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The study aims to identify the effect of a flipped classroom approach designed according to the cognitive theory of multimedia learning on the academic achievements of eighth-grade students (aged 14 years) in Saudi Arabia in computer science. To this end, a quasi-experimental design was used, with a sample of 67 students; 33 students were assigned to the experimental group, whereas 34 comprised the control group. The experimental group was subjected to the flipped classroom approach, whereas the control group was given direct instruction. To measure student achievements, an instrument that measures cognitive skills based on Revised Bloom's taxonomy levels was designed. Findings revealed a positive effect on the experimental group's achievement levels with respect to Bloom's higher order thinking skills, that is, applying, analysing, and evaluating. No difference was found between the two groups in terms of academic achievements at the remembering and understanding levels of Bloom's taxonomy. Moreover, learners with low prior knowledge showed a higher improvement in academic achievements compared with those with high prior knowledge. This corresponds to the assumption of the cognitive theory of multimedia learning that learners with low prior knowledge would benefit from its principles more than learners with high prior knowledge.

Elemental ratios (δ13C, δ15N and C/N) and carbon and nitrogen concentrations in macrophytes, sediments and sponges of the hypersaline Al-Kharrar Lagoon (KL), central eastern Red Sea coast, were measured to distinguish their sources, pathways and see how they have been influenced by biogeochemical processes and terrestrial inputs. The mangroves and halophytes showed the most depleted δ13C values of –27.07±0.2 ‰ and –28.34±0.4 ‰, respectively, indicating their preferential 12C uptake, similar to C3-photosynthetic plants, except for the halophytes Atriplex sp. and Suaeda vermiculata which showed δ13C of –14.31±0.6 ‰, similar to C4-plants. Macroalgae were divided into A and B groups based on their δ13C values. The δ13C of macroalgae A averaged –15.41±0.4 ‰, whereas macroalgae B and seagrasses showed values of –7.41±0.8 ‰ and –7.98 ‰, suggesting uptake of HCO3– as a source for CO2 during photosynthesis. The δ13C of sponges was –10.7±0.3 ‰, suggesting that macroalgae and seagrasses are their main favoured diets. Substrates of all these taxa showed δ13C of –15.52±0.8 ‰, suggesting the KL is at present a macroalgae-dominated lagoon. The δ15N in taxa/sediments averaged 1.68 ‰, suggesting that atmospheric N2-fixation is the main source of nitrogen in/around the lagoon. The heaviest δ15N (10.58 ‰) in halophytes growing in algal mats and sabkha is possibly due to denitrification and ammonia evaporation. The macrophytes in the KL showed high C %, N %, and C/N ratios, but this is not indicated in their substrates due possibly to a rapid turnover of dense, hypersaline waters carrying most of the detached organic materials out into the Red Sea. The δ13C allowed separation of subaerial from aquatic macrophytes, a proxy that could be used when interpreting paleo-sea level or paleoclimatic changes from the coastal marine sediments. [ABSTRACT FROM AUTHOR]

The precast concrete production process faces uncertainties and risks that reduce the efficiency of the Saudi precast concrete industry. Assessing the risk factors' interdependence yields better results than considering individual analyses only. The previous precast risk studies did not consider the interdependencies among risk factors concerning different process stages. This paper aims to identify precast risk factors and prioritize their importance in Saudi Arabia. Using a dynamic Bayesian network, the assessment considers the interrelationships among the risk factors and different production stages. The risk factors were collected from previous studies, evaluated, and classified into the five construction stages by performing structured interviews with ten experts. The probabilities of the root risks and conditional probabilities of intermediate and leaf risks were assessed based on the ten experts. Then, a Monte Carlo simulation was utilized to provide the status of these probabilities, which were considered input data for the GeNIe program. The main results revealed that erection productivity is the highest risk, with a probability value of 0.87. In addition, the design schedule's significance directly impacts production capacity, resulting in a probability value of 0.74. However, the site management risk is low, with a 0.32 probability value. This paper assists practitioners in optimizing construction schedules. [ABSTRACT FROM AUTHOR]

The current article investigates teachers' metaphoric modeling of foreign language teaching and learning at the College of Languages and Translation, King Saud University. It makes use of teaching philosophy statements as a corpus. Our objective is to analyze the underlying conceptualizations of teaching/learning, the teachers' perception of the students, and the teachers' self-perception. To do so, we have adopted a mixture of qualitative and quantitative methods. The framework adopted is Lakoff and Johnson's cognitive theory of metaphor, in particular the primacy of the conceptual over the linguistic, the power of metaphor to highlight and hide experience, and metaphor's inferential system of entailments. The conceptualizations of the domain of foreign language teaching and learning are then measured against concepts in the philosophy of education such as teacher centeredness, student centeredness, and learning centeredness, using cost-benefit analyses.

In this study, we investigated both meat-derived and methicillin-resistant Staphylococcus aureus (MRSA), exploring their genetic relatedness to patient-derived MRSA isolates in Saudi Arabia. We collected 250 meat samples and identified 53 S. aureus isolates, with 79% being methicillin-sensitive Staphylococcus aureus (MSSA) and 21% being MRSA. Moreover, we included 80 clinically confirmed patient-derived MRSA isolates. We identified the most common S. aureus clone in both patients and retail meat. In meat, ST6 and ST97 were the most common clones in 55% of the MRSA isolates, and ST1153 and ST672 were the most common in 21% and 17% of the MSSA isolates. In patients, ST5 and ST6 were the predominant clones in 46% of the S. aureus isolates. CC5/ST5-SCCmecVc-t311 and CC361/ST672-SCCmecV-t3841 were common MRSA clones in both meat and patients. CC97 and CC361 clones were the second most prevalent S. aureus clones in meat and were relatively common in patients. Furthermore, we sequenced and characterized novel S. aureus strains ST8109, ST8110, and ST8111. The genomic similarities between meat- and patient-derived S. aureus isolates suggest that retail meat might be a reservoir for S.aureus and MRSA transmission. Therefore, a structured One Health approach is recommended for S. aureus dissemination, genetic characterization, antibiotic resistance, and impact on human health. [ABSTRACT FROM AUTHOR]

(1) Background: Missed nursing care, an omission error characterized by delayed or omitted nursing interventions, poses significant risks to patients' safety and quality of car.; (2) Methods: This is a quantitative cross-sectional study on 151 nurses who work in NICUs in three main networks in the Eastern Health Province, Saudi Arabia: Dammam (n = 84), Qatif (n = 53), and Jubail (n = 14). The study uses a self-reported questionnaire (MISSCARE) and applies the 5-point Likert Scale. Statistical analysis data were analyzed using SPSS version 23.0. (3) Results: The primary reasons for missed care were shortage of nursing staff and unbalanced patient assignments. Missed nursing care negatively affects job satisfaction and was positively correlated with nurses' intentions to quit their jobs. Inadequate equipment, supplies, and breakdowns in communication between nurses and other healthcare professionals were also significant factors contributing to missed care. (4) Conclusions: Missed nursing care is associated with overwork, nursing shortages, and lower job satisfaction, impacting the quality of care provided in the NICU. Improving working conditions, nurse staffing, and patient assignment planning should be prioritized to address this issue effectively. [ABSTRACT FROM AUTHOR]

Alport syndrome (AS) is a rare genetic disorder categorized by the progressive loss of kidney function, sensorineural hearing loss and eye abnormalities. It occurs due to mutations in three genes that encode for the alpha chains of type IV collagen. Globally, the disease is classified based on the pattern of inheritance into X-linked AS (XLAS), which is caused by pathogenic variants in COL4A5, representing 80% of AS. Autosomal recessive AS (ARAS), caused by mutations in either COL4A3 or COL4A4, represents 15% of AS. Autosomal dominant AS (ADAS) is rare and has been recorded in 5% of all cases due to mutations in COL4A3 or COL4A4. This review provides updated knowledge about AS including its clinical and genetic characteristics in addition to available therapies that only slow the progression of the disease. It also focuses on reported cases in Saudi Arabia and their prevalence. Moreover, we shed light on advances in genetic technologies like gene editing using CRISPR/Cas9 technology, the need for an early diagnosis of AS and managing the progression of the disease. Eventually, we provide a few recommendations for disease management, particularly in regions like Saudi Arabia where consanguineous marriages increase the risk. [ABSTRACT FROM AUTHOR]

There is compelling evidence for the psychological effects of the COVID-19 pandemic and earlier epidemics. However, fewer studies have examined the subjective meaning experience of healthcare providers who have survived COVID-19 as patients. This qualitative study aimed to understand further and describe the life experiences of healthcare providers who have survived COVID-19 as patients in Saudi Arabia. Data was collected using unstructured in-depth individual interviews among n = 10 healthcare providers from public hospitals in Saudi Arabia. Data were analyzed based on a phenomenological approach, which resulted in five themes: (i) physical and psychological signs and symptoms; (ii) self-healing, hiding pain, and family; (iii) fear of complications; (iv) disease stigma & long-term psychological outcomes; (v) emotional support, mental well-being & resignation. The overall synthesis showed that healthcare providers, as patients, experience the same difficulties and stressors as the general public. In some cases, these factors are even worse, as family members, colleagues, and employers develop a new type of stigma. Given the impact of social media and the flow of information of any type, more research is needed to examine the sources used to obtain information by the general public, whether these sources are reliable, and how the public can be taught to use only scientific data and not social data. Understanding the experience of healthcare providers as patients during the pandemic has allowed to look at the feelings and needs of people during illness from a new perspective. As expressed by participants, being a healthcare provider does not reduce the fear of the disease and does not mitigate its consequences in the form of stigmatization and isolation. [ABSTRACT FROM AUTHOR]

Background: Intermittent fasting (IF) is a popular dietary plan for weight loss. In fact, fasting is a common practice in different religions such as Buddhism, Hinduism, Judaism, Christianity, and Islam. During the month of Ramadan, more than 1.5 billion Muslims worldwide fast from dawn to sunset. Ramadan diurnal intermittent fasting (RDIF) has health benefits, including a reduction in cardiovascular disease (CVD) risk and an improvement in mood. However, little is known about the effects of RDIF on lifestyle behaviors, such as regular exercise, consuming healthy diet, and avoiding harmful substances, as well as mental stress, and academic performance in high school and university students. Methods: In this prospective cohort study, two self-reported questionnaires were sent one week before and during the last week of Ramadan (April 2022; Ramadan 1443 in Hijri Islamic Calendar) to assess changes in lifestyle, perceived stress, and academic achievement of medical students at Taif University in Taif city, Saudi Arabia. Healthy lifestyle components data were collected to calculate healthy lifestyle scores, including body mass index, physical activity, adherence to a Mediterranean diet, smoking status, and sleep duration. Results: RDIF was associated with a healthier lifestyle in both female and male participants (pre-RDIF mean score: 2.42 vs post-RDIF mean score: 2.74; statistical power = 0.99; P-value < 0.05). They were more active and adherent to the Mediterranean diet during RDIF. Additionally, the post-RDIF smoking rate declined by 53.4%. Male participants showed higher perceived stress scores during RDIF (pre-RDIF mean score: 19.52 vs post-RDIF mean score: 22.05; P-value < 0.01). No changes in academic performance were observed upon RDIF. Conclusion: Medical students show healthier dietary and lifestyle behaviors and their academic performance is not affected during RDIF. However, perceived stress is higher among male students. [ABSTRACT FROM AUTHOR]

Background. Severe cutaneous adverse drug reactions (SCARs), although rare, are known to be associated with significant morbidity and mortality. SCARs include drug reaction with eosinophilia and systemic symptoms (DRESS), Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and acute generalized exanthematous pustulosis (AGEP). Studies on SCARs are limited in Saudi Arabia. This study aims to characterize SCARs at a tertiary care center in Saudi Arabia. Methods. A cross-sectional study was conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. All inpatient and emergency department consultations to dermatology were electronically reviewed during the period from January 2016 to December 2020. All patients who developed an adverse cutaneous drug reaction were enrolled. Detailed analysis was performed only for SCARs. The culprit medication was determined based on the latency period, history of previous intake of the medication, and drug notoriety. Results. There were 3050 hospital consultations to dermatology during the study period. Cutaneous adverse drug reactions constituted 253 (8.3%) cases. A total of 41 patients with SCARs were identified, accounting for 16.2% of all cutaneous drug reactions. Antibiotics and anticonvulsants were the most common causative drug groups accounting for 28 (68.3%) and 9 (22%) cases, respectively. DRESS was the most common SCAR. The latency period was the longest for DRESS and shortest for AGEP. Vancomycin was responsible for approximately a third of DRESS cases. Piperacillin/tazobactam was the most common cause for SJS/TEN and AGEP. The majority of drugs causing AGEP were antibiotics. The mortality rate was the highest in SJS/TEN (5/11 (45.5%)), followed by DRESS (1/23 (4.4%)) and AGEP (1/7 (14.3%)). Conclusion. SCARs are rare in Saudis. DRESS appears to be the most common SCAR in our region. Vancomycin is responsible for most cases of DRESS. SJS/TEN had the highest mortality rate. More studies are required to further characterize SCARs in Saudi Arabia and Arabian Gulf countries. More importantly, thorough studies of HLA associations and lymphocyte transformation tests among Arabs with SCARs are likely to further improve patient care in the Arabian Gulf region. [ABSTRACT FROM AUTHOR]

This study aims to analyze the impact of oil shocks on the external balance of Saudi Arabia, as one of the largest net oil-exporting countries. To this end, a time-varying parameter vector autoregression model (TVP-VAR) is estimated by using quarterly data covering the period between 1991: Q1 and 2021: Q4. We find that identifying the source of shocks plays an important role in understanding the time-varying impact of shocks on its economy. Our findings indicate that the global oil production shocks excluding Saudi Arabia have a negative and significant impact on the trade balance and are greater than the impact of the Saudi oil production shocks, which is not significant for most of the period. In addition, we found that oil price shocks have more profound and much greater impacts than global and domestic oil supply shocks. This may be attributed to the fact that oil price shocks are more than oil supply shocks, and supply shocks are linked to oil price shocks. However, impulse responses show that the effects of oil shocks are volatile over time and their effects are generally more pronounced during and immediately after global shocks. Our findings have serious implications for the trade balance of Saudi Arabia, particularly in the low and volatile oil price environment. [ABSTRACT FROM AUTHOR]

Objectives: To determine the distinctive clinical and pathological characteristics and outcomes of MF in a Saudi population. Methods: We conducted a retrospective analysis of all MF cases diagnosed clinically with pathological confirmation at King Abdulaziz Medical City in Riyadh from January 2016 to July 2022. Variables include demographical, clinical, and pathological MF traits and disease outcomes. Results: A sum of 73 patients were enrolled. The mean age was 44 years. The female-to-male ratio was 1.3:1. The mean duration between cutaneous manifestations and MF diagnosis was 33 months (2.7 years). Classic MF was the most common variant (60.3%), followed by hypopigmented MF (20.5%). Most patients (82.2%) had early-stage MF (IA, IB, and IIA). Patients who had CD4+/CD8+ with CD8 predominance had a favorable disease course (p=0.029). Topical corticosteroids were the most frequently prescribed treatment (79.5%). Three patients (4.1%) died from MF. The disease- specific survival rate for advanced-stage MF was 84.6%, which was significantly lower compared to early-stage MF (p=0.032). Conclusion: Among the Saudi population, MF has an earlier onset and slightly higher prevalence in females. Hypopigmented MF is more prevalent in this ethnic group. Immunohistochemical staining of CD4+/CD8+ with CD8 predominance may elucidate a favorable disease course. [ABSTRACT FROM AUTHOR]

This study investigated genotypic and phenotypic antimicrobial resistance profiles, phylogenic relatedness, plasmid and virulence composition of 39 Salmonella enterica strains isolated from chicken meat samples using whole genome sequencing (WGS) technology. Four distinct serotypes were identified; Salmonella Minnesota (16/39, 41%), Salmonella Infantis (13/39, 33.3%), Salmonella Enteritidis (9/39, 23.1%), and one isolate was detected for Salmonella Kentucky (1/39, 2.6%), with sequence types (STs) as followed: ST548, ST32, ST11, and ST198, respectively. Phenotypic resistance to tetracycline (91.2%), ampicillin (82.4%), sulfisoxazole (64.7%), and nalidixic acid (61.6%) was the most observed. Resistome analysis revealed the presence of resistance genes to aminoglycosides, β-lactamase, sulfonamides, trimethoprim, phenicol, lincosamide, macrolides, and tetracyclines. Plasmidome showed the presence of eight incompatibility groups, including IncA/C2, IncFIB(K)_1_Kpn3, Col440I&#$95;1, IncR, IncX1, IncI1_1_Alpha, IncFIB(S)/IncFII(S), IncHI2/IncHI2A, IncX2 and ColpVC plasmids across the 39 genomes. Three resistance genes, sul2, tetA and blaCMY-2, were predicted to be located on IncA/C2 plasmid in S. Minnesota isolates, whereas all S. Infantis isolates were positive to IncFIB(K)_1_Kpn3 plasmid that carries blaCTX-M-65 gene. Eleven Salmonella pathogenicity islands and up to 131 stress and/or virulence genes were identified in the evaluated genomes. Phylogenetic analysis showed four phylogroups that were consistent with the identified ST profiles with a high level of inter-diversity between isolates. This is the first genomic characterization of Salmonella isolates from retail chicken meat in Saudi Arabia using WGS technology. The availability of Salmonella genomes from multiple geographic locations, including Saudi Arabia, would be highly beneficial in future source-tracking, especially during epidemiological surveillance and outbreak investigations. [ABSTRACT FROM AUTHOR]

Escherichia coli O157:H7 is a foodborne pathogen, which causes various health conditions in humans, including fatigue, nausea, bloody diarrhoea and in some cases, even death. In 2017, 15.71% of the total imported food products in Saudi Arabia (SA) were meat-based. India and Brazil are two of the top five countries from where SA imports meat. According to the Saudi Food and Drug Authority, in 2017, at least 562, 280, and 50 samples of imported beef, chicken and sheep meat, respectively, were tested for the presence of E. coli O157:H7. Amongst these, E. coli O157:H7 was detected in respectively 6.80% and 2.20% of the tested beef meat samples imported from India and Brazil as well as in respectively 6.96% and 3.57% of the tested chicken samples imported from Brazil and Ukraine. Moreover, the pathogen was detected in 2.13% of the tested sheep meat samples imported from India. The present report provides evidence that imported meat can serve as the carrier of E. coli O157:H7, which may lead to epidemics within the Kingdom of Saudi Arabia. [ABSTRACT FROM AUTHOR]

Simple Summary: The results of prior studies on the genotypes and allele variations of the antiapoptotic gene and the risk of lymphoma are unclear. To address this gap, this case–control study included 205 Saudi patients, 100 of whom had lymphoma, and 105 who were healthy controls. Antiapoptotic genes, including B-cell lymphoma-2 (BCL2-938 C > A), MCL1 (rs9803935 T > G), and survivin (BIRC5-rs17882312 G > C and BIRC5-rs9904341 G > C) were identified using the tetra amplification refractory mutation polymerase chain reaction (PCR). BIRC5-C, MCL1-G, and BIRC5-G alleles were identified using allele-specific PCR. In addition to BCL-2-A mutations, lymphoma patients are more likely to have antiapoptotic gene genotypes and allele variations than healthy volunteers. The results could help classify and identify those at risk of lymphoma in the future. Background: The findings of earlier investigations of antiapoptotic gene genotypes and allele variants on lymphoma risk are ambiguous. This study aimed to examine the relationship between the mutation in the antiapoptotic genes and lymphoma risk among Saudi patients. Methods: This case–control study included 205 patients, 100 of whom had lymphoma (cases) and 105 who were healthy volunteers (controls). We used tetra amplification refractory mutation polymerase chain reaction (PCR) to identify antiapoptotic genes such as B-cell lymphoma-2 (BCL2-938 C > A), MCL1-rs9803935 T > G, and survivin (BIRC5-rs17882312 G > C and BIRC5-rs9904341 G > C). Allelic-specific PCR was used to identify alleles such as BIRC5-C, MCL1-G, and BIRC5-G. Results: The dominant inheritance model among cases showed that mutations in all four antiapoptotic genes were more likely to be associated with the risk of lymphoma by the odds of 2.0-, 1.98-, 3.90-, and 3.29-fold, respectively, compared to controls. Apart from the BCL-2-A allele, all three specified alleles were more likely to be associated with lymphoma by the odds of 2.04-, 1.65-, and 2.11-fold, respectively. Conclusion: Unlike healthy individuals, lymphoma patients are more likely to have antiapoptotic gene genotypes and allele variants, apart from BCL-2-A alterations. In the future, these findings could be used to classify and identify patients at risk of lymphoma. [ABSTRACT FROM AUTHOR]

Vaccination of healthcare providers has recently gained focused attention of public health officials. As HCPs have direct contact with the population, and HCPs significantly influence the population, this study aimed to compare the acceptance rate, advocacy rate, and beliefs about the COVID-19 vaccine among HCPs in two time periods. In this repeated cross-sectional study, different HCPs were assessed in two periods ten months apart, i.e., November to December 2020 and September to October 2021, which were before and after COVID-19 vaccine approval by authorities. The study was conducted in Qatif Central Hospital, Eastern Region of Saudi Arabia. There were 609 respondents: 236 participants in the first period and 373 participants in the second period. Only 13 participants did not get the COVID-19 vaccine. There was around a 40% difference in the acceptance rate between the two study periods; the latter period was higher at 94.7%. Furthermore, 24.1% was the difference between the willingness to advocate the COVID-19 vaccine for others; the first period had a lower percentage (60.1%). Overall, results of the study showed that vaccine hesitancy, as well as the willingness to advocate for the vaccine, were improved between the pre-vaccine approval period and post-vaccine approval period, showing that the efforts made by the government improved COVID-19 acceptance and advocacy among HCPs. However, vaccine hesitancy is not a new issue, and for a better understanding of HCPs' beliefs, a qualitative study is needed. [ABSTRACT FROM AUTHOR]

Background: Quality of working life (QWL) is a multidimensional concept that describes an employee's satisfaction with several work life elements. Quality of nurse working life is considered as a stepping stone for health services improvement, as it affects job satisfaction which, in turn, affects the performance of nurses. Understanding and investigating the nurses' quality of work life in Saudi Arabia is needed for improvement actions. Objectives: This study aimed to examine the quality of nursing work life (QNWL) among nurses working in Saudi Arabia and to determine the association between demographic variables and quality of work life among nurses. Methods: It was a cross-sectional design using Brooks' quality of nursing work life survey. It was distributed among nurses over the kingdom of Saudi Arabia. Results: There were 860 nurses participating in the study. The mean total score for the participants was 174.5+/− 30.3, indicating moderate to high QNWL. The highest score achieved by the nurses was for the work world context (4.29) while the lowest score was for work design dimension (3.92). The study revealed that nationality, income, and shift duration, having a dependent person, and having family accompany the nurse as significant factors affecting the quality of work life among the nurses. Conclusion: A novel contribution of the current study was that the demographic characteristics of the participants, including nationality, income, having family accompany the nurse, having an independent child, or spouse or parents, and shift duration, tended to have a statistically significant correlation with QNWL. The comprehensive results of this study have practical implications whereby authority bodies can create regulatory plans for enhancing satisfaction and performance over the sole utilization of job satisfaction measurements and can thereby improve nurses' retention and turnover rates. [ABSTRACT FROM AUTHOR]

The thrombospondin related anonymous protein (TRAP) is considered one of the most important pre-erythrocytic vaccine targets. Earlier population genetic studies revealed the TRAP gene to be under strong balancing natural selection. This study is the first attempt to analyze genetic diversity, natural selection, phylogeography and population structure in 199 clinical samples from Saudi Arabia using the full-length PfTRAP gene. We found the rate of nonsynonymous substitutions to be significantly higher than that of synonymous substitutions in the clinical samples, indicating a strong positive or diversifying selection for the full-length gene and the Von Willebrand factor (VWF). The nucleotide diversity was found to be π~0.00789 for the full-length gene; however, higher nucleotide diversity was observed for the VWF compared to the thrombospondin repeat region (TSP). Deduction of the amino acid sequence alignment of the PNP repeat region in the Saudi samples revealed six genotypes characterized by tripeptide repeat motifs (PNP, ANP, ENP and SNP). Haplotype network, population structure and population differentiation analyses indicated four distinct sub-populations in spite of the low geographical distance between the sampling sites. Our results suggest the likeliness of independent parasite evolution, creating opportunities for further adaptation, including host transition, and making malaria control even more challenging. [ABSTRACT FROM AUTHOR]

Contraception is one of the common methods of family planning. The oral contraceptive pill (OCP) is among the most effective methods of contraception. This study aimed to assess the knowledge, attitude, and practice of oral contraception use and its side effects among women in the Jazan region, Saudi Arabia. A cross-sectional study was carried out among adult women 18 years and older in the Jazan region. A pre-tested questionnaire was used to assess their demographic characteristics, knowledge, attitudes, previous experience, and pattern of OCP usage. Descriptive analysis and a logistic regression model were used to analyse data. About 570 questionnaires were distributed and achieved a 98.3% response rate. The majority of women participants were between 18 and 25 years old, and 51.4% of the respondents reported that they had previously used or were using OCP. We found that women had good knowledge and a positive attitude towards OCP, with more than half of the users preferring them over other contraceptive methods. This study indicates that attitude, knowledge, and prior experience of OCP have no significant effect on the usage pattern of OCP among women with relatively high socioeconomic status in the Jazan region, Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background. Malaria is still a public health problem in Saudi Arabia specifically in the Jazan region. Plasmodium falciparum knob-associated histidine-rich proteins (PfKAHRPs) play an important role in cerebral malaria pathophysiology as well as pathogenesis of P. falciparum infections. The repeat region of PfKAHRP C-terminal interaction domain has been found to bind to the infected red blood cells and the vascular endothelium. Thus, this study aimed to assess the allelic variations, genetic diversity, and natural selection acting at the C-terminal PfKAHRP between parasite isolates from Saudi Arabia. Materials and Methods. The PfKHARP C-terminal interaction domain was successfully PCR-amplified and sequence data from 441 clinical isolates from Saudi Arabia were obtained. The DnaSP v5.10 software was used to determine the genetic diversity, polymorphism, haplotype, and natural selection. Haplotype network analysis was constructed by using the median-joining method in the NETWORK version 5.0.0.1 software. Results. Alignment and analysis of 441 C-terminal PfKAHRP-deduced amino acid sequences identified 5 genotypes (I–V) based on the decapeptide repeat arrangements (TKEASTSKEA, TKEASTSKGA, TKEASTTEGA, and TKEASTSKRA). Among the repeat types, Type I (49.43%, 218/441) was the most abundant in Saudi Arabia, followed by Type II (48.29%, 213/441). Overall, the nucleotide diversity in the PfKHARP C-terminal region was found to be low in Saudi Arabia (π = 0.00142); however, natural selection tests indicated positive selection (dN-dS = 1.64, P < 0.05) which was due to the variations within the repeat motifs. Genealogical relationship haplotype network of PfKAHRP from 4 different countries (i.e., Saudi Arabia, Iran, Burundi, and India) revealed 1 major shared haplotype cluster (H_1) with samples representative from all 4 countries (Saudi Arabia; n = 441, Burundi; n = 4, Iran; n = 13, and India; n = 1). Conclusion. Since this is the first study to report on genetic diversity of C-terminal PfKAHRP interaction domain and the repeat motifs from clinical samples in Saudi Arabia, it will contribute towards the rational design of antiadhesion drug therapies for P. falciparum malaria. [ABSTRACT FROM AUTHOR]

Background: The English version of the Foot Function Index (FFI) is a reliable and valid tool for measuring pain and functional instability due to chronic lateral ankle instability (CLAI). However, its use among Arabic speakers with CLAI is limited because of the unavailability of the Arabic version of the FFI (FFI-Arb). This study aimed to translate, cross-culturally adapt and validate the FFI from the original English version into Arabic. Methods: The FFI questionnaire was translated using the Beaton guidelines. Two-hundred-and-thirty native Arabic-speaking participants with CLAI were recruited from different physiotherapy clinics in Saudi Arabia. The convergent validity of the FFI-Arb was tested using the Spearman correlation with the Arabic version Cumberland ankle instability tool (CAIT-Arab). Test-retest reliability was tested among 92 participants who completed the form again after seven days. Results: Two-hundred-and-thirty participants were enrolled (mean age = 32.09, Standard deviation (SD) = 8.64 years old). There was excellent internal consistency for the three subscales of FFI: pain (0.95), disability (0.97), and activity limitation (0.86), as for the total score (0.98). Convergent validity was analyzed by Spearman rank correlation between the new translated versions of FFI-Arb and CAIT-Arab. The total FFI-Arb and CAIT-Arab scores were moderately correlated (rho = − 0.569; p < 0.001). Subscales of FFI-Arb, such as pain, disability, and activity limitation, were also moderately correlated with CAIT-Arab (rho = − 0.565, rho = − 0.561, rho = − 0.512; p < 0.001). The construct validity was confirmed by principal component analysis (factor analysis) showing a three-factor structure (eigenvalue 1) of FFI-Arb with a total variance of 77.3%. Test-retest reliability was excellent for the total score of the FFI-Arb and all its subscales (interclass correlation coefficient = 0.984–0.999). Conclusions: The FFI-Arb is a reliable and valid tool for Arabic-speaking patients with CLAI. The FFI-Arb can be utilized in hospitals and clinics in Arabic speaking countries. [ABSTRACT FROM AUTHOR]

COVID-19 is a global pandemic viral infection that has affected millions worldwide. Limited data is available on the effect of COVID-19 on hematological parameters in Saudi Arabia. This study is aimed at examining the role of hematological parameters among COVID-19 patients admitted to King Khalid Hospital in Najran, Saudi Arabia. This is a retrospective, hospital-based study of 514 cases who were recruited during August to October 2020. 257 COVID-19 patients formed the study group, and a further 257 negative subjects formed the control group. Anemia was significantly elevated in positive subjects over controls (respectively, 64.2% and 35.8%), with patients 2.5 times more likely to be anemic (p < 0.01). Thrombocytopenia was higher in patients over controls (respectively, 62% and 38%), with patients ~1.7 times more likely to be thrombocytopenic (p < 0.01). Moreover, leukopenia was significantly higher in patients over controls (respectively, 71% and 29%), with positive subjects ~2.6 times more likely to be leukopenic. Our study results indicate that mild anemia associated with leukopenia may have diagnostic value for COVID-19. Careful assessment of hematological parameters, at baseline and throughout the disease path, will assist physicians in formulating personalized approaches to treatment and promptly offer intensive care to those in greater need. [ABSTRACT FROM AUTHOR]

The demand for liver transplantation in the Kingdom of Saudi Arabia (KSA) is associated with the country's high burden of liver disease. Trends in the epidemiology of liver transplantation indications among recipients in KSA have changed over 20 years. Non-alcoholic steatohepatitis has eclipsed the hepatitis C virus in the country due to the effective treatment strategies for HCV. Risk factors for NASH, like type 2 diabetes mellitus, obesity, and hyperlipidemia, are becoming a major concern and a leading indication for liver transplantation in the KSA. There is also a significantly increased prevalence and incidence of genetic adult familial liver diseases in KSA. New immunosuppressive agents and preservation solutions, improved surgical capabilities, and early disease recognition and management have increased the success rate of liver transplant outcome but concerns about the side effects of immunosuppressive therapy can jeopardise long-term survival outcomes. Despite this, indications for liver transplantation continue to increase, resulting in ongoing challenges to maximize the number of potential donors and reduce patient mortality rate while expecting to get transplanted. The Saudi Center of Organ Transplant is the recognized National Organ Donation Agency for transplantation, which renders important support for procurement and allocation of organs. This guidance document aims to help healthcare providers in managing patients in the liver transplant setting. [ABSTRACT FROM AUTHOR]

Fifty surficial bottom sediments from the Al-Shuaiba Lagoon (80 km south of Jeddah City, eastern Red Sea, Saudi Arabia) were investigated for some major and trace metals to map their concentration distribution in the lagoon, shed light on their origin and controlling factors, and to establish potential risks to living organisms through comparison with sediment quality guidelines (SQGs). Statistical analyses allowed the division of metals into five associations: (1) Mg-Ca-Sr, (2) Al-Zn-Cr-Ni-Cu, (3) Fe–Mn-Li, (4) K and (4) Pb–Cd. Their distributions indicated that elevated values of Al, Mg, Fe, Sr, K, Mn, Li, Zn, Cr, Cu, Pb, Ni and Cd occurred in high intertidal areas and in mangrove sediments. These decreased gradually towards the deeper waters and inlet, except for Ca, which had its highest concentration in the centre of the lagoon. Major elements mainly appear to originate from the mineralization and evaporation of the lagoon's water, whereas trace elements appear to originate from wind-blown dust and runoff, with subsequent concentration in sediments aided by adsorption onto fine particles and organic carbon complexes. Enrichment indices and a pollution load index (PLI) indicated that the lagoon sediments were highly enriched with Sr, Pb and Cd, with the latter two and PLI being the highest at the eastern side of the lagoon. Comparison with the SQGs showed that the concentrations of Cu, Pb and Cd are higher than the effect range low (ERL) and threshold effect level (TEL), but are lower than the effect range median (ERM). This suggests that these metals might cause an occasional threat to the biota in the eastern part of the lagoon. [ABSTRACT FROM AUTHOR]

Unlike the Tethys Realm, the carbon isotope record from the Boreal Realm exhibits a prominent negative excursion before the Jurassic-Cretaceous boundary referred to as the Volgian Isotopic Carbon Excursion (VOICE). The VOICE has been ascribed to restricted-circulation conditions in northern high latitude basins, which decoupled these basins from the global carbon pool. Similar isotopic signal has been identified in the southern hemisphere where it has been attributed to humid conditions and influx of organic matter. The restricted-circulation hypothesis is tested here by examining the depositional record of the Tethyan Late Jurassic–Early Cretaceous succession from central Saudi Arabia. A multi-disciplinary approach, involving sedimentology, sequence stratigraphy, biostratigraphy, and geochemistry, was adopted for studying a composite section covering the Hith, Sulaiy, Yamama, and Buwaib formations. The succession is characterized by restricted salina and sabkha depositional settings at the base that transition upward into an open-marine depositional system. This trend records a long-term sea-level rise during the Early Cretaceous. The carbon isotope record for this succession illustrates two prominent positive excursions of 5.2‰ and 2.6‰ amplitudes at the base and top of the succession, respectively. The larger positive excursion coincides with the restricted-environment facies and shows similarities, in terms of magnitude and trend, to the recovery phase of the VOICE. The upper positive excursion is manifested after a steady drop in the carbon isotope values, and it corresponds to the globally-recognized Weissert event. The results indicate that restricted circulation in the Arabian shelf interior during the Late Jurassic duplicated the VOICE signal. The recognition of the Weissert event signal, on the contrary, denotes restored circulation of the shelf interior with the Tethys. The novelty of this study is demonstrated by the findings that the VOICE might indeed be a global signal and restricted circulation driven by eustacy is the main controlling factor for the VOICE signal. • The role of eustacy and shelf geomorphology in controlling seawater isotopic evolution of carbonate platforms. • Restricted water circulation with the Tethys is manifested by a 5‰ depletion in δ13C carb within the Arabian shelf interior. • The Volgian Isotopic Carbon Excursion (VOICE) is potentially a global signal that extends beyond the Boreal Realm. • The VOICE is recorded in a Tethyan section. [ABSTRACT FROM AUTHOR]

What is known: Limitations of clinical trials in determining all safety concerns related to a drug are well recognized. Monitoring spontaneous adverse drug reaction (ADR) reports remains an easy and relatively inexpensive method for overseeing that a drug remains a safe and effective option for patients. Objective: To characterize and describe ADR reports at one of the largest healthcare institutions in the region and share the measures implemented by the team. Methods: We conducted a retrospective analysis of all ADRs submitted by healthcare providers in a tertiary healthcare system in Saudi Arabia between January 2016 and December 2019. The main outcome measures included reporting rate, patient characteristics, suspected drugs involved, seriousness and reporting specialities. Results and discussion: Throughout this study, 1156 ADR reports were submitted. The top reported ADR was immune system disorders (87.8%). The most represented class were antimicrobials (56.8%), followed by analgesics (11.4%) and diagnostic agents (5.1%). The ADRs were deemed definitely avoidable in 11.4% (132/1156) of the cases, and 24.2% (280/1156) were deemed possibly avoidable. Reporting ADRs has steadily increased over the years at our institution, but there continues to be a lack of reporting by physicians. Almost one‐third of the reported ADRs were considered to be avoidable or possibly avoidable, which is a driver to continue pharmacovigilance activates on an institutional level and provide specific and tailored preventative measures guided by the specific types of ADRs reported. What is new and conclusion: This is the first study to report trends of ADRs spontaneously reported at one of the largest healthcare institutions in the Middle East. It shows similar trends to what has been reported by other institutions, with mainly immediate immunological ADRs being the top reported ADRs, which could be explained by the immediate onset which simplifies the temporal association. Every institution should support and maintain an active ADR team, with responsibilities of evaluating incidents, monitoring trends and most importantly identifying opportunities to improve medication and patient safety. We share here our workflow and hope it serves as a guide for other institutions. [ABSTRACT FROM AUTHOR]

The cyber-security development for future generations is at stake as a global concern. The existing strategic and policy structures on cyber security and awareness-raising at many levels needs more investigation in order to formulate workable and efficient strategic vision that addresses actual needs and challenges. The justification for this work is therefore to test the robustness, in contrast with some of the most technologically advanced countries on the Asian Continent and others like the USA, Japan, of Saudi Arabia's current cyber security strategy in order to keep the NCSS up-to-date. This research aimed to develop a strategic vision to combat cybercrime to enhance cyber security. The research results confirmed the approval of the members of the study community to a medium degree on the reality of digital extremism and cyber terrorism as seen by the researcher. Moreover, the approval of the members of the study community was to a high degree on the role of combating cybercrime in promoting human security as seen by the researcher. The members of the study community agreed with a high degree on the obstacles identified by the researcher to combat cyber-crimes to enhance human security in Saudi Arabia. There was a high approval of the study community members on the strategic vision developed by the researcher to combat cyber-crimes to enhance human security in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Introduction. Sunscreen is an important method of sun protection. Many studies were conducted worldwide on the use of sunscreen but only few done in Saudi Arabia. The aim of our study is to assess the prevalence, practices, and factors associated with sunscreen use among Saudi university students. Materials and Methods. A cross-sectional study was performed at King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A questionnaire on the use of sunscreen was created in English. Quota sampling technique was used since the sample was divided according to gender and college year. Results. A total of 1,011 students were enrolled. Approximately half were males (n = 510). Half of the students used sunscreen (n = 515, 51%). Female gender, high family income, previous history of sunburn, tanning bed use, and use of other sun protection methods were factors independently associated with sunscreen use. The main reasons for using sunscreen were prevention of sunburns, dark spots, skin cancer, and overall skin darkening. Eighty percent of participants used other methods of sun protection. Sunscreen with a sun protection factor (SPF) > 30 was used in 59% of students. However, the majority did not know if the sunscreen they use provided broad-spectrum coverage or not. Only 35% of students apply sunscreen in both sunny and cloudy days. Most students apply sunscreen less than 10 minutes before going out and do not repeat the application throughout the day. More than 90% of students seem to apply insufficient amount of sunscreen. Conclusion. Almost half of the population in the study use sunscreen. We have identified several areas of improper use of sunscreen. Increasing the awareness of effective sunscreen use in our community might be needed. [ABSTRACT FROM AUTHOR]

Introduction. Alopecia areata (AA) is a common autoimmune disorder of hair follicles characterized by patches on nonscarring hair loss. Reports of prevalence and clinical characteristic of AA in Saudi Arabia are limited. The aim of our study is to describe the prevalence and clinical characteristics of Saudi patients with AA. Materials and Methods. A retrospective cross-sectional study was conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with AA between January 2016 and December 2017 were included. Data included patient demographics, type of AA, disease duration, family history of AA, and comorbid autoimmune diseases. Results. A total of 216 patients with AA were included. The overall prevalence of AA was approximately 2.3%. The mean disease duration at the time of presentation was 2 months while the mean age of onset was 25.61 years. The most common type of AA in both adult and pediatric groups was the patchy type involving the scalp. Comorbid diseases were found in 32.41% of patients. Common associated conditions included hypothyroidism, diabetes mellitus, and atopic diseases. Conclusion. The overall prevalence of AA among a population of Saudi patients is 2.3%. AA prevalence is higher in pediatrics than adults. Common comorbid conditions include hypothyroidism, diabetes mellitus, and atopic diseases. [ABSTRACT FROM AUTHOR]

The study aims to identify the effect of a flipped classroom approach designed according to the cognitive theory of multimedia learning on the academic achievements of eighth‐grade students (aged 14 years) in Saudi Arabia in computer science. To this end, a quasi‐experimental design was used, with a sample of 67 students; 33 students were assigned to the experimental group, whereas 34 comprised the control group. The experimental group was subjected to the flipped classroom approach, whereas the control group was given direct instruction. To measure student achievements, an instrument that measures cognitive skills based on Revised Bloom's taxonomy levels was designed. Findings revealed a positive effect on the experimental group's achievement levels with respect to Bloom's higher order thinking skills, that is, applying, analysing, and evaluating. No difference was found between the two groups in terms of academic achievements at the remembering and understanding levels of Bloom's taxonomy. Moreover, learners with low prior knowledge showed a higher improvement in academic achievements compared with those with high prior knowledge. This corresponds to the assumption of the cognitive theory of multimedia learning that learners with low prior knowledge would benefit from its principles more than learners with high prior knowledge. Lay Description: What is already known about this topic: Increasingly, K‐12 teachers around the world are using the flipped classroom approach (FCA) with their students.Previous studies have shown mixed results on the effects of flipped learning on academic achievements.Scholarly research is limited regarding the use of cognitive theory of multimedia learning (CTML) as a theoretical framework for designing instructional videos in flipped learning.Several flipped learning studies have not provided data of their outcomes or assessment as per level of cognition. What this paper adds: This study presents an improved approach for flipped learning by integrating CTML with flipped learning.A comparison was conducted for the effects of FCA designed according to CTML on the academic achievements of students with high and low prior knowledge.A proposed model has been introduced for the application of flipped learning in K‐12 education. Implications for practice and/or policy: Designing instructional videos in flipped learning should be based on a theoretical framework.Flipped learning research needs to employ Bloom's taxonomy to understand the outcomes or assessments according to cognition levels.Adopting FCA designed according to CTML may be more important for teachers whose students clearly suffer from poor academic achievements. [ABSTRACT FROM AUTHOR]

Injectable gold is known to deposit in the dermis for life, and such patients are at risk of developing chrysiasis post-laser exposure. It is unknown if patients with history of edible gold consumption would develop a similar reaction after quality-switched laser exposure. Our aim is to assess if patients with history of edible gold consumption develop chrysiasis after quality-switched laser exposure. This is a proof of concept pilot study conducted between September 2017 and September 2018 at two dermatology clinics in Riyadh, Saudi Arabia. Adult patients who have history of edible gold consumption were recruited to receive a spot test with different quality-switched lasers in a hidden, non-sun-exposed skin site. The test area was photographed before, immediately after, and 10 min after laser exposure. The test area was examined by two independent investigators for the development of chrysiasis. A total of 10 patients (five male and five female) were enrolled. The mean age was 31.7 years. Forty percent of subjects consumed edible gold more than once, and the duration of last intake ranged from 3 weeks to 3 months. Chocolate was the main source of edible gold. All participants had no chrysiasis reaction post-quality-switched laser exposure. Contrary to our hypothesis, all participants with history of short-term edible gold consumption did not develop chrysiasis after quality-switched laser exposure. Further controlled studies including more patients with longer duration and higher frequency of edible gold consumption are needed. [ABSTRACT FROM AUTHOR]

Molecular identification of major blast resistance (R) genes in rice was performed in a group of 10 rice (Oryza sativa) genotypes from Egypt and Saudi Arabia using six DNA markers (T8042, NSB, YL153/YL154, RM3843, RM3330, and z4794) belonging to three classes: single-nucleotide polymorphisms (SNPs), simple sequence repeats (SSRs), and insertion-deletions (InDels). The markers were chosen based on their linkage to six major R genes (Pit, Pib, Pi39 (t), Pi40 (t), Piz/Piz-t, and Pita/Pita2). The studied markers showed low allelic diversity, with the number of alleles identified in a single genotype ranging between two and nine alleles. The Egyptian genotype Eg-N-7 had two alleles of the Pi40 (t) gene, while the Saudi Arabian genotype Al-Ahsa1 had nine alleles that belonged to the seven R genes. The studied genotypes were also assessed for 19 agro-morphological traits. Analysis of variance of the studied traits showed significant differences among the genotypes. The putative associations between molecular markers and the agro-morphological traits were examined using associationmapping approach by employing the unified mixed model. Eight significant marker-trait associations were detected for eight agro-morphological traits (plant height, panicle length, sterility percentage, grain width, grain shape, elongation percentage, gelatinization temperature, and days to maturity). The phenotypic variance shown by each marker ranged between 43% and 65%. The findings of the current study will assist in identifying possible blast resistance genotypes for future rice breeding programs. Additionally, the results highlight the possible dual usage of specific markers in genotypic screening as well as in determining marker-trait associations. [ABSTRACT FROM AUTHOR]

The current study addresses lack of knowledge about assessment and management of postpartum depression (PPD) among nurses and midwives in Saudi Arabia. A descriptive, cross-sectional design was used to recruit a convenience sample of 181 nurses and 143 midwives. Data were collected using a selfadministered questionnaire. Nurses and midwives lacked knowledge about various aspects of PPD, including its definition, prevalence, symptoms, risk factors, screening tools, and treatment. Only one third of participants were confident in their ability to provide education for women about PPD. Participants' selfconfidence to educate women about PPD was significantly correlated with their level of knowledge about assessment and management of PPD. Continuing education is recommended for health care professionals to improve knowledge regarding PPD. Further studies are needed to determine the eff ectiveness of educational interventions on improving knowledge, practice, and self-confidence about PPD. [ABSTRACT FROM AUTHOR]

Due to the scarcity, randomness, and extremity of rainfall events in arid regions, planning and management of water resources are essential. Rainfall in many arid regions such as Saudi Arabia is characterized by high intensity and short duration during which flash floods occur and cause not only major loss in life and structures but also a huge loss of clean water. Understanding the relationship between rainfall and runoff is the key issue in the management and control of water resources. In this study, two approaches have been applied using Hydrologic Engineering Center’s Hydraulic Modeling System model to simulate flood hydrographs of a mountainous watershed located on the west side of Saudi Arabia. The first approach was based on incorporating losses through the soil conservation service (SCS) curve number and SCS unit hydrograph. The second approach was based on effective rainfall in which excess rainfall was computed by Horton’s infiltration method and the Phi index method. Results revealed that the performance of losses incorporation approach was poor in simulating runoff hydrographs in all studied storms. Its main drawback was the ineffective representation of flow mass conservation and the early generation of runoff due to rainfall input. In contrast, the effective rainfall approach simulated runoff hydrographs efficiently; moreover, results were comparable with many of those reported in the literature. The two critical hydrograph parameters of peak flow and time to peak were simulated accurately by Phi index method and Horton’s infiltration method. The sensitivity analysis showed that the peak flow is directly proportional to the curve number and inversely proportional to the initial abstraction. From water management point of view, the simulated hydrographs added a valuable piece of information about the quantification of lost and stored rainwater. About 55%–70% of rainwater infiltrates through the soil profile and recharges the underlined groundwater reservoir, hence becomes a major source of water in the region. [ABSTRACT FROM AUTHOR]

Background/Aims: Hepatitis D virus (HDV) is a defective RNA virus that is dependent on hepatitis B surface antigen (HBsAg) for transmission and replication. HDV significance arises from the possibility of poor prognosis of hepatitis B virus (HBV) infection. In Saudi Arabia, HDV prevalence varied from 8 to 32% before the HBV vaccination program and ranged from 0 to 14.7% after the vaccination program was started. The last study, performed in 2004, showed a prevalence of 8.6% in hospital-based HBV cases and 3.3% in healthy donors. The aim of this study was to investigate the prevalence and molecular characterization of HDV in chronic hepatitis B (CHB) patients at the King Abdulaziz University Hospital in Jeddah, Saudi Arabia by molecular and serological techniques. To the best of our knowledge, this is the first study to detect HDV at the molecular level in Saudi Arabia. Patients and Methods: The study included samples from 182 CHB patients from Jeddah; 13 samples with HBsAg negative were excluded. Samples were tested for HDV-Ab, viral RNA by reverse transcriptase-polymerase chain reaction (RT-PCR) in the HDV L-Ag region and sequence analysis. Results: The mean age of the participants was 44.36 years; 75.1% of the participants were Saudi nationals, 58% were males. Nine samples were positive for HDV-Ab and four were borderline; all were subjected to RT-PCR amplification. Three of the positive HDV-Ab cases and 1 borderline case were positive by RT-PCR. All the positive cases had HBV genotype D, and the positive RT-PCR cases were positive for HBV DNA. One of the HDV viremic samples was of genotype 1 by sequencing. The prevalence of HDV in the study was 7.7%, which was lower in Saudis (6.3%) than in non-Saudis (11.9%). Conclusion: HDV coinfection does not seem to have an effect on the clinical status of the recruited CHB cases in this study. More studies are needed to investigate the genetic diversity in other areas such as the southern parts of the Kingdom. [ABSTRACT FROM AUTHOR]

The use of topical olive oil (OO) for skin health is common among Saudis and worldwide. Therefore, this cross-sectional study is aimed at assessing the use of topical OO for skin health among Saudis in Riyadh, Saudi Arabia. The questionnaire was administered to Saudis at four different malls in Riyadh, Saudi Arabia. A total of 401 participants were enrolled in the study. The results showed that the average knowledge score of the participants was 3.4±0.3 (out of 5) and 87% had fair knowledge. The top source of knowledge among the participants was friends/relatives. In the attitude section, the average score was 4.1±0.5 (out of 5). Females had a higher attitude score 4.2±0.5 as compared to males 4±0.5 (P=0.03). The most common reason for using topical OO among the participants was skin moisturizing (73%). Female gender was the only significant factor associated with the use of topical OO (P<0.001). The use of topical OO for skin health is highly prevalent in Riyadh, Saudi Arabia. Therefore, more awareness of the benefits and adverse effects of topical OO use is required especially from health educational organizations. The preliminary results of this study suggest further research with a larger sample in an academic setting across the nation. [ABSTRACT FROM AUTHOR]

Abstract: Dental education programs must make every effort to balance the demands of academic and clinical training of students, provide a reasonable quality of life and adequately prepare them for the continuing stress involved in the profession. This challenge has led to considerable interest in identifying sources of stress for students in dental education programs. Our study was structured with a prime objective of determining the perceived causes of stress among undergraduate dental students of the academic year 2009–10, at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Four hundred and twenty-five students participated with the overall response rate of 76.4%. This cross-sectional, questionnaire-based survey was carried out in the study population utilizing the 41-item modified Dental Environmental Stress (DES) scale, to assess the sources of stress and its severity. Descriptive statistics were calculated for severity and sources of stress. Results indicated that there was a positive recalibration of student perceptions in the areas of transition from preclinical to clinical level; “Performance pressure” stressed third year students the most. However, “Clinical requirements” was the greatest stressor with the highest mean for the fourth and fifth year students. The mean value of total DES score of female students is also statistically higher than that of male students (p <0.05). The item scores “Patient treatment”, “performance pressure” and “social stressors” are significantly more stressful in married than in the single study subjects (p <0.05). The overall findings of this investigation showed that dental students of King Saud University, perceived high levels of stress across all of the five study years with notable significance in the factor domain of “Workload”. [Copyright &y& Elsevier]

The objective of the present study is the assessment of Jeddah ambient air quality in terms of PM2.5, and the associated lead 7 years after phasing out leaded gasoline in Saudi Arabia. Twenty-four air samples were collected at four locations throughout Jeddah during the period from December 23, 2008 to April 6, 2009. The collected PM2.5-samples were analyzed by ICP-MS for determination of lead. The average atmospheric PM2.5 concentration was 50.8 µg/m3. Atmospheric PM2.5-concentrations were higher than the 24-h U.S. National Ambient Air Quality Standards (NAAQS) in 14 sample events. The average lead concentration for all samples was 0.07326 µg/m3. Atmospheric lead concentration was dependent on the sampling location. Concentrations at the two southern locations were higher than at the two northern locations. Southern locations had higher lead concentrations due to very high traffic density, in addition to their proximity to industrial zone. In general, the results of this study show a considerable decrease in atmospheric lead concentration 7 years after phasing out leaded gasoline. The study recommends further studies to accurately determine the current sources of atmospheric lead. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the most important causes of delay in public utility projects, based on the frequency and severity of the causes. A survey of randomly selected samples of contractors, consultants, and owners was carried out to assess the frequency of occurrence and the severity of impact of sixty potential delay causes. A frequency index and a severity index were determined for each cause. An importance index for each cause was then computed as the product of the frequency and severity indices. The results showed that the three parties surveyed generally agree on the importance ranking of delay causes. The causes were grouped also into six major categories of delay. The analysis showed lack of agreement among the parties on the ranking of the major categories of delay. [ABSTRACT FROM AUTHOR]

Provides information on a study on corporate mentoring in a developing economy, specifically in Saudi Arabia. Discussion on the elements of the basic model for industrial development being followed in the country; Synthesis of the comments of the respondents; Conclusions and recommendations.

This article discusses the results of a cross-cultural comparison of the managerial values of U.S. joint ventures in Saudi Arabia. In 1986, there have been 268 joint projects between Saudi Arabia and the U.S. This increasing penetration by U.S.-Saudi joint business ventures has led the Saudi government to experiment with policies intended to protect and control economic activity in Saudi Arabia. Management expert Peter Drucker reported that a better understanding of values, attitudes and managerial practices will become increasingly crucial to the effectiveness of multinational corporations. Hence, an understanding of the behavioral interactions between the Saudi manager and his American counterpart is of growing importance for effective managerial practices.

Background: urinary incontinence is a distressing common medical disease in which patient cannot control leakage of urine. The prevalence of urinary incontinence differs between countries and between different studies. The risk factors for urinary incontinence including increasing age, chronic cough, medical co-morbidity, childbirth, obesity, depression, smoking, gender and previous hysterectomy. Aim of the work: this study aimed to assess the prevalence of urinary incontinence in Saudi females and its associated risk factors. Methods: this was a cross-section study based on a survey on the internet, it included 400 female participants with a minimum age of 30 years old. Results: the prevalence of urinary incontinence was 44.25%, 66.3% of them were in age of 50 years and above. 43.5% of participants were obese, 19.5% were post-menopausal, 6.25% performed hysterectomy, 37.5 % had parity more than 3 times, 33% had depression and 35.5% had diabetes. Conclusion: prevalence of urinary incontinence was moderate. The most common risk factors for urinary incontinence were older age, menopause and high parity. [ABSTRACT FROM AUTHOR]

Natural radioactivity of soil samples has been studied in many countries of the Arabian Peninsula, including Saudi Arabia. Radiological indices based on soil radioactivity have been widely used in these studies. However, there are no available data about natural radioactivity of fine aerosol particles in such countries. The objective of this study is to determine the activity concentrations of 40K, 232Th and 238U in airborne PM2.5 and the associated internal inhalation radiation dose to the public in Jeddah City, Saudi Arabia. Twenty-four air samples in four locations throughout Jeddah were collected and analyzed for PM2.5 and the associated K, Th and U. The activity concentrations of the isotopes 40K, 232Th and 238U were calculated. High atmospheric PM2.5 concentrations (mean: 50.81 ± 34.02 μg/m3) were found. The natural radioactivity associated with PM2.5 due to the isotopes 40K, 232Th and 238U were 301.8 ± 76.1, 11.8 ± 4.2 and 10.8 ± 3.4 Bq/kg, respectively, and the Raeq was calculated as 44.9 ± 14.0 Bq/kg. The inhalation annual effective radiation dose to the public due to natural isotopes of the airborne PM2.5 was in the range 15.03–58.87 nSv/year, depending on the age group. Although these dose values were associated with the PM2.5 fraction only, they were higher than the world references values in air reported in the UNSCEAR, 2000 report. [ABSTRACT FROM AUTHOR]

Burning fossil fuels is a major concern for global warming control. In Saudi Arabia, steam power plants that relay on boilers to produce the steam accounted for around 50% of the total electricity generation capacity in 2021, in addition to 15% capacity from co-generation power plants. Fossil-based energy production produces harmful emissions, mostly NOx. The case of combustion efficiency and NOx emissions is complicated and cannot be addressed by simple theoretical model. This paper investigates the existing literature exploring data driven approaches via Artificial Intelligence (AI) and machine learning (ML) in a variety of applications, including mainly boiler optimization for efficient and clean energy production. The study discusses the importance of energy intelligence for industries in supporting decision making and prediction considering supervised learning, unsupervised learning, semi-supervised learning, and reinforcement learning. Expert systems, artificial neural networks (ANN), genetic algorithms (GA), fuzzy logic (FL), and different hybrid systems, which incorporate two or more techniques, are all included in AI systems. A condensed review of some recent literature is presented on the applications of support vector machines, ANN, GA, FL, and hybrid systems to combustion systems for emphasizing boilers' performance and emissions. An overview of boiler dynamics and control are presented and the use of AI for trade-off between boiler's efficiency and NOx emissions is discussed, with special focus being made on hydrogen combustion. The reported findings in this study demonstrate the promise of AI in control of emissions and optimization of performance in boilers with the least amount of construction and operating expenditures. The complexity and a number of restrictions present in emissions control systems, however, may reduce the likelihood of success. The specific perspectives are found to be data availability, data reliability, validity of methodology, and system complexity. It is concluded that wide variety of AI approaches have been used in a diversity of disciplines for modelling, predicting performance and controlling emissions of combustion processes. It is indicated that data representing the history and performance of real systems along with the proper selection of the AI model are crucial for setting up such systems. Based on this study, it can be stated that AI models are great tools towards better performance of boilers at minimum emissions. [ABSTRACT FROM AUTHOR]

Aim: The use of UNOS calculated panel reactive antibodies (cPRA) calculator to calculate sensitization for Saudi patients may not be relevant due to different donor pools. In this study, we compared HLA frequency of deceased donors at King Fahad Specialist Hospital-Dammam (KFSH-D) with UNOS frequency to evaluate the applicability of implementing the UNOS cPRA temporarily among Saudi patients. Methods: Medium resolution HLA class I and II genotypes were obtained from 148 deceased donors. Separate allele frequency was calculated for KFSH-D deceased donors belonging to West Asia, East Asia, South Asia and Africans. Phylip (v5) was used to calculate Nei’s genetic distance and generate Neighbor-joining (NJ) trees. Results: Majority of deceased donors at KFSH-D were of Asian descent.[figure1]In comparison to the antigen frequency in UNOS donors, some antigens were more frequent (eg, A24, B7, B8, B13, B27, B35, B44, DR10 and DQ5) while others were less frequent (eg, A3, DR1, DR4, DR7, DR13 and DR15). Genetically, South Asians and East Asians were closure to UNOS Asian donors while West Asians were closure to Caucasians.[figure2] Conclusions: Deceased donors analyzed at KFSHD have genetic similarity with Caucasian and Asian donors of UNOS. Adequate method for measuring the level of HLA sensitization based on national Saudi deceased donors HLA frequency is needed to establish a Saudi Arabian cPRA. [Copyright &y& Elsevier]

Objectives: To evaluate the various skin conditions diagnosed in intensive care unit (ICU) patients., Methods: This is a descriptive retrospective study of all adults, pediatric, and neonatal patients who were admitted to the ICU and had a dermatological manifestation during hospital stay or patients who had dermatological condition that requires ICU admission. All skin conditions were categorized and analyzed., Results: A total of 344 ICU patients with 365 different dermatological conditions were included in the study. The age of patients ranged from less than 1-96 years, with a mean age of 43.6±30.1 years. Of the patients, 189 (54.9%) were males. The top 3 general disease categories observed were skin infections, inflammatory and autoimmune diseases, and drug reactions. The most commonly reported dermatological disorders included morbilliform drug eruption (6.8%), contact dermatitis (6.3%), vasculitis (5.5%), herpes zoster (4.6%), purpura due to thrombocytopenia (3.8%), dermatitis/eczema (3.8%), candidiasis (3.8%), infantile hemangioma (2.7%), unclassified drug reaction (2.5%), intertrigo (2.5%), and herpes simplex virus (2.5%)., Conclusion: Dermatological disorders can occur at various levels of severity in the ICU. Skin infections, inflammatory and autoimmune diseases, and drug reactions were found to be the most prevalent conditions., (Copyright: © Saudi Medical Journal.)

Malaria is often characterized by a complicated disease course due to multifaceted intrinsic genetic factors of the host and the parasite. This study aimed to investigate the role of interleukin-27 ( IL-27 ) gene polymorphisms in Plasmodium falciparum malaria infection in a Saudi Arabian cohort. This case-control study obtained blood samples from 250 malaria patients with P. falciparum and 200 randomly identified healthy control subjects from the Malaria Center in the Jazan area. Malaria patients were grouped into three cohorts as follow: low (<500 parasites/µl of blood), moderate (500-1000 parasites/µl of blood), and high (>1000 parasites/µl of blood) parasitemia. The results show that the IL-27 variant rs181209 was significantly associated with malaria patients ( P  = 0.026). Similarly, the homozygous GG genotype of rs26528 was also associated with risk of developing P. falciparum malaria ( P  = 0.032). The minor allele C of variant rs181206 exhibited an association with low to moderate parasitemia ( P  = 0.046). Furthermore, the rs181209 AA genotype was statistically significant in age group 1-5 years ( P  = 0.049). In conclusion, this study suggests that variant rs181209 and rs26528 could be associated with the risk of malaria infection by P. falciparum in the population studied.

Objectives: The objectives of this study were to identify the composition of oral microbiota in a cohort of patients with sickle cell anemia (SCA) and a high mean number of decayed, missing, and filled permanent teeth (DMFT) and compare it to a cohort of patients with SCA and a low number of DMFT and elucidate the effect of fetal haemoglobin levels on the oral microbiota composition., Methods: Patients who had been diagnosed with SCA, who were homozygous for sickling β-globin mutation (β S /β S ), who had Arab-Indian haplotype, and who ranged in age from 5 to 12 years were included in this study. Oral saliva from each participant (n = 100) was collected in GeneFiX™ Saliva DNA Microbiome Collection tube and DNA was extracted using GeneFiX™ DNA Isolation Kits. The composition of oral 16S rRNA from patients with SCA and high dental caries (n = 27, DMFT ≥5) and low dental caries (n = 73, DMFT ≤4) was analysed. Sequencing was performed on an Ion Personal Genome Machine using, Ion PGM Hi-Q view Sequencing 400-bp kit., Results: We observed an overall increase in abundance of Proteobacteria, Chloroflexi, and Bacteroidetes in the high DMFT index group compared to those with a low DMFT index. In addition, there was an overall increased abundance of microbiota from Proteobacteria, Fusobacteria, Firmicutes, and Bacteroidetes in the patients with SCA with low fetal haemoglobin compared to those with high fetal haemoglobin (P < .05). Enterobacteriaceae species were the most significant abundant species of bacteria found in both the high DMFT index group and low fetal haemoglobin cohort (P < .05)., Conclusions: Our data indicate that SCA in Saudi patients with high DMFT have a higher predominance of pathogenic bacteria compared to those with low DMFT. Furthermore, SCA in Saudi patients with low fetal haemoglobin have a higher predominance of pathogenic bacteria compared to those with higher fetal haemoglobin., Competing Interests: Conflict of interest None disclosed., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)