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Nowadays, studying the macrophytes distribution climatic change reducing effect through land surface temperature is vital. 17 locations with 102 stands were randomly chosen to illustrate the vegetation physiognomy in Wadi Al-Sharaea, Makkah Province, Saudi Arabia. A total of 110 species from 77 genera and 33 families were detected during the field study, with the Poaceae family predominant. Therophytes were the dominant life form (38.2% of the total species), followed by chamaephytes (30.0%), and bioregional elements were the dominant chorotype. Remote sensing data were acquired to evaluate land surface temperature (LST), normalized difference built-up index (NDBI), and normalized difference vegetation index (NDVI) from 2002 and 2018. The study assesses the relationship between organic matter, plant diversity species, vegetation cover, and LST. Principal component analysis (PCA) was applied, and the obtained data showed that PCA1 and PCA2 represent about 25.29% and 16.34%, respectively. Cluster analysis was used to identify the commonality of the groups among the data from points clustered into four significant clusters. On the other hand, LST correlated with the distribution of some families, such as Caryophyllaceae, Boraginaceae, Euphorbiaceae, and Molluginaceae. The families that correlated to LST show the tolerance of these families to high temperatures. Results showed that Limeaceae, Poaceae, and Zygophyllaceae families grow in soil with high organic matter. These findings indicated fundamental advances in understanding the temperature response of organic matter and plant diversity. [ABSTRACT FROM AUTHOR]

Date palm leaves were compounded with polypropylene (PP) and UV stabilizers to form composite materials. The stability of the composites in natural weathering conditions of Saudi Arabia and in accelerated weathering conditions was investigated. The composites were found to be much more stable than PP under the severe natural weathering conditions of Saudi Arabia and in accelerated weathering trials. Compatibilized samples are generally less stable than uncompatibilized ones as a result of the lower stability of the maleated polypropylene. Irgastab and Tinuvin are found to be efficient stabilizers for PP/cellulose fibre composites. In addition to enhanced stability imparted by the presence of the fibres in the composites, enhanced interfacial adhesion resulting from oxidation of the polymer matrix can be the source of retention of mechanical strength. [Copyright &y& Elsevier]

Background: Nuclear medicine diagnostic and treatment procedures represent significant sources of ionizing radiation exposure for both staff and patients. Consequently, assessing and optimizing radiation doses are crucial to minimize potential side effects., Aim: This study seeks to evaluate the effective radiation doses associated with common diagnostic and treatment procedures, as well as propose diagnostic reference levels (DRLs), within two nuclear medicine centers in Madinah, Saudi Arabia., Methodology: Data from 445 patients were gathered from two nuclear medicine centers in the Madinah region of Saudi Arabia. The data were categorized based on the type of nuclear medicine (NM) procedure, the chemical composition of the administered radiopharmaceutical, as well as patient age and weight. Effective radiation doses for prevalent NM procedures were computed, and suggested DRLs were formulated., Results: Effective radiation doses were analyzed for 16 adult and 2 pediatric NM procedures (divided into 8 groups). The effective radiation doses for adult diagnostic nuclear medicine procedures range from 0.05 mSv (Nanocoloid) to 29 mSv (67Ga-citrate). For pediatric procedures, the doses range from 0.80 mSv (5-year-old undergoing renal DTPA) to 1.6 mSv (1-year-old undergoing renal DMSA). Furthermore, DRL values were determined for both adult and pediatric NM procedures. The study's findings demonstrated a high degree of concordance between effective radiation doses and DRL values, aligning well with previously published research., Conclusion: While the effective radiation doses outlined in this study were generally within acceptable limits and consistent with prior research findings, optimizing radiation doses remains imperative, particularly for pediatric NM procedures., 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 Ltd. All rights reserved.)

Background: Radiation is an integral part of routine medical practice, but it carries a risk to the health of medical staff. Hence, it should be assessed periodically. The study's goal was to quantify the levels of radiation exposure for medical staff at King Faisal Medical Complex (KFMC), Taif City Saudi Arabia, and to assess their radiation protective procedures in practice., Methods: The study looked at the thermoluminescence dosimeters (TLDs) records of 50 medical professionals who were exposed to radiation while working at KFMC from 2019 to 2020 in Taif city, Saudi Arabia. In Riyadh, radiation exposure is read from skin TLDs using Harshaw model 6600 plus detectors. The Excel software was utilized to process the obtained data for calculating effective doses. A questionnaire was also distributed to the medical staff to assess their radiation protection procedures. The Statistical Package for Social Sciences (SPSS) program version 23 was used to analyze the obtained data., Results: The mean annual effective doses of the medical staff in 2019 and 2020 were determined to be 1.14 mSv and 1.4645 mSv, respectively, with no significant difference in effective doses between males and females in either year. The socio-demographic features of the medical personnel were examined, and the findings revealed that the majority of participants were male radiological technologists. The rate of adherence to radiation protection techniques was 68%, with a normally distributed dispersal. The amount of adherence varied significantly depending on nationality, occupation, and academic qualification., Conclusion: According to the research, the mean annual effective dosage for medical professionals at KFMC was significantly below the recommended level, indicating satisfactory compliance with the ALARA radiation safety concept., 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 Ltd. All rights reserved.)

Background and Aim: Spiral computed tomography (CT) scans, which are considered a high-contrast resolution, quick and cross-sectional imaging technique, have grown in popularity as a result of technological advancements. However, these advancements have brought with them the potential for significantly increased radiation doses to the patient. Consequently, many organizations recommended optimization and establishing diagnostic reference levels. The aim of the current study was to assess CT radiation dose and propose a local diagnostic reference level (LDRL) for the adult trunk [chest and abdomen] using CT dose parameters such as CT dose index volume (CTDI vol ) and dose length product (DLP) as well as to compare the practices for aforementioned examinations between two hospitals in Taif and Abha cities in Saudi Arabia., Materials and Methods: Data from 428 patients (216 for abdomen and 212 for chest) who were examined in two hospitals in Taif and Abha City in Saudi Arabia from December 2022 to March 2023, are used in this study. The data for hospitals in Taif and Abha are presented as 'T' and 'A' throughout this manuscript. The parameters of exposure and slice thickness were recorded in a specially designed data sheet together with the gender, age and patients morphometric. Microsoft Excel version 2010 was used to analyze results and plot the figures. The LDRL was achieved from the third quartile of CTDIvol and DLP for each hospital and examination., Results: The average DLP (mGy-cm) and CTDI vol (mGy) for the chest and abdomen were 243 mGy cm, 5.8 mGy and 549 mGy cm, 8.6 mGy respectively. The average effective dose (ED) for chest and abdomen were 5.10 and 21.10 mSv, respectively. The proposed LDRL for the chest and abdomen were 6.9 mGy (CTDIvol), 375 mGy-cm (DLP), 7.8 mGy (CTDIvol), and 747 (DLP) mGy-cm, respectively., Conclusion: Hospital 'A' irradiated patients with a higher dose for the abdomen exam than Hospital 'T', but both hospitals agreed on the amount of radiation dose received by patients for chest imaging. The proposed LDRL for two examinations was less than the DRL obtained from the literature., 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.)

Introduction: Awareness of screening procedures and illness warning signals is critical for expanding and implementing screening programs in society, which would improve the odds of early identification of breast cancer., Objectives: This study aimed to evaluate the knowledge, awareness, attitudes, and practices related to breast cancer risk factors, signs, symptoms and methods of screening among female faculty and students at Hail University in the Kingdom of Saudi Arabia., Methods: A cross-sectional study was conducted from January 2021 through February 2021 in the Hail region of Saudi Arabia. A closed-ended questionnaire, which consisted of 37 questions, was distributed online (using a Google Forms link) in both English and Arabic languages. Data was collected from 425 female subjects who participated in the study., Results: The study showed an overall knowledge level of 46.36% regarding breast cancer. Participants had average knowledge about risk factors, signs, and symptoms, whereas their awareness and practice of breast self-examination and screening methods were weak., Conclusion: The current study concluded that public awareness of breast cancer remains relatively low, and Saudi Arabia still needs several public awareness initiatives using mass media, such as television, the Internet, and radio, as well as social media. Special awareness programs should also be held in places where a large number of women can easily be reached, such as colleges, universities, and hospitals., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Almeshari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The Hajj is an annual religious mass gathering event held in Makkah, Saudi Arabia. With millions of participants from across the globe attending the Hajj, the risk of importation, transmission, and global spread of infectious diseases is high. The emergence of antimicrobial resistant (AMR) bacteria is of worldwide concern and the Hajj poses a serious risk to its dissemination. This review aims to synthesize published literature on AMR bacteria acquisition and transmission associated with the Hajj., Methods: We searched electronic databases to identify literature published between January 1990 and December 2021. The search strategy included medical subject headings and keyword terms related to AMR bacteria and the Hajj., Results: After screening 2214 search results, 51 studies were included in the analysis. The review found 6455 AMR bacteria transmissions related to the Hajj. Thirty predominantly enteric or respiratory disease-causing AMR bacterial species were reported with isolates identified in cases on five continents. Most were male, aged above 50 years and were diagnosed in Makkah. Most cases were identified through hospital-based research; few cases were detected in community or primary health care settings., Conclusions: This review provides a contemporary account of knowledge related to AMR transmission at the Hajj. It emphasizes the need for the enhancement of surveillance for AMR bacteria globally.

Staff occupational radiation exposure is limited to 20 mSv annually to preclude tissue reaction and lower risk of cancer effect. Staff occupational exposure arises during the preparation, injection, and scanning of the patients. Recent studies reported that nuclear medicine personnel might exceed the annual dose limit in high workload and poor radiation protection circumstances. Therefore, an accurate estimation of the annual dose limit is recommended. The goal of this research is to calculate the cumulative external effective dose (mSv) per year for nuclear medicine physicians, technologists, and nurses at SPECT/CT department. A total of 15 staff worked in the nuclear medicine department at King Saud Medical City (KSMC), Riyadh, Saudi Arabia were evaluated for the last six years. 99m Tc is used more frequently for most of the patients. The procedures include renal, cardiac scintigraphy procedures. Staff dose was quantified using calibrated thermoluminecnt dosimeters (TLD-100) with an automatic TLD reader (Harshaw 6600). Exposure to ionizing radiation was evaluated in terms of deep doses (Hp(10) were evaluated. The overall average and standard deviation of the external doses for nuclear medicine physicians, technologists' and nurses were 1.8 ± 0.7, 1.9 ± 0.6, 2.0 ± 0.9, 2.2 ± 0.8, 6.0 ± 2.8, and 3.6 ± 1.3 for the years 2015,2016,2017,2018,2019, and 2020, respectively. Technologists and nurses received higher doses of compared to the nuclear medicine physicians. Technologists and nurses involved in radionuclide preparation, patients' injection, and image acquisition. Staff annual exposure is below the annual dose limits; however, this external dose is considered high compared to the current workload., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The current study was aimed to estimate the entrance surface air kerma (ESAK, mGy) for adult patients undergoing conventional radiography of Anteroposterior pelvis examination, and finally to establish a local diagnostic reference level (DRL). A total of 500 patients were exposed to diagnostic radiation in four hospitals (coded A, B, C, and D) in Taif and Kharaj city, Saudi Arabia, with different X-ray equipment specifications. Patient demographic data like age (y), body mass index (BMI) in kg/m 2 as well as exposure factors and X-ray tube output were recorded. ESAK (mGy) was first calculated using the exposure data and tube output values, then the ESAK values were used to estimate entrance surface dose (ESD). The average BMI was 23.9 kg/m 2 . The mean tube potential used in A, B, C, and D hospitals and the corresponding estimated ESD were found to be 74.2, 69.8, 73, 76,7 kVp, and 2.54, 2.64, 2.94, 3.03 mGy respectively. The correlation coefficient between ESAK and BMI was found to be 0.98. When compared to computed radiography (CR), the conventional X-ray digital radiography reduces the radiation exposure in pelvic imaging by a factor of 1.18. The third quartile of median proposed a lower than the DRL of the previous studies., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: In this large-scale cluster-randomized controlled trial (cRCT) we sought to assess the effectiveness of facemasks against viral respiratory infections., Methods and Results: Over three consecutive Hajj seasons (2013, 2014, 2015) pilgrims' tents in Makkah were allocated to 'facemask' or 'no facemask' group. Fifty facemasks were offered to participants in intervention tents, to be worn over four days, and none were offered to participants in control tents. All participants recorded facemask use and respiratory symptoms in health diaries. Nasal swabs were collected from the symptomatic for virus detection by reverse transcription polymerase chain reaction. Clinical symptoms and laboratory results were analyzed by 'intention- to-treat' and 'per-protocol'. A total of 7687 adult participants from 318 tents were randomized: 3864 from 149 tents to the intervention group, and 3823 from 169 tents to the control group. Participants were aged 18 to 95 (median 34, mean 37) years, with a male to female ratio of 1:1.2. Overall, respiratory viruses were detected in 277 of 650 (43%) nasal/pharyngeal swabs collected from symptomatic pilgrims. Common viruses were rhinovirus (35.1%), influenza (4.5%) and parainfluenza (1.7%). In the intervention arm, respectively 954 (24.7%) and 1842 (47.7%) participants used facemasks daily and intermittently, while in the control arm, respectively 546 (14.3%) and 1334 (34.9%) used facemasks daily and intermittently. By intention-to-treat analysis, facemask use did not seem to be effective against laboratory-confirmed viral respiratory infections (odds ratio [OR], 1.4; 95% confidence interval [CI], 0.9 to 2.1, p = 0.18) nor against clinical respiratory infection (OR, 1.1; 95% CI, 0.9 to 1.4, p = 0.40). Similarly, in a per-protocol analysis, facemask use did not seem to be effective against laboratory-confirmed viral respiratory infections (OR 1.2, 95% CI 0.9-1.7, p = 0.26) nor against clinical respiratory infection (OR 1.3, 95% CI 1.0-1.8, p = 0.06)., Conclusion: This trial was unable to provide conclusive evidence on facemask efficacy against viral respiratory infections most likely due to poor adherence to protocol., Competing Interests: Professor Robert Booy has received funding from Baxter, CSL, GSK, Merck, Novartis, Pfizer, Roche, Romark and Sanofi Pasteur for conducting research other than this, travel to conferences or consultancy work; all funding received is directed to research accounts at The Children’s Hospital at Westmead. Dr Harunor Rashid has received fees from Pfizer, Sanofi Pasteur and Novartis for consulting or serving on an advisory board. The other authors have no competing interests to declare.

Background: Intense congestion during the Hajj pilgrimage amplifies the risk of meningococcal carriage and disease, and there have been many meningococcal outbreaks reported amongst pilgrims. Thus, a strict vaccination policy is enforced by the host country and either polysaccharide or conjugate quadrivalent meningococcal vaccines are mandatory. However, unlike conjugate vaccines, the polysaccharide vaccine is not thought to reduce pharyngeal carriage of meningococci., Methods: A single-blinded, randomized, controlled trial amongst pilgrims from Saudi Arabia and Australia during the Hajj seasons of 2016-2017 was conducted to compare MenACWY-Conjugate vaccine with MenACWY-Polysaccharide vaccine, to determine if the conjugate vaccine is more effective in reducing asymptomatic carriage of meningococci, and whether the effect may be long-standing. Oropharyngeal swabs were obtained pre-, immediately post- and 6-11 months following completion of Hajj and tested for the presence of meningococci., Results: Amongst 2000 individuals approached, only 1146 participants aged 18-91 (mean 37.6) years agreed to participate and were randomized to receive either the polysaccharide (n = 561) or the conjugate (n = 561) vaccine, 60.8% were male, and 93.5% were from Saudi Arabia. Amongst oropharyngeal swabs obtained before Hajj, only two (0.2%) tested positive for Neisseria meningitidis. Similarly, meningococci were identified in only one sample at each of the post-Hajj and late follow-up visits. None of the carriage isolates were amongst the serogroups covered by the vaccines. A post hoc analysis of the third swabs revealed that 22.4% of all participants (50/223) were positive for Streptococcus pneumoniae nucleic acid., Conclusion: The low overall carriage rate of meningococci found amongst Hajj pilgrims in 2016 and 2017 demonstrates a successful vaccination policy, but neither supports nor refutes the superiority of meningococcal conjugate ACWY vaccine over the polysaccharide vaccine against carriage. Although an association could not be established in this study, molecular epidemiology would help to establish the role of Hajj in facilitating transmission of pneumococci and inform vaccination policy., (© International Society of Travel Medicine 2020. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

Studies on the assessment of indoor air pollutants in terms of concentration and characterization in the Gulf Cooperation Council (GCC) countries have been recently carried out. This review assesses the health effects associated with indoor air pollution exposures in GCC, including other air pollutants (siloxanes, flame retardants, synthetic phenolic antioxidants) which were not explored in a previous study. In addition, the influence of ventilation conditions due to different indoor environments was also investigated. It was revealed that there is a lack of human health assessment studies on most indoor air pollutants in almost all GCC countries, except the United Arab Emirates, Kingdom of Saudi Arabia and Kuwait, where few attempts were made for some specific pollutants. Commonly reported plausible health effects potentially associated with indoor air pollution were related to respiratory symptoms and sick building syndrome (SBS). Many of the current health assessment studies in GCC countries were based on predictions and/or estimates of exposures rather than clinically based observational studies. Measured ventilation levels and indoor air velocities in most buildings failed to meet the American Society of Heating, Refrigerating and Air-conditioning Engineers (ASHRAE) threshold limits of 8 L/s/p and 0.18-0.25 m/s, respectively. Additionally, limited studies have investigated respiratory symptoms and SBS potentially attributable to poor ventilation in the region. It is highly recommended that future indoor air quality (IAQ) studies in GCC should focus more on epidemiologic and intervention studies.

Background : Influenza is a common respiratory infection at Hajj. Thus, influenza vaccine is recommended for Hajj pilgrims but data on its effectiveness from a large sample are unavailable. This analysis aims to assess the effectiveness of the trivalent seasonal influenza vaccine (TIV) among Hajj pilgrims. Patients and methods : A 'test-negative' case-control analysis using data from individual studies was conducted. Included studies involved participants from Saudi Arabia, India, Australia and the United Kingdom who attended Hajj in Makkah, Saudi Arabia in different years between 2005 and 2015. Pilgrims who developed symptoms of respiratory infection during Hajj were included in these studies. Participants' vaccination histories were recorded and respiratory samples were collected to test for influenza by PCR. Vaccine effectiveness (VE) was calculated after adjusting for potential confounders. Results : A total of 1,569 pilgrims were included in this analysis. Influenza vaccine uptake was 52.2% and the attack rate of influenza was 8.2%. The estimated overall VE was 43.4% (95% CI 11.4% to 63.9%, P = 0.01). VE against a specific subtype of influenza was not significant. Conclusion : The current analysis has shown that TIV is moderately effective among Hajj pilgrims, but the vaccine uptake has been suboptimal. Power was much reduced when testing for influenza subtypes.

Middle East respiratory syndrome coronavirus (MERS-CoV) has emerged in the Arabian Gulf region, with its epicentre in Saudi Arabia, the host of the 'Hajj' which is the world's the largest mass gathering. Transmission of MERS-CoV at such an event could lead to its rapid worldwide dissemination. Therefore, we studied the frequency of viruses causing influenza-like illnesses (ILI) among participants in a randomised controlled trial at the Hajj 2013. We recruited 1038 pilgrims from Saudi Arabia, Australia and Qatar during the first day of Hajj and followed them closely for four days. A nasal swab was collected from each pilgrim who developed ILI. Respiratory viruses were detected using multiplex RT-PCR. ILI occurred in 112/1038 (11%) pilgrims. Their mean age was 35 years, 49 (44%) were male and 35 (31%) had received the influenza vaccine pre-Hajj. Forty two (38%) pilgrims had laboratory-confirmed viral infections; 28 (25%) rhinovirus, 5 (4%) influenza A, 2 (2%) adenovirus, 2 (2%) human coronavirus OC43/229E, 2 (2%) parainfluenza virus 3, 1 (1%) parainfluenza virus 1, and 2 (2%) dual infections. No MERS-CoV was detected in any sample. Rhinovirus was the commonest cause of ILI among Hajj pilgrims in 2013. Infection control and appropriate vaccination are necessary to prevent transmission of respiratory viruses at Hajj and other mass gatherings.

Pallido-pyramidal syndromes combine dystonia with or without parkinsonism and spasticity as part of a mixed neurodegenerative disorder. Several causative genes have been shown to lead to pallido-pyramidal syndromes, including FBXO7, ATP13A2, PLA2G6, PRKN and SPG11. Among these, ATP13A2 and PLA2G6 are inconsistently associated with brain iron deposition. Using homozygosity mapping and direct sequencing in a multiplex consanguineous Saudi Arabian family with a pallido-pyramidal syndrome, iron deposition and cerebellar atrophy, we identified a homozygous p.G53R mutation in C19orf12. Our findings add to the phenotypic spectrum associated with C19orf12 mutations., (Copyright © 2013 Elsevier B.V. All rights reserved.)

We describe the clinical patterns and case-fatality rate associated with severe Rift Valley fever (RVF) in patients who were admitted to the Gizan regional referral hospital during an outbreak of RVF in Saudi Arabia from September through November 2000. A total of 165 consecutive patients (136 men and 29 women) were prospectively studied; all were identified according to a strict case definition, were confirmed to have RVF by serologic testing, and were treated according to a predetermined protocol. The major clinical characteristics of RVF included a high frequency of hepatocellular failure in 124 patients (75.2%), acute renal failure in 68 patients (41.2%), and hemorrhagic manifestations in 32 patients (19.4%). Sixteen patients had retinitis and 7 patients had meningoencephalitis as late complications in the course of the disease. A total of 56 patients (33.9%) died. Hepatorenal failure, shock, and severe anemia were major factors associated with patient death.

Admissions for scorpion sting in 1 year and deaths resulting from scorpion sting over 3 years were analysed. Features that indicated the severity of the clinical condition were identified. Pulmonary oedema and shock were the usual causes of death. Poor management of fluid therapy was responsible for the frequently unsatisfactory resolution of envenoming, especially when purified human plasma was used. The role of the scorpion antivenom used is questioned and controversy regarding the most appropriate sedative to use in the management of scorpion sting is still not resolved. An in-depth study of these management issues is urgently required.