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Abstract Background Despite the increased recommendations for influenza vaccination, particularly among high-risk groups such as young children, Yemen lacks an influenza vaccination program, and the influenza vaccine is not included in the national immunization regime. This is exacerbated by the country’s fragile infrastructure, as well as the devastating consequences of the ongoing conflict, which include child undernutrition and strained healthcare resources. Thus, the objective of the current study is to assess the public attitudes and perceptions toward vaccinating children against influenza in Yemen. Methods A cross-sectional study was conducted by distributing a validated survey questionnaire to potential participants using convenience sampling. Descriptive statistics were used to summarize sociodemographic data, knowledge of influenza vaccines, and attitudes and perceptions regarding vaccinating children against influenza. Logistic regression analysis was employed to identify associations between independent variables and the acceptance of vaccines for children. Results A total of 853 eligible individuals, parents and non-parents, successfully completed the survey. The uptake of the influenza vaccine among the participants was notably low as the majority (69.2%) had not previously received the vaccine, although the majority expressed a willingness to get vaccinated in the future (59.4%). The majority (68.5%) were willing to vaccinate children. The largest percentage of the participants who expressed hesitancy toward children’s vaccination cited multiple reasons to reject the vaccine (39.7%), with concerns regarding the safety of the vaccine being the predominant barrier to its acceptance for children (29.6%). On the other hand, motivating factors for vaccinating children included the validation of the vaccine’s safety and efficacy, endorsement of the vaccine by the government and physicians, integration of the vaccine into the national immunization program, and the provision of the vaccine free of charge and through schools. Significant predictors for vaccine acceptance in children included male gender, knowledge of the protective effect of the influenza vaccine, previous receipt of the vaccine, and a willingness to receive the vaccine in the future. Conclusions The study highlights the need for educational health campaigns to raise awareness and remove misconceptions regarding influenza and the role, benefits, and availability of its vaccine. These findings can serve as a robust foundation for the future design and implementation of an influenza vaccination program for children in Yemen.

In this study, nanostructured ZnNiCo2O4 and MnNiCo2O4 electrodes were fabricated by spray pyrolysis method and annealed at 550oC for 2 h. The structural, optical, and Photoelectrochemical properties were studied. The structural properties were examined using X-ray diffraction (XRD). The results show that the samples have cubic spinel structure. The atomic percentage determined by (EDX) and the thickness (cross section) of films measured by (FE-SEM), as well as the surface roughness measured through (AFM) are all used for analysis. The optical properties were investigated by UV-visible spectrophotometer, the energy band gaps of ZnNiCo2O4 and MnNiCo2O4 were estimated to be approximately 2.2 and 2.4 eV respectively. The photoelectrochemical, comprising of photocurrent density, linear sweep voltammograms (LSV) and Mott-Schottky (MS), displayed flat band values of (1.5 eV and -0.55 eV) Vs NHE for ZnNiCo2O4 and MnNiCo2O4 respectively, where the conduction band and valance band values of ZnNiCo2O4 were (C. B= -0.6 eV and V.B= 1.6 eV ), while those of MnNiCo2O4 were (C.B= -0.65 eV and V.B= 1.75 eV ). The corresponding photocurrent densities for ZnNiCo2O4 and MnNiCo2O4 were 35 µA/cm2 and 50 µA/cm2, respectively. The electrodes were comprehensively studied for ZnNiCo2O4 and MnNiCo2O4 under a neutral water condition.

Traditional approaches to monitoring water quality in aquaculture tanks present numerous limitations, including the inability to provide real-time data, which can lead to improper feeding practices, reduced productivity, and potential environmental risks. To address these challenges, this study aimed to create an accurate water quality monitoring system for Asian seabass fish farming in aquaculture tanks. This was achieved by enhancing the accuracy of low-cost sensors using simple linear regression and validating the IoT system data with YSI Professional Pro. The system's development and validation were conducted over three months, employing professional devices for accuracy assessment. The accuracy of low-cost sensors was significantly improved through simple linear regression. The results demonstrated impressive accuracy levels ranging from 76% to 97%. The relative error values which range from 0.27% to 4% demonstrate a smaller range compared to the values obtained from the YSI probe during the validation process, signifying the enhanced accuracy and reliability of the IoT sensor by using simple linear regression. The system's enhanced accuracy facilitates convenient and reliable real-time water quality monitoring for aquafarmers. Real-time data visualization was achieved through a microcontroller, Thingspeak, Virtuino application, and ESP 8266 Wi-Fi module, providing comprehensive insights into water quality conditions. Overall, this adaptable tool holds promise for accurate water quality management in diverse aquatic farming practices, ultimately leading to improved yields and sustainability.

In this work, an absolute method to calibrate an α-spectrometer is proposed taking into account the Source-to-Detector, and lateral distances due to eccentric source distribution. An analytical formula to calibrate an α-spectrometer is derived and the Simpson's integration method was utilized to solve these equations in its integral form numerically using a written C computer code. The general Monte Carlo N-particle code, MCNP as well as experimental measurements for some standard α-emitters are used to benchmark the proposed method. An agreement was found between the efficiency results calculated by MC and the proposed method with a maximum relative difference of about 0.5%. While, experimental measurement of α-emitters activity employing the proposed method differs by about 1.65% from the certified values. Accounting for the man made error allows to accurately quantify the assayed sample. Therefore, the inaccuracy in the efficiency results due to non-accurate inputs pertained to the source, and detector radii, Source–Detector distances, and eccentric source distribution are investigated in the Source-to-Detector distance range of (4 to 44 mm). The results show that a difference of ±1% in the detector radius, and Source-to-Detector distance than the normal values yields a relative difference of about ±2%, while a difference of ±50% in the source radius or source lateral distance from detector symmetry axis could only yields inaccuracy of less than ±3% in the efficiency results.

Background: Obesity in children is a critical public health issue in developed countries and developing countries. The establishment of health-related behaviors in childhood, significantly influenced by parental involvement, underscores the need for effective intervention measures. Aim: This original research is a systematic review and meta-analysis that aimed to investigate the impact of parental involvement on the prevention and management of childhood obesity, focusing on outcomes such as BMI z-score, exercise levels, screen time, dietary self-efficacy, and percentage body fat. Methods: Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of 12 randomized controlled trials (RCTs) identified through comprehensive searches of PubMed, Scopus, Web of Science, and the Cochrane Library, including RCTs involving children aged 2–18 years with parental or caregiver participation, reporting on the specified outcomes. Data analysis was performed using RevMan 5.3, employing a random effects model. Results: A total of 5573 participants were included. The meta-analysis revealed a significant reduction in BMI z-score (MD = −0.06, 95% CI: −0.09 to −0.02, p = 0.005, I2 = 58%), a non-significant increase in exercise levels (SMD = 0.26, 95% CI: −0.01 to 0.52, p = 0.05, I2 = 52%), and a significant reduction in screen time (MD = −0.36 h per day, 95% CI: −0.61 to −0.11, p = 0.005, I2 = 0%). Dietary self-efficacy also improved significantly (MD = 0.59, 95% CI: 0.12 to 1.05, p = 0.01, I2 = 0%). However, changes in percentage body fat did not reach statistical significance (MD = −1.19%, 95% CI: −2.8% to 0.41%, p = 0.15, I2 = 0%). Conclusion: Parental involvement in childhood obesity interventions significantly impacts BMI z-score, exercise levels, screen time, and dietary self-efficacy but not percentage body fat. These findings highlight the importance of engaging parents in obesity prevention and management strategies.

Abstract Introduction Pharmaceutical care services (PCs) have evolved significantly over the last few decades, with a greater focus on patient’s safety and proven effectiveness in a wide range of contexts. Many of the evidence supporting this technique comes from the United States, the evaluation and adoption of (PCs) which differ greatly across the globe. Objective The goal of this study was to identify and assess the efficacy of pharmaceutical care services in various pharmaceutical aspects throughout seventeen Middle Eastern nations. Method The Arkesy and O’Malley technique was used to conduct a scoping review. It was conducted using PubMed/Medline, Scopus, Cochrane Library, Springer Link, Clinical Trials, and Web of Science etc. The Van Tulder Scale was utilized in randomized trials research, whereas the dawn and black checklists were used in non-randomized trials research. A descriptive and numerical analysis of selected research was done. The scope of eligible PCs, pharmaceutical implementers, study outcomes, and quality were all identified by a thematic review of research. Results There were about 431,753 citations found in this study, and 129 publications were found to be eligible for inclusion after analysing more than 271 full-text papers. The study design was varied, with 43 (33.3%) RCTs and 86 (66.7%) n-RCTs. Thirty-three (25.6%) of the studies were published in 2020. Jordan, Saudi Arabia, and Turkey were home to the majority of the studies (25.6%, 16.3%, and 11.6%) respectively. Thirty-seven studies (19.7%) were concerned with resolving drug related problems (DRPs), whereas 27 (14.4%) were concerned with increasing quality of life (QOL) and 23 (12.2%) with improving drug adherence. Additionally, the research revealed that the average ratings of the activities provided to patients improved every year. Conclusion Studies in the Middle East continue to provide evidence supporting the positive impact of pharmaceutical care services on both hard and soft outcomes measured in most studies. Yet there was rare focus on the value of the implemented services. Thus, rigorous evaluation of the economic impact of implemented pharmaceutical care services in the Middle East and assessment of their sustainability is must.

Background: Patient-centered care and integrating health informatics are essential to delivering high-quality healthcare services and improving patient outcomes. Despite their crucial role, research on health informatics in community settings is limited in Jordan, emphasizing the necessity for evaluating the state of pharmacy informatics. Purpose: The study aimed to evaluate community pharmacists' prior experience, attitudes, and perceived barriers to adopting information technology in their practice. Methods: An online cross-sectional survey was conducted from August to November 2020 to assess community pharmacists' prior experience, attitudes, and perceived barriers to using information technology to enhance their daily practice. Results: A total of 431 Community pharmacists participated in the study. Most of the participants were female (68.7%), aged 25 to 35 (53.8%), and having 5–10 years of professional experience (47.1%). Only 12.8% had prior experience with health informatics. The majority agreed that health informatics systems would be clear and understandable to use (84 %), limit drug addiction (82.1%), facilitate data exchange between physicians and pharmacists (81.7%), and enhance medication safety (82.1%). However, over two-thirds of participants agreed on potential barriers to implementing health information technology in their daily practice, such as technology difficulties (71.2%), resistance to change (73.8%), and a lack of competencies (77.5%). Statistically significant relationships were found between positive attitudes and age (p = 0.001), gender (0.004), experience duration (p = 0.001), and education level (p = 0.001). Apart from the workplace, sociodemographic characteristics were significantly associated with perceived barriers to implementing health informatics (p

Background: Recently, there has been a marked increase in the incidence of cancer, HIV, and other noncommunicable diseases globally. Thus, the demand for palliative care (PC), including end-of-life care, continues to grow worldwide. Physiotherapy has an important role in PC as it aims to alleviate symptoms and improve quality of life by optimising independent levels of function. Objective: To assess the level of knowledge, awareness and current practice of PC amongst Nigerian physiotherapists in clinical practice. Method: Our study used a cross-sectional descriptive census-based method and recruited practising physiotherapists in Nigeria. An electronic questionnaire was used to collect data over 12 weeks, comprising 36 semistructured questions in four domains: personal information, knowledge, awareness and current practices regarding PC. Data were analysed using a pragmatist paradigm. Results: Of the 426 physiotherapists who participated, 50% (n = 213) had a postgraduate degree, 49.5% (n = 211) had a bachelor’s degree and 0.5% (n = 2) had a Doctor of Physical Therapy degree. The results also indicate that 73.9% (n = 315) of the participants had sufficient knowledge about PC, 80.5% (n = 343) had a sufficient level of awareness about PC and 66.7% (n = 284) were using current clinical practices in the rehabilitation of critically ill patients or those with chronic conditions. Conclusion: It was concluded that most Nigerian physiotherapists had sufficient knowledge and awareness about PC and were involved in the management of patients requiring PC physiotherapy. Clinical implication: It can be understood that a large proportion of Nigerian physiotherapists have clinical experience managing patients requiring PC, despite inadequate formal training in this field.

This study uses advanced machine learning approaches to predict the kerf open deviation (KOD) when a CO2 laser is used to cut polymeric materials. Four polymeric materials, namely polyethylene (PE), polymethyl methacrylate (PMMA), polypropylene (PP), and polyvinyl chloride (PVC), were cut under the same conditions. The process control factors were the power of the laser beam (80–140 W) and cutting speed (1–6 mm/s), while sheet thickness, standoff distance, and gas pressure were kept constant during experiments. KOD between the upper and lower opens of the kerf was the process response. KOD was predicted using three machine learning models, namely a conventional artificial neural network (ANN), a hybrid neural network–humpback whale optimizer (HWO-ANN), and a hybrid neural network–particle swarm optimizer (PSO-ANN). Experimental data for all polymeric materials were employed to train and test all models. The hybrid neural network–humpback whale optimizer model outperformed other models to predict KOD for all cut materials. The root-mean-square error between predicted and experimental data was 0.349–0.627 µm, 0.085–0.242 µm, and 0.023–0.079 µm for conventional neural network, neural network–particle swarm model, and neural network–humpback whale model, respectively.

Neutron sources are utilized for different aims, such as studying the material’s internal structure, investigating the materials’ crystal structures, and neutron therapy. Using more than one isotopic neutron source in some aims could be beneficial. Herein, a neutron irradiator consisting of two 241Am-9Be neutron sources has been designed. Radiation characterizations, including the neutron fluence and dose rate, were investigated. The Monte Carlo simulation code Monte Carlo N-particle transport code version 5 (MCNP5) was used to conduct all the required investigations to achieve an optimal design. Two factors were considered; the first was the dose rate due to both neutron and gamma radiations to meet radiation protection requirements; MCNP5 was used to determine the adequate thickness of the shielding material. The second parameter is the neutron fluence. Two irradiation sites have been proposed, one for fast neutron irradiation and the other for thermal neutron irradiation. By utilizing MCNP5, we have determined the radiation characterization at the two sites to be used as the irradiation sites. After the optimal design had been produced, the thermal and the epithermal neutron fluences inside the two irradiation sites were determined experimentally. The experimental results showed a perfect agreement with the simulation ones. The neutron irradiator designed from merged two isotopic neutron sources could be a benefit in the neutron radiation applications in the labs.

BackgroundThe seasonal influenza vaccine is an important preventive measure against influenza and its associated complications. In Yemen, there is no seasonal influenza vaccination policy, and the influenza vaccine is excluded from the national immunization program. Data on vaccination coverage remain scarce with no previous surveillance programs or awareness campaigns implemented in the country. The current study aims to assess the awareness, knowledge, and attitudes of the public in Yemen toward seasonal influenza and their motivators and perceived barriers to receiving its vaccine.MethodsA cross-sectional survey was carried out using a self-administered questionnaire that was distributed to eligible participants using convenience sampling.ResultsA total of 1,396 participants completed the questionnaire. The respondents showed a median knowledge score of influenza of 11.0/15.0, and most of them (70%) were able to recognize its modes of transmission. However, only 11.3% of the participants reported receiving the seasonal influenza vaccine. Physicians were the respondents' most preferred information source for influenza (35.2%), and their recommendation (44.3%) was the most cited reason for taking its vaccine. On the contrary, not knowing about the vaccine's availability (50.1%), concerns regarding the safety of the vaccine (17%), and not considering influenza as a threat (15.9%) were the main reported barriers to getting vaccinated.ConclusionThe current study showed a low uptake of influenza vaccines in Yemen. The physician's role in promoting influenza vaccination seems to be essential. Extensive and sustained awareness campaigns would likely increase the awareness of influenza and remove misconceptions and negative attitudes toward its vaccine. Equitable access to the vaccine can be promoted by providing it free of charge to the public.

Abstract Introduction Coinfection with dengue and hepatitis A is rare and challenging for physicians since their clinical features can be overlapping. These infections are self-limiting but can become complicated by subsequent infective endocarditis. We report a case of infective endocarditis following a coinfection with dengue and hepatitis A. Case presentation A 17-year-old Yemeni male patient was admitted to the hospital complaining of yellowish discoloration of the skin and sclera associated with dark urine and a diffuse skin rash on the trunk and upper limbs followed by intermittent high-grade fever. Coinfection was confirmed by hepatitis A immunoglobulin M and dengue immunoglobulin M. At the time of diagnosis, white blood cells were normal, with mild neutrophilia and thrombocytopenia along with elevated C-reactive protein. Five days later, the patient was readmitted to the emergency department, complaining of high-grade fever, fatigue, myalgia, nausea, and vomiting. A systolic heart murmur was heard, and infective endocarditis was confirmed by the visualization of two vegetations on the mitral valve and coagulase-negative staphylococci after blood culture. Supportive therapies were initiated for hepatitis A and dengue fever, whereas infective endocarditis was treated with antibiotics for 4 weeks. The patient recovered completely from dengue, hepatitis A, and infective endocarditis. Conclusion In endemic areas, it is reasonable to screen for coinfection with dengue and hepatitis A since they are superimposed on each other. Subacute infective endocarditis may occur following initial dengue and hepatitis A coinfection, especially among patients with rheumatic heart disease. An echocardiogram is a pivotal workup for evaluating a patient with persistent fever of unknown origin.

Background: Mental health in medical students is well researched, with physiotherapy students receiving less attention even though psychiatry is a recognised specialty within physiotherapy. Objectives: To assess the prevalence and correlates of depression, anxiety and stress among physiotherapy clinical students. Methods: A descriptive cross-sectional study design was employed on 402 physiotherapy clinical students aged 17–40 years using a convenience sampling method. The data were collected using the self-administered 42-items Depression, Anxiety and Stress scale (DASS) and the data were analysed using a Chi-square test and binary logistic regression analysis. Results: The prevalence of depression, anxiety and stress among these students was 79.9%, 85.6% and 81.6%, respectively. The results indicate that financial status and social life influenced depression by 20.6% (odds ratio [OR] [95%] = 1.206 [1.110, 1.311]) and 36% (OR [95%] = 1.360 [1.050, 1.764]), respectively. Fear of repeating a class influenced anxiety by eight times (OR [95%] = 8.330 [6.643, 10.422]). Fear of repeating a class, financial status and academic performance influenced stress by eight times (OR [95%] = 8.360 [6.677, 10.470]), 17.5% (OR [95%] = 1.175 [1.083, 1.275]) and 18.1% (OR [95%] = 1.181 [1.083, 1.276]), respectively. Conclusion: Our study concluded that there was a high prevalence of depression, anxiety and stress among physiotherapy clinical students. These outcomes suggest that more attention needs to be given to improving physiotherapy clinical students’ mental health, which will ultimately improve learning outcomes. Clinical implications: The long-term effects of psychological distress could potentially impact students’ academic performance. It may also have long-lasting effects after graduation. Therefore, students who are at risk of developing psychological symptoms are needed to be thoroughly examined and then receive early required interventions.

The study analyzed the gamma radioactivity levels due to radionuclides (226Ra, 232Th, and 40K) by the Gamma-Ray spectrometry method and calculated health hazards in rocks in Central and Western Gilgit-Baltistan, North Pakistan. The results of average activity concentrations of collected rock samples were 714.82 Bq kg−1 for 40K, 44.47 Bq kg−1 for 232Th, and 56.21 Bq kg−1 for 226Ra, respectively. The values of Indoor Excessive Lifetime Cancer Risk ELCR (in) in the samples are much greater than the permissible limit of 1.19 × 10−3. The values are also higher than safe limits for building materials (0.31 × 10−3) for seven samples. According to statistical analysis, the calculation shows the correlation coefficient value higher than the safe limit. Between 226Ra and 232Th correlation coefficient value is (0.92) and 40K and 226Ra correlation coefficient value (0.97) seemed to be positively high value. For Pearson’s correlation p 0.05. For Absorbed Dose (D), Effective dose (H), Annual Equivalent dose (E), And most important lifetime cancer risk (ELCR) R2 = 0.99 which shows a strong correlation between them. We have concluded that areas, where these rocks are exposed on a large scale, are not suitable for living. The diorite, granite, leucogranite, pegmatite, amphibolite, and gneiss are highly radioactive and should not be used as a building material..

Theoretical research has numerous challenges, particularly about modeling structures, unlike experimental analysis, which explores the mechanical behavior of complex structures. Therefore, this study suggests a new model for functionally graded shell structures called “Tri-coated FGM” using a spatial variation of material properties to investigate the free vibration response incorporating the porosities and microstructure-dependent effects. Two types of tri-coated FG shells are investigated, hardcore and softcore FG shells, and five distribution patterns are proposed. A novel modified field of displacement is proposed by reducing the number of variables from five to four by considering the shear deformation effect. The shell is rested on a viscoelastic Winkler/Pasternak foundation. An analytical solution based on the Galerkin approach is developed to solve the equations of motion derived by applying the principle of Hamilton. The proposed solution is addressed to study different boundary conditions. The current study conducts an extensive parametric analysis to investigate the influence of several factors, including coated FG nanoshell types and distribution patterns, gradient material distribution, porosities, length scale parameter (nonlocal), material scale parameter (gradient), nanoshell geometry, and elastic foundation variation on the fundamental frequencies. The provided results show the accuracy of the developed technique using different boundary conditions.

The objective of the current work was to fabricate, optimize and assess olive oil/phytosomal nanocarriers to improve quercetin skin delivery. Olive oil/phytosomal nanocarriers, prepared by a solvent evaporation/anti-solvent precipitation technique, were optimized using a Box–Behnken design, and the optimized formulation was appraised for in vitro physicochemical characteristics and stability. The optimized formulation was assessed for skin permeation and histological alterations. The optimized formulation (with an olive oil/PC ratio of 0.166, a QC/PC ratio of 1.95 and a surfactant concentration of 1.6%), and with a particle diameter of 206.7 nm, a zeta potential of −26.3 and an encapsulation efficiency of 85.3%, was selected using a Box–Behnken design. The optimized formulation showed better stability at ambient temperature when compared to refrigerating temperature (4 °C). The optimized formulation showed significantly higher skin permeation of quercetin when compared to an olive-oil/surfactant-free formulation and the control (~1.3-fold and 1.9-fold, respectively). It also showed alteration to skin barriers without remarkable toxicity aspects. Conclusively, this study demonstrated the use of olive oil/phytosomal nanocarriers as potential carriers for quercetin—a natural bioactive agent—to improve its skin delivery.

Objectives: To evaluate the ethics of pharmaceutical marketing practices in Sana’a city, Yemen. Methods: A cross-sectional study was conducted among 400 physicians and 50 pharmaceutical companies in the period from March to August 2018. Data about pharmaceutical marketing ethics were collected from physicians and pharmaceutical companies using two types of self-administrated, structured questionnaires. Data were analyzed with appropriate statistical tests using IBM SPSS Statistics, version 21.0. Results: The majority of physicians (60.0%) agreed that medical samples had been used most frequently as a promotional tool for pharmaceutical marketing, followed by gifts (14.0%). More than half of physicians were satisfied with the way of pharmaceutical marketing in Yemen. Personal relationships and medical samples and gifts were the factors affecting their prescriptions, being reported by about a third of physicians each. Meanwhile, most physicians (44.0%) preferred medical conferences and exhibitions as a promotional benefit to be gotten for prescribing the company’s products. The majority of physicians (62.0%) agreed that the availability of medical samples affect their prescriptions, and about 28.2% of physicians reported that all medical samples are used by their patients. Most physicians (37.0%) perceived that only 50% of medical representatives respond well to their queries related to marketed drugs, and 41.5% of physicians agreed that global companies are more compliant with ethical marketing. About 60% of the physicians reported not facing unethical promotions, and the majority (54.0%) agreed that unethical pharmaceutical marketing is the responsibility of companies, physicians, and representatives. There was a statistically significant difference in the proportion of drug prescriptions affected by medical representative visits and availability of medical samples on prescription in relation to the work experience of physicians. On the other hand, there was a statistically significant difference in facing an unethical promotion offered by companies for prescribing their products and the attribution of unethical pharmaceutical marketing in relation to the type of medical profession of physicians. Conclusions: Pharmaceutical marketing in Yemen still depends on traditional tools, with the lack of ethical guidelines or codes for pharmaceutical marketing in the country. Work experience and medical profession of physicians can significantly affect pharmaceutical marketing. The spread of unethical marketing is the responsibility of pharmaceutical companies, physicians and medical representatives. Therefore, it is recommended to develop well-defined and updated ethical standards and national guidelines for pharmaceutical marketing by the Ministry of Public Health and Population. Furthermore, official campaigns should be regularly carried out to control and restrict unethical promotion. Further studies on the ethics of pharmaceutical marketing are also recommended. Pharmaceutical companies should continuously train their medical representatives and provide physicians with the latest medical knowledge about new drugs. Keywords: Pharmaceutical marketing, Ethics, IFPMA guidelines, Sana’a

Abstract Background Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS). Methods This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality. Results Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely to present with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p

BackgroundSchistosomiasis (SCH) and soil-transmitted helminthiasis (STH) are known to be endemic in Yemen. However, the distribution of both diseases had not previously been assessed by a well-structured national mapping study covering all governorates. The main aim of this study was, therefore, to map the prevalence of SCH and STH in Yemen in order to better inform implementation of effective national control and elimination interventions. The assessment of the distribution of anaemia was also included as a well-known consequence of infection with both SCH and STH. Secondarily, the study aimed to provide a broad indication of the impact of large-scale treatment on the distribution of infection.Methodology and principal findingsTo achive these aims, 80,432 children (10-14 years old) from 2,664 schools in 332 of Yemen's 333 districts were included, in 2014, into this national cross-sectional survey. Countrywide, 63.3% (210/332) and 75.6% (251/332) of districts were found to be endemic for SCH and STH respectively. More districts were affected by intestinal than urogenital SCH (54.2% and 31.6% respectively). SCH infection was mostly mild and moderate, with no districts reporting high infection. One quarter (24.4%) of Yemeni districts had high or moderate levels of Ascaris lumbricoides infection. Infection with Trichuris trichiura was the second most common STH (44.9% of districts infected) after A. lumbricoides (68.1%). Hookworm was the least prevalent STH (9.0%). Anaemia was prevalent in 96.4% of districts; it represented a severe public health problem (prevalence ≥ 40%) in 26.5% of districts, and a mild to moderate problem in two thirds of the districts (33.7% and 36.1% respectively).ConclusionThis study provided the first comprehensive mapping of SCH, STH, and anaemia across the country. This formed the basis for evaluating and continuing the national control and elimination programme for these neglected tropical diseases in Yemen.

This study aims to use limestone wasted from the factory of stone carving for the adsorption of Pb(II) ion from aqueous solution. The process of adsorbing Pb(II) ion was achieved by using the patch method at conditions of (mass of adsorbent = 0.3, 0,6, 1.2 g, contact time = 15, 30, 45, 60, 120 min, particles size = 150, 250, 300 µm, pH media = 2, 3, 4, 5, 6, 7, 8, 9, temperature = 288, 298, 308, 318 K and initial concentration = 50, 70, 90, 100 mg/L) to obtain the best adsorption conditions. The atomic absorption spectroscopy was used to determine the concentration of the Pb(II) ion after the adsorption steps. Results show that the limestone was efficient for the removal of Pb(II) ion with efficiency reaching 99.5 % when 1.2 g of limestone was used. The study also revealed that the smaller particle size of limestone is, the higher percentage of removal will be. The adsorption increased almost rapidly with pH up to 5. The adsorbent uptake reaches the maximum after 15 min of contact. The Freundlich, Langmuir and Temkin isotherms plots show a good linearity, where R2 was more than 0.99, suggesting a good agreement with the experimental data.

Intestinal parasite infection (IPI) is still a very important public health issue. The severity of the parasitic disease has been reported as a high infection in immunocompromised patients and children. Hence, this study aimed to investigate the prevalence of intestinal parasites among immunocompromised patients and children with various gastrointestinal system complications in Sana’a city, Yemen, with different variables, including genus and age, and explore the risk factors associated with parasitic intestinal infections. The study socioeconomic data and certain behavioral and environmental risk factors and stool samples were collected from immunocompromised adult and children’s patients, including children (one to eight years old), pregnant women, diabetes mellitus patients, cancer patients, HIV patients, and older adults. Out of 436 fecal samples, the overall prevalence rate of IPIs among immunocompromised patients and children in Sana’a was 51.8%. In contrast, the rate of infection in children (26.1%) was higher than that in old patients (25.7%) and in females (38.5%) and higher than that in males (13.3%). The protozoa (44.5%) have been shown more than intestinal helminths (7.3%) in samples, and the most common intestinal protozoan was Giardia lamblia and Entamoeba histolytica (13.8% and 12.8%), respectively. The most common intestinal helminthiasis was Hymenolepis nana with 1.8%. Concluding that the rate of infection was high for several reasons, including lack of commitment to hygiene as not handwashing after using the toilet (88.9%), eating uncovered food (56.3%), poor sanitation as lack of water sources (59.5%), reduced health education, and presence of other family members infected by parasites (61.3%). Interventions are required to reduce intestinal parasites, including health education on personal hygiene for patients, increasing awareness, and improving the environment and healthcare system.

The Ministry of Public Health in Yemen continues the implementation of school and community-based preventive chemotherapy with praziquantel and albendazole for the control and elimination of schistosomiasis and soil-transmitted helminths (STH). The latest remapping to update the distribution of schistosomiasis and STH was conducted seven years ago. This study aimed to estimate the prevalence, intensity and associated risk factors of Schistosoma mansoni and STH among schoolchildren in An-Nadirah District, Ibb Governorate, Yemen. A cross-sectional study was carried out among schoolchildren aged 6-15 years in four selected schools. Biological, demographic, socioeconomic and environmental data were collected using a pre-tested questionnaire. S. mansoni and STH eggs were detected and counted by the microscopic examination of Kato-Katz fecal smears. Out of 417 schoolchildren, 17.0% were infected with at least one intestinal helminth. Prevalence of S. mansoni and STH were 6.5% and 9.1%, respectively. The most prevalent parasite among STH was Ascaris lumbricoides (8.4%). Unemployed fathers (Adjusted Odds Ratio (AOR) = 3.2; 95% Confidence interval (CI): 1.23, 8.52; P = 0.018), eating exposed food (AOR: 2.9; 95%CI = 1.24, 6.89; P = 0.014), not washing hands before eating and after defecation (AOR: 4.8; 95%CI = 1.77, 12.81; P = 0.002), and schools located close to water stream (AOR: 22.1; 95%CI = 5.12, 95.46; P

The industrial production of 3D printing is known as additive manufacturing (AM), in which a computer controls the process of producing 3D objects. Although x-ray computed radiography (XCT) is extensively used in the quality control and testing of additive manufacturing products, the gamma-ray radiography capabilities for these applications still need to be investigated. This study aimed to evaluate the performance of gamma-ray radiography using americium-241 (Am-241) as the gamma source. Here, we inspected fused deposition three-dimensional (3D) modeling products produced from polylactic acid (PLA) as thermoplastic samples. Radiographic testing of 3D-printed thermoplastic samples was performed using Monte Carlo simulations and validated by experimental studies. We used Am-241 (gamma-ray source) to conduct simulations and experiments investigations; two simulations were used: one by using 59.6 keV energy of gamma-ray and the other using all gamma-ray energies, including 16.96 keV, 26.3446 keV% 2.31 up to 662.40 keV. Also, we performed the x-ray radiography test to be used as a standard. The results showed that the defect detectability in the 3D-printed PLA samples using Am-241 as a gamma-ray source is comparable to that of x-ray results. This study concluded that the Am-241 could be used as the gamma-ray source to perform the radiography test for the products produced by 3D-printed thermoplastics.

This study was carried out to investigate the effect of two different doses of oxytocin on weight. Adult male rabbits (15) were weighed and provided with food twice daily for 3 weeks to determine the amount of food consumed daily and the time spent feeding by each rabbit. After 3 weeks the rabbits were weighed and divided randomly into 3groups: the control group, the low dose group, and the high dose group. The animals were injected daily for 3 weeks. During that time the amount of food consumed and the time spent feeding in both periods were determined. After the end of the treatment period the rabbits were weighed, and sacrificed. The results of this study showed that before treatment the rabbits consumed more food in the evening period than they did in the afternoon period. The mean time spent feeding in the evening period was slightly higher than that spent in the afternoon period; however, this difference was not statistically significant. After treatment, there was still significant difference between the means of the consumed food in the afternoon and the evening period for the control group. The mean amounts of food consumed in both periods by the treated groups were slightly reduced, but this reduction was not statistically significant. Furthermore, the mean time spent feeding in the evening period was slightly higher than that of the afternoon period for the 3 groups; however, these differences were not significant. The mean weight of the control group was slightly increased after treatment with the hormone; and the mean weights of the treated groups were slightly reduced after treatment. However, changes in body weighs were not statistically significant.

The present study proposes a simple synthesis technique for producing bunsenite cadmium oxide nanoparticles. A variety of techniques were used to determine the structure, morphology, elemental content, and optical properties of bunsenite cadmium oxide nanoparticles. The samples’ XRD spectra at 500 °C and above confirmed the presence of cubic bunsenite and cadmium oxide structures. The crystallite size was increased from 29 nm to 62 nm as the calcined temperature increased from 500 °C to 800 °C. The dispersion of the particles of bunsenite cadmium oxide improved with an increasing calcination temperature. An equivalent increasing trend was indicated by the mean grain size displayed via field emission scanning electron microscopy (FESEM) micrographs. Furthermore, the UV-Vis spectra showed that multiple energy band gaps attenuated as the calcination temperature increased. The mean particle size, as measured by transmission electron micrographs, appeared to increase in tandem with the calcination temperature. The obtained bunsenite and cadmium oxide nanoparticles have potential for employment in a wide range of semiconductor applications.

Background: HIV-associated peripheral neuropathy (PN) is a common neurological complication associated with HIV infection. Distal symmetrical polyneuropathy (DSPN) is the most commonly occurring type, which is associated with symptoms such as numbness, unsteady gait and, in some cases, muscle atrophy and weakness when myelinated nerve fibres are affected. If unmyelinated nerve fibres are affected, a painful neuropathy and autonomic symptoms may occur. Objectives: This research study assessed the effects of a strength exercise intervention on balance impairment and gait disturbance amongst individuals living with HIV-associated DSPN. Method: The study was a single-blinded, randomised controlled trial (RCT) with participants sourced from four HIV centres in Kano metropolis, Nigeria. The intervention was supervised and included progressive resistance exercise (PRE) (three 40-min sessions per week for 12 weeks) using a quadriceps bench (n = 44). The control group (CG) included the non-exercise group (n = 47). The two groups continued to receive routine care. Data were summarised and analysed using inferential statistics (SPSS version 20 program) with the alpha level set at 0.05. Results: At 12 weeks, the results revealed significant improvement with regard to balance performance (p = 0.001) and walking ability (p = 0.001) in the training group. In contrast, no significant differences in balance (P = 0.677) or gait (P = 0.578) were observed in the CG. Conclusion: The findings suggest that PRE is beneficial for balance impairment and gait disturbance caused by neuropathy in persons living with HIV and receiving antiretroviral drugs.

Intestinal schistosomiasis is a neglected tropical disease, causing morbidity and mortality in tropical and subtropical countries. Despite the frequent implementation of mass drug administration with praziquantel, the reinfection with Schistosoma mansoni is still common in Yemen. In addition, there is a scarcity of information on the impact of S. mansoni on nutritional status and anemia among schoolchildren. The present study aimed to determine prevalence and risk factors of intestinal schistosomiasis and investigate its impact on nutritional status and anemia among schoolchildren in Sana'a Governorate, Yemen. It was conducted in 2018 on 445 schoolchildren aged 5-15 years. Biodata, socio-economic, demographic, behavioral and environmental data were collected using a standard questionnaire. S. mansoni was identified and quantified by microscopic examination of Kato-Katz fecal smear. Hemoglobin concentration and anthropometric measurements were estimated using standard methods. The prevalence of S. mansoni was higher in Al-Haimah Al-Dakheliah (33.9%) than Bani Mater (1.4%). Household without tap water (Adjusted Odds Ratio (AOR) = 2.9, 95% Confidence interval (CI): 1.12, 7.55, P = 0.028) was the independent risk factor of the infection. The prevalence of wasting and stunting was 25.0% (95%CI: 21.2%, 29.2%) and 45.8% (95%CI: 41.2%, 50.5%), respectively. The prevalence of underweight among schoolchildren aged 5-10 years was 27.3% (95%CI: 21.9%, 33.4%). The prevalence of anemia was 31.7% (95%CI: 27.5%, 36.2%) with 0.5%, 21.1% and 10.1% being severe, moderate and mild anemia, respectively. S. mansoni (AOR = 4.1, 95%CI: 2.16, 7.84, P < 0.001) and early adolescence (AOR = 6.8, 95%CI: 4.26, 10.82, P < 0.001) were independent predictors of stunting among schoolchildren. The early adolescent schoolchildren (AOR = 3.1, 95%CI: 1.86, 4.97, P < 0.001) and children from families with low (AOR = 2.1, 95%CI: 1.01, 4.15, P = 0.046) or moderate wealth (AOR = 2.3, 95%CI: 1.11, 4.77, P = 0.026) were significantly more wasted. Early adolescence (AOR = 1.8, 95%CI:1.14, 2.78, P = 0.011), female (AOR = 1.6, 95%CI: 1.03, 2.43, P = 0.038) and Al-Haimah Al-Dakheliah District (AOR = 3.4, 95%CI: 1.20, 9.55, P = 0.021) were independent risk factors for anemia. The study findings indicate highly focal prevalence of schistosomiasis in Sana'a Governorate with a public health significance that varies from low to high risk. Approximately half of schoolchildren were stunted, which was associated with S. mansoni infection and early adolescence. One quarter of schoolchildren were wasted with early adolescent schoolchildren and children from poor families being at high risk of wasting. Anemia was a moderate public health threat affecting the female and the early adolescent schoolchildren. The study suggests the implementation of control measures to combat schistosomiasis and integrated diseases control programmes to improve the health status of schoolchildren in Sana'a Governorate.

This study investigated the translucency of 3D-printed denture base resins modified with zirconium dioxide nanoparticles (ZrO2NPs) under thermal cycling. A total of 110 specimens were fabricated and divided into 3 groups according to the materials, i.e., heat-polymerized resin, and 3D-printed resins (NextDent, and ASIGA). The 3D-printed resins were modified with 0, 0.5, 1, 3, and 5 wt.% of ZrO2NPs. All the specimens were subjected to 5000 thermal cycles. The translucency was measured using a spectrophotometer. The results showed that the heat-polymerized resin had considerably higher translucency than the 3D-printed resins. Compared to the unmodified group, the translucency decreased significantly after adding 5% ZrO2NPs to NextDent and 3% ZrO2NPs to ASIGA resins. The highest translucency was achieved for NextDent by adding 0.5% ZrO2NPs and for ASIGA without any ZrO2NPs. It was found that the average concentration level in ASIGA was significantly higher than that in NextDent. These findings revealed that 3D-printed resins have lower translucency than heat-polymerized acrylic resin, and adding ZrO2NPs at low concentrations did not affect the translucency of the 3D-printed resins. Therefore, in terms of translucency, 3D-printed nanocomposite denture base resins could be considered for clinical applications when ZrO2NPs are added at low concentrations.

Objectives: Macrolides have been reported to be associated with improved outcomes in patients with viral pneumonia related to influenza and other viruses, possibly because of their immune-modulatory effects. Macrolides have frequently been used in patients with Middle East Respiratory Syndrome (MERS). This study investigated the association of macrolides with 90-day mortality and MERS coronavirus (CoV) RNA clearance in critically ill patients with MERS. Methods: This retrospective analysis of a multicenter cohort database included 14 tertiary-care hospitals in five cities in Saudi Arabia. Multivariate logistic-regression analysis was used to determine the association of macrolide therapy with 90-day mortality, and the Cox-proportional hazard model to determine the association of macrolide therapy with MERS-CoV RNA clearance. Results: Of 349 critically ill MERS patients, 136 (39%) received macrolide therapy. Azithromycin was most commonly used (97/136; 71.3%). Macrolide therapy was commonly started before the patient arrived in the intensive care unit (ICU) (51/136; 37.5%), or on day1 in ICU (53/136; 39%). On admission to ICU, the baseline characteristics of patients who received and did not receive macrolides were similar, including demographic data and sequential organ failure assessment score. However, patients who received macrolides were more likely to be admitted with community-acquired MERS (P = 0.02). Macrolide therapy was not independently associated with a significant difference in 90-day mortality (adjusted odds ratio [OR]: 0.84; 95% confidence interval [CI] :0.47–1.51; P = 0.56) or MERS-CoV RNA clearance (adjusted HR: 0.88; 95% CI:0.47–1.64; P = 0.68). Conclusions: These findings indicate that macrolide therapy is not associated with a reduction in 90-day mortality or improvement in MERS-CoV RNA clearance. Keywords: Macrolides, MERS-CoV, Critical care, Pneumonia, Influenza, Azithromycin

To improve the structural stiffness, strength and reduce the weight of nanoplate structure, functionally graded (FG) graphene-reinforced nanocomposite (GRNC) laminated plates are exploited in this paper. The bending and buckling behaviors of FG-GRNC laminated nanoplates are investigated by using novel quasi-3D hyperbolic higher order shear deformation plate theory in conjunction with modified continuum nonlocal strain gradient theory, which considered both length and material scale parameters. The modified model of Halpin–Tsai is employed to calculate the effective Young’s modulus of the GRNC plate along the thickness direction, and Poisson’s ratio and mass density are computed by using the rule of mixture. An analytical approach of the Galerkin method is developed to solve governing equilibrium equations of the GRNC nanoplate and obtain closed-form solutions for bending deflection, stress distributions and critical buckling loads. A detailed parametric analysis is carried out to highlight influences of length scale parameter (nonlocal), material scale parameter (gradient), distribution pattern, the GPL weight fraction, thickness stretching, geometry and size of GPLs, geometry of the plate and the total number of layers on the stresses, deformation and critical buckling loads. Some details are studied exclusively for the first time, such as stresses and nonlocality effect.

Objectives: To assess the awareness of healthcare providers in Sana’a city of the most frequently antibiotic-resistant bacterial isolates encountered in clinical settings, the factors associated with the emergence of such resistance and the strategies to counteract antibiotic resistance. Methods: This cross-sectional study included 416 healthcare providers; namely, 167 physicians, 61 pharmacists and 188 nurses, from four public and two private hospitals in Sana’a. Data about demographics, awareness of the most frequently isolated antibiotic-resistant bacteria in clinical settings, the factors possibly associated with such resistance and the best strategies to counteract antibiotic resistance were collected using a pre-designed questionnaire. Data were then analyzed using suitable statistical tests. Results: The majority of healthcare providers were aware of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa as the two most frequently encountered bacterial species in clinical practice, with non-statistically significant differences in the awareness level among physicians, pharmacists and nurses. However, a statistically significant difference was found among healthcare providers regarding their awareness of the most possible factors contributing to antibiotic resistance. In this regard, pharmacists were significantly more aware of the contribution of the extensive use of newer generations of antibiotics (P = 0.030), inappropriate prescribing of antibiotics (P = 0.010) and use of antibiotics without prescription (P = 0.045) to the emergence and spread of antibiotic resistance than physicians and nurses. On the other hand, physicians and nurses were significantly more aware of the role of reducing the length of hospital stay (P = 0.005), limiting the use of medical instrumentation (P = 0.036), use of narrow-spectrum antibiotics (P = 0.005), surveillance for antibiotic resistance (P = 0.004), development of infection control policies and procedures (P

In the present work, a thermal treatment technique is applied for the synthesis of CexSn1−xO2 nanoparticles. Using this method has developed understanding of how lower and higher precursor values affect the morphology, structure, and optical properties of CexSn1−xO2 nanoparticles. CexSn1−xO2 nanoparticle synthesis involves a reaction between cerium and tin sources, namely, cerium nitrate hexahydrate and tin (II) chloride dihydrate, respectively, and the capping agent, polyvinylpyrrolidone (PVP). The findings indicate that lower x values yield smaller particle size with a higher energy band gap, while higher x values yield a larger particle size with a smaller energy band gap. Thus, products with lower x values may be suitable for antibacterial activity applications as smaller particles can diffuse through the cell wall faster, while products with higher x values may be suitable for solar cell energy applications as more electrons can be generated at larger particle sizes. The synthesized samples were profiled via a number of methods, such as scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FT-IR). As revealed by the XRD pattern analysis, the CexSn1−xO2 nanoparticles formed after calcination reflect the cubic fluorite structure and cassiterite-type tetragonal structure of CexSn1−xO2 nanoparticles. Meanwhile, using FT-IR analysis, Ce-O and Sn-O were confirmed as the primary bonds of ready CexSn1−xO2 nanoparticle samples, whilst TEM analysis highlighted that the average particle size was in the range 6−21 nm as the precursor concentration (Ce(NO3)3·6H2O) increased from 0.00 to 1.00. Moreover, the diffuse UV-visible reflectance spectra used to determine the optical band gap based on the Kubelka–Munk equation showed that an increase in x value has caused a decrease in the energy band gap and vice versa.

Objective: To determine the prevalence and risk factors for Trichomonas vaginalis infection among pregnant women seeking health care in Sana’a city. Methods: This cross-sectional study was conducted among pregnant women seeking health care in private clinics and governmental primary health care centers in Sana’a during the period from October 2014 to June 2015. Data on sociodemographic and clinical characteristics as well as possible risk factors of T. vaginalis infection were collected from 287 pregnant women using a pre-designed questionnaire by trained researchers. Vaginal discharges were then collected and examined microscopically for motile T. vaginalis trophozoites. Results: The overall prevalence of T. vaginalis infection was 11.1%, with a higher infection rate among pregnant women aged 26-40 years old, housewives and rural residents. Age, literacy status and the age at first sexual intercourse were significantly associated with T. vaginalis infection among pregnant women. Presence of vaginal discharge (OR = 8.33; 95% CI: 2.47–28.03, P

Abstract Background Universal coverage of the targeted malaria-endemic areas with long-lasting insecticidal nets (LLINs) is implemented as one of the key interventions for malaria control and elimination in Yemen. In 2013, through a mass campaign, LLINs were distributed to the targeted communities in Al Hudaydah governorate. This study aimed to assess the ownership of, access to, and use of LLINs. It also aimed to identify factors associated with not using LLINs in malaria-endemic areas of Al Hudaydah in the Tihama region, west of Yemen. Methods A cross-sectional survey was conducted in four districts (Ad Durayhimi, Al Marawi’ah, Al Mansuriyah and Bayt Al Faqiah) in Al Hudaydah during February 2016. A total of 701 households were included in this study. Data on socio-demographic characteristics and availability of LLINs were collected by interview and observation. Four indicators for malaria prevention using LLINs; proportion of households with at least one LLIN, proportion of households with at least one LLIN for every two people, proportion of population with access to LLINs in the surveyed households and proportion of population who slept under LLINs the previous night of the survey were calculated as indicated by Roll Back Malaria Monitoring and Evaluation Reference Group. Use to access ratio was assessed. Factors associated with not using LLINs among people with access were also investigated. Results Of 701 households with 4900 de facto population, ownership of at least one LLIN was 90.6%, while 24.1% owned at least one for every two people during the survey in 2016. The overall proportion of people with access to LLINs was 51.5% (95% CI 50.1–52.9). Only 19.0% (95% CI 17.9–20.1) slept under LLINs the night before the survey and the overall use to access ratio was 0.37. The proportions of children under 5 years of age with access to and use of LLINs were 13.7 and 42.5%, respectively. On the other hand, the proportions of pregnant women with access to and use of LLINs were 16.4 and 20.0%, respectively. Multivariable analysis identified that people living in Al Mansuriyah district [adjusted odds ratio (AOR) = 3.29, 95% confidence interval (CI) 1.35–8.01; P = 0.009)], having three or more damaged LLINs in the house (AOR = 2.76, 95% CI 1.79–4.25; P

This study aimed to identify the application degree of administrative accountability and organizational governance, and the relationship between them in the directorates of education in Jordan from the viewpoint of its adm nistrative leaders. The researchers used descriptive statistics- correlation through two tools. A survey for administrative accountability and consisted of -20- items, while the second survey was for organizational governance, it consisted of 40 items concerned with five areas, which are: Revelation and transparency, effective participation, control and administrative responsibility, justice and integrity, and efficiency and effectiveness. The sample consisted of 272 educational leaders from 6 directorates. This represents 14% of the sample community. The results showed that the application degree of administrative accountability and organizational governance in the directorates of education in Jordan was moderate. The results also indicated that there was a significant positive relationship between the application degree of administrative accountability and the application of administrative governance in the directorates of education.

Carriage tasks are common and can lead to shoulder and lower back injuries. Wearable carriage aids have shown mixed effects on local physical demand measures. This study examined the impact of a wearable carriage aid on whole-body physiological measures (normalized oxygen consumption, minute ventilation, respiratory rate, and heart rate) to obtain a more comprehensive assessment regarding aid effectiveness. Additionally, this study investigated the effect of wearing the device on perceived balance. The potential moderating effect of carried load mass was considered. The examination was conducted while walking on a treadmill at a constant speed (2 km/h) for 5 min and was completed by 16 participants. Wearing the device reduced normalized oxygen consumption (~14%), minute ventilation (~7%), and heart rate (~3%), while substantially improving perceived balance (~61%). These effects were consistent across examined carried load levels. Although this study highlighted the potential for the developed aid, future studies are required for more diverse and realistic testing conditions.

Onchocerciasis in Yemen is one of the most neglected diseases, where baseline estimates of onchocerciasis and monitoring of the impact of ivermectin regularly administered to the affected individuals on its transmission are lacking. Therefore, this study aimed to determine the anti-Ov16 IgG4 seroprevalence among local communities of Hodeidah and Al-Mahwit governorates of Tihama region. The factors possibly associated with previous exposure to infection were also studied.This cross-sectional study was conducted in two ivermectin-targeted districts endemic for onchocerciasis in Hodeidah and Al-Mahwit and two untargeted districts with unknown previous endemicity in Hodeidah between February and July 2017. For 508 residents sampled by a multi-stage random approach, data were collected and blood specimens were screened for anti-Ov16 IgG4 using the SD BIOLINE Onchocerciasis IgG4 rapid tests. The study revealed an overall anti-Ov16 IgG4 rate of 18.5% (94/508) in all surveyed districts, with 10.2% (12/118) of children aged ≤10 years being seropositive. Moreover, rates of 8.0% (4/50) and 6.1% (4/66) were found in districts not officially listed as endemic for the disease. Multivariable analysis confirmed the age of more than ten years and residing within a large family as the independent predictors of exposure to infection.Onchocerciasis transmission is still ongoing as supported by the higher anti-Ov16 IgG4 seroprevalence rate among children aged ≤10 years compared to that (

BACKGROUND:Middle East Respiratory Syndrome Coronavirus (MERS-CoV) leads to healthcare-associated transmission to patients and healthcare workers with potentially fatal outcomes. AIM:We aimed to describe the clinical course and functional outcomes of critically ill healthcare workers (HCWs) with MERS. METHODS:Data on HCWs was extracted from a multi-center retrospective cohort study on 330 critically ill patients with MERS admitted between (9/2012-9/2015). Baseline demographics, interventions and outcomes were recorded and compared between survivors and non-survivors. Survivors were approached with questionnaires to elucidate their functional outcomes using Karnofsky Performance Status Scale. FINDINGS:Thirty-Two HCWs met the inclusion criteria. Comorbidities were recorded in 34% (11/32) HCW. Death resulted in 8/32 (25%) HCWs including all 5 HCWs with chronic renal impairment at baseline. Non-surviving HCW had lower PaO2/FiO2 ratios 63.5 (57, 116.2) vs 148 (84, 194.3), p = 0.043, and received more ECMO therapy compared to survivors, 9/32 (28%) vs 4/24 (16.7%) respectively (p = 0.02).Thirteen of the surviving (13/24) HCWs responded to the questionnaire. Two HCWs confirmed functional limitations. Median number of days from hospital discharge until the questionnaires were filled was 580 (95% CI 568, 723.5) days. CONCLUSION:Approximately 10% of critically ill patients with MERS were HCWs. Hospital mortality rate was substantial (25%). Patients with chronic renal impairment represented a particularly high-risk group that should receive extra caution during suspected or confirmed MERS cases clinical care assignment and during outbreaks. Long-term repercussions of critical illness due to MERS on HCWs in particular, and patients in general, remain unknown and should be investigated in larger studies.

Introduction: Pharmacists in community or hospital setting play a key role in reporting Adverse Drug Reaction (ADRs) during practice. Under reporting is considered as a profession malpractice worldwide. Aim: To determine the level of knowledge and perception about phramacovigilance and ADRs reporting among final year pharmacy students of Universities in Sana’a Yemen. Materials and Methods: A cross-sectional study design was conducted among 385 final year pharmacy students. One public and four private universities were selected randomly using a validated self-administered questionnaire. The questionnaire contained data about student demographic data, knowledge and perception about the ADRs. The data was analysed by SPSS program and Chi-square tests were used to assess the significance of association. Results: The male students were more knowledgeable than female (p=0.035), as well as private university students had better ideas on how to report ADRs than public university students (p=0.009). Private university students reported that pharmacovigilance topic is well covered in their curriculum compared to public university students (p≤0.001). A significant difference was seen amongst the students of public and private universities when asked about reporting ADRs in future, former found more confident (p≤0.001). Furthermore, the private university students also had more command on the concept of post-marketing surveillance than public university students (p≤0.001). The private university students in Yemen were more known to causality assessment of ADRs as compared to the students of public universities (p≤0.001). The results of perception revealed regarding perception toward ADRs and pharmacovigilance. Female students (p≤0.018) and private universities students (p≤0.001) had positive perception than male and public university students respectively. Conclusion: The findings showed poor knowledge among students in Sana’a Universities and positive perception towards pharmacovigilance and ADRs reporting. A poor knowledge among the future pharmacists suggests need for educational interventions and improvement of strategies to ease the reporting mechanisms. Steps can be taken to improve pharmacovigilance tools and methods in Yemen as well as incorporating subjects of pharmacovigilance in the health faculty’s curriculum in Yemen.

Visceral leishmaniasis (VL) is a debilitating, often fatal disease caused by Leishmania donovani complex; however, it is a neglected tropical disease. L. donovani complex comprises two closely related species, L. donovani that is mostly anthroponotic and L. infantum that is zoonotic. Differentiation between these two species is critical due to the differences in their epidemiology and pathology. However, they cannot be differentiated morphologically, and their speciation using isoenzyme-based methods poses a difficult task and may be unreliable. Molecular characterization is now the most reliable method to differentiate between them and to determine their phylogenetic relationships. The present study aims to characterize Leishmania species isolated from bone marrows of Yemeni pediatric patients using sequence analysis of the ribosomal internal transcribed spacer-1 (ITS1) gene. Out of 41 isolates from Giemsa-stained bone marrow smears, 25 isolates were successfully amplified by nested polymerase chain reaction and sequenced in both directions. Phylogenetic analysis using neighbor joining method placed all study isolates in one cluster with L. donovani complex (99% bootstrap). The analysis of ITS1 for microsatellite repeat numbers identified L. infantum in 11 isolates and L. donovani in 14 isolates. These data suggest the possibility of both anthroponotic and zoonotic transmission of VL-causing Leishmania species in Yemen. Exploring the possible animal reservoir hosts is therefore needed for effective control to be achieved.