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Abstract Childhood and adolescence, vital in shaping adult life and society, are profoundly impacted during conflicts like Syria’s devastating war. This study explores the prevalence of behavioral disorders in Syrian children and adolescents, examining the influence of war and family-related factors. This cross-sectional study was conducted on children aged 2–17 years at a children’s outpatient clinic in Damascus, Syria. We assessed parents’ quality of life, war and family-related factors, and behavioral difficulties through parental interviews using two questionnaires: the Arabic version of the Strengths & Difficulties Questionnaire (SDQ) and the brief Arabic version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). 74.67% of children aged 2–4 years and 61.29% of children aged 5–17 years were experiencing behavioral difficulties, with emotional difficulties being the most prevalent ones. Children exposed to kidnapping, family losses, lack of school enrollment, and those with parents having lower education, lower socioeconomic status, and poorer quality of life exhibited higher Total SDQ scores. The high prevalence of behavioral difficulties among children and adolescents in Syria is a major concern, with both direct and indirect war-related factors contributing to this issue.

IntroductionThe unprecedented impact of the coronavirus pandemic (COVID-19) has had profound implications on the ASD community, including disrupting daily life, increasing stress and emotional dysregulation in autistic children, and worsening individual and family well-being.MethodsThis study used quantitative and qualitative survey data from parents in Qatar (n=271), to understand the impact of the COVID-19 pandemic on autistic children and their families in Qatar. The questionnaire was a combination of open-ended (qualitative) and closed-ended (quantitative) questions to explore patterns in the experiences of the different families, as well as to contrive themes. The survey was created in a way to evaluate the psychological, academic/intervention, economic, and other impacts of the pandemic related measures on a sample of multicultural families residing in the State of Qatar during the peak period of confinement and physical distancing in 2020. Data acquisition involved the utilization of Google Forms. Subsequent quantitative analysis employed the SPSS software and chi-square analysis for numerical examination, enabling the characterization of the studied population and exploration of associations between parental stress levels and variables such as employment status, therapy accessibility, presence of hired assistance, and alterations in their childs skills. Concurrently, qualitative data from written responses underwent thorough categorization, encompassing themes such as emotional isolation, mental or financial challenges, and difficulties in obtaining support.ResultsParents expressed distress and disturbance in their daily lives, including profound disruptions to their childrens access to treatment, education, and activities. Most parents reported deteriorations in their childrens sleep (69.4%), behavioral regulation (52.8%), and acquired skills across multiple domains (54.2%). Parents also reported decreased access to family and social support networks, as well as decreased quality of clinical and community support. Qualitative analysis of parental responses revealed that child developmental regression was an important source of parental stress.Discussion and conclusionThe greater impact of the pandemic on autistic children and their families emphasizes the need for accessible and affordable health, education, and family services to manage their special needs.

There are concerns about the potency of epinephrine (EPI), norepinephrine (NE), and phenylephrine (PE) stored in syringes for later infusions in clinical care. The objective of our study was to optimize a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to determine the concentrations EPI, NE, and PE dissolved in normal saline and stored in 50 mL 3-part Becton Dickinson syringes.

Purpose: In line with business goals of customer satisfaction, higher education institutions of learning consider excellent student experience a priority. Teaching and learning are important aspects of satisfaction that are monitored annually by universities using tools such as the National Student Survey (NSS). The NSS results are useful for educational planning and informing consumer choices. This research measured undergraduate student experiences on an interdisciplinary project using the NSS framework. Hinged on diversity, the purpose was to investigate whether full-time (FT), part-time (PT) and degree apprenticeship students with varied work experience enhance their learning studying together on an interdisciplinary project. Design/methodology/approach: This research has measured, using the NSS criteria, student experiences on an interdisciplinary project on a civil engineering programme. It benchmarks the quality of learning and student understanding and perceptions of learning. The method is based upon a literature review and questionnaire survey of students. Findings: Results indicate good amounts of peer influence on learning in a simulated interdisciplinary team setting supported by a mix of diverse work experience in students' background. Originality/value: Sections of the NSS are extended with additional questions to capture the impact that FT, PT and degree apprenticeship study modes, closely associated with students' background of job experience, have on teaching and learning.

Global warming induces to increase of greenhouse gases in the atmosphere and plays a crucial role in determining the future trend in climatology and hydrology of a watershed. This paper aims to investigate the implications of global warming on future climate and its consequents on streamflow of the Adhaim River Basin (ARB). For this purpose, the Long Ashton Research Station-Weather Generator (LARS-WG) and Soil and Water Assessment Tool (SWAT)-Based models were implemented. The climate and hydrologic records for the period 1990-2019 were used as a Reference Period (RP) and projected to 2080 under Representative Concentration Pathways (RCPs 2.6, 4.5, and 8.5) and five Global Climate Models (GCMs). The results show that the region of ARB tends to become hotter and drier with an increase in mean temperature by 1.2, 2.9, and 4.6 °C under the considered RCPs, respectively. However, precipitation tends to decrease from 366 mm/y in RP to 320.2, 302, and 300.5 mm/y by 2080 under the considered RCPs. Consequently, the streamflow will decrease to about 28, 26, and 24 m3/s by 2080 under the considered RCPs, respectively, compared with 28.96 m3/s in RP. Therefore, adaptation strategies are highly recommended to alleviate the negative impacts of climate change, and the implications of climate change on groundwater, water demand, and adaptation plans should be investigated in future studies.

Abstract Animal and human data indicate variable effects of interferons in treating coronavirus infections according to inflammatory status and timing of therapy. In this sub-study of the MIRACLE trial (MERS-CoV Infection Treated with a Combination of Lopinavir–Ritonavir and Interferon β-1b), we evaluated the heterogeneity of treatment effect of interferon-β1b and lopinavir–ritonavir versus placebo among hospitalized patients with MERS on 90-day mortality, according to cytokine levels and timing of therapy. We measured plasma levels of 17 cytokines at enrollment and tested the treatment effect on 90-day mortality according to cytokine levels (higher versus lower levels using the upper tertile (67%) as a cutoff point) and time to treatment (≤ 7 days versus > 7 days of symptom onset) using interaction tests. Among 70 included patients, 32 received interferon-β1b and lopinavir–ritonavir and 38 received placebo. Interferon-β1b and lopinavir–ritonavir reduced mortality in patients with lower IL-2, IL-8 and IL-13 plasma concentrations but not in patients with higher levels (p-value for interaction = 0.09, 0.07, and 0.05, respectively) and with early but not late therapy (p = 0.002). There was no statistically significant heterogeneity of treatment effect according to other cytokine levels. Further work is needed to evaluate whether the assessment of inflammatory status can help in identifying patients with MERS who may benefit from interferon-β1b and lopinavir–ritonavir. Trial registration: This is a sub-study of the MIRACLE trial (ClinicalTrials.gov number, NCT02845843).

Temperature and coagulant types have an important impact on the quantity and quality of the residue (sludge) in water and wastewater treatment processes. Temperature influences water viscosity and the distribution of the coagulant in water. Coagulants can promote the agglomeration of fine particles into larger flocs so that they can be more easily separated from the water. Experiments have been conducted to explore the relationship between temperature (16-26°C), the type of coagulant, and sludge dewaterability (estimated using the capillary suction time (CST)). Alum, Ferric, and Moringa oleifera Lam were used as coagulants. The influences of different mixer shapes, turbidity values, and flocs sizes on sludge dewaterability have been assessed. The results show that ferric chloride was unaffected by temperature, whereas alum and M. oleifera performances were influenced by temperature. CST results using the coagulant ferric chloride, regardless of mixer shape, turbidity, and floc size, were insensitive to temperature differences.

Abstract Sources and levels of heavy metals (HMs) in soil and dust of urban and suburban areas in Riyadh (industrial city) and Mahad AD’Dahab (mining area) cities in Saudi Arabia were reported in this study. Additionally, the concentrations of HMs in different soil particle size fractions (> 250, 63–250 and 2). The hazard index values of dust and soil ( 1, suggesting non-carcinogenic risk. Therefore, the dust and soil samples from the mined area of Mahad AD’Dahab had a higher pollution levels, as well as ecological and human health risks than those from Riyadh. Hence, the pollution of such residential environments with HMs (especially Cd, Cu, Zn, and Pb) needs to be monitored.

An assessment of the total hydrologic response of arid and semi-arid river basins to various scenarios of climate change by considering evapotranspiration, streamflow, and snowmelt is essential for sustainable management of water resources. The Diyala River Basin in Iraq has been chosen as a typical case study of dozens of river basins in arid and semi-arid regions. Here, the Long Ashton Research Station-Weather Generator (LARS-WG), the Soil and Water Assessment Tool (SWAT), and the SWAT Calibration and Uncertainty Program (CUP) were used to evaluate the total response by considering three Representative Concentration Pathways (RCPs); RCPs 2.6, 4.5, and 8.5 over three periods, 2021–2040, 2041–2061, and 2061–2080. The results indicate that by the year 2080, the basin will experience a temperature increase by 6.6, 10.1, and 16.6% for RCP 2.6, RCP 4.5, and RCP 8.5, respectively. The corresponding reduction in precipitation will be 3.2, 6.4, and 8.7%, resulting in 38.8, 47.9, and 52.8% fall in streamflow for RCPs 2.6, 4.5, and 8.5, respectively. Due to the increase in temperature, an earlier and less contribution of snowmelt is expected in the projected streamflow. Our findings provide a useful reference and a guide to decision makers for developing adaption plans to sustainably manage water resources in the Diyala River Basin and other similar basins in arid and semi-arid regions. HIGHLIGHTS The study provides valuable information on possible future changes in streamflow under a changing climate.; LARS-WG, SWAT, SWAT-CUP, and three RCP scenarios to predict the hydrologic response of a river basin are used.; Precipitation is predicted to decrease, resulting in a reduction in streamflow.; This study supports the sustainable use of water resources in a changing climate.; This study serves the development of adaptation plans to climate change and its effects.;

Objectives The aim of this study was to first assess the knowledge and perception of first-year university students in Iraq about COVID-19 in general and SARS-CoV-2 latest variant of concern, and to evaluate the attitudes towards protection measures including vaccination.Study design A cross-sectional study was conducted among newly enrolled students at the American University of Iraq-Baghdad. Mann-Whitney U and Kruskal-Wallis tests were used to test an association between the outcomes measured on a 5-point Likert scale and the binary and the categorical independent variables, respectively. χ2 test was used to test the association between nominal categorical variables, while Kendall’s τ-b was used for ordinal variables.Participants Students (n=432) were invited to fill out a survey specifically tailored to assess their knowledge, perception and attitude towards Omicron variant and COVID-19 vaccines acceptance. 363 students enrolled in various majors participated in this study.Results Assessment of COVID-19 knowledge and perception revealed that students still lack reliable info and data about FDA-approved treatment options (70.5%), SARS-CoV-2 variants (96.5%) and approved vaccines. Students’ attitude and practices towards recommended safety measures should be reassessed to better manage the pandemic. Adherence level was shown to be associated with the belief in its capacity to effectively manage the new variant. Interestingly, 85% of the students have received at least one dose of approved vaccine. A significant positive correlation was detected between the level of adherence to recommended precautions and the intention to take a third booster shot if proven effective.Conclusions Students’ reliable knowledge about COVID-19 pandemic including the various strains and approved vaccines should be improved to better manage the pandemic and set foundations for a more appropriate approach when another pandemic occurs. Special workshops should be organised to ensure that students and the public have a more trusted source of information about COVID-19.

Abstract Human carbonic anhydrase XII (hCA XII) isozyme is of high therapeutic value as a pharmacological target and biomarker for different types of cancer. The hCA XII is one of the crucial effectors that regulates extracellular and intracellular pH and affects cancer cell proliferation, invasion, growth and metastasis. Despite the fact that interaction features of hCAs inhibitors with the catalytic site of the enzyme are well described, lack in the selectivity of the traditional hCA inhibitors based on the sulfonamide group or related motifs is an urgent issue. Moreover, drugs containing sulfanomides can cause sulfa allergies. Thus, identification of novel non-classical inhibitors of hCA XII is of high priority and is currently the subject of a vast field of study. This study was devoted to the identification of novel potential hCA XII inhibitors using comprehensive set of computational approaches for drug design discovery: generation and validation of structure- and ligand-based pharmacophore models, molecular docking, re-scoring of virtual screening results with MMGBSA, molecular dynamics simulations, etc. As the results of the study several compounds with alternative to classical inhibitors chemical scaffolds, in particular one of coumarins derivative, have been identified and are of high interest as potential non-classical hCA XII inhibitors.

Autism spectrum disorder (ASD) is an umbrella term that encompasses several disabling neurodevelopmental conditions. These conditions are characterized by impaired manifestation in social and communication skills with repetitive and restrictive behaviors or interests. Thus far, there are no approved biomarkers for ASD screening and diagnosis; also, the current diagnosis depends heavily on a physician’s assessment and family’s awareness of ASD symptoms. Identifying blood proteomic biomarkers and performing deep blood proteome profiling could highlight common underlying dysfunctions between cases of ASD, given its heterogeneous nature, thus laying the foundation for large-scale blood-based biomarker discovery studies. This study measured the expression of 1196 serum proteins using proximity extension assay (PEA) technology. The screened serum samples included ASD cases (n = 91) and healthy controls (n = 30) between 6 and 15 years of age. Our findings revealed 251 differentially expressed proteins between ASD and healthy controls, of which 237 proteins were significantly upregulated and 14 proteins were significantly downregulated. Machine learning analysis identified 15 proteins that could be biomarkers for ASD with an area under the curve (AUC) = 0.876 using support vector machine (SVM). Gene Ontology (GO) analysis of the top differentially expressed proteins (TopDE) and weighted gene co-expression analysis (WGCNA) revealed dysregulation of SNARE vesicular transport and ErbB pathways in ASD cases. Furthermore, correlation analysis showed that proteins from those pathways correlate with ASD severity. Further validation and verification of the identified biomarkers and pathways are warranted.

BACKGROUND: Researchers have investigated the presence of families during cardiopulmonary resuscitation (CPR) to determine its benefits and barriers and the points of view of healthcare professionals, patients, and families. Family presence during resuscitation (FPDR) is debatable. Many professional health organizations worldwide, such as the Emergency Nurses Association, have suggested that healthcare facilities implement rules and policies that encourage the attendance of families and relatives during CPR. However, this does not consider the nurses' points of view or self-confidence during FPDR. The main aim of this study is to evaluate nurses' perceptions and self-confidence related to family presence during CPR in Saudi Arabia.MATERIALS AND METHODS: This descriptive correlation study was conducted between March and April 2022 at King Abdul Aziz University Hospital in Jeddah. A survey was completed by participants to collect their sociodemographic data. The relationship between Family Presence Risk-Benefit Scale (FPS-BS) and the Family Presence Self-Confidence Scale (FPS-CS) was analyzed using Pearson's correlation test.RESULTS: The study's participants consisted of 147 nurses. Regarding the FPDR, nurses had a moderately positive perception and level of confidence. Moreover, the level of self-confidence varied significantly by age group and years of experience. The results of the Pearson correlation indicated that there was a significant association between FPS-CS and FPR-BS (r = 0.221, P < .001). When implementing FPDR, nurses who see more benefits from it are more confident.CONCLUSION: According to the findings, the nurses who felt more comfortable including patients' families in resuscitation efforts also saw FPDR as having more advantages. FPDR has several effects on the healthcare team providing CPR. Nursing leaders should develop policies for their teams and instruct nurses and other healthcare professionals. Considering the clear benefits of clinical practice and family involvement in resuscitation, it is suggested to give this experience first using simulation and role-playing.

Climate change and population growth play crucial roles in the planning of future water resources management strategies. In this paper, a balancing between projected water resources and water demands in the Iraqi Part of the Tigris River Basin (TRB) was evaluated till the year 2080 based on RCPs 2.6, 4.5 and 8.5 and population growth. This paper examined a sustainable adaptation plan of water resources in the TRB considering three scenarios; (S1) as no change in the current strategy, (S2) as improved irrigation efficiency and (S3) as improved irrigation and municipal water use efficiency. The results showed a decline in streamflow will occur in the range from 5 to 18.4% under RCP 2.6 and RCP 8.5, respectively. The minimum increase in water demand is expected for RCP 2.6 (maximum increase for RCP 8.5) by 51.8 (208.2), 9.9 (42) and 1.2 (7)% for the municipal–industrial, irrigation and environmental water demands, respectively, compared with the RP. The main finding indicated that S1 is the worst scenario, with water stress in four provinces, especially on the warmest RCP. Whereas, under S2 and S3 conditions, water stress can be eliminated. Increasing ambition towards adaptation becomes obligatory for developing sustainable water sources, supporting water food securities and increasing resilience towards climate change. [ABSTRACT FROM AUTHOR]

The letter discusses a retrospective case series on the use of assisted reproductive technology (ART) in women with epilepsy (PWE) who desire pregnancy. The study found that seizure control can be maintained despite the use of exogenous hormones. The authors emphasize the need for interdisciplinary collaboration and further research to optimize care for PWE undergoing ART. They also provide a table outlining considerations for epilepsy during different stages of in vitro fertilization (IVF) protocols. [Extracted from the article]

Angiofibroma is an uncommon, highly vascular benign lesion that occurs in the head and neck region, typically arising in the nasopharyngeal area, potentially with a locally aggressive course. Angiofibroma with a primary intraoral presentation is extremely rare; few case reports have been published in the literature, with only three cases of angiofibroma in the mandible published to date. In this case, a 37-year-old man presented with swelling at the right mandible and underwent enucleation of the lesion under general anesthesia. After 1-year follow-up, there were no signs of recurrence.

Abstract The MIRACLE trial (MERS-CoV Infection tReated with A Combination of Lopinavir/ritonavir and intErferon-β1b) investigates the efficacy of a combination therapy of lopinavir/ritonavir and recombinant interferon-β1b provided with standard supportive care, compared to placebo provided with standard supportive care, in hospitalized patients with laboratory-confirmed MERS. The MIRACLE trial is designed as a recursive, two-stage, group sequential, multicenter, placebo-controlled, double-blind randomized controlled trial. The aim of this article is to describe the statistical analysis plan for the MIRACLE trial. The primary outcome is 90-day mortality. The primary analysis will follow the intention-to-treat principle. The MIRACLE trial is the first randomized controlled trial for MERS treatment. Trial registration ClinicalTrials.gov, NCT02845843. Registered on 27 July 2016.

The effect of external roof shading on the spatial distribution of air temperature and relative humidity in a greenhouse (Tin and RHin) was evaluated under the arid climatic conditions of Riyadh City, Saudi Arabia. Two identical, evaporatively-cooled, single-span greenhouses were used in the experiment. One greenhouse was externally shaded (Gs) using a movable black plastic net (30% transmissivity), and the other greenhouse was kept without shading (Gc). Strawberry plants were cultivated in both greenhouses. The results showed that the spatial distribution of the Tin and RHin was significantly affected by the outside solar radiation and evaporative cooling operation. The regression analysis showed that when the outside solar radiation intensity increased from 200 to 800 W m–2, the Tin increased by 4.5°C in the Gc and 2°C in the Gs, while the RHin decreased by 15% in the Gc and 5% in the Gs, respectively. Compared with those in the Gc, more uniformity in the spatial distribution of the Tin and RHin was observed in the Gs. The difference between the maximum and minimum Tin of 6.4°C and the RHin of 10% was lower in the Gs than those in the Gc during the early morning. Around 2°C difference in the Tin was shown between the area closed to the exhausted fans and the area closed to the cooling pad with the external shading. In an evaporatively-cooled greenhouse in arid regions, the variation of the Tin and RHin in the vertical direction and along the sidewalls was much higher than that in the horizontal direction. The average variation of the Tin and RHin in the vertical direction was 5.2°C and 10% in the Gc and 5.5°C and 13% in the Gs, respectively. The external shading improved the spatial distribution of the Tin and RHin and improved the cooling efficiency of the evaporative cooling system by 12%, since the transmitted solar radiation and accumulated thermal energy in the greenhouse were significantly reduced.