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Higher Education Institutions (HEIs) providing online education have been facing challenges in an increasingly competitive market. Consequently, brand equity has gained importance. This study takes a holistic approach and identifies the antecedents of brand equity and the impact these have on building brand equity of online universities. Data was collected from 242 E-learners studying in online universities in United Arab Emirates, Saudi Arabia and Kuwait. The research model was empirically tested using structural equation modeling. The findings support four of the six hypotheses. Learning environment, reputation, career prospects and corporate social responsibility influence brand equity. This study contributes to the literature by offering a deductively generated model to guide future research on brand equity related to online universities. The findings of this study offer practical insights and managerial implications for university administrators engaged in building a brand equity. Detailed discussion of the theoretical and practical implications concludes the paper.

This study aimed to investigate the effectiveness of reciprocal teaching (RT) in improving high school female students' attitudes toward reading in a second language as the results might shed light on effective teaching practices in the L2 classrooms. To this end, a self-report questionnaire was developed and validated by the researcher. A quasi-experimental design was used, whereby the study sample was divided into two groups, experimental and control. The experimental group was taught reading in English classes by means of RT strategies, whereas the matched control group was taught reading by means of traditional instructive techniques. Both groups completed the self-report questionnaire on reading skills and motivation during term time, ensuring that the participants in the experimental group completed the questionnaire within ten weeks of the intervention. The findings show significant correlations between RT strategies and both reading comprehension and motivation to read, and are also effective in improving students' perception of their reading skills and motivation to read. Accordingly, the study recommends other researchers to investigate the effect of RT on students' performance and considering implementing RT with the use of technology in English as foreign language (EFL) classrooms.

Language anxiety as a specific aspect of language acquisition has occupied a great body of research for the past few decades. In this study, the level of foreign language anxiety among English language learners was investigated. This study was carried out with a quantitative research design using a survey methodology to collect data about the participants' language anxiety. The sample of the study included 100 university students from the college of Education at Princess Nora University in the Kingdom of Saudi Arabia. The participants were randomly selected. For this research study, Foreign Language Classroom Anxiety Scale developed by Horwitz, Horwitz, and Cope (1986) was used to collect the research data. Based on the findings of the study, several implications are highlighted.

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: It has been argued in the literature that quality assurance is a relative concept. In view of the new challenges (and opportunities) created by e-learning institutions in the Gulf Cooperation Council (GCC) countries, this paper aims to explore the dimensions of quality assurance in e-learning and test the psychometric properties of the underlying dimensions. Design/methodology/approach: A sequential mixed methods approach was applied in this study. In the qualitative phase, items were generated using the inductive and deductive approaches. This was then followed by the quantitative phase where data was collected from 275 senior academics, scholars and administrators associated with e-learning institutions in Kuwait, UAE and Saudi Arabia. Findings: The findings of this study revealed that e-learning quality assurance is a multidimensional construct. The dimensions of accreditation, assessment, accountability and benchmarking were identified. Further, the model demonstrated adequacy in its validity and reliability. Practical implications: In the light of proliferation of e-learning courses in GCC countries, the results of this are invaluable to enable administrators and instructors to design strategy and foster innovation in the domain of quality assurance. E-learning institutions operating in a competitive environment have to design and implement an effective strategy to achieve innovation, uniqueness and diversity in the educational sector of their countries. Originality/value: This paper has successfully validated an e-learning quality assurance questionnaire, which can be used effectively for evaluating e-learning programmes.

Background: Vitiligo is a chronic skin disorder characterized by the acquired depigmentation of the skin, arising from the selective destruction of melanocytes. This study aims to explore the public knowledge, awareness, and attitude towards vitiligo in Saudi Arabia. Method: An online cross-sectional survey study was conducted to assess public knowledge of vitiligo in October 2022. The questionnaire tool was created utilizing thorough literature reviews of papers that looked at public knowledge of vitiligo. The factors influencing the participants' knowledge of vitiligo were identified using binary logistic regression analysis. Results: A total of 372 individual participated in this study. The mean knowledge score of the study participants was 8.2 (SD: 3.6) out of 22 (37.3% out of 100%), which represents weak level of knowledge of vitiligo among the study participants. Logistic regression analysis identified that females, younger participants (19-30 years old), and those who work in the healthcare sector were more likely to be knowledgeable about vitiligo compared to others (p0≤0.5). Conclusion: It is highly recommended that Saudi Arabia prioritize awareness initiatives. The study demonstrates the widespread occurrence of the condition and the profound psychological impact it has, leading to feelings of isolation and diminished self-worth. Clearly, targeted educational programs are necessary to rectify misconceptions and foster comprehension, particularly among underinformed groups. Collaborating with healthcare professionals could prove to be highly beneficial. [ABSTRACT FROM AUTHOR]

Background. The COVID-19 pandemic had an enormous impact on people's quality of life worldwide. Appropriate use of facemasks is an important checkpoint in containing the spread of infection, which was believed to provide the desired level of protection and preserve the community. Given the relative novelty of facemask use in the general population, it is imperative to prioritize the promotion of appropriate facemask utilization and identify factors that may contribute to poor adherence. Aim. This study assessed the factors that determined facemask use among the public. Methods. A cross-sectional questionnaire-based study was conducted among the residents of the Kingdom of Saudi Arabia between November 2020 and January 2021. The current study explored the factors such as demographic characteristics influencing the knowledge and practice of proper use of facemasks. The study included a total of 198 participants. The results were derived through binomial logistic regression analysis to determine the relationship between the demographic characteristics and responses. Results. The key findings of the study which are crucial in developing targeted intervention strategies to enhance the responsible use and disposal of facemasks are gender, income and employment. A significant difference was found between male and female participants regarding a positive approach to using facemasks, such as washing their hands (P = 0:042). In addition, homemakers differed significantly from students, regarding the correct usage of facemasks (P = 0.026). The study participants were aware that hand hygiene is essential when putting on and removing facemasks. Despite wearing facemasks properly, adult participants possessed less knowledge about the hazards of reusing facemasks and appropriate disposal (ORD0.202, 95% CI [0.032-1.298]). Conclusion. The present research identified gender, income, and employment as the primary attributes that play a pivotal role in the formulation of focused intervention tactics aimed at improving the cautious use and appropriate disposal of facemasks. It is essential to implement nationwide awareness activities, such as information campaigns, to enhance knowledge. Health authorities should establish a functional infrastructure for the collection and disposal of used facemasks by the general public, starting with the dissemination of knowledge. Moreover, the results of the present study have significant implications for health preventive programs aimed at preparing for future pandemics, since they highlight the specific demographic groups that should be prioritized in the development of such policies. Furthermore, it is advisable to integrate these interventional initiatives with national health polices to promote preparedness for handling future pandemics. [ABSTRACT FROM AUTHOR]

BACKGROUND: The preparticipation physical evaluation (PPE) monograph is a vital resource for medical providers aimed at ensuring the safety and well-being of athletes during sports participation by screening for injuries and disease risk factors. However, the concept of PPE is relatively new in Saudi Arabia, where primary care physicians (PCPs) often lack the proper training for it. This study's aim was to assess PCPs' knowledge and practice of PPE and identify associated factors. MATERIALS AND METHODS: A self-administrated web-based questionnaire was distributed to PCPs in the Eastern Province of Saudi Arabia. The questionnaire covered the various aspects of PPE knowledge (including general principles, components, contraindications of sports participation, concerning history and physical findings, electrocardiography interpretations, and ethical considerations) as well as PPE practice. Initial treatment of data included descriptive statistics.; Chisquare tes or Fisher's exact test as, as appropriate, were used to determine association of knowledge and practices with various independent variables. RESULTS: Of the 240 contacted PCPs, 192 responded yielding a response rate of 80%; 50.5% had no prior PPE training. About 43% of the PCPs had not encountered PPE during their examination, but the remainder performed monthly PPE. Notably, 82.8% demonstrated a poor level of knowledge regarding PPE and only 43% had a satisfactory level of practice. CONCLUSION: This study revealed that a significant proportion of PCPs displayed poor knowledge of PPE and <½ of our sample showed satisfactory practice levels. Recommendations to establish the local guidelines regarding PPE for PCPs to follow should be emphasized and PPE training integrated into both undergraduate and postgraduate family medicine curricula. These measures are crucial for the enhancement of the safety of athletes in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: Effective inter-professional collaboration is vital for optimizing healthcare outcomes. This study focuses on healthcare workers in the Jizan Region, Kingdom of Saudi Arabia (KSA), to evaluate their knowledge, attitudes, and challenges concerning inter-professional collaboration. Aim: The study aims to assess the current state of interprofessional collaboration among healthcare workers (HCWs) in the Jizan Region, KSA, with a focus on understanding their knowledge levels, attitudes, identifying potential barriers, and examining the relationships between knowledge, attitudes, and demographic factors. Method: A descriptive and quantitative cross-sectional research design was employed, involving multidisciplinary healthcare teams in selected Jizan Region hospitals. Data were collected through a questionnaire measuring knowledge and attitudes, and analyses were conducted using SPSS version 28. Findings and Results: The demographic profile of healthcare workers in Jizan, KSA, reveals a predominantly male workforce (90.6%) with diverse educational backgrounds, notably featuring a high percentage of Ph.D. holders (33.1%). Psychometrically validated scales indicate positive attitudes (M=44.40) and high knowledge levels (M=49.34) among participants, with positively skewed distributions. Healthcare professionals displayed overwhelmingly positive attitudes (207 out of 257) and high knowledge levels toward emphasizing a positive foundation for collaborative practices in the region. Conclusion: The study contributes valuable insights to the KSA healthcare context, indicating a positive foundation for inter-professional collaboration. Recommendations include tailored training programs and interventions addressing communication barriers. Limitations, such as the crosssectional nature of the study, should be considered in interpreting the results. [ABSTRACT FROM AUTHOR]

Despite the availability of human papillomavirus (HPV) vaccines and screening facilities at various health centers in Saudi Arabia, the annual death rate due to cervical cancer is high. Therefore, knowledge and awareness are essential for self-care and educating others, particularly among healthcare students. The present descriptive, cross-sectional study explored female pharmacy students' knowledge, attitudes, and practices related to cervical cancer. A total of 140 students participated in the survey. The survey was conducted for the period between April 2022 to September 2023. We observed a good knowledge score and positive attitudes among 8.5% and 93.5% of participants, respectively. A total of 10% of the study participants reported good practice scores. Most participants had never been screened for cervical cancer (94.3%). Among the non-screened subjects, feeling healthy and lacking information were the participants' significant reasons for not screening for cervical cancer. A positive history of cancer related to smoking significantly impacted the knowledge score (p = 0.050). The current study reveals that healthcare awareness programs for cervical cancer and HPV vaccination are necessary at the level of educational institutions to improve public health. [ABSTRACT FROM AUTHOR]

Measuring patient safety culture in the community pharmacy can help with identifying areas for development. The current study is a descriptive, cross-sectional, electronic survey conducted among pharmacists working in community pharmacies located in the southern region of Saudi Arabia. The community pharmacy version of the "Pharmacy Survey on Patient Safety Culture" (PSOPSC) was used to collect data. The positive response rate (PRR) was calculated as per the guidance provided by the Agency for Healthcare Research and Quality (AHRQ). Based on the PRR, two least-achieved items (<25%) were taken for further analysis to identify the possible predictors. A sum of 195 pharmacists were included in this study and most of them were working in chain pharmacies. The highest PRRs were observed with teamwork (94.99), and patient counseling (94.13), followed by physical space and environment (93.07). The lowest PRRs were observed with staffing, work pressure, and pace (47.70), followed by communication openness (72.60). Specific characteristics, such as experience and the number of working hours, are significantly related to a poor PRR. The current study results indicate that the scope for improving patient safety exists in various areas of community pharmacies. However, it is necessary to prioritize the need based on a positive response rate. [ABSTRACT FROM AUTHOR]

Falls from height (FFH) are considered the most dangerous accident in the global construction industry, especially in emerging economies like Saudi Arabia. This study investigates the causative factors responsible for FFH accidents in the construction industry in Saudi Arabia. The approach used by the study entailed a review of the extant literature to identify the main causes of FFH accidents. The identified causes were used to develop a questionnaire survey, which was administered to construction professionals in Saudi Arabia. Useable feedback from ninety-one responses was obtained and consequently analysed using the Relative Agreement Index (RAI). The results revealed that the top three causes include "lack of training", "no safety inspection", and "no safety meeting and seminar between stakeholders". The causes were also categorized into three groups including "unsafe acts", "unsafe conditions", "communication barriers", and "management commitment", where "unsafe acts" was the most influential category. The significance of this study is its potential to help control the occurrence of FFH in the construction industry through the adoption of relevant controls, safety training, and risk-based decision-making in the planning and execution of construction works. [ABSTRACT FROM AUTHOR]

This paper undertakes a case study of a business school within a leading university in the Middle East, which has implemented a quality system and has gained accreditation by the Association to Advance Collegiate Schools of Business International. The paper reviews the development of the quality system and examines the concept of service quality in business education. The aim of this study is to address the paucity of service quality research in business education in this region. Empirical research is used to determine the factors that influence student evaluation of service quality. With data collected from 310 students, the study identifies six factors that influence students' evaluations of service quality. Research implications of the study are then discussed. (Contains 2 tables.)

Background: Continuous local infiltration analgesia (CLIA) can be administered via intraarticular or periarticular techniques in patients undergoing total knee arthroplasty (TKA). The purpose of this investigation was to retrospectively report a single-center experience of epidural analgesia with subcutaneous CLIA versus epidural analgesia without CLIA among patients undergoing TKA. Methods: This single-center retrospective study was conducted in Saudi Arabia. From January 01, 2014, to December 30, 2020, medical records of all patients who underwent TKA were reviewed. Patients who received subcutaneous CLIA with epidural analgesia were assigned to the intervention group, whereas those who received epidural analgesia without subcutaneous CLIA were assigned to the control group. The efficacy endpoints included: (i) postoperative pain scores at 24 h, 48 h, 72 h, and 3 months; (ii) postoperative opioid consumption at 24 h, 48 h, 72 h, and 24–72 h (cumulative); (iii) length of hospital stay; and (iv) postoperative functional recovery of the knee 3 months post-operation, according to the Knee Injury and Osteoarthritis Outcome Score. Results: At rest and during mobilization, the CLIA group (n = 28) achieved significantly lower postoperative pain scores 24 h, 48 h, 72 h, and 3 months post-operation than the non-CLIA group (n = 35). Subgroup analysis revealed that the CLIA group achieved significantly less opioid consumption 24 h and 48 h post-operation than the non-CLIA group. There was no difference between the groups regarding the length of hospital stay or functional scores 3 months post-operation. There was no significant difference between the groups regarding the rate of wound infection, other infections, and readmission within 30 days. Conclusion: Subcutaneous CLIA is a technically feasible and safe procedure without major adverse events but with reduced postoperative pain scores (at rest and during mobilization) and opioid consumption. Additional larger studies are warranted to confirm our results. Moreover, a head-to-head comparison between subcutaneous CLIA and periarticular or intraarticular CLIA is an interesting prospective investigation. [ABSTRACT FROM AUTHOR]

Historically, the combination of generous subsidies along with extreme climate has led to unsustainable domestic electricity consumption in Saudi Arabia. The residential sector constitutes a significant portion of this consumption. Amid the economic challenges, the country enforced a new electricity tariff for residential consumers in 2018. This study thus leverages change in 2018–2020 by collecting and analyzing the electricity consumption data of 73 households in the Eastern Province of Saudi Arabia. The energy consumption is modeled based on the households' attributes (e.g., dwelling type, ownership, number of residents, rooms, ventilation type, etc.) and applied tariffs using a machine learning technique. The extreme learning machine (ELM) is employed in solving the overfitting problem due to low-volume data. The correlation matrix is also constructed to determine the relationship between the household attributes. The ELM model developed in this study extracts the correlation between the input variables in determining energy consumption and also predicts the energy consumption related to low consumption data. The findings indicated that the electricity consumption between the pre-revised tariff year and the revised tariff enforcement year saw a reduction which was consistent in the subsequent years. This was also validated by the paired sample t-test, which showed a significant decrease in electricity consumption for the study period. The analysis also revealed that several household attributes had a relatively high impact on the reduction in the electricity consumption level following the revised tariffs, whereas the majority of the attributes had a moderate impact. In addition to these key findings, the demonstrated pathway adopted in this study is itself a methodological contribution that provides critical information about the sensitivity of the impacts of tariffs on energy consumption with respect to different household attributes. Economic factors being the critical stress need to be blended with existing energy consciousness for positive changes in favor of energy-saving behavior of the household members. The study does not attempt to represent the population of concern, but demonstrates a methodology that would help unleash inherent energy consciousness in favor of sustainable and energy-efficient behavior. [ABSTRACT FROM AUTHOR]

The big five personality traits and entrepreneurial mindset (EM) are crucial individual-level elements that determine entrepreneurial intention (EI). This study examines the impact of big five personality traits and EM, on EI using the theory of planned behavior. Besides, this study examined the role of entrepreneurial self-efficacy (ESE) and attitude toward entrepreneurship (ATE) influences EI. To achieve the research objectives, a quantitative approach was used. Structural equation modeling (SEM) and path analysis were conducted using SmartPLS software. Data were collected from 270 respondents through online questionnaires. Findings of the study revealed that big five personality traits influence ESE and ATE which led to EI. Finally, the moderating role of entrepreneurial passion was also found to have strong effect on influence ESE and ATE. This study offers evidence and insights that academics, educators, and others involved in the creation or expansion of entrepreneurial knowledge can use as a reference point. [ABSTRACT FROM AUTHOR]

Concerns about climate change and rising energy demands have grown as a result of fast population rise and global industrialization. The construction industry has a huge impact on the energy and environmental sectors, accounting for about 40% of global energy consumption and a large portion of overall territorial emissions. There is a need for a shift in mindset when it comes to energy usage, as well as enhanced energy efficiency approaches and radical energy efficiency initiatives. As an energy-saving solution, the green roof, also known as the living roof has suitability and environmental benefits on many levels, while also strengthening aesthetic features and provoking structural innovation. Moreover, drought-prone areas, e.g. Saudi Arabia, have significant household energy demands. The Saudi building sector consumes more than 76% of the country's total electric power generation. As a result, the purpose of this study is to provide a general overview of living roof technology and its potential in Saudi Arabia as an energy-saving strategy. An overview of the building envelope, the impact of cladding design considerations on power usage, the benefits of a living roof, costbenefit analysis, green policies, and examples from other countries are included in the paper. Other environmental benefits, besides the energy-saving potential of living roofs, were shown to boost the quantitative benefits of the living roof idea. A more detailed study is needed, among other things, to evaluate the energy-saving potential of living roofs based on the weather of various locations. [ABSTRACT FROM AUTHOR]

Background. Obesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. The aim of this study was to analyze the type of relationship between the dental caries and obesity among school children in Al-Jouf region of Saudi Arabia. Methods. This cross-sectional study was conducted among 400 participants aged 6 to 14 years. The study involved measuring caries (dmft/DMFT), assessing body mass index (BMI), and administering a self-completion questionnaire. An independent t-test, one- way ANOVA, and multivariate logistic regression analyses were performed. Results. Out of 400 participants, 380 agreed to participate in the study. Overall caries prevalence among the participants was 76.1% and mean DMFT and dmft values were 2.8 ± 1.0 and 3.7 ± 1.6. Among the factors associated with mean caries scores, relation between DMFT scores and frequency of consumption of sugar was statistically significant (F D 3.82,0.01). Regression models has identified children with increased BMI values has 3.2 times more risk of getting dental caries in permanent teeth (P D 0:001). Conclusion. There was a positive association between obesity and dental caries in school going Saudi Arabian children. Comprehensive multidisciplinary approach by health professionals is recommended for preventive public health issues related to caries and obesity in teenagers. [ABSTRACT FROM AUTHOR]

Simultaneous optimization of energy and water quality in real-time large-sized water distribution systems is a daunting task for water suppliers. The complexity of energy optimization increases with a large number of pipes, scheduling of several pumps, and adjustments of tanks' water levels. Most of the simultaneous energy and water quality optimization approaches evaluate small (or hypothetical) networks or compromise water quality. In the proposed staged approach, Stage 1 uses a risk-based approach to optimally locate the chlorine boosters in a large distribution system based on residual chlorine failures and the associated consequences in different land uses of the service area. Integrating EPANET and CPLEX software, Stage 2 uses mixed integer goal programming for optimizing the day-ahead pump scheduling. The objective function minimizes the pumping energy cost as well as the undesirable deviations from goal constraints, such as expected water demand. Stage 3 evaluates the combined hydraulics and water quality performances at the network level. The implementation of the proposed approach on a real-time large-sized network of Al-Khobar City in Saudi Arabia, with 44 groundwater wells, 12 reservoirs, 2 storage tanks, 191 mains, 141 junctions, and 17 pumps, illustrated the practicality of the framework. Simulating the network with an optimal pumping schedule and chlorine boosters' locations shows a 40% improvement in water quality performance, desired hydraulics performance with optimal pump scheduling, and an average 20% energy cost reduction compared to the normal (unoptimized) base case scenario. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal membrane oxygenation (ECMO) has been used as a rescue strategy in patients with severe with acute respiratory distress syndrome (ARDS) due to SARS-CoV-2 infection, but there has been little evidence of its efficacy. Objectives: To describe the effect of ECMO rescue therapy on patient-important outcomes in patients with severe SARS-CoV-2. Methods: A case series study was conducted for the laboratory-confirmed SARS-CoV-2 patients who were admitted to the ICUs of 22 Saudi hospitals, between March 1, 2020, and October 30, 2020, by reviewing patient's medical records prospectively. Results: ECMO use was associated with higher in-hospital mortality (40.2% vs. 48.9%; p = 0.000); lower COVID-19 virological cure (41.3% vs 14.1%, p = 0.000); and longer hospitalization (20.2 days vs 29.1 days; p = 0.000), ICU stay (12.6 vs 26 days; p = 0.000) and mechanical ventilation use (14.2 days vs 22.4 days; p = 0.000) compared to non-ECMO group. Also, there was a high number of patients with septic shock (19.6%) and multiple organ failure (10.9%); and more complications occurred at any time during hospitalization [pneumothorax (5% vs 29.3%, p = 0.000), bleeding requiring blood transfusion (7.1% vs 38%, p = 0.000), pulmonary embolism (6.4% vs 15.2%, p = 0.016), and gastrointestinal bleeding (3.3% vs 8.7%, p = 0.017)] in the ECMO group. However, PaO2 was significantly higher in the 72-h post-ECMO initiation group and PCO2 was significantly lower in the 72-h post-ECMO start group than those in the 12-h pre-ECMO group (62.9 vs. 70 mmHg, p = 0.002 and 61.8 vs. 51 mmHg, p = 0.042, respectively). Conclusion: Following the use of ECMO, the mortality rate of patients and length of ICU and hospital stay were not improved. However, these findings need to be carefully interpreted, as most of our cohort patients were relatively old and had multiple severe comorbidities. Future randomized trials, although challenging to conduct, are highly needed to confirm or dispute reported observations. [ABSTRACT FROM AUTHOR]

Growing usage of social media has provided marketers a better space to engage with customers. However, research examining effects of social media marketing from the perspective of branding, has been relatively unexplored. Further, few researches on international branding have investigated the influence of brand's localness/non-localness on consumer-brand relationships. The purpose of this paper is to increase an understanding of the antecedents of social media marketing and their effects on purchase intention, as well as the moderating influence of local and nonlocal brands on these relationships. Data were collected online from 343 social media users in Saudi Arabia. The research model was empirically tested using structural equation modeling. The findings support most of the proposed direct and moderating effects. Brand trust, brand community, brand awareness and interaction were found to influence purchase intention. Brand origin had a moderating effect in the relationships between brand trust and interaction with purchase intention. The proposed framework contributes to social media marketing and branding research by integrating the contingent effect of brand localness and non-localness. Detailed discussion of the theoretical and practical implications concludes the paper. [ABSTRACT FROM AUTHOR]

The purpose of this study is to measure and document the maximum level of broadband radiofrequency electromagnetic radiations in the vicinity of cellular base stations. The measured broadband frequency range from 467.5 MHz to 3.5 GHz, which includes most cellular services, is considered. The power densities were found to vary from 40 µW m−2 to 34.12 mW m−2. The field measurements of 276 different sites distributed across various rural and urban areas regions in the Kingdom of Saudi Arabia were conducted, and the radiation levels were assessed. It is observed that the broadband radiation power densities were found to be higher in urban areas as compared to rural ones, whereas the maximum radiation point was found to be closer to the cellular base stations in the urban areas. The broadband radiation levels were to be compliant with the International Commission on Non-Ionizing Radiological Protection and US Federal Communication Committee standards for general public. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this study is to examine the influence of service quality on student's satisfaction. Design/methodology/approach - Using empirical research, the study identified previously validated scales of service quality and student satisfaction. Using the SERVPERF scale, data were collected from 279 students studying in public and private universities across Saudi Arabia. The model fit of the scale was assessed to ensure that the data produced accurate outcomes. Structural equation modelling was used to test the effects of independent variables on dependent variables. Findings - The results suggest that four of the five dimensions of service quality, namely, tangibility, reliability, responsiveness and assurance had a significant effect on students' satisfaction. Empathy was not found to contribute to student satisfaction. The findings broaden and deepen our understanding of how the dimensions of service quality reinforce students' satisfaction. Research limitations/implications - Future research can also incorporate in the model other variables, academic and non-academic, related to student satisfaction. Practical implications - The results have useful implications for decision-makers in higher education institutions who strive to enhance students' satisfaction and increase the quality of higher education programmes, particularly in Saudi Arabia and the Gulf region in general. Originality/value - This study uses the SERVPERF scale, which is empirically superior to the SERVQUAL scale for measuring student satisfaction. [ABSTRACT FROM AUTHOR]

Curriculum development has been carried out to improve English as a Foreign Language (EFL) courses in Saudi public schools; however, EFL learners still have difficulties in writing. This study examines the difficulties that Saudi female EFL learners face in writing in secondary high schools. The study also aims to identify 12th grade female EFL learners' needs in improving their writing skills. The research findings might help curriculum designers and EFL teachers to make improvements to a curriculum that meet EFL learners' needs. The participants were 216 female EFL learners studying in public schools in Jeddah. A questionnaire including closed items on a Likert scale and one open-ended question were used to collect data, which were then analysed quantitatively and qualitatively. The results illustrate that female EFL learners' main difficulties in EFL writing are mechanics, use of proper vocabulary, and organization of texts. Additionally, female learners expressed their needs and suggestions for improving their writing skills which are related to the specific difficulties they face. Accordingly, the researchers suggest establishing a well-designed writing program which provides learners with sufficient training in writing skills by increasing the number of hours given to writing. [ABSTRACT FROM AUTHOR]

Background: Keratoconus (KC) is a progressive, bilateral, asymmetric, ectatic disease that leads to progressive corneal thinning and protrusion, which results in progressive visual impairment and irregular astigmatism. Early detection plays a critical role in the management and prognosis. Awareness of the population at risk improves early screening and utilization of eye health care. The aim of the present study is to assess the awareness level among non-medical students toward KC, Abha city, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among the nonmedical students from January 2019 to May 2019 in the Southern Region of Saudi Arabia. A total of 393 nonmedical students were randomly selected through the university admission deanship records. Electronic consents were obtained from all participants. Close-ended questionnaires were circulated using the university official electronic mails. Results: A total of 374 females and 19 males were responded. Among those who had poor awareness, majority were female (95.7%) and belonged to the age group of 17–21 years (68.3%). Similar pattern was seen in the study participants with fair awareness. However, 57.1% of the study participants with good awareness belonged to the age group of 22–26 years. Conclusion: Visual impairment is a common condition among young population. Onset and severity of KC are diverse among countries. Early screening for the population at risk could hasten the appropriate medical intervention and reduce the burden of this condition. The level of awareness considered a key factor for a better utilization of the eye health care. [ABSTRACT FROM AUTHOR]

Copyright of Neurosciences is the property of Neurosciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Risk factors for human-to-human transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) are largely unknown. After MERS-CoV infections occurred in an extended family in Saudi Arabia in 2014, relatives were tested by using real-time reverse transcription PCR (rRT-PCR) and serologic methods. Among 79 relatives, 19 (24%) were MERS-CoV positive; 11 were hospitalized, and 2 died. Eleven (58%) tested positive by rRT-PCR; 8 (42%) tested negative by rRT-PCR but positive by serology. Compared with MERS-CoV-negative adult relatives, MERS-CoV-positive adult relatives were older and more likely to be male and to have chronic medical conditions. Risk factors for household transmission included sleeping in an index patient's room and touching respiratory secretions from an index patient. Casual contact and simple proximity were not associated with transmission. Serology was more sensitive than standard rRT-PCR for identifying infected relatives, highlighting the value of including serology in future investigations. [ABSTRACT FROM AUTHOR]

Aim This study evaluated the survival outcome, pattern of failure and prognostic factors in cervix uteri cancer patients. Methods We reviewed the data of 60 patients with stages IB-IVA cancer who were treated between January 2004 and December 2010. Results Most patients ( n = 50; 83%) had squamous cell carcinoma. Stage IIB was the most common presentation ( n = 41; 68%). Forty-seven patients (78%) received Cisplatin concurrent with radiotherapy (CRT). The 2- and 4-year overall survival (OS) was 82% and 79%, respectively. Prolongation of the overall treatment time (OAT) for greater than 56 days, advanced stage and pretreatment hemoglobin (Hb) levels (<10 g/dL) negatively predicted OS ( P = 0.039, P = 0.044 and P = 0.008, respectively). The 2- and 4-year disease-free survival (DFS) rates were 80% and 69%, respectively. Vaginal infiltration and brachytherapy (orthogonal versus CT-based planning) were significant factors for the prediction of relapse ( P = 0.048 and P = 0.049, respectively). The 2- and 4-year loco-regional control (LRC) rates were 78% and 70%, respectively, and the distant metastasis-free survival (DMFS) rates were 82% and 79%, respectively. Vaginal infiltration was the only negative predictive factor for LRC ( P = 0.045), and pathological tumor grade was the only factor indicative of distant metastases ( P = 0.037). Grade 3 or 4 late rectal reactions were reported in two patients (3%), and no patients developed grade 3 or 4 urinary reactions. Conclusion The treatment results in our cervix uteri cancer patients and the prognostic factors are comparable to those of previous reports. Orthogonal brachytherapy planning and vaginal infiltration negatively predicted relapse. [ABSTRACT FROM AUTHOR]

In the domain of marketing, research on customer satisfaction have been widely conducted. In terms of purchase decision-making process, stock investors are also engaged in significant portion of the process given the wide variety of products available in today's financial markets. The aim of this study is to examine the criteria used by retail investors' in selecting brokerage firms and illustrates across different segments of investors. By having an understanding of investor behaviour, brokerage firms will be better positioned to serve customers and improve their quality of services. While studies on investor behaviour have been conducted in the past, these have been mainly from perspective of financial analysts; the focus has been finance specific areas such as portfolio decision-making, the structure of the financial markets, and the movements of stock and bonds. [ABSTRACT FROM AUTHOR]

Extant research has focused on monitoring the behaviour of people who use mobile banking (MB) but it has paid little attention to understanding the impact of information technology usage behaviour due to cultural differences. Humans are the weakest link in information technology adoption; past research has shown that not all users are predisposed to change their behaviour radically and adopt new channels of banking. This paper examines the demographic patterns of users and non-users of MB. The paper also investigates the attitudinal influences of users and non-users of MB based on innovation attributes. Using empirical research, the study identifies constructs of innovation attributes that were perceived to be significantly different among the users and non-users of MB. The study provides valuable insights into MB in Saudi Arabia that have not been previously investigated. From a practical point, findings of this study will be particularly useful to banks, financial institutions and telecommunication service providers. [ABSTRACT FROM PUBLISHER]

Background: Previous studies have reported the lower reference limit (LRL) of quantitative cord glucose-6- phosphate dehydrogenase (G6PD), but they have not used approved international statistical methodology. Using common standards is expecting to yield more true findings. Therefore, we aimed to estimate LRL of quantitative G6PD detection in healthy term neonates by using statistical analyses endorsed by the International Federation of Clinical Chemistry (IFCC) and the Clinical and Laboratory Standards Institute (CLSI) for reference interval estimation. Methods: This cross sectional retrospective study was performed at King Abdulaziz Hospital, Saudi Arabia, between March 2010 and June 2012. The study monitored consecutive neonates born to mothers from one Arab Muslim tribe that was assumed to have a low prevalence of G6PD-deficiency. Neonates that satisfied the following criteria were included: full-term birth (37 weeks); no admission to the special care nursery; no phototherapy treatment; negative direct antiglobulin test; and fathers of female neonates were from the same mothers' tribe. The G6PD activity (Units/gram Hemoglobin) was measured spectrophotometrically by an automated kit. This study used statistical analyses endorsed by IFCC and CLSI for reference interval estimation. The 2.5th percentiles and the corresponding 95% confidence intervals (CI) were estimated as LRLs, both in presence and absence of outliers. Results: 207 males and 188 females term neonates who had cord blood quantitative G6PD testing met the inclusion criteria. Method of Horn detected 20 G6PD values as outliers (8 males and 12 females). Distributions of quantitative cord G6PD values exhibited a normal distribution in absence of the outliers only. The Harris-Boyd method and proportion criteria revealed that combined gender LRLs were reliable. The combined bootstrap LRL in presence of the outliers was 10.0 (95% CI: 7.5-10.7) and the combined parametric LRL in absence of the outliers was 11.0 (95% CI: 10.5-11.3). Conclusion: These results contribute to the LRL of quantitative cord G6PD detection in full-term neonates. They are transferable to another laboratory when pre-analytical factors and testing methods are comparable and the IFCC-CLSI requirements of transference are satisfied. We are suggesting using estimated LRL in absence of the outliers as mislabeling G6PD-deficient neonates as normal is intolerable whereas mislabeling G6PD-normal neonates as deficient is tolerable. [ABSTRACT FROM AUTHOR]

Many banks in Saudi Arabia are starting to offer banking services through mobile phones. However, not many studies investigate the factors that may help the bankers to design mobile services, which are suitable for and adoptable by bank customers. This study fills this gap and examines a number of factors affecting the mobile banking adoption. Using Diffusion of Innovation as a baseline theory, data are obtained from 330 actual mobile banking users. It is found that relative advantage, compatibility, and observability have positive impact on adoption. Contrary to the findings in extant literature, trialability and complexity have no significant effect on adoption. Perceived risk has a negative impact on adoption. The findings of this study will have practical implications for banking industry in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Purpose – With competitive pressures increasing, outsourcing has become a common phenomenon in today's global economy. While there is growing evidence of organizations increasingly seeking to outsource their information technology (IT) functions, there have been few comprehensive studies on this subject from the Middle East region. The purpose of this paper is to investigate the usage of IT outsourcing in Saudi Arabia. Design/methodology/approach – Empirical research is used to study the extent that firms use the services of IT companies, the time period these have been used, the decision-making process for outsourcing IT function, and its impact on the organization. Findings – Results based on the analysis of data relating to 178 firms in Saudi Arabia indicate that most of these users are satisfied with the service providers and have largely seen positive developments within the organization. Research limitations/implications – Limitations of this paper relate to the relatively small size of the sample. This somewhat limits generalization of findings to the entire Kingdom of Saudi Arabia. Practical implications – Findings have several practical implications for small startup companies and even larger companies that are deciding to outsource IT function in the Arabian Gulf region. The results provide managers with evidence supporting the benefits of IT outsourcing. Originality/value – This paper makes a valuable contribution given the fact that there are only a limited number of comprehensive studies dealing with the assessment of IT outsourcing functions. [ABSTRACT FROM AUTHOR]

Background/Aims: The crude frequency of colorectal cancer (CRC) is second to breast cancer in the Kingdom of Saudi Arabia (KSA). To assess the future burden of CRC in the country, we designed a model that takes into consideration the recent lifestyle pattern and the growth and aging of the population. Methods: We compared CRC statistics for KSA (using data from the National Cancer Registry) with that from the Surveillance, Epidemiology and End Results (SEER) databases of the United States of America (USA). We used the Joinpoint regression program to identify changes in secular trends, while the GLOBOCAN 2002 software was used to project future incidence and mortality. Results: Between 1994 and 2003, age-standardized rates (ASRs) for CRC in KSA almost doubled, as compared to a nonsignificant decline in USA. Between 2001 and 2003, while the annual percent change (APC) of CRC incidence in the USA showed a nonsignificant decrease in females, APC in Saudi females showed a nonsignificant rise of six percent. On the other hand, the rising incidence among Saudi males, during the years 1999 to 2003, was significant, with an APC of 20.5%. The projection model suggested that the incidence of CRC in KSA could increase fourfold in both genders by the year 2030. Conclusions: In KSA, the present and expected increase in CRC rates is alarming. Pragmatic recommendations to face that challenge are discussed. The present work could serve as a model to study other prevalent types of cancer, particularly in developing countries. [ABSTRACT FROM AUTHOR]

Globally, the food retailing industry is seen as most dynamic and rapidly changing. In this paper we investigate the shopping behavior of shoppers in Saudi Arabia, the largest retail market in Arabian Peninsula. Using empirical research, this paper examines factors influencing shopping decisions and the attitude toward shop- ping of shoppers in Saudi Arabia. Comparisons based on demographic factors are also discussed. The article discusses the findings and makes recommendations to retail store management. Future research directions are also suggested. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to measure the quality of service from customers' perspective. With an enormous growth in internet banking, this paper discusses how banks can be competitive by providing quality services. Design/methodology/approach - This study is based on a questionnaire survey conducted in Saudi Arabia. Based on an extensive review of literature, the paper uses empirical research to analyse service quality of internet banking services provided by banks in Saudi Arabia. Findings - Results based on a factor analysis identify three factors that influence users' evaluation of service quality of internet banking services. These factors are labelled as "efficiency and security", "fulfilment" and "responsiveness". Research limitations/implications - This research is useful for banks in order to improve service quality and retain/gain a share of the market in a highly competitive industry. Practical implications - The findings are important to enable bank managers to have a better understanding of customers' perception of service quality of internet banking and consequently of how to improve their satisfaction with respect to the online aspects of service quality. Originality/value - This paper makes a valuable contribution given the fact that there are only a limited number of comprehensive studies dealing with the assessment of electronic service quality in banking environment. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of Amblyopia and other refractive errors and to identify the factors associated with these disorders. Methods: The study was carried out in Jeddah, Kingdom of Saudi Arabia, in 1999, on children enrolled in governmental kindergartens during the academic year 1419-1420H. Children were screened for Amblyopia, any child who failed to pass the screening examination, was referred to the ophthalmolgist for complete examination. A 95% confidence interval was used to describe the prevalence of eye disorders. Results: The number of children referred to the ophthalmologists was 102. Out of this figure, 70% of children kept their appointment. Seventy-two children had decreased visual acuity of 20/30 or worse. The final diagnoses were as follows: Amblyopia in 8 cases, which, give a prevalence rate of 1.3% (95% confidence intervals: 0.4-2.3); refractive errors in 50 cases (69%); strabismus in 4 cases (6%), duane syndrome in 2 cases (3%); and 8 children (11%) were completely normal. The positive predictive value of visual screening examination was 89%. We found no significant correlation between Amblyopia and the risk factors mentioned in the literature. Conclusions: Vision screening is very important and recommended to be carried out as part of periodic health examination for pre school children. It is cost effective, highly sensitive, acceptable and easy to be administered. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to examine the role of consumer protection agencies, In the light of growing importance of consumerism in developing countries, the paper measures the level of satisfaction with the performance provided by five different consumer protection agencies, in a chosen country, Saudi Arabia. Design/methodology/approach - This study is based on a questionnaire survey conducted in Saudi Arabia. Based on a model developed for this study, the paper uses empirical research to determine customers' satisfaction with consumer protection agencies. Findings - Results based on testing of hypotheses indicate that overall satisfaction is primarily derived from the objectives and roles played by consumer protection agencies. Results reveal that consumers assign different levels of importance to various dimensions when evaluating satisfaction with consumer protection agencies in Saudi Arabia. Research limitations/implications - Limited sample size and the generalization of results for the entire Kingdom although the sample has been confined to the eastern province region are the limitations of this study. Practical implications - The findings of this study have implications on the manner in which consumer protection agencies in Saudi Arabia must operate. Besides, findings of this study have also implications for business operating in Saudi Arabia. Originality/value - This study makes a valuable contribution given the fact that there is a dearth of empirical studies covering the measurement of consumer satisfaction role played by consumer protection agencies in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Purpose - With competitive pressures placing an increasing dependence on the ability of organizations to deliver customer-adapted products quickly and on time, logistics has been an area that has been subjected to investigation. While there is a growing evidence of organizations increasingly seeking to outsource their logistics activities, there have been few comprehensive studies on the outsourcing of logistics in the Middle Eastern region. The purpose of this paper is to examine the usage of third party logistics (TPL) services in Saudi Arabia. Design/methodology/approach - Empirical research is used to study the extent firms use the services of logistics companies; the time period these have been used; the decision-making process for choosing contract logistics and its impact on the organization. Findings - Results based on the analysis of data relating to 496 firms in Saudi Arabia indicate that most of these users are satisfied with the services providers and has largely seen positive developments within the organization. Practical implications - The results provide managers with evidence supporting the benefits of logistics outsourcing. The study also contains useful information for the providers of contract logistics services on the most frequently used services. Originality/value - This study makes a significant addition to literature on logistics outsourcing as little empirical research has been previously reported from Arab world and Saudi Arabia. Saudi Arabia to establish linkages between organizations and TPL providers. Moreover, the results of this study will also serve as a future benchmark for the entire Gulf Cooperation Council region, as Saudi Arabia happens to be the largest country in the Middle East. [ABSTRACT FROM AUTHOR]

Among one of the most far-reaching influences of the Interact, especially from the perspective of business and market models, is the concept and application of eCommerce. Today, this erstwhile 'experimental' commerce model has become a standard platform for streamlining business flows and broadening product outreach. This is validated by the significant emphasis by a number of countries in developing robust eCommerce architectures tailored to suit their economical-social systems. An interesting case study in this perspective is the Kingdom of Saudi Arabia, especially given its emphasis on local, regional and religious traditions. Presently, with a tremendous growth rate in Internet connectivity, the Kingdom is actively moving towards large-scale adoption of eCommerce systems. In 2001, a two year project was initiated to study the present influence of Internet on social, educational and business systems within the Kingdom. One of the major aspects was the analysis of user responses collected over the two-year period through a number of surveys, which were designed based on two prominent behavioural models: Theory of Planned Behaviour and Roger's Theory of Diffusion of Innovations. The consequent analysis of the results was supported and in some cases verified with linear regression models. This paper reports on the consequent findings, which identify factors that may significantly affect the adoption of eCommerce in the Kingdom. [ABSTRACT FROM AUTHOR]

The objective of this study is to examine the reuse of wastewater for beneficial purposes. To accomplish this objective, the efficiency of slow sand filters in removing total coliforms (TC) was studied using a probabilistic method. Three pilot scale slow sand filters were constructed at Alkhobar wastewater treatment plant, Dhahran, Saudi Arabia. The removal efficiency of filters was estimated under different operating control parameters, which included filtration rate (q), sand bed depth (d) and sand grain size (c). The Type III extreme value distribution best fitted the removal efficiency data. A multiple linear regression analysis was performed to develop a relationship for mean removal efficiency as a function of control parameters. The predicted mean response and experimental results of previous studies were compared to validate the empirical regression model. The control parameters and influent concentrations of total coliform were used in Monte Carlo (MC) simulations for calculating the reliability index (β). The reliability index and corresponding risk were calculated for lognormally distributed safety margins (SM). An effluent standard of 100 total coliform/100 mL was defined as capacity of the filter to ascertain the risks of exceedence, which was approximately less than 50 for 95% of the time. Pre and/or post disinfection would be necessary to meet the stipulated effluent standards for unrestricted agriculture use. [ABSTRACT FROM AUTHOR]

Purpose: To compare objective and subjective assessments of post-operative sensitivity when class 1 cavities, lined with glass-ionomer or adhesive bonding system, were restored with resin-based composite (RBC). Materials and Methods: Occlusal cavities on homologous contra-lateral posterior teeth in 44 male patients attending primary health centers in Riyadh, Saudi Arabia were restored with RBC after a cavity lining of either a light cured glass-ionomer cement (Vitrebond) or an adhesive bonding system (One-Step). Results: Cold response measurements 24 hrs, 7 days and 1 month post-operarively showed that die threshold of pulpal response was significantly lower (P< 0.05) in the restored teeth, when the adhesive bonding system served as cavity liner. In addition, based on the patients' subjective assessments, the prevalence of mild or severe post-operative sensitivity was significantly higher (P< 0.05), 24 hrs and 7 days post-operatively, in the teeth with the adhesive bonding system as a cavity liner. After a post-operative period of 1 month, however, there was no significant difference (P> 0.05) between the prevalence of post-operative sensitivity when the restored teeth received a lining of either glass-ionomer or adhesive bonding system. [ABSTRACT FROM AUTHOR]

Rapid population growth has led to significant demand for residential buildings around the world. Consequently, there is a growing energy demand associated with increased greenhouse gas (GHG) emissions. The residential building energy demand in arid countries such as Saudi Arabia is supplied with fossil fuel. The existing consumption pattern of fossil fuels in Saudi Arabia is less sustainable due to the depletion of fossil fuel resources and resulting environmental impacts. Buildings built in hot and arid climatic conditions demand high energy for creating habitable indoor environments. Enormous energy is required to maintain a cool temperature in hot regions. Moreover, climate change may have different impacts on hot climatic regions and affect building energy use differently. This means that different building interventions may be required to improve the performance of building energy performance in these geographical regions, thereby reducing the emissions of GHGs. In this study, this framework has been applied to Saudi Arabia, a hot and arid country. This research proposes a community–government partnership framework for developing low-carbon energy in residential buildings. This study focuses on both the operational energy demand and a cost-benefit analysis of energy use in the selected geographical regions for the next 30 years (i.e., 2050). The proposed framework primarily consists of four stages: (1) data collection on energy use (2020 to 2050); (2) setting a GHG emissions reduction target; (3) a building intervention approach by the community by considering cost, energy, and GHG emissions using the Technique for Order of Performance by Similarity to the Ideal Solution (TOPSIS) to select the best combinations in each geographical region conducting 180 simulations; and (4) a clean energy approach by the government using grey relational analysis (GRA) to select the best clean energy system on the grid. The clean energy approach selected six different renewable power generation systems (i.e., PV array, wind turbine, hybrid system) with two storage systems (i.e., battery bank and a combination of electrolyte, fuel cell, and hydrogen tank storage). This approach is designed to identify the best clean energy systems in five geographical regions with thirty scenario analyses to define renewable energy-economy benefits. This framework informs through many engineering tools such as residential building energy analysis, renewable energy analysis, multi-criteria decision analysis (MCDA) techniques, and cost-benefit analysis. Integration between these engineering tools with the set of energy policies and public initiatives is designed to achieve further directives in the effort to reach greater efficiency while downsizing residential energy demands. The results of this paper propose that a certain level of cooperation is required between the community and the government in terms of financial investments and the best combinations of retrofits and clean energy measures. Thus, retrofits and clean energy measures can help save carbon emissions (enhancing the energy performance of buildings) and decrease associated GHG emissions, which can help policy makers to achieve low-carbon emission communities. [ABSTRACT FROM AUTHOR]

Abstract: Tako-Tsubo cardiomyopathy (TTC) is a nonischemic cardiomyopathy characterized by reversible left ventricular dysfunction that is seen predominantly in postmenopausal women (>80%). The syndrome has symptoms that are similar to acute myocardial infarction, such as electrocardiogram changes (ST-segment elevation and subsequent giant T wave inversion) and abnormal cardiac enzymes. The clinical prognosis is usually benign. This article reports the first case of a TTC in a premenopausal Saudi woman. Early diagnosis of TTC excludes the use of stents, thrombolytics, and long-term coronary heart disease medications. [ABSTRACT FROM AUTHOR]

Blunt vertebral artery injury (VAI) is associated with severe cervicocephalic trauma and may have devastating consequences. This study aimed to determine the incidence and nature of VAI in polytrauma patients. The secondary objective was to assess the association of VAI with previously suggested risk factors. It was a retrospective observational study of all polytrauma patients admitted to the trauma unit between April 2018 and July 2019, who had CT neck angiography to diagnose blunt VAI according to modified Denver criteria. Out of 1084 admitted polytrauma patients, 1025 (94.6%) sustained blunt trauma. Of these, 120 (11.7%) underwent screening CT neck angiography. VAI was detected in 10 (8.3%; 95% CI 4.1–14.8) patients. There were three patients with Grade I injury, two with Grade II, and five with Grade IV injury. Among all trauma admissions, the incidence of diagnosed VAI was 0.9% (95% CI 0.5–1.8). Among patients suspected of VAI, there was no univariable association of VAI with C-Spine fracture: OR 4.2 (95% CI 0.51–34.4; p = 0.18). There were two (20%) deaths related to VAI. Traumatic VAI was uncommonly detected in this major trauma service in Saudi Arabia. High suspicion and liberal screening by CT angiography in cases where VAI is possible should be considered to avoid missed injuries. [ABSTRACT FROM AUTHOR]

The primary purpose of this study is to identify the underlying factors of supply chain integration in organisations operating in Saudi Arabia. Empirical research is used to study the extent and nature of supply chain integration and its relationship with organisational performance. Results based on statistical analyses show that organisation strategy does have a positive impact on the supply chain integration, while environmental uncertainty has negative impact on supply chain integration. Other findings relating to relationship between supply chain integration and business performance are also reported. The findings of this study have implications on how firms develop and maintain relations with supply chain partners. This study makes a valuable contribution given the fact that there is a dearth of empirical studies of this nature focusing on in the Middle East region. [ABSTRACT FROM AUTHOR]