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This study investigates the thermodynamic performance of a solar-powered absorption cooling system. The system uses a lithium bromide-water (LiBr-H2O) absorption refrigeration system (ARS) integrated with evacuated solar collectors (ETSC) and thermal energy storage (TES) to provide a 3 kTR cooling capacity for a university campus. The paper examines the performance of the integrated system under different design and operating conditions as well as the performance of each subsystem, i.e., ETSC, TES, and ARS. Furthermore, a parametric energy and exergy analysis is applied, where different parameters are studied, such as the temperatures of the generator, the condenser, the evaporator, and the absorber. In addition, the system performance is examined with the variation in environmental conditions. The coefficient of performance (COP), exergetic efficiency, exergy destruction, and fuel depletion ratio (FDR) are used to evaluate the system’s performance. The ETSC and the TES are studied under the variation in solar radiation through the day in two seasons: summer and winter. The results revealed that the increase in generator temperature positively impacts the COP of the ARS while lowering the condenser and absorber temperature gives the same positive effect. Furthermore, the main reason for the exergy destruction is found to be the solar collector, which is responsible for destroying 89% of the input solar exergy. Additionally, 4.7% of the inlet exergy is destroyed in the generator, which makes 4.5% of the total exergy loss. The TES destroyed 4.8% of the total solar exergy input. The energy analysis shows that the ARS achieves an energetic COP of about 0.77, while the exergy analysis revealed that the exergetic COP is 0.21.

Malaria is a parasitic infection that may result in an acute, life-threatening illness. It is a major public health problem in the tropical world. The disease is caused by the parasites of the genus Plasmodium and is transmitted by female Anopheles mosquitoes. Saudi Arabia is in the elimination phase of malaria control. Several parts of Saudi Arabia report cases of imported malaria among travelers and visitors. The city of Makkah in Saudi Arabia has a population of about 2.3 million. Moreover, over 6 million religious visitors from different parts of the world visit Makkah annually. During the COVID-19 outbreak, travel restrictions were enforced in Makkah to contain the spread of COVID-19. We compare the total reported cases of malaria in Makkah before, during, and after COVID-19 travel restrictions in this retrospective cross-sectional study. Data on demographics, clinical data, and laboratory parameters were collected from the medical records of the Ministry of Health, Saudi Arabia. The annual malaria incidence rates in Makkah were 29.13/million people (2018), 37.82/million people (2019), 15.65/million people (2020), 12.61/million people (2021), and 48.69/million people (2022). Most of the malaria cases in Makkah were caused by Plasmodium falciparum, followed by P. vivax. Sudan, Nigeria, Yamen, Pakistan, and India are the top five countries contributing to malaria cases in Makkah. Weekly malaria case analyses revealed that COVID-19-related travel restrictions resulted in zero malaria cases in Makkah, indicating the magnitude of the travel-related malaria burden in the city.

This prospective quasi-experimental study from the NASAM (National Approach to Standardize and Improve Mechanical Ventilation) collaborative assessed the impact of evidence-based practices including subglottic suctioning, daily assessment for spontaneous awakening trial (SAT), spontaneous breathing trial (SBT), head of bed elevation, and avoidance of neuromuscular blockers unless otherwise indicated. The study outcomes included VAE (primary) and intensive care unit (ICU) mortality. Changes in daily care process measures and outcomes were evaluated using repeated measures mixed modeling. The results were reported as incident rate ratio (IRR) for each additional month with 95% confidence interval (CI). A comprehensive program that included education on evidence-based practices for optimal care of mechanically ventilated patients with real-time benchmarking of daily care process measures to drive improvement in forty-two ICUs from 26 hospitals in Saudi Arabia (>27,000 days of observation). Compliance with subglottic suctioning, SAT and SBT increased monthly during the project by 3.5%, 2.1% and 1.9%, respectively (IRR 1.035, 95%CI 1.007–1.064, p = 0.0148; 1.021, 95% CI 1.010–1.032, p = 0.0003; and 1.019, 95%CI 1.009–1.029, p = 0.0001, respectively). The use of neuromuscular blockers decreased monthly by 2.5% (IRR 0.975, 95%CI 0.953–0.998, p = 0.0341). The compliance with head of bed elevation was high at baseline and did not change over time. Based on data for 83153 ventilator days, VAE rate was 15.2/1000 ventilator day (95%CI 12.6–18.1) at baseline and did not change during the project (IRR 1.019, 95%CI 0.985–1.053, p = 0.2812). Based on data for 8523 patients; the mortality was 30.4% (95%CI 27.4–33.6) at baseline, and decreased monthly during the project by 1.6% (IRR 0.984, 95%CI 0.973–0.996, p = 0.0067). A national quality improvement collaborative was associated with improvements in daily care processes. These changes were associated with a reduction in mortality but not VAEs. Registration The study is registered in clinicaltrials.gov (NCT03790150).

Structural insulated panels (SIPs) are widely used in residential and commercial buildings due to their reliable mechanical and thermal performance. However, using framing members and nails to join SIPs causes thermal bridging across the insulation and thus increases heat losses from the building envelope. Alternatively, SIPs joined with embedded camlock systems can overcome this issue. In this paper, a parametric study of the effects of the camlock system material and SIP geometric design on the thermal performance of SIP walls was investigated using a multi-scale finite element modeling approach. The model considers the structural design details of the camlock system. In addition, the effects of the SIP materials, SIP thickness, and the number of camlock systems per unit area on the through-thickness thermal conductivity of the SIP walls are examined. It was found that the SIP thickness is a dominating factor influencing the thermal performance of the SIP. The through-thickness (overall) thermal conductivity of the SIP wall increases linearly with the increase in the number of camlock systems used per unit area. However, it rises exponentially with the increasing SIP thickness. The reduction in the overall R-value of the SIP caused by the camlock system embedded in the SIP did not exceed 13.8%.

Three-dimensional printing technologies are transforming various sectors with promising technological abilities and economic outcomes. For instance, 3D-printed concrete (3DPC) is revolutionizing the construction sector with a promise to cut projects’ costs and time. Therefore, 3DPC has been subjected to extensive research and development to optimize the mechanical and thermal performance of concrete walls produced by 3D printing. In this paper, we conduct a comparative investigation of the thermal performance of various infill structures of 3DPC walls. The targeted outcome is to produce an infill structure with optimized thermal performance to reduce building energy consumption without incurring additional material costs. Accordingly, a computational model is developed to simulate the thermal behavior of various infill structures that can be used for 3DPC walls. The concrete composition and the concrete-to-void fraction are maintained constant to focus on the impact of the infill structure (geometric variations). The thermal performance and energy-saving potential of the 3DPC walls are compared with conventional construction materials, including clay and concrete bricks. The results show that changing the infill structure of the 3DPC walls influences the walls’ thermal conductivity and, thereby, the building’s thermal performance. The thermal conductivity of the examined infill structures is found to vary between 0.122 to 0.17 W/m.K, while if these structures are successful in replacing conventional building materials, the minimum annual saving in energy cost will be about $1/m2. Therefore, selecting an infill structure can be essential for reducing building energy consumption.

An analysis is carried out to examine the effects of chemical reactions on the flow of two-phase non-miscible liquids streaming through rotating parallel plates. The plates are isothermal and insulated electrically. The Couette flow is considered for the electrically conducting two phase viscous-Casson fluids under the impacts of inclined magnetic flux and applied electric field. The problem is also discussed under the influence of different orders of chemical reactions. The modelled equations elaborating the present situation under the implemented suppositions are transformed to ordinary differential equations. The numerical solution for the obtained equations is obtained with suitable matching conditions at the interface region using the shooting technique. The results are also validated by comparing them with the results of a well-known finite difference based numerical scheme known as the Keller-Box method. The numerical results for sundry parameters involved in the flow problem are presented through graphs and discussed in detail.

ZnO is an important II-IV n-type direct bandgap semiconductor material that has exhibited wide consideration due to its applications in optoelectronic devices. In the present investigation, untreated and plasma-treated ZnO NPs were fabricated by a sol-gel route and analyzed with XRD, Raman, UV-Vis spectra, and I–V characteristic techniques. To be used in electronic applications, the ZnO nanoparticles were subjected to a plasma treatment process to tune their optical, vibrational mode, structural and electrical properties. XRD confirmed the pure Wurtzite tetragonal phase crystalline nature of produced samples. The average crystalline size, lattice constant, unit cell volume, and porosity were found in the range of 3.81–4.68 nm, a = 3.217–3.323 Å and c = 2.032–2.178 Å, 5.662–11.274 Å3 and 7.09–5.03%, respectively. The Raman spectra revealed that the intensity of Raman bands was increased due to the increase in the vibrational amplitude and increase in force constants with the enhancement in grain size, these spectra results are in good agreement with XRD and reveal the purity of samples. The bandgap found reduced from 3.56 eV to 3.39 eV by plasma treatment. The electrical studies revealed that plasma treatment improves the electrical properties of ZnO NPs without producing any structural distortions. I–V characteristic curves confirmed that the conductivity was increased from 8.3 X 10−6 to 5.5 X 10−4 ℧ cm−1 on plasma treatment which caused an increase in leakage current. The improved structural, vibrational mode, optical and electrical properties of prepared ZnO NPs make them a suitable candidate for application in electronic devices.

This paper recovers cubic-quartic perturbed solitons in fiber Bragg gratings with quadratic-cubic law nonlinear refractive index. The unified Riccati equation expansion method and the modified Kudryashovâs approach make this retrieval of soliton solutions possible. The parameter constraints, for the existence of such solitons, are also presented.

Background: Diabetes is a costly and serious health problem that is increasing markedly. The quality of care is a major issue among diabetic patients. This study aims to assess the quality of care provided to diabetic patients using the American Diabetes Association (ADA) indicators. Methods: This was a cross-sectional study conducted using a retrospective chart review. The population was adult diabetic patients (type 2) who had attended the National Guard's primary healthcare centers, Makkah region, Saudi Arabia, from January 1, 2017, to December 31, 2018. Results: We studied 400 adult diabetic patients aged 30–97 years with a mean age of 58.25 (SD = 11.9). The length of time with diabetes ranged from 1 to 42 years with a mean of 9.66 years (SD = 7.6). Among all the primary healthcare centers (PHCs), specialized polyclinic (SPC) had the highest number of patient visits. Furthermore, the SPC had the highest number of patients with complications; the primary healthcare center with the fewest complications was Iskan-Jeddah. The results show that the control of hemoglobin A1C (HbA1C) was better in 2018 than in 2017. Conclusion: There is improved and adequate care provided to patients among the assessed primary healthcare centers in the Makkah region. Nevertheless, there remains a need for interventions to maintain comprehensive data on diabetes performance. Monitoring and proper education on diabetic care to patients are suggested to achieve better control of diabetes and delay the occurrence of complications.

The unsteady boundary layer flow and thermal transportation analysis of an incompressible Oldroyd-B nanofluid driven by stretching cylinder is scrutinized with analytically approach in this study. The governing unsteady boundary layer equations (PDEs) are first established, and then these PDEs are converted into highly nonlinear ordinary differential equations (ODEs) using appropriate similarity transformations. The obtained equations are then solved in the form of series solutions via homotopy analysis method (HAM) for the velocity, temperature, and concentration fields. Additionally, the convergence analysis of the analytic series solutions is discussed. The model under consideration predicts the features of both the relaxation and retardation times effects. The aspects of thermophoresis and Brownian motion characteristics due to nanoparticles are studied by employing Buongiorno's model. The findings demonstrated that when the curvature parameter increases, the velocity, temperature, and concentration distributions near the cylinder's surface enhanced. Moreover, the velocity profile, for relaxation and the retardation times parameters, showed the opposite behavior. Also, the unsteadiness parameter enhanced the fluid velocity. The comparison of some current and old results is remarkable.

Abstract Background Ramadan is the ninth month of the Islamic calendar were Muslims fast from dawn until sunset. This prolonged fasting period might have an impact on patients with diabetes and their disease control. This study aimed to determine the variation in visits at the Emergency Room department (ER) during Ramadan in comparison with other lunar months at a tertiary care hospital in Jeddah city in relation to the diabetes emergencies. Methodology A retrospective cross-sectional study was conducted using electronic medical record review of patients with diabetes emergencies who visited ER of a Military hospital, from 9th to 11th lunar months during 2017–2018. Diabetes patients who visited ER and aged more than 18 years old were included. Frequency of ER visits, sociodemographic characteristics and clinical features were determined. Chi-square test, Student ‘s t-test and one-way ANOVA at p

Functionalized oxindoles and pyrrolizidines form the central structural framework for numerous natural products with extensive biological and pharmacological applications. The requirement for high regio- and stereoselectivity is the main obstacle in the synthesis of such five-membered heterocycles. Multicomponent cycloaddition reactions often provide an efficient and straightforward approach for the preparation of specific regio- and stereoisomers. In this article, the regio- and stereochemistry of the polar [3 + 2]-cycloaddition (32CA) reaction of azomethine ylides prepared by the reaction of isatin derivatives and L-proline with a series of (E)-3-(2-oxo-2-(pyren-1-yl)ethylidene)indolin-2-ones was investigated by experimental and theoretical methods. Among the isatin and (E)-3-(2-oxo-2-(pyren-1-yl)ethylidene)indolin-2-one derivatives, a remarkable inversion of regioselectivity was observed in the 32CA reaction of azomethine ylide generated by the reaction of L-proline and 5-chloroisatin or N-methyl-5-chloroisatin with (E)-5-chloro-3-(2-oxo-2-(pyren-1-yl)ethylidene)indolin-2-one. The regio- and stereochemical assignment of the structures of the cycloaddition products was determined by one- and two-dimensional (1D&2D) homonuclear and heteronuclear correlation nuclear magnetic resonance spectroscopy. The molecular mechanism as well as the regio- and stereoselectivity of the cycloaddition were investigated by means of global and local reactivity indices and a density functional theory (DFT) and explained in detail on the basis of the transition state stabilities of the reactants.

Context: Identification of modifiable risk factors of neurocognitive dysfunction (NCDs) that would help in preventing neurocognitive dysfunction by means of appropriate measures. Objectives: The study aims to provide an insight into the extent and cofactors ofNCDs among Saudi type II diabetes (T2DM) patients at the primary care level. Settings and Design: A cross-sectional study was conducted at five randomly selected primary health care centers (PHCCs) of Jeddah, Saudi Arabia. Subject and Methods: T2DM patients above 40 years, who were followed for T2DM diagnosed ≥ 1 year ago were recruited. The Arabic version of the Mini-Mental State Evaluation (MMSE) was used for screening NCDs, using education-adjusted cut-offs. Statistical Analysis Used: Sociodemographic, diabetes-related, and other clinical and lifestyle factors were analyzed as cofactors of NCDs. Results: The study included 236 T2DM patients, who had mean ± SD age of 60.29 ± 9.45 years. The majority (61.0%) were female, and mean ± SD duration of T2DM was 14.1 ± 8.4 years (range = 1–45 years). The prevalence of NCDs was 35.2% (95% CI = 29.1%, 41.6%), and 5.1% of the participants had MMSE scores ≤ 10 indicating severe neurocognitive impairment. The congruence of significant sociodemographic factors delineated a high-risk profile, and multivariate regression analysis showed female gender, low educational level, longer duration of diabetes, geriatric age at T2DM diagnosis, inadequate glycemic control, and sedentary lifestyle as the independent risk factors for NCDs. Conclusions: The population of middle-aged and older T2DM patients is highly exposed to NCDs, with the great contribution of other comorbidities and higher risk incurred by older, lowly educated females with long diabetes duration. Further improvements should be achieved to enhance the care offered to diabetic patients by improving glycemic control, screening for comorbidities, and early detection of neurocognitive decline.

Background: Irritable bowel syndrome (IBS) is the most prevalent functional gastrointestinal disorder. Diet may play a role in triggering the symptoms. We aimed to measure the prevalence of IBS and its types, and its association with food restrictions among the Saudi population, using the Rome IV criteria. Methods: A cross-sectional study was conducted in the outpatient clinics of three major hospitals in Riyadh in conjunction with an electronic survey which was shared on social media. A total of 1,319 subjects (706 males and 613 females) completed a questionnaire of four domains (sociodemography, Rome IV, food restriction, and herbs) between Nov 2019 and February 2020. Convenience sampling was used. Results: IBS was diagnosed in 104 subjects (7.9%) and, of these, 52% were IBS-M (mixed) type. The prevalence was higher in women than in men (4.9% vs. 3.0%; P = 0.006). A significant association was found between the presence of IBS symptoms and low income (P = 0.010), and not working (P < 0.0001). Most of the IBS patients showed food restriction related to milk (P < 0.0001) and legumes (P = 0.0029), besides other types of food and drinks. Conclusions: IBS is less common among the Saudi population. A female gender, low family income, and working status, have the highest association with IBS. The foods most often restricted were legumes and milk. Future community studies may present an opportunity to relate with cultural differences and food preferences.

Background: Asthma is a chronic inflammatory disease characterized by reversible airway obstruction, hyperresponsiveness, and remodeling. Asthma prevalence has increased significantly globally over the last decade, and it remains incurable to this date. Aims and Objectives: The present study evaluated some of the antiasthmatic medicinal plants to assess their mode of action. Materials and Method: Animal models for milk-induced leukocytosis, milk-induced eosinophilia, mast cell degranulation, clonidine-induced catalepsy, and active paw anaphylaxis were used to assess the pharmacological effects of Ammi visnaga, Medicago sativa, and Urtica dioica. Results: Mice pretreated with diazepam, methanolic extract of M. sativa, and U. dioica exhibited significant (P < 0.05) inhibition in milk-induced leukocytosis. However, only M. sativa showed statistically significant (P < 0.05) results. All plants showed a statistically significant (P < 0.05) tendency to decrease milk-induced eosinophilia. Methanolic extracts of all plants significantly (P < 0.05) protected mast cells against degranulation by clonidine. A. visnaga and U. dioica significantly (P < 0.05) protected mice against clonidine-induced catalepsy. An acute treatment by M. sativa potentiated the catalepsy, while it significantly inhibited the catalepsy (P < 0.05) upon chronic treatment. In the allergic inflammation model, methanolic extracts of all plants under study decreased paw thickness in a statistically significant manner (P < 0.05). Conclusion: All the three plants in this study demonstrated anti-inflammatory and antihistaminic effects, as well as decreased paw thickness, validate anti-allergic properties. A. visnaga showed a mast cell-stabilizing effect. A. visnaga and U. dioica inhibited the histamine-mediated clonidine-induced catalepsy from mast cells which proves the antihistaminic activity of these plants.

A one-pot multicomponent synthesis and application of new imidazopyridazine based N-phenylbenzamides is described. An atom-economical method involving dimethyl phthalate, substituted anilines, and pyridazine-4,5-diamine provided the desired compounds in 120–150 min with 80–85% yield. The reaction was catalyzed with phosphoric acid, and glycerol was used as a safer, greener solvent. Anticancer evaluation against selected cancer cell lines revealed that compound 4e was the most active from the series and exhibited IC50 values below 9.1 µM. Compounds 4h and 4d also displayed good and comparable IC50 values (10.2–12.1 µM). Molecular docking and molecular dynamic studies showed that compound 4e exhibit good binding affinity and stable complex formation with ABL1-kinase protein, respectively. Additional computational predictions such as ADME and drug-likeness demonstrated the potential of the new benzamides as leads for further development.

Copper oxide nanoparticles were successfully synthesized through a simple and ‘green’ route using starch as a capping and stabilizing agent under ultrasonic irradiation in alkaline medium. Unique reaction condition was prepared by ultrasonic irradiation, releasing the stored energy in the collapsed bubbles and heats the bubble contents that leads to Cu(II) reduction in the presence of starch. The obtained nanoparticle (CuO NPs@Starch) was characterized by advanced physical and chemical techniques like Transmission Electron Microscope (TEM), Fourier-transform infrared spectroscopy (FTIR), Uv–Vis spectroscopy, scanning electron microscopy (SEM), X-ray Diffraction (XRD) and energy-dispersive X-ray analysis (EDX). The properties of CuO NPs@Starch against gastric cancer (AGS and KATO III), pancreatic cancer (AsPC-1 and MIA PaCa-2), and colon cancer (HCT 116 and HCT-8) were evaluated. The viability of malignant cancer cell lines reduced dose-dependently in the presence of CuO NPs@Starch. After clinical study, CuO NPs@Starch can be utilized as an efficient drug in the treatment of gastric, pancreatic, and colon cancers in humans.

A net of pegmatite veins crosscut gneiss and dismembered ophiolitic ultramafic rocks are abundant in the Migif-Hafafit culmination area, South Eastern Desert, Egypt. Some of these pegmatites are corundum-bearing. Corundum-bearing pegmatites are studied in eight localities around the Migif-Hafafit complex. The present study aims to integrate field investigation, whole rock and corundum chemistry, remote sensing studies, and the conventional methods to detect the corundum-bearing pegmatites, which led to finding out the genesis of the corundum mineralization. In addition, the tectonic regime has been detected using bulk rock geochemistry. False-color composite (FCCs), band ratio (BR), principal component analysis (PCA), minimum noise fraction (MNF), decorrelation stretch (DS), and the constrained energy minimization (CEM) image processing algorithms were proposed and applied on Landsat-8 OLI, and Sentinel-2A data to discriminate the exposed lithological units and to detect the corundum-bearing pegmatites in the study area. These detected pegmatites are structurally controlled following the NW-SE direction. The ultramafic rocks are the host of six areas and the gneisses are the host rocks of the two others. Gneisses and pegmatites are characterized by a steep slope of LREEs relative to HREEs with week Eu negative anomaly. The studied pegmatites have both plumasite and marundite. On the other hand, the studied corundum has Al2O3 content up to 99.72 wt% in pegmatite-gneiss and up to 100 wt.% in pegmatite-ultramafics. Corundum is ascribed to metamorphic/metasomatic type according to its chromosphere. Desilication in pegmatites led to the excess of alumina content in the residual melt producing corundum mineralization.

In this paper, a system with controllable parameters for describing the evolution of polarization modes in nonlinear fibers is studied. Using the Horita’s method, the coupled nonlinear Schrödinger equations are transformed into the bilinear equations, and the one- and two- bright soliton solutions of system (3) are obtained. Then, the influencing factors on velocity and intensity in the process of soliton transmission are analyzed. The fusion, splitting and deformation of the solitons caused by their interactions are discussed. Finally, a method for adjusting the inconsistencies of sine-wave soliton transmission is given. The conclusions of this paper may be helpful for the related research of wavelength division multiplexing systems.

Background: Diabetic neuropathy is the most common long-term complications of diabetes, frequently presenting as painful diabetic peripheral neuropathy (PDPN), which can significantly impair patients' quality of life (QOL). This study set to estimate the prevalence of PNPD and health-related quality of life (HRQoL) in the setting of primary health care in Saudi Arabia. Methods: This study was conducted in primary health-care centers affiliated with the National Guard Health Affairs in Western Saudi Arabia. Arabic version of the Douleur Neuropathique 4 questionnaire was administered on diabetic patients to screen for neuropathic pain and short-form 12 questionnaire to assess HRQoL. Results: The study screened (n = 349) Type 2 diabetic patients. The prevalence of PDPN was 33.2%. PDRN was more likely to affect females (adjusted odds ratio [“AOR”] =1.96, P = 0.024), and those living with diabetes for over 15 years (AOR = 2.26, P = 0.039), and those on insulin treatment (AOR: 2.33, P = 0.010) alone or in combination (AOR = 1.78, P = 0.034). Both physical and mental components (MCs) of QOL scores were significantly higher in diabetic patients without PDPN compared to those with it; 49.57 ± 9.31 versus 40.77 ± 8.14 for physical component QOL and 51.72 ± 9.36 versus 44.35 ± 8.12 for MC QOL, P < 0.001. Discussion and Conclusion: Painful peripheral neuropathy is relatively common among type 2 diabetic patients in Western Saudi Arabia and impacts both physical and MCs of the QOL of affected patients.

The present study aims to investigate a new fractional model describing the dynamical behaviour of the tuberculosis infection. In this new formulation, we use a recently introduced fractional operator with Mittag–Leffler nonsingular kernel. To solve and simulate the proposed model, a new and efficient numerical method is developed based on the product-integration rule. Simulation results are provided and some discussions are given to verify the theoretical analysis. The results indicate that employing the nonsingular operator can extract the hidden aspects of the model under consideration while these features are invisible when we use the ordinary time-derivatives. Therefore, the non-integer calculus supplies more flexible models describing the asymptotic behaviours of the real-world phenomena and helps us to better understand their complex dynamics.

Background:. Central slip and volar plate injuries rarely occur in the same finger, with only two cases previously reported in published literature. In these two patients, both teenagers, two highly distinct protocols were used. Here, we report a third case involving a 51-year-old gentleman who closed a door on his left third finger. Methods:. Because the fractures were noncomminuted and only minimally displaced, he was treated nonsurgically using a multi-step process of splinting to prevent impairment of either proximal interphalangeal joint extension or flexion, combined with active range of motion exercises. This included five weeks of splinting in neutral, 24-hour daily use of a proximal interphalangeal dorsal block, followed by active range of motion exercises combined with nocturnal splinting using a PIP volar block over the next 7 weeks, with relative motion and Joint Jack splints added over the final 4 of these 7 weeks. Results:. Twelve weeks after initial splinting, the patient’s finger was pain free, with swelling largely resolved, normal extension (−10 degrees) and near-normal flexion (95 degrees) achieved, and full function restored. The patient was very satisfied with the result. Conclusions:. Ours is just the third case of concomitant central slip and volar plate injuries reported in the literature. Other surgeons are strongly encouraged to publish similar cases, approaches, and results, as clinical wisdom can sometimes be gleaned from even a small number of well-documented clinical cases.

NASAM (National Approach to Standardize and Improve Mechanical Ventilation) is a national collaborative quality improvement project in Saudi Arabia. It aims to improve the care of mechanically ventilated patients by implementing evidence-based practices with the goal of reducing the rate of ventilator-associated events and therefore reducing mortality, mechanical ventilation duration and intensive care unit (ICU) length of stay. The project plans to extend the implementation to a total of 100 ICUs in collaboration with multiple health systems across the country. As of March 22, 2019, a total of 78 ICUs have registered from 6 different health sectors, 48 hospitals, and 27 cities. The leadership support in all health sectors for NASAM speaks of the commitment to improve the care of mechanically ventilated patients across the kingdom.

Background: Sudden cardiac arrest (SCA) is a major cause of mortality, yet its epidemiological and outcome data in hospitals from Saudi Arabia are limited. Objectives: This study aimed to evaluate the prevalence, risk factors and outcomes of SCA in a teaching hospital in Jeddah, Saudi Arabia. Methods: This retrospective study included all patients aged ≥18 years with SCA who were resuscitated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 1 and December 31, 2016. Data were retrieved from the hospital medical records as flow sheets designed in accordance with the Utstein-style recommendations. Factors relating to mortality were analyzed using descriptive analyses and chi-square test. Results: A total of 429 cases of SCA met the inclusion criteria, and its prevalence was 7.76 cases/1000 adult hospital admission. Of these, 61.3% were male, and the mean age was 58.4 years, with 36.6% aged >65 years. Only 3.5% were outside-hospital cardiac arrests. The most common initial rhythm was pulseless electrical activity/asystole (93.2%), while ventricular tachycardia/ventricular fibrillation was documented in only 29 cases (6.8%). The overall rate of return to spontaneous circulation (ROSC) was 56.2%, and 56.8% in cases of in-hospital cardiac arrest (IHCA). Patients with SCA due to sepsis had significantly increased mortality (P < 0.000; odds ratio [OR] = 0.24 [0.12–0.47 95% confidence interval [CI]), while those with SCA due to respiratory causes had significantly better survival outcomes (P = 0.001; OR = 2.3 [1.5–3.8 95% CI]). No significant differences in outcomes were found between other risk factors, including cardiac causes. Conclusion: In this population, the prevalence of SCA in adults was higher than reported in many similar studies. Further, sepsis was found to affect the survival rate. Although the rate of ROSC for IHCA patients was favorable compared with other studies, it is relatively poor. This finding signifies the need to identify and control risk factors for SCA to improve survival.

Introduction: Physical activity (PA) plays an important role in diabetes management. This study aimed to evaluate the level of PA and the barriers toward practicing regular PA among patients with type 2 diabetes mellitus (T2DM) attending primary healthcare centers (PHCs) in Jeddah during 2018. Materials and Methods: A total of 250 patients were interviewed face-to-face in three PHCs. Two questionnaires were used in this study. The first questionnaire measured the level of PA of the participants. The second questionnaire aimed to identify barriers to PA. For analysis, simple descriptive statistics, Chi-square, T-test, and analysis of variance were used. Results: The prevalence of physical inactivity was found to be 38.4%. Males and females composed 40% and 37.4% of the participants, respectively. Lack of social support, lack of energy, fear of injury, and lack of skills were identified as significant barriers to PA according to the level of PA. Conclusion: Our findings may provide baseline data for future research on this topic and information for healthcare professionals to improve their efforts in promoting the overall health of patients with T2DM.

The security and privacy concerns in vehicular communication are often faced with schemes depending on either elliptic curve (EC) or bilinear pair (BP) cryptographies. However, the operations used by BP and EC are time-consuming and more complicated. None of the previous studies fittingly tackled the efficient performance of signing messages and verifying signatures. Therefore, a chaotic map-based conditional privacy-preserving authentication (CM-CPPA) scheme is proposed to provide communication security in 5G-enabled vehicular networks in this paper. The proposed CM-CPPA scheme employs a Chebyshev polynomial mapping operation and a hash function based on a chaotic map to sign and verify messages. Furthermore, by using the AVISPA simulator for security analysis, the results of the proposed CM-CPPA scheme are good and safe against general attacks. Since EC and BP operations do not employ the proposed CM-CPPA scheme, their performance evaluation in terms of overhead such as computation and communication outperforms other most recent related schemes. Ultimately, the proposed CM-CPPA scheme decreases the overhead of computation of verifying the signatures and signing the messages by 24.2% and 62.52%, respectively. Whilst, the proposed CM-CPPA scheme decreases the overhead of communication of the format tuple by 57.69%.

The traditional method to obtain optimum bitumen content and the relevant parameters of asphalt pavements entails time-consuming, complicated and expensive laboratory procedures and requires skilled personnel. This research study uses innovative and advanced machine learning techniques, i.e., Multi-Expression Programming (MEP), to develop empirical predictive models for the Marshall parameters, i.e., Marshall Stability (MS) and Marshall Flow (MF) for Asphalt Base Course (ABC) and Asphalt Wearing Course (AWC) of flexible pavements. A comprehensive, reliable and wide range of datasets from various road projects in Pakistan were produced. The collected datasets contain 253 and 343 results for ABC and AWC, respectively. Eight input parameters were considered for modeling MS and MF. The overall performance of the developed models was assessed using various statistical measures in conjunction with external validation. The relationship between input and output parameters was determined by performing parametric analysis, and the results of trends were found to be consistent with earlier research findings stating that the developed predicted models are well trained. The results revealed that developed models are superior and efficient in terms of prediction and generalization capability for output parameters, as evident by the correlation coefficient (R) (in this case >0.90) for both ABC and AWC.

The aim of the present study is to link the thermal expansion, spectral reflectance, and physico-mechanical aspects of different types of commercial granitic rocks with their mineralogical and chemical composition. The granitic rock types were characterized using several analyses, including petrography, chemical, mineralogical, and thermo-gravimetrical analysis using XRF, XRD, and TG/DTG/DSC techniques. The rock types were subjected to several performance tests, such as tests of their thermal expansion, spectral reflectance, and physico-mechanical properties. The results revealed that quartz, albite, and potash feldspar with minor amounts of mica (biotite/muscovite/annite) are the main mineralogical constitutes, in addition to some alteration minerals, such as kaolinite, saussorite, and prehnite. The studied granitic rocks were classified as monzogranite/syenogranite of high K-calc-alkaline and peraluminous characters and are related to late- to post-collisional settings. The thermogravimetrical analysis revealed that the overall mass loss over the whole temperature range up to 978 °C did not exceed 3% of the initial weight for all studied rocks. The results of thermal expansion revealed that the maximum change in linear thermal expansion for all rock types did not exceed 0.015% of their initial lengths at an unusual air temperature of 50 °C. The spectral analysis revealed that iron and hydroxyl ions are the main spectral absorption features that appeared in the VIS-NIR and SWIR regions, in addition to the appearance of the common and distinctive absorption peaks of the main mineral composition. Furthermore, the spectral reflectance demonstrated that the granitic rock types of low iron oxide content achieved a high reflectivity percent in the VIS-NIR and SWIR spectral regions compared with those of high iron content. As a general trend, the granitic rock types of high iron content and/or lower quartz content exhibited a high performance regarding their physical and mechanical properties, such as water absorption, apparent porosity, bulk density, compressive strength, and abrasion resistance. The results of water absorption, density, strength, and abrasion resistance of the studied granitic rocks are in the range of 0.14–0.31%, 2582–2644 kg/m3, 77.85–222.75 MPa, and 26.27–55.91 Ha, respectively, conforming to the requirements of ornamental stones according to the ASTM standard.

Recently, the demand for reliable and high-speed wireless communication has rapidly increased. Orthogonal frequency division multiplexing (OFDM) is a modulation scheme that is the newest competitor against other modulation schemes used for this purpose. OFDM is mostly used for wireless data transfer, although it may also be used for cable and fiber optic connections. However, in many applications, OFDM suffers from burst errors and high bit error rates. This paper presents the utilization of a helical interleaver with OFDM systems to efficiently handle burst channel errors and allow for Bit Error Rate (BER) reduction. The paper also presents a new interleaver, FRF, the initial letters of the authors’ names, for the same purpose. This newly proposed interleaver summarizes our previous experience with many recent interleavers. Fast Fourier transform OFDM (FFT-OFDM) and Discrete Wavelet Transform OFDM (DWT-OFDM) systems are used to test the efficiency of the suggested scheme in terms of burst channel error removal and BER reduction. Finally, the general complexity of the FRF interleaver is different from that of the helical interleaver in terms of hardware requirements. The performance of the proposed scheme was studied over different channel models. The obtained simulation results show a noticeable performance improvement over the conventional FFT-OFDM and the FFT-OFDM systems with the helical interleaver. Finally, the disadvantage of the proposed FRF interleaver is that it is more complex than the helical interleaver.

This article examines magnetohydrodynamic three-dimensional (3D) squeezed flow by a rotating permeable channel subject to Dufour and Soret impacts. Impact of viscous dissipation is also considered. An applied magnetic field is considered subject to electrically conducting viscous fluid. The change from the non-linear partial differential framework to the non-linear ordinary differential framework is assumed into position by utilizing appropriate variables. Governing differential frameworks are computed numerically by shooting method. Numerical results have been achieved by considering numerous values of emerging flow parameters. Contributions of influential parameters on physical quantities are studied thoroughly. Surface drag coefficients and mass and heat transport rates are also processed and examined. Furthermore, the concentration and temperature distributions are reduced for larger values of Soret number. The prime interest of presented study is to model and examine the Dufour and Soret aspects in concentration and energy expressions. To our knowledge, no such analysis has been addressed in the literature yet.

This paper secures optical dromions, domain walls and conservation laws for Kundu–Mukherjee–Naskar equation. Three integration approaches are applied. These are traveling wave hypothesis, method of undetermined coefficients and Lie symmetry. Finally, multiplier approach yielded two conservation laws supported by the model. These are power and Hamiltonian that are expressed in quadratures.

This paper addresses optical solitons in birefringent fibers that is modeled by complex Ginzburg–Landau equation with Kerr law nonlinearity. Three forms of integration architecture retrieves soliton and other solutions to the model. The solitons are classified and their existence criteria are also presented.

This paper applies exp-function expansion algorithm to secure to cubic-quartic dark and singular optical solitons in birefringent fibers that are studied with four forms of nonlinear refractive index. These solitons are listed along with their existence criteria and are also classified.

The formation of a protein layer “corona” on the nanoparticle surface upon entry into a biological environment was shown to strongly influence the interactions with cells, especially affecting the uptake of nanomedicines. In this work, we present the impact of the protein corona on the uptake of PEGylated zein micelles by cancer cells, macrophages, and dendritic cells. Zein was successfully conjugated with poly(ethylene glycol) (PEG) of varying chain lengths (5K and 10K) and assembled into micelles. Our results demonstrate that PEGylation conferred stealth effects to the zein micelles. The presence of human plasma did not impact the uptake levels of the micelles by melanoma cancer cells, regardless of the PEG chain length used. In contrast, it decreased the uptake by macrophages and dendritic cells. These results therefore make PEGylated zein micelles promising as potential drug delivery systems for cancer therapy.

Breast cancer is one of the common malignancies among females in Saudi Arabia and has also been ranked as the one most prevalent and the number two killer disease in the country. However, the clinical diagnosis process of any disease such as breast cancer, coronary artery diseases, diabetes, COVID-19, among others, is often associated with uncertainty due to the complexity and fuzziness of the process. In this work, a fuzzy neural network expert system with an improved gini index random forest-based feature importance measure algorithm for early diagnosis of breast cancer in Saudi Arabia was proposed to address the uncertainty and ambiguity associated with the diagnosis of breast cancer and also the heavier burden on the overlay of the network nodes of the fuzzy neural network system that often happens due to insignificant features that are used to predict or diagnose the disease. An Improved Gini Index Random Forest-Based Feature Importance Measure Algorithm was used to select the five fittest features of the diagnostic wisconsin breast cancer database out of the 32 features of the dataset. The logistic regression, support vector machine, k-nearest neighbor, random forest, and gaussian naïve bayes learning algorithms were used to develop two sets of classification models. Hence, the classification models with full features (32) and models with the 5 fittest features. The two sets of classification models were evaluated, and the results of the evaluation were compared. The result of the comparison shows that the models with the selected fittest features outperformed their counterparts with full features in terms of accuracy, sensitivity, and sensitivity. Therefore, a fuzzy neural network based expert system was developed with the five selected fittest features and the system achieved 99.33% accuracy, 99.41% sensitivity, and 99.24% specificity. Moreover, based on the comparison of the system developed in this work against the previous works that used fuzzy neural network or other applied artificial intelligence techniques on the same dataset for diagnosis of breast cancer using the same dataset, the system stands to be the best in terms of accuracy, sensitivity, and specificity, respectively. The z test was also conducted, and the test result shows that there is significant accuracy achieved by the system for early diagnosis of breast cancer.

Salvadora persica L. (S. persica, Siwak) is an ethnic plant that is widely used for improving oral hygiene. This study aimed to provide a phytochemical profiling of S. persica ethyl acetate fraction (SPEAF) and to evaluate the healing activity of a muco-adhesive formula of the fraction against acetic acid-induced oral ulcers in rats. HPLC-ESI-QTOF-MS-MS analysis of SPEAF resulted in the tentative identification of 56 metabolites containing fatty acids (23%), urea derivatives (10.5%) and sulphur compounds (10%), in addition to several amides, polyphenols and organic acids (6.5%, 5% and 2%, respectively). For the first time, 19 compounds were identified from S. persica. In vitro and in vivo experiments indicated that the extract is non-toxic. SPEAF exhibited superior healing activities compared to both the negative and positive control groups on days 7 and 14 of tongue ulcer induction. This was confirmed by histopathological examinations of haematoxylin and eosin-stained (H&E) and Masson’s trichrome-stained tongue sections. Moreover, SPEAF showed potent anti-inflammatory activities, as evidenced by the inhibited expression of interleukin-6 (IL-6) and tumour necrosis alpha (TNF-α). Moreover, SPEAF exhibited potent antioxidant activity, as it prevented malondialdehyde (MDA) accumulation, reduced glutathione (GSH) depletion and superoxide dismutase (SOD) exhaustion. SPEAF significantly enhanced hydroxyproline tongue content and upregulated collagen type I alpha 1 (Col1A1) mRNA expression. SPEAF also improved angiogenesis, as shown by the increased mRNA expression of the angiopoietin-1 (Ang-1). In conclusion, S. persica has a wide range of secondary metabolites and ameliorates acetic acid-induced tongue ulcers in rats. This can be attributed, at least partly, to its anti-inflammatory, antioxidant, procollagen and angiogenic activities. These findings provide support and validity for the use of S. persica as a traditional and conventional treatment for oral disorders.

This study investigates the endothelial protective activity of flavokawain A (FKA) against oxidative stress induced by ochratoxin A (OTA), which acts as a mycotoxin, and its primary mechanisms in in vitro models. Reactive oxygen species, in general, regulate oxidative stress that significantly contributes to the pathophysiology of endothelial dysfunctions. OTA exerts toxicity through inflammation and the accumulation of ROS. This research is aimed at exploring the defensive function of FKA against the endothelial injury triggered by OTA through the Nrf2 pathway regulated by PI3K/AKT. OTA exposure significantly increased the nuclear translocation of NFκB, whereas we found a reduction in inflammation via NFκB inhibition with FKA treatment. FKA increased the PI3K and AKT phosphorylation, which may lead to the stimulation of antioxidative and antiapoptotic signaling in HUVECs. It also upregulated the phosphorylation of Nrf2 and a concomitant expression of antioxidant genes, such as HO-1, NQO-1, and γGCLC, depending on the dose under the oxidative stress triggered by OTA. Knockdown of Nrf2 through small interfering RNA (siRNA) impedes the protective role of FKA against the endothelial toxicity induced by OTA. In addition, FKA enhanced Bcl2 activation while suppressing apoptosis marker proteins. Therefore, FKA is regarded as a potential agent against endothelial oxidative stress caused by the deterioration of the endothelium. The research findings showed that FKA plays a key role in activating the p-PI3K/p-AKT and Nrf2 signaling pathways, while suppressing caspase-dependent apoptosis.