningocele defects were created in 28 fetuses and repaired with PMSCs at 3 × 105 cells/cm2 of scaffold from Line A (n = 6), Line B (n = 7) and Line C (n = 5) and compared to no PMSCs (n = 10). Ambulation was scored as ≥13 on the Sheep Locomotor Rating Scale.ResultsIn vitro, Line A and B had higher neuroprotective capability than no PMSCs (1.7 and 1.8 respectively vs 1, p = 0.02, ANOVA). In vivo, Line A and B had higher large neuron densities than no PMSCs (25.2 and 27.9 respectively vs 4.8, p = 0.03, ANOVA). Line C did not have higher neuroprotection or larger neuron density than no PMSCs. In vivo, Line A and B had ambulation rates of 83% and 71%, respectively, compared to 60% with Line C and 20% with no PMSCs.ConclusionThe in vitro neuroprotection assay will facilitate selection of optimal PMSC lines for clinical use.Level of evidencen/a.Type of studyBasic science.