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Background/purpose: Exploration of early practicing dental professionals' awareness and attitude toward inferior alveolar nerve block IANB will directly inform efforts to improve clinical practices and ensure patient safety. The aim was to highlight the students, interns, and junior dentists’ awareness and attitude toward the IANB, failure, and related complications in the Kingdom of Saudi Arabia (KSA). Materials and methods: An open web-based survey prepared according to the Checklist for reporting results of Internet e-surveys CHERRIES recommendations was designed and carried out across different regions of the KSA. The questionnaire was composed of four main sections including the participant's details, and qualifications; inferior alveolar nerve block delivery; participants' education, and training-related questions; and attitudes toward proposed solutions to overcome the related failure and complications. Results: 262 participants completed the questionnaire (94 dental students, 79 interns, and 89 junior dentists). There was a significant difference in the following findings: males performed IANBs more frequently than females (P

Economic Dispatch (ED) in Combined Heat and Power Systems (CHPSs) is critical for optimising fuel costs while managing Power-Only (PO), CHP, and Heat-Only (HO) stations. Robust optimisation strategies are necessary to tackle the growing non-convexity of the ED issue, particularly when considering transmission losses. This research introduces a Modified Artificial Hummingbird Optimisation Algorithm (MAHOA) that integrates a linear controlling strategy and various territorial foraging tactics to enhance global and local search capabilities. These enhancements facilitate coordinated diversification and intensification activities, leading to more effective problem-solving. The MAHOA is compared to the conventional AHOA through testing on 7-station and 24-station CHPS systems. Three distinct power and heat loading levels are investigated. For the 7-station CHPS, the MAHOA showed significant improvements in robustness, with the lowest standard deviations of 0.0017, 3.373, and 0.0233 $/hr, indicating 99.83 %, 35.92 %, and 98.22 % improvements over the AHOA. For the 24-station CHPS, it also shows significant improvements of 0.381 %, 0.45 %, 0.448 %, and 2.815 % in terms of mean, minimum, standard deviation, and maximum values. The MAHOA outperforms the AHOA in 95 % of the simulation runs with faster convergence to optimal solutions. Compared to other methods reported in the literature, the MAHOA offers a viable and superior solution mechanism.

Background: First-aid knowledge among the general public is critical for saving lives in medical emergencies before expert care arrives. However, studies show persistent gaps in layperson first-aid capacity worldwide. This study assessed first-aid knowledge and awareness among adults in Al-Ahsa City, Saudi Arabia, to identify strengths and weaknesses to guide tailored interventions. MATERIALS AND METHODS: A cross-sectional survey was conducted among 716 adults recruited through convenience sampling. A structured questionnaire collected sociodemographics and assessed knowledge across 12 first-aid scenarios involving bleeding control, burns, seizures, choking, and cardiopulmonary resuscitation (CPR). Results: Just 59.2% correctly identified direct pressure to stop bleeding, and 61.2% knew proper burn first aid. Only 52% recognized the pediatric CPR compression-to-ventilation ratio (15:2), and 36.2% identified the chest compression rate of 100/min. For choking, 73.9% endorsed abdominal thrusts for children, but only 60.9% knew backslaps for infants. Females scored higher on bleeding (94.5% vs 92.8% correct) and abdominal thrusts (83.6% vs 66.1%), while males were more knowledgeable on burns (70.4% vs 53.8%) and infant choking (81.1% vs 44.7%). Younger and more educated respondents had higher scores. Conclusions: Major gaps exist in implementing proper first-aid techniques, especially differentiation by age. Deficits in direct bleeding control, high-quality CPR, and tailored pediatric care represent high-risk knowledge weaknesses in this population. Targeted education programs focused on skill-building in these areas, particularly for higher-risk demographics like the elderly and less educated, are critically needed to strengthen public preparedness and save lives. Findings provide key insights to inform evidence-based interventions.

Background: Low back pain (LBP) is the most prevalent orthopedic condition worldwide. University students are more likely to have this issue due to their demanding and time-consuming course load. This study aimed to investigate the prevalence of LBP and the factors that lead to it among students at the Imam Mohammad Ibn Saud Islamic University (IMSIU). Methods: This cross-sectional study targeted undergraduate students using an online self-administered questionnaire. A descriptive analysis method was conducted. Results: Of the 830 students who completed the survey, 71.4% were females. About two-thirds were aged between 18 and 22 years. Our study shows that 68.2% had complained of recent LBP. The most significant prevalent factor associated with LBP among IMAMU students, 94.2%, was prolonged sitting. Heavy object lifting is 93.2%, and unhealthy seating/body position is 90.2%, which comes in second and third place. Those who complained about the discomfort of their lecture hall seats were shown to be dramatically more likely (5.549 times more) to develop LBP than students who did not. Students with a positive history of depression were significantly more prone (2.565-fold) to LBP. A positive family history of LBP and smoking cigarettes were found to increase the chance of developing LBP. Conclusion: LBP among IMSIU students is high, mainly because of prolonged sitting, heavy object lifting, and unhealthy sitting and/or body position. There is a strong association between LBP and a positive family history of LBP, smoking, and uncomfortable seats. Prevenive measures, such as an intervention program for university students, are required.

Background & objectives: Dengue poses a considerable public health threat in Saudi Arabia, with escalating outbreaks in Jazan, where seasonal rains create ideal mosquito breeding conditions. Elucidating local epidemiological dynamics is imperative to strengthen evidence-based prevention policies. This study analyzed the spatiotemporal, demographic, and meteorological patterns of dengue in Jazan from 2015-2020. Methods: This retrospective cross-sectional study utilized surveillance records for 3427 confirmed dengue cases. Descriptive analyses characterized geographic, seasonal, age, gender, and nationality distributions. Forecasting models project expected epidemics through 2025. Regression analysis identified climate factors associated with monthly case counts. Results: Dengue exhibited shifting seasonal peaks, transitioning into year-round transmission by 2019, indicating endemic establishment. Cases clustered in different high-burden sectors annually, requiring localized vector control. The majority of affected individuals were young male adults, with gender gaps narrowing over time. Saudi nationals had an escalating incidence, but non-citizens showed a higher risk, signaling importation threats. Seasonal outbreaks were associated with temperature, wind speed, and direction. Interpretation & conclusion: Enhanced surveillance, outbreak forecasting, targeted control activities, and integrated prevention policies grounded in continuous evidence assessment can effectively address endemic dengue transmission in Jazan. This study provides key insights to optimize data-driven decision-making for dengue control in Saudi Arabia.

Most renewable energy sources are intermittent and seasonal, making energy storage and consumption problematic. Hydrogen gas can save and convey chemical energy, making it a promising sustainable energy source. Electrochemical water electrolysis technology’s sustainable and efficient hydrogen gas production attracts global attention. Higher hydrogen production rates enhance hydrogen volumetric energy capacity by storing intermittent hydrogen gas in high-pressure tanks. Pressurized storage tanks are cost-effective and efficient. Hydrogen gas may be stored economically and efficiently in pressurized tanks, making electrochemical water electrolysis a sustainable energy source. This paper introduced hydrogen as an alternative to natural gas, detailed water electrolysis technologies for hydrogen production, and highlighted how they can manufacture hydrogen efficiently and cost-effectively. The theoretical volume of gaseous hydrogen and oxygen that could be produced by electrolyzing water under typical temperature and pressure (STP) circumstances, assuming a 100% efficiency rate of the process. Since there are always two moles of hydrogen produced by electrolysis and one mole of gas occupies the same volume, the volume of hydrogen developed from water is twice that of oxygen. The volume of liberated oxygen is 0.21 (L/min), and the volume of liberated hydrogen is 0.42 (L/min) with a current density of 30 A, for instance, the tracer’s diffusion coefficient for all conceivable flow rates. A maximum value of 90 liters per hour was determined to be the threshold at which the diffusion coefficient increased with increasing flow rate. It would appear that the diffusion coefficient remains unchanged at flow rates greater than 90 liters per hour.

Background: It has been more than a decade since fusion prostate biopsy (FPB) has been used in the diagnosis of prostate cancer (PCa). Therefore, patients with a previous history of negative FPB and ongoing suspicion of PCa are beginning to emerge. This study investigated whether the first biopsy type (standard or fusion) should be effective in deciding on a second biopsy. Methods: Male patients aged 40–75, with a serum prostate-specific antigen (PSA) value of less than 10 ng/mL and a negative biopsy history within the last 24 months, who underwent FPB in our clinic due to persistent PSA elevation and/or suspicious multiparametric prostate magnetic resonance imaging (MpMRI) findings were included to the study. Patients were divided into groups according to the type of first biopsy (Group 1; those whose first biopsy was FPB, Group 2; those whose first biopsy was standard prostate biopsy). Some demographic and clinical data of the groups, as well as PCa detection rates, were compared. A p value of less than 0.05 was considered statistically significant. Results: A total of 275 patients (Group 1: 84, Group 2: 191) were included in this study. The groups were similar in terms of age, PSA values before the first biopsy, PSA values before the second biopsy, family history of PCa, and prostate volume. PCa was detected at a higher rate in Group 2 than Group 1 (23% vs 15.5%, p = 0.044). Concluison: The data obtained from this study indicate that the type of initial biopsy should be taken into account when deciding on FPB in secondary patients with a previous negative biopsy history.

Background: Noncommunicable diseases (NCDs) are a significant concern for global health as they significantly contribute to mortality and morbidity. In Saudi Arabia, NCDs account for a substantial portion of deaths. Understanding barriers to adopting a healthy lifestyle is crucial for effective prevention and management. The study aims to identify barriers to physical activity and healthy eating to inform targeted interventions that promote healthier behaviors and reduce the burden of NCDs in this population. Aim: This study aims to determine the barriers to healthy lifestyle among patients attending primary health-care clinics in King Abdulaziz Medical City (KAMC) in Riyadh city, Saudi Arabia. Settings and Design: This is a cross-sectional study; data were collected from January 2023 to July 2023. This study was conducted in three main primary health-care centers (Khashm-Ala’an, Umm-alhammam, and Iskan) of KAMC, Riyadh. Methods: A quantitative cross-sectional study was conducted in Riyadh city. The study utilized a questionnaire adapted from previous research. Results were considered significant when the P < 0.05. Results: The study included 383 participants aged 15 to over 45 years, with a significant proportion in the 15–29 years of age group. Approximately half were male, with the majority having attained a university education or higher. A considerable portion had never been married and reported incomes below 10,000 SR per month. Physical inactivity affected nearly half of the participants, primarily attributed to a lack of willpower, followed by factors such as lack of energy and time constraints. Barriers to a healthy diet mirrored those of physical activity, with lack of willpower and time being prominent factors. These barriers exhibited various associations with demographic variables such as age, gender, education, marital status, and income. Conclusion: With 383 participants, the study skewed toward young, educated, unmarried individuals with lower incomes. While nearly half reported physical inactivity and unhealthy diets, citing lack of willpower and time constraints as primary reasons, further analysis is needed to explore how these barriers connect with the diverse demographic makeup of the study population.

Background: Self-medication is a concern at the global level. It comes with complications and different health issues. This study measures the prevalence, influential factors, and reasons behind self-medication. Methods: A descriptive cross-sectional study was conducted at Imam Mohammad Ibn Saud Islamic University. The prevalence and influential factors were measured between September and November 2023. Statistical analysis was performed using RStudio (R version 4.3.1). We used frequencies and percentages to present categorical variables. Using a convenient sampling technique. Factors associated with using self-medication and the differences between students of the medical college and their non-medical counterparts were assessed using Pearson’s Chi-squared test or Fisher’s exact test. Statistical significance was considered at P < 0.05. Result: We initially received 410 responses on the online platform. However, we excluded seven responses from those who disagreed to participate and 12 from participants outside Riyadh. The majority of the participants were female (67.5%). Three hundred nineteen (319) participants indicated that they had ever used self-medications, accounting for a prevalence of 81.6%. Regarding the reasons for self-medication, the most frequently cited factors were ‘previous experience’ (66.5%) and ‘time-saving’ (50.2%). Additionally, the primary source of drug information utilized for self-medication practices was predominantly from ‘relatives/friends’ (62.4%) and ‘pharmacologists’ (48.0%). Medications were primarily used for headache (76.8%), fever (48.6%), and pain (47.3%). The most commonly used classes of drugs used for self-medication were painkillers (84.0%), vitamins (42.0%), and eye drops (32.9%). Conclusion: The results showed that the prevalence of self-medication is high in the surveyed population. There has been an association between monthly income and the prevalence of self-medication. As pharmacists are the second most common source of drug information, it is essential to increase responsibility and avoid marketing and personal benefiting behavior as they are considered a reliable source of information in the population. Healthcare organizers can utilize our study to educate people about the adverse effects of self-medication.

Aim: Acute appendicitis is a frequent surgical emergency which affects the lower right quadrant of the abdomen. Failure to diagnose this condition might result in perforation, abscess development, or peritonitis if not tackled. Hyponatremia was the focus of our retrospective cohort investigation because it may serve as a biochemical indicator for spotting serious forms of acute appendicitis in our patient group. Materials and Methods: All pediatric patients aged up to 14 years who were admitted to the Prince Sultan Military Medical City, under our service between 2020 and 2023 were retrospectively reviewed. Data of interest were retrieved from the medical files of our study subjects and entered into Excel sheets, including medical history, age, sex, type of referral, and associated comorbidities, as well as clinical data such as abdominal pain, nausea/vomiting, anorexia, fever, changes in bowel movement, dysuria, and any recent histories of upper respiratory tract infection. Results: Thirty-one (19%) patients were found to have a complicated acute appendicitis, confirmed by the presence of gross or micro-perforation and segmental gangrenous segment on histopathological analysis. Statistically significant differences were observed in those patients with the complicated form, compared to others with the non-complicated form of acute appendicitis in terms of preoperative sodium levels, along with intra-operative findings of perforated appendices. Compared to the non-complicated patients, those with complicated acute appendicitis had a much lower mean blood sodium level. Conclusion: This study suggests the use of hyponatremia as a potential biomarker for complicated cases. Early diagnosis and appropriate response can assist medical and surgical practitioners in providing more focused and effective management plans for complicated cases, which would improve patient outcomes.

Diabetic retinopathy is a serious complication of diabetes that can lead to blindness if not detected and treated early. Automated detection of diabetic retinopathy requires effective feature extraction techniques to enhance diagnostic accuracy. This study aims to develop a method for detecting diabetic retinopathy by utilizing Local Binary Pattern (LBP) combined with wavelet transform, and then classifying the extracted features using Support Vector Machine (SVM). The approach includes feature extraction from retinal images using LBP and wavelet transform. The extracted features are subsequently classified with SVM to evaluate performance in detecting diabetic retinopathy. Analysis results show that the dominant feature is found in the fifth row with a value of 0.57006, indicating the effectiveness of the LBP method in feature extraction. The developed model demonstrates high performance with an accuracy of 95.59%, precision of 96%, recall of 97.96%, and F1-score of 96.97%. The combination of feature extraction methods with SVM proves to be effective and reliable in detecting diabetic retinopathy, offering low error rates and high accuracy, thus potentially serving as a valuable tool in clinical diagnosis

Abstract Background The role of dietary fat quality in promotion of cardiovascular diseases is studies before. However, the results are inconsistent. Recently, cholesterol to saturated fatty acid index (CSI) is suggested as a novel indicator of the atherogenicity and thrombogenicity potential of a diet. However, due to limited number of studies, in the current cross-sectional study, we aimed to evaluate the role of CSI in metabolic and inflammatory response among obese individuals. Methods In the current cross-sectional study 488 obese individuals aged 18–50 years old were involved in volunteer based invitation from outpatient obesity clinics. Subjects underwent anthropometric assays including weight, height, waist circumference (WC) and body composition and their fasting blood sample were obtained for biochemical assessments including blood sugar, serum lipids, hs-CRP and IL-6 concentrations by commercial kits. Physical activity was also assessed by short form of international physical activity questionnaire (IPAQ). Results According to our results, being at the top tetile of CSI was associated with higher anthropometric indices including weight, height, WC, FFM, and basal metabolic rate (BMR) compared with those at the lowest tertile (P

Abstract Objective The present study sought to assess the prevalence and determinants of tobacco use (cigarette smoking and shisha use) and khat chewing among Yemeni adolescents, and to evaluate their knowledge and attitudes toward these habits. Methods This school-based cross-sectional study was conducted among 13 to 19-year-old students attending middle/high schools (both private and public) across five main cities in Yemen. Data were collected using self-administered questionnaires comprising questions/items related to sociodemographic data, cigarette smoking, shisha use, khat chewing, and knowledge on and attitudes toward these habits. Bivariate and multivariate analyses were used to explore the most determinant factors. Results A total of 7505 students were recruited from 42 schools across five major cities in Yemen. The prevalence rates of khat chewing, cigarette smoking, and shisha use were 42.4%, 6.8%, and 19.3%, respectively. Compared to females, male subjects reported significantly higher prevalence of khat chewing (51.4% vs. 23.5%, p

Mediastinal parathyroid cysts (MPCs) are extremely rare, benign lesions arising from the parathyroid glands and residing within the thoracic cavity. This study aims to advance understanding of MPC, emphasizing accurate diagnosis and management approaches for this rare condition. A 46-year-old woman presented with dysphagia for one week. Blood tests revealed elevated parathyroid hormone (PTH) (112.8 pg/mL) and normal serum calcium (9.54 mg/dL). Ultrasonography identified a large, well-defined cystic nodule measuring 46 × 30 × 25 mm, extending retro-sternally in the right upper third of the chest. A subsequent high-resolution computed tomography scan of the chest revealed a large space-occupying lesion (47 × 43 × 31 mm) in the superior mediastinum, near the esophagus, suggesting an esophageal duplication cyst or, less likely, a bronchogenic cyst. Video-assisted thoracoscopic surgery (VATS) was performed, and the entire cyst was excised, confirmed histologically as a mediastinal parathyroid cyst. Mediastinal involvement of PCs poses diagnostic challenges due to their rarity and diverse clinical presentations. Surgical excision is necessary for symptomatic cases, with VATS emerging as a favorable approach.

Abstract Background This study aimed to compare serum prostate specific antigen (PSA), Soluble E-cadherin (sE-cad), and Inosine Monophosphate Dehydrogenase-2 in predicting prostate cancer aggressiveness by determining their correlations with Gleason score and International Society of Urological Pathology (ISUP) Grade Groups. Methods This was a hospital-based descriptive quantitative cross-sectional study whereby we enrolled 48 newly diagnosed prostate adenocarcinoma patients in the study. Their serum was analysed for PSA, sE-cad, and IMPDH-2. Pearson correlation coefficient was used to test the correlation between the serum sE-cad and Gleason score while Spearman rho correlation coefficient was used for PSA and IMPDH-2. The correlation coefficient (r) was graded as very weak (

Abstract Objectives The main objective of the study was to explore the perspectives of healthcare professionals (HCPs) regarding artificial intelligence (AI) and to identify challenges in its incorporation in the healthcare sector of Pakistan. Methods A qualitative exploratory study design was adopted. The study was conducted from January 15th to February 29th, 2024, and HCPs (doctors, pharmacists and nurses) from two tertiary care teaching hospitals in southern Punjab, Pakistan were taken as the study population. The interviews were conducted with the help of a semi structured interview schema. A thematic approach was adopted to analyse the data. Results Out of 40 HCPs approached, 25 participated in the study with a response rate of 62%. The participants included in the study were doctors (14), pharmacists (6) and nurses (5). The participants had limited knowledge regarding AI and its basics. However, they showed positive perceptions about its incorporation. They believed that many of the problems faced by the healthcare sector of Pakistan can be minimized by AI incorporation. They believed that AI can boost up the efficiency of healthcare providers, reduce their workload, save time and minimize medical errors. Four main themes with multiple subthemes were identified: (1) Cognizance of AI, (2) Acceptability of AI among HCPs and training requirements for effective incorporation, (3) Merits and Demerits of AI, and (4) Challenges in incorporation of AI with proposed solutions. Conclusion HCPs showed a willingness to embrace AI incorporation and believed that it may bring numerous benefits to the health system. Policymakers should take necessary steps to ensure AI incorporation in our healthcare sector.

Abstract Ionized Mg (iMg) may offer a more reliable indicator of Mg status during acute illness than total Mg (tMg) concentrations. This study aimed to determine the prevalence of dysmagnesemia and their relationship using iMg and tMg. The clinical and biochemical characteristics as well as health outcomes and their association with iMg and tMg were also assessed. A prospective study including all eligible adult patients (≥18 years) who were hospitalized in the General Internal Medicine unit at Sultan Qaboos University Hospital (SQUH) for 3.5 months in 2023. The iMg and tMg concentrations were collected on all at the admission. In total 500 patients were included (females 49.2%) with a median age of 64.5 years (IQR: 48-77). The prevalence of hypomagnesemia and hypermagnesemia by iMg concentrations was 3.4% and 26.6%, respectively, while by tMg concentrations 13.2% and 11.0%, respectively. The agreement between both measurements was strong (r=0.665, p

Abstract Medicinal plants (MPs) have long been used for their therapeutic properties in traditional forms of medicine. However, the presence of potentially toxic elements (PTEs) in MPs raises concerns about their safety, efficacy, and potential adverse effects on human health. The current study aimed to determine the level of potentially toxic and essential elements (PTEEs) in commonly consumed MPs in Zabol, Iran, along with their health risk assessments. To conduct the present study, 10 types of MPs widely used in Zabol, Iran, were selected, and 15 samples of each type (150 samples in total) were taken. Each sample was analyzed for the presence of various PTEEs using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES) for Lead (Pb), cadmium (Cd), chrome (Cr), nickel (Ni), copper (Cu), zinc (Zn), iron (Fe), aluminum (Al) and manganese (Mn); and Atomic Absorption Spectrometry (AAS) for arsenic (As) and mercury (Hg). Finally, to better comprehend the scope of exposure and its possible effects, the Monte Carlo simulation method is successfully applied to assess human health risks related to PTEs in MPs. Statistical analysis revealed statistically significant (P

Abstract Background Resilience is an essential psychological trait that empowers individuals to adapt and thrive in the face of challenges. Although it is acknowledged that health professionals need to possess high levels of resilience, there has been limited research comparing how different groups of health students, particularly school leaver undergraduates and mature age graduate entry students, develop resilience in their coursework. Methods This study combines both objective (academic grades with validated survey results) and subjective data (interviews) to compare how resilience is related to academic coursework performance for two groups of pharmacy students: the mature age graduate entry (GE, N = 64) learners and school leaver undergraduate (UG, N = 208) learners. We employed a sequential explanatory mixed methods design using surveys, academic performance data and semi-structured interviews. The survey tapped constructs related to resilience (burnout, stressors and coping methods) while the interviews elicited a more nuanced understanding of individual and environmental factors. Results Although there was no statistical difference in burnout experience between the two groups, GE students exhibited more positive resilience attitudes than UG when selecting resilience statements on the survey. Both cohorts indicated in the survey that engaging in distraction activities (physical exercise, sleeping, listening to music, anything other than the stressor) was their most preferred method of relieving stress. Within UG student survey responses, those who indicated support from partners, friends and family had better academic performance, while those who did not report coping methods did worse academically. The three key environmental factors we identified that contributed to both undergraduate and graduate entry resilience were workload, feedback provision and psychosocial support. Conclusions Currently, there is still a need for resilience programs geared at academic success to be implemented in higher education. This study provides objective evidence of academic success coupled with exploration into the nuances of resilience amongst different student groups. It not only highlights the differing resilience development strategies and burnout coping mechanisms in emerging health professionals, but showcases the juxtaposition of two different learner groups (UG and GE students) within a discipline. The cross-cohort facilitation of learning as in the discipline-specific strategies identified can help both groups develop resilience and inform future innovations. By comparing mature-age graduate students and younger-in-age undergraduate students, we identified a wider range of strategies and more positive attitudes to burnout in mature-age students. Health and clinical educators in university health degrees, clinical placements and clinical workplaces can develop effective training materials based on findings from this study to 1) assist undergraduate younger-age health students with developing resilience and 2) further refine mature-age health students’ and practicing health professionals’ resilience in today’s fast-paced clinical workplaces.

Abstract Background Pseudophakic cystoid macular edema (PCME) is a known complication of cataract surgery that contributes to decreased visual acuity. Mechanical manipulation associated with the release of inflammatory mediators is the leading hypothesis for PCME. To date, no standardized prophylactic protocol has been established to effectively reduce the incidence of PCME. This study assessed the efficacy and safety of nonsteroidal anti-inflammatory drops (NSAIDs) and corticosteroids for the prevention of PCME. Method We searched the following databases MEDLINE, EMBASE, and Cochrane Central. Register of Controlled Trials and included randomized controlled trials (RCTs) that studied the efficacy of NSAID vs. placebo, NSAID vs. steroid, or NSAID + steroid vs. placebo, reporting the incidence of PCME, macular thickness, and best-corrected visual acuity. The risk ratio (RR) with a 95% confidence interval (CI) and a random-effects model was used. The risk of bias was assessed using the revised Cochrane risk-of-bias tool. Results A total of 18 RCTs were included in this study (n = 2959). Nine RCT showed low risk of bias, 7 RCT showed unclear risk of bias, and 2 RCT had high risk of bias. The incidence of cystoid macular edema among patients treated with NSAIDs was significantly lower (RR = 0.33, P

Midazolam is generally effective and safe to be widely used in the management of seizures, procedural sedation, and anxiolytic. However, paradoxical reactions, though rare, present clinical challenges. Flumazenil is the preferred option for reversing the reactions. Additionally, ketamine, physostigmine, and haloperidol have been successfully used to counteract the adverse effects (AEs). Herein, we report an 11-year-old girl with epilepsy who was brought to the emergency department with a breakthrough seizure. Approximately 10 minutes after a midazolam administration, she developed increased agitation, confusion, uncontrollable crying, and excessive random movements. Despite receiving 4 doses of flumazenil, no improvement was observed. However, the AEs ceased following the administration of ketamine. This report may increase awareness of the uncommon AEs and equip clinicians to effectively handle such occurrences.

Integrating Artificial Intelligence (AI) and E-learning platforms has become increasingly prevalent in the rapidly evolving landscape of higher Education. However, amidst this technological advancement, the role of Emotional Intelligence (EI) and its impact on the efficacy of AI-driven educational tools still needs to be explored. This pilot study seeks to elucidate the intricate relationship between Emotional Intelligence, Artificial Intelligence, and E-Learning in Higher Education. Drawing upon a multidisciplinary approach, this study investigates the correlation between students' Emotional Intelligence competencies and their engagement with AI-driven E-Learning platforms. The findings of this pilot study are expected to shed light on several critical aspects. Firstly, it aims to uncover how Emotional Intelligence influences students' receptivity to AI-infused E-Learning environments, potentially elucidating strategies for optimizing user experience and learning outcomes. Moreover, by exploring the reciprocal influence between Emotional Intelligence and AI algorithms, this research endeavors to contribute to the refinement of AI technologies, fostering greater personalization and adaptability in educational settings. Furthermore, this study endeavors to address the ethical implications inherent in the intersection of Emotional Intelligence, Artificial Intelligence, and E-Learning. By elucidating the potential risks and benefits associated with integrating these technologies, it seeks to inform policymakers, educators, and AI developers alike, facilitating the responsible deployment of AI-driven educational tools. Therefore, its innovative methodology and comprehensive approach aspire to pave the way for future research endeavors, ultimately enriching the educational landscape with insights prioritizing technological advancement and human well-being.

A common indicator used to examine the frequency and distribution of antibiotic resistance against other enteric bacteria in humans and animals is the commensal enteric bacterium, Escherichia coli. The transmission of plasmids harboring ESBL enzymes, primarily generated by E. coli, is the cause of this resistance. The purpose of this study was to identify the CTX-M gene in ESBL-producing E. coli from broiler chicken cloacal swabs in traditional Surabaya markets. The samples used were 96 cloacal swabs from broiler chickens in the traditional markets of Dukuh Kupang, Keputran, Pacar Keling, and Pucang. The antibiotic disks used in this study belonged to five different antibiotic classes; they are aztreonam (monobactam), chloramphenicol (phenicol), kanamycin (aminoglycoside), ciprofloxacin (fluoroquinolone), and tetracycline (tetracycline). Presumptive ESBL strains were then molecularly screened for the presence of CTX-M gene. Results revealed that out of the 96 chicken cloacal swab samples collected, 58 (60.42%) were positive for E. coli based on morphological culture, Gram staining, and biochemical tests. Additionally, 15 out of the 58 E. coli isolates recovered from broiler chicken cloacal swabs were multidrug-resistant (MDR) while 7 of E. coli isolates harbored CTX-M gene. Conclusively, this study has shown that broiler chickens sold in traditional Surabaya markets harbor MDR E. coli which possess CTX-M gene. Conditions in traditional markets with low levels of cleanliness and chickens placed close together can spread resistance genes with serious public health consequences. Therefore, it is imperative to observe good hygienic practices in Surabaya traditional markets in order to curtail the spread of MDR bacterial pathogens in the food chain.

The problem most often encountered in fish farming is disease which can cause a decrease in fish production levels. Parasites cause one of the infectious diseases found in fish farming. The presence of parasites can cause a decrease in the quality of the growth of fish production. The purpose of this study was to identify the prevalence of ectoparasites on Nile tilapia in Sidoarjo, Indonesia. Ninety-six samples from two ponds were examined under the microscope to find out the presence of ectoparasite that exists in the outside body part of the fish. Samples were collected from skin, fins, tail, and gills using native methods and observed under a microscope in the Division of Parasitology Laboratory, Faculty of Veterinary Medicine, Universitas Airlangga. The results of this study showed 86 samples positively infected by ectoparasite and 10 showed negative. The ectoparasites found in this study were Trichodina sp., Chilodonella sp., Ichthyophthirius multifillis, Gyrodactylus sp., and Dactylogyrus sp. The highest prevalence is Trichodina sp. and Dactylogyrus sp. The number of fish infested by ectoparasite is 89.56%, this is classified in the usual category. The highest prevalence occurs in infestations of Trichodina sp. i.e.72.91% which were contained in the 70 samples. While the lowest prevalence was in Gyrodactylus sp. by 8.32% in 8 fish samples. Double infections from two different ponds were 70% within 33 samples which were included in the usual category.

Abstract In societies where education holds high significance and parental ambitions for their children’s academic achievements are profound, understanding the rationale behind parental school choice becomes crucial. This study aims to explore the question: Are Saudi parents rational in selecting their children’s schools? Through an in-depth analysis of preferences and decision-making factors, this research endeavors to shed light on the intricate dynamics influencing parental school choice within the Saudi Arabian context. To achieve this objective, semi-structured interviews were conducted with Saudi parents whose children were enrolled in private schools (K-12). The findings indicate that cultural or religious identity emerged as a predominant factor, encompassing elements such as gender segregation in schools, parental preference for English over Arabic language learning, and the emphasis on Islamic religious education. Additionally, accessibility factors such as the physical location of the school and school fees emerged as significant determinants of parental preferences for their children’s schools. Wellbeing emerged as a crucial factor in parental decision-making. Furthermore, certain academic considerations emerged as a primary influencing factor in Saudi parents’ school selection. These considerations included skills development, school pedagogy, school staff quality, and learning outcomes.

Abstract In the rice-based system of mid-latitudes, mineral nitrogen (N) fertilizer serves as the largest source of the N cycle due to an insufficient supply of N from organic sources causing higher N losses due to varying soil and environmental factors. However, aiming to improve soil organic matter (OM) and nutrients availability using the best environmentally, socially, and economically sustainable cultural and agronomic management practices are necessary. This study aimed to enhance nitrogen use efficiency (NUE) and grain yield in rice-based systems of mid-latitudes by partially replacing inorganic N fertilizer with organic inputs. A randomized complete block design (RCBD) was employed to evaluate the effects of sole mineral N fertilizer (urea) and its combinations with organic sources—farmyard manure (FYM) and poultry compost—on different elite green super rice (GSR) genotypes and were named as NUYT-1, NUYT-2, NUYT-3, NUYT-4, NUYT-5, and NUYT-6. The study was conducted during the 2022 and 2023 rice growing seasons at the Rice Research Program, Crop Sciences Institute (CSI), National Agricultural Research Centre (NARC), Islamabad, one of the mid-latitudes of Pakistan. The key objective was to determine the most effective N management strategy for optimizing plant growth, N content in soil and plants, and overall crop productivity. The results revealed that the combined application of poultry compost and mineral urea significantly enhanced soil and leaf N content (1.36 g kg− 1 and 3.06 mg cm− 2, respectively) and plant morphophysiological traits compared to sole urea application. Maximum shoot dry weight (SDW) and root dry weight (RDW) were observed in compost-applied treatment with the values of 77.62 g hill− 1 and 8.36 g hill− 1, respectively. The two-year mean data indicated that applying 150 kg N ha⁻1, with half provided by organic sources (10 tons ha⁻1 FYM or poultry compost) and the remainder by mineral urea, resulted in the highest N uptake, utilization, and plant productivity. Thus, integrated management of organic carbon sources and inorganic fertilizers may sustain the productivity of rice-based systems more eco-efficiently. Further research is recommended to explore root and shoot morphophysiological, molecular, and biochemical responses under varying N regimes, aiming to develop N-efficient rice varieties through advanced breeding programs.

Abstract Drought stress (DS) adversely affects a plant’s development and growth by negatively altering the plant’s physio-biochemical functions. Previous investigations have illustrated that seed priming with growth regulators is an accessible, affordable, and effective practice to elevate a plant’s tolerance to drought stress. Melatonin (MT) is derived from the precursor tryptophan and can improve germination, biomass, and photosynthesis under stress conditions. The current study examined the effect of melatonin seed priming on two wheat cultivars (Fakhar-e-Bhakkar and Akber-19) cultivated under severe drought conditions (35% FC). There were 6 levels of melatonin (i.e., M0 = control, M1 = 1 mg L− 1, M2 = 2 mg L− 1, M3 = 3 mg L− 1, M4 = 4 mg L− 1 and M5 = mg L− 1) which were used for seed priming. Our results confirmed that seed priming with M2 = 2 mgL− 1 concentration of MT alleviates the negative effects of DS by boosting the germination rate by 54.84% in Akber-19 and 33.33% in Fakhar-e-Bhakkar. Similarly, leaf-relative water contents were enhanced by 22.38% and 13.28% in Akber-19 and Fakhar-e-Bhakkar, respectively. Melatonin pre-treatment with 2 mgL− 1 significantly enhanced fresh and dry biomass of shoot and root, leaf area, photosynthetic pigments, osmoprotectants accumulation [total soluble proteins (TSP), total free amino acids (TFAA), proline, soluble sugars, glycine betaine (GB)] and lowered the amount of malondialdehyde (MDA) and hydrogen peroxide (H2O2) production by elevating antioxidants [Ascorbic acid, catalase (CAT), Phenolics, peroxidase (POD) and superoxide dismutase (SOD)] activity under drought stress (DS). Meanwhile, under control conditions (NoDS), the melatonin treatment M1 = 1 mgL− 1 effectively enhanced all the growth-related physio-biochemical attributes in both wheat cultivars. In the future, more investigations are suggested on different crops under variable agroclimatic conditions to declare 2 mgL− 1 melatonin as an efficacious amendment to alleviate drought stress.

Abstract A smart grid (SG) is a cutting-edge electrical grid that utilizes digital communication technology and automation to effectively handle electricity consumption, distribution, and generation. It incorporates energy storage systems, smart meters, and renewable energy sources for bidirectional communication and enhanced energy flow between grid modules. Due to their cyberattack vulnerability, SGs need robust safety measures to protect sensitive data, ensure public safety, and maintain a reliable power supply. Robust safety measures, comprising intrusion detection systems (IDSs), are significant to protect against malicious manipulation, unauthorized access, and data breaches in grid operations, confirming the electricity supply chain’s integrity, resilience, and reliability. Deep learning (DL) improves intrusion recognition in SGs by effectually analyzing network data, recognizing complex attack patterns, and adjusting to dynamic threats in real-time, thereby strengthening the reliability and resilience of the grid against cyber-attacks. This study develops a novel Mountain Gazelle Optimization with Deep Ensemble Learning based intrusion detection (MGODEL-ID) technique on SG environment. The MGODEL-ID methodology exploits ensemble learning with metaheuristic approaches to identify intrusions in the SG environment. Primarily, the MGODEL-ID approach utilizes Z-score normalization to convert the input data into a uniform format. Besides, the MGODEL-ID approach employs the MGO model for feature subset selection. Meanwhile, the detection of intrusions is performed by an ensemble of three classifiers such as long short-term memory (LSTM), deep autoencoder (DAE), and extreme learning machine (ELM). Eventually, the dung beetle optimizer (DBO) is utilized to tune the hyperparameter tuning of the classifiers. A widespread simulation outcome is made to demonstrate the improved security outcomes of the MGODEL-ID model. The experimental values implied that the MGODEL-ID model performs better than other models.

Abstract Brain tumor, a leading cause of uncontrolled cell growth in the central nervous system, presents substantial challenges in medical diagnosis and treatment. Early and accurate detection is essential for effective intervention. This study aims to enhance the detection and classification of brain tumors in Magnetic Resonance Imaging (MRI) scans using an innovative framework combining Vision Transformer (ViT) and Gated Recurrent Unit (GRU) models. We utilized primary MRI data from Bangabandhu Sheikh Mujib Medical College Hospital (BSMMCH) in Faridpur, Bangladesh. Our hybrid ViT-GRU model extracts essential features via ViT and identifies relationships between these features using GRU, addressing class imbalance and outperforming existing diagnostic methods. We extensively processed the dataset, and then trained the model using various optimizers (SGD, Adam, AdamW) and evaluated through rigorous 10-fold cross-validation. Additionally, we incorporated Explainable Artificial Intelligence (XAI) techniques-Attention Map, SHAP, and LIME-to enhance the interpretability of the model’s predictions. For the primary dataset BrTMHD-2023, the ViT-GRU model achieved precision, recall, and F1-score metrics of 97%. The highest accuracies obtained with SGD, Adam, and AdamW optimizers were 81.66%, 96.56%, and 98.97%, respectively. Our model outperformed existing Transfer Learning models by 1.26%, as validated through comparative analysis and cross-validation. The proposed model also shows excellent performances with another Brain Tumor Kaggle Dataset outperforming the existing research done on the same dataset with 96.08% accuracy. The proposed ViT-GRU framework significantly improves the detection and classification of brain tumors in MRI scans. The integration of XAI techniques enhances the model’s transparency and reliability, fostering trust among clinicians and facilitating clinical application. Future work will expand the dataset and apply findings to real-time diagnostic devices, advancing the field.

Abstract Nitrogen deficiency in low organic matter soils significantly reduces crop yield and plant health. The effects of foliar applications of indole acetic acid (IAA), trehalose (TA), and nanoparticles-coated urea (NPCU) on the growth and physiological attributes of tomatoes in nitrogen-deficient soil are not well documented in the literature. This study aims to explore the influence of IAA, TA, and NPCU on tomato plants in nitrogen-deficient soil. Treatments included control, 2mM IAA, 0.1% TA, and 2mM IAA + 0.1% TA, applied with and without NPCU. Results showed that 2mM IAA + 0.1% TA with NPCU significantly improved shoot length (~ 30%), root length (~ 63%), plant fresh (~ 48%) and dry weight (~ 48%), number of leaves (~ 38%), and leaf area (~ 58%) compared to control (NPCU only). Additionally, significant improvements in chlorophyll content, total protein, and total soluble sugar, along with a decrease in antioxidant activity (POD, SOD, CAT, and APX), validated the effectiveness of 2mM IAA + 0.1% TA with NPCU. The combined application of 2mM IAA + 0.1% TA with NPCU can be recommended as an effective strategy to enhance tomato growth and yield in nitrogen-deficient soils. This approach can be integrated into current agricultural practices to improve crop resilience and productivity, especially in regions with poor soil fertility. To confirm the efficacy of 2mM IAA + 0.1% TA with NPCU in various crops and climatic conditions, additional field studies are required.

Abstract This study investigates simulation of pharmaceutical separation via membrane distillation process by computational simulation and machine learning modeling strategy. The efficacy of three regression models, i.e., Multi-layer Perceptron (MLP), Gamma Regression, and Support Vector Regression (SVR) in predicting the solute concentration, C(mol/m³), was evaluated. The hyper-parameters were optimized by fine-tuning the models using the Red Deer Algorithm (RDA). Computational analyses were carried out for removal of pharmaceuticals from solution by membrane distillation in continuous mode. Mass transfer and machine learning models were implemented focusing on concentration of solute in the feed section of membrane. Results indicate that the Multi-layer Perceptron model achieved great accuracy with an R2 of 0.9955, an MAE of 0.0084, and an RMSE of 0.0148, effectively capturing complex nonlinear relationships in the data. Gamma Regression also performed acceptably, with fitting R2 of 0.9214, showing its suitability for positively skewed data. The Support Vector Regression model, while capturing the general trend, showed the lowest performance with an R2 of 0.8710. These findings suggest that the Multi-layer Perceptron is the most accurate model for this dataset, followed by Gamma Regression and Support Vector Regression. This underscores the importance of careful model selection and optimization in regression analysis in combination with computational simulation of membrane processes.

Abstract Background Mental disorders account for a significant proportion of the world’s disease burden and are more significant among females than males. However, most global mental health research is sex neutral, including in the Kingdom of Saudi Arabia. This study, therefore, estimated the prevalence of mental disorders and investigated the sociodemographic correlates, sex disadvantage factors, and treatment-seeking in Saudi women concerning lifetime and 12-month mental disorders. Method The Saudi National Mental Health Survey is a stratified multistage clustered area probability design. Lifetime and 12-month mental disorders were assessed through the Composite International Diagnostic Interview (CIDI 3.0). The correlates considered for this study included age-at-interview, education, marital status, employment status, socioeconomic status (SES), any chronic condition and household characteristics (region, urbanicity, and income), as well as domestic violence, age at marriage and in a polygamous marriage. Data was analysed using PROC SURVEYFREQ procedure as well as logistic regression in SAS 9.2. Results Overall, 24.7% and 35.9% of Saudi women experienced at least one of the disorders in the prior 12 months and at least once in their lifetime, respectively. Anxiety disorders were the most frequently reported 12-month and lifetime disorders, followed by mood disorders. The region, urbanicity, chronic conditions, employment status, as well as certain sex disadvantage factors were significantly associated with both 12-month and lifetime disorders. Most women did not seek treatment for 12-month mental disorders (86.2%) and lifetime disorders (73.8%). Conclusion Our study confirms that mental health issues, particularly anxiety and mood disorders, are highly prevalent among Saudi women, influenced by chronic conditions and sex-related factors like domestic violence and polygamy. Future research should focus on improving mental health literacy, using rigorous study designs to explore female-specific variables, and investigating genetic and environmental factors.

The productivity of cassava in acid dryland is generally still low. Fertilization, land amelioration, and superior varieties are the main solutions for increasing cassava productivity. This research aimed to determine the response of high-yielding varieties and fertilization technology packages to the growth and yield of cassava in acid dryland of Sukaharja Village, Warung Kiara District, Sukabumi Regency, West Java. The contents of organic carbon, nitrogen, and magnesium of the soil is below the minimum threshold, so the application of N fertilizer, organic matter, and ameliorant is expected to increase plant growth. The research consisted of two treatment factors: two cassava varieties and three fertilization technologies. The treatments were arranged in a completely randomized split-plot experimental design with three replications with variety as the main plot and fertilization technology package as the subplots. The treatment effect was observed on the character of plant height, wet biomass weight, stem diameter, number of tubers, tuber length, tuber diameter, tuber weight (large and small) per plant, and tuber yield per plot to be converted per ha. Tuber quality was observed by observing water content, percent dry matter, and starch yield. The results showed that the fertilization technology package increased plant height, fresh biomass weight, stem diameter, large tuber weight per plant, and yield per hectare in both varieties. Differences in varieties and fertilization technology packages have no effect on starch levels.

In this study, the influence of the torsional rigidity of the connected shafts, couplings and the working body of the machine, as well as the damping capacity of the coupling, on the torsional impact moment generated in the machine transmission is investigated. Unlike existing classical calculation models, the torsional stiffness of the connected shafts, the torsional damping ability of the coupling and the effects of the moment ratio are taken into consideration together. Under these conditions an analytical expression for the shock moment or resonance coefficient is obtained. The main novelties in obtaining of this expression are the ratio of the torsional stiffness of the connected shafts with the torsional stiffness of the coupling and the acceptance of the moment of resistance of the working body of the machine depending on the torsional stiffness. It has been found that the considered factors have a significant effect on the resonance zone. Finally, different and overlapping conditions are determined when determining the value of the resonance coefficient characterizing the torque impact moment, calculated according to the classical and proposed models.

Adsorption techniques are frequently used to eliminate particular forms of pesticides. This work aims to describe the process of adsorbing abamectin (ABM) from aqueous systems onto adsorbents and some factors affecting the process' effectiveness. Water hyacinth (WH) was chemically processed utilizing calcium alginate-immobilized WH and sodium alginate as adsorbent. The Response Surface Method (RSM) was implemented to enhance operational aspects of the adsorption procedure on the removal of (ABM) residues from aqueous solution. The results show that 95.65% of the abamectin was removed under the optimum conditions of pH=3, 1000 mg/L of immobilized WH, particle size=5 µm, shaking speed =200 rpm, and 30 mg/L of ABM concentration throughout 180 min contact time. The model's predicted response results also show a decent agreement with the experimental data (R2 = 86.64%), proving the effectiveness of this approach for developing precise predictions. The responses were assessed using a second-order polynomial multiple regression model, which confirmed a successful adjustment with the obtained data using analysis of variance (R2 = 92.0%, R2adj = 88.92%, and R2pred = 82.92%). In conclusion, the results demonstrated the potential application and beneficial adsorption effectiveness of WH in removal of the pesticides from an aqueous solution.

In this study, a new two-parameter discrete distribution is introduced by mixing Poisson and Quasi-Shanker distributions. The new model is named Poisson Quasi-Shanker-(PQS) distribution. Some important mathematical properties of the proposed distribution are derived including factorial moments, moment-generating function, variance, and dispersion index. The parameters of PQS distribution are estimated using the maximum likelihood estimation approach. A Monte Carlo simulation is carried out to illustrate the behavior of derived estimators. The applicability of the new model is assessed using two datasets from different areas. It is concluded the proposed distribution is more flexible as compared to the considered competitive distributions.

Air pollution has significant detrimental impacts on the environmental compartments and human health. The present study investigates the interactions between selected air pollutants, including CO, O3, NO2, SO2, PM10, and PM2.5, in Tehran megacity, the capital of Iran, using statistical modeling and simulating approaches. Data on selected air pollutants have been extracted from 16 sensors across Tehran during 2013–2022. Using the development of three machine learning models, including XGBoost (XGB), LightGBM (LGBM) and Random Forest (RF), significant relationships between the air pollutants were observed. The comparison of the models demonstrated that the RF model has the highest level of optimality in forecasting the concentrations of CO, O3, NO2, and SO2 (R2CO = 0.63, R2O3 = 0.6, R2NO2 = 0.54, R2SO2 = 0.55). The LGBM model provided higher optimality for NO2 and PM2.5 (R2NO2 = 0.56, R2PM2.5 = 0.88), while the XGB model exhibited higher accuracy for the PM10 (R2PM10 = 0.88). Regarding the results obtained from the statistical models, it can be inferred that the RF model has superior performance in the forecasting of gaseous pollutants. Moreover, the XGB and LGBM models exhibited comparable performance and therefore may be regarded as appropriate options for PM prediction. The findings from the simulations indicated that a rise in an individual pollutant likely leads to an increase in other pollutants. Consequently, implementing air quality management strategies for a specific pollutant meaningfully, directly influences other pollutants, highlighting the significance of considering the chemical aspect of air pollutants interaction and enforcing air pollution management rules.

Background: Category III (AUS; Atypia of Undetermined Significance) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was established to describe thyroid nodule features that are neither benign nor cancerous. OBJECTIVES: This study aims to evaluate the rate of thyroid malignancy in patients diagnosed with AUS at the Armed Forces Hospital Southern Region (AFHSR), Saudi Arabia. Method: The patients (508) diagnosed with AUS in their thyroid nodules underwent fine-needle aspiration cytology (FNAC). Data were collected through a chart-based approach, reviewing patients’ medical records and relevant information. Results: Among the cases, the majority were females (84.6%). Among the different age groups, individuals between 40 and 50 years had the highest prevalence of thyroid nodules (32.5%). Approximately 27% of patients exhibited tumor sizes larger than 4 cm. FNAC results revealed 16.5% benign, 26% AUS, and 22.4% follicular neoplasm cases. Histopathology indicated 54.1% of benign and 37.2% of malignant cases. Papillary carcinoma accounts for 80.4% of all malignant cases. A significant correlation was observed between FNAC and postoperative histopathology (P value < 0.05). Hypoechoic nodules exhibited 33.9% of malignant cases, and calcification was observed in 25% of the cases. A significant association was found between malignancy and echogenicity and between malignancy and calcification (P value = 0.003 and 0.001, respectively). Conclusion: The findings of this study identify malignancy in thyroid nodules with AUS cytopathology, particularly in the Southern region of Saudi Arabia. The correlation between pre-surgery FNAC and postoperative histopathology supports FNAC’s diagnostic value. Additionally, echogenicity and calcification can potentially contribute to predicting nodule malignancy.

Background: To end the COVID-19 pandemic, we need to reach herd immunity. A successful pediatric COVID-19 immunization program is the only way to achieve this goal. The objective of this study was to determine the views of parents in Saudi Arabia on the COVID-19 vaccine in children. MATERIALS AND METHODS: This cross-sectional study took place within the Family Medicine Pediatric clinics at the King Faisal Specialist Hospital and Research Center (KFSH and RC). All parents of patients of Family Medicine Pediatric Clinics at KFSH and RC, Riyadh, were invited to participate in this study between January 2022 and June 2022. A culturally sensitive and specially designed questionnaire was administered using an interview-based model. Results: Safety concerns were the primary reason for vaccine hesitancy among parents, with 29.7% of parents expressing concerns about side effects and 25.1% not knowing where to get reliable information about vaccines. Negative information and lack of perceived need were also important factors, with 17.1% and 18.3% of parents citing these reasons, respectively. Poor knowledge about vaccines was a significant predictor of parental vaccine hesitancy. Mothers had more concerns about the efficacy and safety of vaccines than fathers. Conclusion: Our study demonstrated a negative attitude toward the pediatric COVID-19 vaccine among parents in Saudi Arabia. A higher level of awareness about the vaccine was significantly associated with planning on having the vaccine. There is a need for effective awareness programs for better pediatric COVID-19 vaccine-related education to increase the acceptance of the vaccine among parents in Saudi Arabia.

Background: This systematic review and meta-analysis aimed to investigate the current evidence on the efficacy of tympanostomy and adenoidectomy in children with otitis media with effusion in comparison with tympanostomy alone following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Materials and Methods: We completed a comprehensive search of PubMed, Web of Science, Scopus and Cochrane Library databases for relevant studies published in the literature with no date restrictions. We collected the results of the databases search and removed duplicated studies by Rayyan QCRI and EndNote Software X8. We used an Excel sheet for screening titles and abstracts, full text and data extraction. For quality assessment, we used Cochrane Handbook of Systematic Reviews of Interventions 5.1.0 using the quality assessment table provided in Part 2 and Chapter 8.5, and quantitative data synthesis was done using Review Manager (RevMan) software version 5.4. Results: The literature search showed 1510 studies, of which five studies were included in data synthesis. The study measured the effect through number of acute otitis media (AOM) episodes, cumulative number of AOM episodes, siblings with Otitis media (OM), hearing level hearing loss scale of the left, and right ears. The pooled effect estimates showed significant difference between tympanostomy with adenoidectomy versus tympanostomy alone in hearing level hearing loss scale of both ears (SMD -0.17, 95% CI [-0.29, -0.05], P-value=0.005). However, the pooled results were not heterogeneous (P < 0.25, I2 = 24%). Conclusions: Tympanostomy with adenoidectomy improves hearing compared to tympanostomy alone, but both treatments have similar effects on ear infection rates. Further research with larger samples is needed to confirm these findings and assess long-term benefits.

Abstract Background Tuberculosis (TB) is one of the most widespread infectious diseases worldwide, typically persisting in the body as a latent TB infection (LTBI). Patients with type 2 diabetes have an increased risk of LTBI progressing to active TB. Therefore, this study determined the prevalence and predictors of LTBI and assessed the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) in diagnosing LTBI among type 2 diabetics in Sana’a city, Yemen. Methods A cross-sectional study was conducted among 150 type 2 diabetics in private health facilities in Sana’a in 2023. Data about demographics, diabetes-related characteristics, and potential risk factors for LTBI were collected using a structured questionnaire. Patients were then screened for LTBI using TST and IGRA. Univariate analysis was used to identify LTBI-associated risk factors, and multivariable binary logistic regression was used to identify independent predictors of LTBI. The agreement between TST and IGRA for diagnosing LTBI was assessed using Cohen’s kappa coefficient (κ). Results LTBI was prevalent among 29.3% of type 2 diabetics using both types of tests (25.3% with IGRA and 21.3% with TST). Male gender was an independent predictor of LTBI (AOR = 4.4, 95% confidence interval: 1.30–15.08; P = 0.018). However, being employed (AOR = 0.3, 95% CI: 0.09–0.75; P = 0.013) and longer duration since diabetes diagnosis (AOR = 0.3, 95% CI: 0.12–0.98; P = 0.046) were identified as predictors of lower LTBI risk. The agreement between TST and IGRA for the diagnosis of LTBI was 88%, with a good and statistically significant agreement between the two test types (κ = 0.670; P

Abstract This study examines the factors influencing organic food consumption and willingness to pay premium prices in the context of an emerging economy. The extended attitudinal behavior-scenario model, rooted in Signaling theory, served as the foundation for the proposed model. A convenience sample of 470 young Chinese consumers was collected through online and offline surveys. Partial least squares structural equation modeling was used to test the hypothesized relationships. The results reveal that consumers’ environmental concern, environmental values, value perception, price sensitivity, and green promotion significantly affect their attitudes toward organic food. In addition, consumers’ health consciousness, value perception, price sensitivity, and green promotion demonstrate significant positive effects on their intention to consume organic food. Moreover, consumer attitude toward organic food substantially influences their intention to consume it. Similarly, consumer attitude, intention, and green psychological benefits significantly affect their willingness to pay premium prices for organic food. In addition, the indirect effects of consumer attitude toward organic food and intention to consume in the relationship between the factors and willingness to pay premium prices provide interesting findings. This study offers valuable guidance for policymakers in developing appropriate strategies to expand the organic food market and provides a solid foundation for future research on organic food consumption. This study suggests that policymakers should concentrate on enhancing awareness and knowledge of organic food, promoting organic food production, and prioritizing campaigns that emphasize the exceptional health advantages of organic food to encourage greater consumption.

Abstract Salinity stress adversely affects plant growth by disrupting water uptake, inducing ion toxicity, initiating osmotic stress, impairing growth, leaf scorching, and reducing crop yield. To mitigate this issue, the application of kaempferol (KP), caffeic acid (CA), and plant growth-promoting rhizobacteria (PGPR) emerges as a promising technology. Kaempferol, a flavonoid, protects plants from oxidative stress, while caffeic acid, a plant-derived compound, promotes growth by regulating physiological processes. PGPR enhances plant health and productivity through growth promotion, nutrient uptake, and stress mitigation, providing a sustainable solution. However, combining these compounds against drought requires further scientific justification. That’s why the current study was conducted using 4 treatments, i.e., 0, 20 µM KP, 30 μM CA, and 20 µM KP + 30 μM CA without and with PGPR (Bacillus altitudinis). There were 4 replications following a completely randomized design. Results showed that 20 µM KP + 30 μM CA with PGPR caused significant enhancement in potato stem length (14.32%), shoot root, and leaf dry weight (16.52%, 11.04%, 67.23%), than the control. The enrichment in potato chlorophyll a, b, and total (31.86%, 46.05%, and 35.52%) was observed over the control, validating the potential of 20 µM KP + 30 μM CA + PGPR. Enhancement in shoot N, P, K, and Ca concentration validated the effective functioning of 20 µM KP + 30 μM CA with PGPR evaluated to control. In conclusion, 20 µM KP + 30 μM CA with PGPR is the recommended amendment to alleviate salinity stress in potatoes.

Abstract Protein–protein interaction (PPI) prediction is vital for interpreting biological activities. Even though many diverse sorts of data and machine learning approaches have been employed in PPI prediction, performance still has to be enhanced. As a result, we adopted an Aquilla Influenced Shark Smell (AISSO)-based hybrid prediction technique to construct a sequence-dependent PPI prediction model. This model has two stages of operation: feature extraction and prediction. Along with sequence-based and Gene Ontology features, unique features were produced in the feature extraction stage utilizing the improved semantic similarity technique, which may deliver reliable findings. These collected characteristics were then sent to the prediction step, and hybrid neural networks, such as the Improved Recurrent Neural Network and Deep Belief Networks, were used to predict the PPI using modified score level fusion. These neural networks’ weight variables were adjusted utilizing a unique optimal methodology called Aquila Influenced Shark Smell (AISSO), and the outcomes showed that the developed model had attained an accuracy of around 88%, which is much better than the traditional methods; this model AISSO-based PPI prediction can provide precise and effective predictions.

Abstract Background The increasing levels of stress among students worldwide pose a significant challenge to educational institutions. This study aims to systematically identify and analyse the factors contributing to student stress using advanced machine learning techniques. Objective To explore the primary stressors affecting students and to evaluate the interrelations among psychological, physiological, environmental, academic, and social factors in influencing student stress levels. Methods The study utilized a comprehensive dataset, StressLevelDataset.csv, collected from a diverse group of 1100 students across various educational institutions. We employed machine learning tools, including correlation analysis and feature importance analysis using Random Forest models, to identify and rank the most significant stressors. Results Key findings suggest that psychological factors like self-esteem and physiological factors like sleep quality are crucial predictors of stress levels in students. A significant negative correlation was found between students’ anxiety levels and their academic performance, highlighting the adverse impacts of psychological stress on educational outcomes. Conclusion The results underscore the importance of targeted interventions focusing on mental health and well-being within educational settings. By addressing the identified stressors, particularly in the psychological and physiological domains, educational institutions can enhance student well-being and improve academic performance.

Abstract Background Neuroinflammation is involved in the pathogenesis of almost every central nervous system disorder. As the brain’s innate immune cells, microglia fine tune their activity to a dynamic brain environment. Previous studies have shown that repeated bouts of peripheral inflammation can trigger long-term changes in microglial gene expression and function, a form of innate immune memory. Methods and results In this study, we used multiple low-dose lipopolysaccharide (LPS) injections in adult mice to study the acute cytokine, transcriptomic, and microglia morphological changes that contribute to the formation of immune memory in the frontal cortex, hippocampus, and striatum, as well as the long-term effects of these changes on behavior. Training and tolerance of gene expression was shared across regions, and we identified 3 unique clusters of DEGs (2xLPS-sensitive, 4xLPS-sensitive, LPS-decreased) enriched for different biological functions. 2xLPS-sensitive DEG promoters were enriched for binding sites for IRF and NFkB family transcription factors, two key regulators of innate immune memory. We quantified shifts in microglia morphological populations and found that while the proportion of ramified and rod-like microglia mostly remained consistent within brain regions and sexes with LPS treatment, there was a shift from ameboid towards hypertrophic morphological states across immune memory states and a dynamic emergence and resolution of events of microglia aligning end-to-end with repeated LPS. Conclusions Together, findings support the dynamic regulation of microglia during the formation of immune memories in the brain and support future work to exploit this model in brain disease contexts.

ÖZ: Antik Nysa şehri kalıntılarının yakınında bulunan Sultanhisar, günümüzde Aydın iline bağlı ilçelerden biridir. Aydın yöresi XIII. yüzyıl sonlarında Menteşe Bey’in fethiyle Türk hakimiyetine alınmış ve bu bölge Türkmenlerin yoğun olarak yerleştikleri bir bölge haline gelmiştir. İlk kez I. Bayezid’in 1389-90 yılındaki seferiyle Osmanlı hakimiyetine alınan bölge kısa süre sonra Osmanlı hakimiyetinden çıkmış ve XV. yüzyılın ilk yarısında kati bir şekilde Osmanlı egemenliğine alınmıştır. Osmanlı devrinde bölgede XV. ve XVI. yüzyıllar boyunca birkaç kez tahrir işlemi yapılmıştır. Tahrir işlemleri sayesinde bahsi geçen dönemde Sultanhisar kazasının idari ve iktisadi durumuna dair bilgiler elde edilmiş, ayrıca kazadaki tarımsal üretim faaliyetlerine ve diğer vergi gelirleriyle ilgili veriler kayıt altına alınmıştır. Bu çalışmada tahrir defterlerindeki kayıtlardan yola çıkılarak Sultanhisar’ın XV. ve XVI. yüzyıllardaki durumu ele alınacak ve tahrir defterlerindeki veriler değerlendirilecektir. ABSTRACT: Sultanhisar, located near the ruins of the ancient city of Nysa, is one of the districts of Aydın province today. Aydın region was taken under Turkish rule with the conquest of Menteşe Bey at the end of the XIIIth century and this region became a region where Turkmens were settled. The region, which was first taken under Ottoman rule with Bayezid I's campaign in 1389-90, soon fell out of Ottoman rule and was taken under Ottoman rule permanently in the first half of the XVth century. During the Ottoman period, the region was surveyed several times throughout the XVth and XVIth centuries. Thanks to the tahrir records, information on the administrative and economic status of Sultanhisar district in the mentioned period was obtained, as well as data on agricultural production activities and other tax revenues in the district were recorded.In this study, the situation of Sultanhisar in the XVth and XVIth centuries is discussed based on the records in the tahrir books and the data in the tahrir books are discussed.

Duckweed grown in the water treatment unit of the Nineveh Pharmaceutical Factory contribute to reducing the level of pollution, and are used as a partial substitute for animal protein in common carp fingerling diets, in a growth experiment that lasted for 56 days, where the replacement rates reached 16.67, 33.33, and 50%, that is, a replacement rate, 0%, 2.6%, 5.2%, and 7.8% for treatments T1, T2, T3, and T4 of the total diet, respectively. The results of the statistical analysis showed that the fishes that fed the third diet were significantly superior (P≤0.05) to the other experimental diets in terms of criteria, final weight, total growth, daily gain, relative and specific growth rate, feed intake, feed conversion ratio, feed efficiency ratio, and protein efficiency ratio compared to the control treatment. The results showed that the highest percentage of pollutant removal from the water cleared from the treatment unit was in the spring season, which was represented by both total solids and phosphate compared to the winter and autumn seasons, while the highest percentage of nitrates was in the autumn season. It is clear from what was mentioned above that it is possible to partially replace duckweed with animal protein and that it is effective in reducing pollution of the water discharged from the process unit of the pharmaceutical factory.

Bu çalışmada öncelikle endüstriyel boyutta bir damıtma sistemine mikrodalga desteğinin nasıl sağlanacağı noktasında benzetim çalışmaları yapılmış ve endüstriyel boyutta bir MDD sistemi tasarlanmıştır. Damıtma kazanına 4´3 adet magnetron yerleştirilerek mikrodalga desteği sağlanmıştır. Adaçayı bitkisinin testleri hem geleneksel hem de bu MDD sistemi kullanılarak gerçekleştirilmiştir. Ayrıca, adaçayının sap ve yapraklarıyla birlikte damıtılması veya sadece yapraklarının damıtılarak elde edilen uçucu yağ sonuçları karşılaştırılmıştır. Damıtma sonucu elde edilen uçucu yağların kimyasal analizleri GC-MS cihazı ile yapılmış ve önerilen sistemin damıtma süreçlerine etkileri değerlendirilmiştir. Elde edilen sonuçlara göre, herba kullanılan iki farklı durum için MDD sistemiyle elde edilen yağ verimi geleneksel sisteme göre %10 artmıştır. Herba ve yaprak ayrı ayrı MDD sistemi kullanılarak destile edilmiştir ve sadece yaprakların damıtılması durumunda verim artışı %100 den fazla olmaktadır. Kimyasal bileşenlerdeki değişimler detaylı olarak incelenmiştir.