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Early education helping young children manage prejudiced attitudes towards themselves and others is urgent. Early childhood (EC) teachers in Saudi Arabia are making significant changes by applying an anti-bias approach to deal with such issues with young children. In the study reported on here we used a quantitative approach to explore anti-bias education, including an analysis of approaches to the cultural environment, which includes teaching practices and associated learning resources. Many teachers (n = 142) in the cities of Jeddah and Riyadh in Saudi Arabia contributed to this study by completing a questionnaire. Teachers' classroom practices, such as role-play, pictures, books, toys, and materials in teaching children the concept of antibias, were deeply explored. The results of the study show that the greater the previous experience of teachers in teaching children from a culture different from their own, the greater the application of the concept of anti-bias in creating the classroom environment. There is a need for further studies on the extent to which anti-bias education is being implemented on a larger scale in primary schools in Saudi Arabia. more...

This study examines the role of learning-centred leadership practices of school principals towards the fulfilment of teachers' basic psychological needs, which, in turn, predict the wellbeing of teachers. The data was collected from 1124 teachers from 37 primary and secondary schools in Riyadh province of the Kingdom of Saudi Arabia. Structural equation modelling (SEM) was employed to test the hypothetical relationships. The results affirmed the significant effect of school principals' learning-centred leadership practices on teacher wellbeing via the fulfilment of teachers' basic psychological needs. The findings provide important insights into how learning-centred school leadership can provide a school environment that would ensure the positive wellbeing of teachers, which, in turn, would lead to better academic achievement of students. more...

Chemotherapy-induced cytopenia (CIC) is characterized by neutropenia, anemia, and thrombocytopenia, which are common and serious complications in cancer treatment. These conditions affect approximately 60% of patients undergoing chemotherapy and can significantly impact quality of life, treatment continuity, and overall survival. The use of growth factors, including granulocyte colony-stimulating factors (GCSFs), erythropoietin-stimulating agents (ESAs), and thrombopoietin receptor agonists (TPO-RAs), has emerged as a promising strategy for managing CIC. However, the use of these growth factors must be approached with caution. This review provides an overview of the mechanisms, efficacy, and safety of growth factors in the management of CIC. Additionally, we discuss predictive markers for treatment response, potential risks, and highlight areas for future research. more...

This study investigated the potential impact of Internet connection quality and device compatibility on learners' adoption of Massive Open Online Courses (MOOCs) by employing the Technology Acceptance Model as a framework. A descriptive cross-sectional research design was applied to data collected from 1,587 learners, followed by a two-way multivariate analysis of variance. The results showed that the Internet connection quality and device compatibility factors affected learners' acceptance of MOOCs when the factors were tested together (p = 0.004), or separately (p < 0.001). Moreover, Internet connection quality and device compatibility factors affected learners' perceived usefulness (p < 0.001), ease of use (p = 0.008), and their intention towards continued use of MOOCs (p = 0.006). This study provided significant evidence for the need to consider learners with low Internet connectivity and device compatibility when designing MOOCs. It thereby implies that designers of MOOCs should develop alternative learning modalities to accommodate individuals with limited Internet connectivity. This approach aims to not only augment the initial adoption of MOOCs but also ensure their long-term viability and endurance. Specifically, the study recommends the creation of low-bandwidth versions of MOOCs, and the implementation of offline viewing options to mitigate bandwidth constraints and enhance learners' receptiveness to them. This strategic approach, in turn, is anticipated to facilitate the wider diffusion and sustainability of MOOCs. more...

ABSTRACT Background and Aims Antibiotic resistance in Saudi Arabia has led to decreased efficacy of conventional triple therapy for Helicobacter pylori (H. pylori) eradication, prompting the development of alternative treatments like levofloxacin‐based triple and bismuth‐based quadruple therapies. However, comparative data regarding its efficacy are lacking. Therefore, this study's goal was to compare the efficacy of levofloxacin‐based triple therapy with that of standard bismuth‐based quadruple therapy as first‐line regimens. Methods This retrospective analysis included 197 treatment‐naïve adults with H. pylori infection who received levofloxacin‐based triple (levofloxacin + amoxicillin + PPI) therapy (n = 81) or standard bismuth‐based quadruple (bismuth + tetracycline + metronidazole + PPI) therapy (n = 116). H. pylori eradication was evaluated 4–8 weeks after medication administration using the 13C‐urea breath test, and variables that could affect the rate of success were examined. Results There were no differences between groups in terms of age, sex, nationality, or type of proton pump inhibitor (PPI) used. The bismuth‐based quadruple therapy group exhibited a markedly superior success rate compared to the levofloxacin‐based triple therapy group when the latter was administered for 7 or 10 days (81.03% vs. 6.66%, p more...

Background: Deep vein thrombosis (DVT) is a leading cause of death disability. DVT can be classified based on the location and extent of the clot into isolated distal DVT (iDDVT), isolated proximal DVT (iPDVT), or mixed DVT. The aim of this study is to explore the baseline characteristics and clinical outcomes of patients with different types of DVT. Methods: This was a retrospective study of patients who experienced their first DVT event and received an anticoagulant for management. The outcomes of this study include evaluating patients’ characteristics for patients with DVT and assessing the incidence of recurrent DVT, major bleeding (MB), VTE-related rehospitalization, and DVT-related inpatient mortality across different types of DVT. Results: A total of 493 patients were included in the study. Of those, 273 (55.4%) had iPDVT, 25 (5.1%) had iDDVT, and 195 (39.6%) had mixed DVT. The VTE etiology was similar across the groups except for the leg injury, which was significantly higher in patients with iDDVT (24%) compared to iPDVT (6.2%) and mixed DVT (5.6%) ( P = .002). At 12 months, a total of 49 patients (9.9%) had a recurrent DVT event; 25 (9.2%) in the iPDVT group, 3 (12.0%) in the iDDVT group, and 21 (10.8%) in the mixed DVT group ( P = .797). Rates of MB, re-hospitalization, and death from DVT were similar between the groups. Conclusion: Baseline characteristics were not significantly linked to the risk of developing a specific type of lower extremity DVT. Long-term outcomes were similar across all DVT types. more...

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

Background: Nursing staff outcomes, such as job satisfaction, work quality, emotional well-being, intent to leave, and the practice environment, have been linked to improvements in patient outcomes and staff job satisfaction. However, existing studies have not captured the impact of nursing models on emotional exhaustion and practice environments in the context of Saudi Arabia. Additionally, there is a gap in empirical evidence regarding the effectiveness of organizing nursing work within a total nursing or team nursing care model in ensuring staff well-being. Objective: This study aimed to examine the nursing care models used in a government hospital and their association with nurses’ emotional exhaustion and perceptions of the practice environment. Methods: A cross-sectional study was conducted with 314 nurses working at a hospital. Data were collected from January to May 2024 using the Maslach Burnout Inventory™ (MBI) to measure emotional exhaustion and the Practice Environment Scale of the Nursing Work Index (PES-NWI) to assess perceptions of the practice environment. Regression analyses were performed to examine the relationships between the nursing care model, emotional exhaustion, and the practice environment. Results: Among the 314 nurses surveyed, 201 (64%) reported using a total care model, 103 (32.8%) used a team nursing model, and 10 (3.2%) were unsure of the model used. Regression analysis revealed a significant association between the nursing care model and emotional exhaustion (p more...

In today’s highly competitive airline industry, understanding the factors that influence customer loyalty is paramount for airline companies seeking to maintain a competitive edge. This study investigates the impact of Electronic Customer Relationship Management (E-CRM) on customer loyalty within the context of the airline industry, with a specific focus on the mediating role of customer experience. By examining how E-CRM strategies influence customer loyalty and the underlying mechanisms through which customer experience mediates this relationship, this research aims to provide valuable insights for airline companies striving to enhance customer satisfaction and retention. Using a quantitative research approach, the study targeted Royal Jordanian travelers as the primary research participants. A sample of 386 individuals who have flown with Royal Jordanian Airlines was selected using a convenience sampling method. Data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) Version 26. This study reveals that E-CRM dimensions have a statistically significant impact on customer loyalty and experience. Furthermore, the findings show that customer experience mediates the relationship between E-CRM dimensions and customer loyalty. In light of these findings, this study recommends focusing on improving the effectiveness and reliability of the Royal Jordanian Airlines website. This includes initiatives aimed at improving a website’s efficiency, strengthening security measures, and ensuring a high level of dependability to increase customer loyalty. more...

Recent developments have seen a significant increase in the number of educational videos being made, mostly for use as a resource in a range of educational levels and different specializations. Indeed, currently, many universities either provide videos as supplementary resources or, indeed, offer entire courses as online learning materials. The qualitative study this paper presents was conducted to answer the following questions: "How have educational videos (lectures/tutorials) published on YouTube affected the university students' studies at both postgraduate and undergraduate levels?" and "would it be better to upload these types of videos onto a university website?" The aim was to explore the experiences of students from two universities (one a high-ranking university and one from a developing country) regarding online educational videos and to assess the extent to which these kinds of videos influence their studies. The data collection method used was individual interviews with students from two different universities to gather their perspectives, their opinions, and their aspirations regarding such videos. The results section analyzes and discusses the students' varied opinions. Based on the research findings, several recommendations are made to develop a useable design to add videos to university websites. Finally, the research discussed how this study's findings contribute during the COVID-19 pandemic. more...

Research on intelligent secured virtual assistant (ISVA) systems for disabled people is essential in order to meet the special requirements and overcome the difficulties they confront. The delicate nature of user interactions makes security and privacy considerations paramount in virtual assistant platforms. The gaps and weaknesses in existing systems can be identified by researching the context of current practice concerning their features, usability, limits in security procedures, and privacy restrictions. Therefore, we present a framework that combines blockchain-based security with federated learning (FL) to address the current shortcomings of virtual assistant technology. The examination focuses on two primary facets of cutting-edge virtual assistants. Firstly, it evaluates existing IoT-based virtual personal assistant systems designed for persons with disabilities, examining their features, usability, and limitations. The aim is to identify the specific needs and requirements of individuals with disabilities, considering their unique challenges and preferences in utilizing virtual assistant technologies. Second, considering the sensitivity of the information sent between users and virtual assistants, it explores the issues of security and privacy that arise while using such systems. The investigation covers authentication, data encryption, access control, and data privacy rules to provide a snapshot of the prevailing state protecting virtual assistants. Besides this, the framework strengthens the privacy and security of virtual assistants using blockchain technology. Through several empirical trials, it is found that the framework maintains better performance and usability, along with the provision of robust security mechanisms to safeguard user data and guarantee privacy. more...

In recent years, there have been several attempts to help visually impaired and illiterate people to overcome their reading limitations through developing different applications. However, most of these applications are based on physical button interaction and avoid the use of touchscreen devices. This research mainly aims to find a solution that helps both visually impaired and illiterate people to read texts present in their surroundings through a touchscreen-based application. The study also attempts to discover the possibility of building one application that could be used by both type of users and find out whether they would use it in the same efficiency. Therefore, a requirements elicitation study was conducted to identify the users’ requirements and their preferences and so build an interactive interface for both visually impaired and illiterate users. The study resulted in several design considerations, such as using voice instructions, focusing on verbal feedback, and eliminating buttons. Then, the reader mobile application was designed and built based on these design preferences. Finally, an evaluation study was conducted to measure the usability of the developed application. The results revealed that both sight impaired and illiterate users could benefit from the same mobile application, as they were satisfied with using it and found it efficient and effective. However, the measures from the evaluation sessions also reported that illiterate users had used the develop app more efficiently and effectively. Moreover, they were more satisfied, especially with the application’s ease of use. more...

تم التحقيق في تأثير القيادة الفوضوية على رضا المعلمين عن وظائفهم في المؤسسات التعليمية السعودية في هذه الدراسة. قدم 90 معلمًا معلومات عبر استبيان منظم، وتم جمع البيانات باستخدام منهج البحث الوصفي والعينة العشوائية الطبقية. تظهر النتائج أنه في حين يوجد نقص في سلوكيات القيادة السلبية، لا يزال هناك مجال للتطور في مجالات توزيع الواجبات وحل النزاعات. ويضع المعلمون قيمة عالية على قدرة المديرين على حل المشكلات والتواصل بشكل متسق. والرضا الوظيفي، بشكل عام، جيد إلى حد ما، كما أن فرص النمو المهني والمساعدة الإدارية ذات قيمة عالية. ولزيادة الرضا الوظيفي وفعالية القيادة، تقترح الدراسة تشجيع الاعتراف بالأداء، وزيادة المشاركة في صنع القرار، والحفاظ على التواصل المفتوح. وقد أظهر المعلمون اتفاقًا عاليًا مع العبارة "بشكل عام، أشعر بالرضا عن وظيفتي" (المتوسط ​​= 3.52). وعلى الرغم من أنها ليست في قمة الرضا، فإن هذا المستوى يشير إلى أن المعلمين راضون بشكل عام عن وظائفهم، حتى في المجالات التي لا يوجد فيها سوى اتفاق معتدل. وبشكل عام، يتأثر الرضا الوظيفي الإجمالي أيضًا بالسمعة التي بناها المعلمون من خلال التدريس (المتوسط ​​= 3.72) والشعور بالاحترام المجتمعي لمهنتهم (المتوسط ​​= 3.59). لقد بلغ متوسط ​​الرضا الوظيفي (3.48) وهو مرتفع، بينما بلغ متوسط ​​القيادة الفوضوية (3.02) وهو متوسط ​​من وجهة نظر المعلمين السعوديين، وبلغ معامل الارتباط بين القيادة الفوضوية والرضا الوظيفي (0.031) وقيمة R2 0.001))، ويشير الانحدار المحسوب إلى عدم وجود تأثير للقيادة الفوضوية في التنبؤ بالرضا الوظيفي من وجهة نظر المعلمين في المدارس السعودية. more...

Background: With the growing incidence of diabetic-related complications such as retinopathy and the well-understood role of screening and telemedicine around the world in preventing and managing this potentially blinding disease, there comes the importance of awareness toward this silent eye condition. Awareness ideally should be raised both from the patients' and physicians' perspectives. This study aims to assess the awareness of primary care physicians (PCPs) towards diabetic retinopathy (DR) and its management. Materials and Methods: A survey considering professional background, knowledge, and practices was distributed electronically to all PCPs in the Kingdom of Bahrain and analyzed using SPSS Vs 21. Results: A total of 83 physicians completed the survey; 81.9% were female and 96.4% were Bahraini. More than 60% of them accurately knew screening guidelines for type 1 and 2 DR. Of the total, 72.5% would refer patients to the ophthalmologist even if asymptomatic, and 97.6% correctly stated that a dilated eye exam is the method of choice most efficient for assessing DR. Nearly 60% knew about the current treatment modalities for DR and 91.3% knew about the presence of a national screening program in the Kingdom. Conclusion: The overall knowledge of DR was good with some potential gaps in information about screening. PCPs could benefit from regular refresher courses for more precise practices on screening and referral of retinopathy. more...

AbstractOral squamous cell carcinoma (OSCC) is the most common epithelial tumor of the oral cavity. Gingival tumors, a unique type of OSCC, account for 10% of these malignant tumors. The antineoplastic properties of statins, including pitavastatin (PV), and the essential oil of the Pinus densiflora leaf (Pd oil) have been adequately reported. The goal of this investigation was to develop nanostructured lipid carriers (NLCs) containing PV combined with Pd oil and to determine their cytotoxicity against the cell line of human gingival fibroblasts (HGF-1). A central composite quadratic design was adopted to optimize the nanocarriers. The particle size and stability index of the nano-formulations were measured to evaluate various characteristics. TEM analysis, the entrapment efficiency, dissolution efficiency, and the cytotoxic efficiency of the optimized PV-loaded nanostructured lipid carrier drug delivery system (PV-Pd-NLCs) were evaluated. Then, the optimal PV-Pd-NLCs was incorporated into a Carbopol 940® gel base and tested for its rheological features and its properties of release and cell viability. The optimized NLCs had a particle size of 98 nm and a stability index of 89%. The gel containing optimum PV-Pd-NLCs had reasonable dissolution efficiency and acceptable rheological behavior and acquired the best cytotoxic activity against HGF-1 cell line among all the formulations developed for the study. The in vitro cell viability studies revealed a synergistic effect between PV and Pd oil in the treatment of gingival cancer. These findings illustrated that the gel containing PV-Pd-NLCs could be beneficial in the local treatment of gingival cancer. more...

Here, we, for the first time, compared the cardioprotective effects of third-generation vasodilating beta-blocker nebivolol (Neb) and conventional beta-blocker metoprolol (Met) on LPS-induced injury in H9c2 cardiomyoblasts. Our findings denoted that Neb and Met pretreatment diminish LPS-mediated cytotoxicity and oxidative stress. Concomitantly, LPS-triggered inflammatory cytokines activation was significantly suppressed by Neb but not by Met. Pretreatment with either Neb or Met alleviated LPS-mediated mitochondrial impairment by enhancing the expression of genes related to its biogenesis such as PGC-1α, NRF1, and TFAM. On the contrary, Neb but not Met-upregulated mitochondrial fusion-related genes such as OPA, and MFN2. In summary, our findings suggest that Neb and Met treatment significantly ameliorated the LPS-induced cytotoxicity and oxidative stress. Additionally, these findings suggest that Neb but not Met significantly down-regulates LPS-induced proinflammatory factors, probably by enhancing mitochondrial biogenesis and fusion. more...

BACKGROUND: Infection is the second-leading cause of death among cancer patients, but there have been few studies on the effectiveness of novel antimicrobial agents to treat carbapenem-resistant Enterobacterales in cancer patients. OBJECTIVE: Evaluate the mortality and clinical outcomes of ceftazi-dime-avibactam for OXA-48- and/or New Delhi metallo-β-lactamase (NDM)-producing Enterobacterales infection in cancer patients. DESIGN: Retrospective observational cohort study SETTING: Tertiary academic medical center in Riyadh, Saudi Arabia SUBJECTS AND METHODS: This study included patients who had cancer and received ceftazidime-avibactam for at least 72 hours for infections caused by OXA-48- and/or NDM-producing Enterobacterales. We excluded patients who died within 72 hours of treatment, patients with polymicrobial infections, and patients who did not receive appropriate antimicrobial therapy. MAIN OUTCOMES AND MEASURES: Primary outcomes were 30-day mortality and hospital mortality. Secondary outcomes included clinical cure, relapse, and reinfection. SAMPLE SIZE: 32 cancer patients RESULTS: The 30-day mortality among all patients was 15/32 (47%), clinical cure was achieved in 19/32 (59%) of the patients, and the relapse and reinfection rates were 2/19 (10.5%) and 4/17 (23.5%), respectively. CONCLUSION: This is the largest study to evaluate clinical outcomes associated with infections caused by OXA-48- and/or NDM-producing Enterobacterales in cancer patients. The mortality rate remains high; however, ceftazidime-avibactam is an encouraging alternative for treating severe infections in cancer patients. LIMITATIONS: Small sample size and single center. more...

Samar Abdullah AlGhamdi,1 Khaled Altowairqi,1 Yazan Ghazi Altowairqi,1 Hanaa Alkharobi,1 Eman Alfayez,1 Rowaina Mansouri,1 Bushra Aljahdali,2 Arwa Badahdah,2 Naif Mari Alqarni,3 Ghadah Sidqi Qumusan,3 Aziza Alrafiah4 1Department of Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 3AlRuhaily Medical Center, General Dentistry, Jeddah, Saudi Arabia; 4Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi ArabiaCorrespondence: Aziza Alrafiah, Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia, Email aalrafiah@kau.edu.saBackground: Sex hormones strongly influence the health and ailment of the oral cavity. For instance, a woman’s oral health is influenced by her menstrual cycle, menopause, pregnancy, and usage of oral contraceptives. The use of various therapeutic medication results in intraoral alterations. Oral contraceptive pills (OCPs) are among the drugs that produce intraoral alterations. The study’s objective was to evaluate attitudes and oral health conditions of Saudi women’s utilizing OCPs in Jeddah, Saudi Arabia.Methods: A cross-sectional questionnaire-based study was conducted among Saudi women in Jeddah, Saudi Arabia. The self-administered questionnaire was made and sent to women to evaluate the attitude and oral health condition of women utilizing OCPs. The women using OCPs were asked to self-administer 17 questions to evaluate attitudes and oral health conditions. The questionnaire had multiple-choice questions and was consisted of four sections.Results: The number of participants who used contraceptives was 125 (35.9%) women; of them, only 94 (75.2%) used oral contraceptives. The duration of using oral contraceptives mainly was 1– 5 years (39.4%), then > 5 years (34.0%), and < 1 year (26.6%). Of the 94 women, 34 (36.2%) had gingival diseases, 23 (24.5%) treated their gums; and 13 (13.8%) cleaned their gums at a dental clinic regularly. Times of teeth brushing per day were one time in 32 women (34%), twice in 47 women (50.0%), and three times in 15 (16.0%). Of the 94 women, 4 (4.3%) were smoking, 24 (25.5%) took medication other than OCPs, and 16 (17.02%) had chronic diseases. Common oral complications noticed by participants were gum bleeding after brushing (51.6%), dental caries (25.5%), and oral ulcers (10.6%).Conclusion: Females on OCPs had a high rate of gingival bleeding, dental caries, and oral ulcers. OCPs users had poor periodontal and gingival health. Establishing an oral hygiene program was necessary to treat gingival and periodontal inflammation that exacerbated by OCPs.Keywords: oral contraceptives, oral cavity, attitude, women more...

Abstract We investigated how preservice teachers observe and analyze their competencies through self-reflection and video-learning community strategies and how self-recorded videos influence their microteaching experience. We aimed to improve preservice teachers’ competencies in light of the Saudi National Professional Teaching Standards. Semi-structured interviews were conducted, and a thematic analysis was performed to extract themes identifying preservice teachers’ experiences and perceptions. The results indicated that the use of self-recorded videos can influence the microteaching experience and help identify development gaps, analyze weaknesses and strengths, and reflect upon them. The results showed that preservice teachers hold positive perceptions and experiences of self-recorded videos to improve their Saudi National Professional Teaching Standards competencies via self-reflection and video learning community. Furthermore, personalized learning principles benefit preservice teacher training programs through self-reflection and self-analysis without coach intervention. This study presents discussions, implications, and recommendations that are relevant to both researchers and practitioners. more...

Quorum-sensing inhibitors have recently garnered great interest, as they reduce bacterial virulence, lower the probability of resistance, and inhibit infections. In this work, meta-bromo-thiolactone (mBTL), a potent quorum and virulence inhibitor of Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA), was formulated in chitosan nanoparticles (ChNPs) using the ionic gelation method. The mBTL-loaded-ChNPs were characterized by their particle size, polydispersity index, zeta potential, morphology, and drug release profile. The results show that the mBTL-loaded-CNPs comprised homogenized, spherical nanoparticles ranging from 158 ± 1.3 to 284 ± 5.6 nm with a sustainable release profile over 48 h at 37 °C. These findings confirm the successful preparation of mBTL-loaded-ChNPs. Confocal laser scanning microscopy showed a significant reduction in the number of viable cells, indicating the antibacterial efficacy of mBTL. Biofilms were observed by scanning electron microscopy, which showed that the bacterial cells in the control experiment were enclosed in thick biofilms. In the presence of mBTL, the bacterial cells remained disordered and did not form a biofilm. mBTL-loaded-ChNPs represent a potential approach to overcoming antimicrobial resistance in the treatment of MRSA infection. more...

The study aimed to develop a biodegradable scaffold incorporating valproic acid (VPA) for improved human bone marrow-derived mesenchymal stem cell (hBMSC) proliferation, differentiation, and bone mineral synthesis. A chitosan–gelatin (CH-G) scaffold was fabricated and loaded with varying concentrations of VPA (1, 3, 5 mM/L). In vitro studies assessed drug release, cell proliferation, morphology, mineralization, and gene expression. VPA was rapidly released from the scaffold, with over 90% cumulative release within seven days. Cells cultured on VPA-loaded scaffolds exhibited significantly enhanced proliferation and mineralization compared to the control. VPA treatment upregulated osteocalcin and runt-related transcription factor 2 (Runx-2) expression, key markers of osteogenic differentiation. The CH-G scaffold, particularly with 1 mM/L VPA, demonstrates excellent biocompatibility and promotes hBMSC-mediated bone regeneration. This novel approach holds promise for future applications in bone tissue engineering. more...

Background: The choice of prosthesis for aortic valve replacement (AVR) remains challenging. The risk of anticoagulation complications vs. the risk of aortic valve reintervention should be weighed. This study compared the outcomes of bioprosthetic vs. mechanical AVR in patients older and younger than 50. Methods: This retrospective study was conducted from 2009 to 2019 and involved 292 adult patients who underwent isolated AVR. The patients were divided according to their age (above 50 years or 50 years and younger) and the type of valves used in each age group. The outcomes of bioprosthetic valves (Groups 1a (>50 years) and 1b (≤50 years)) were compared with those of mechanical valves (Groups 2a (>50 years) and 2b (≤50 years)) in each age group. Results: The groups had nearly equal rates of preexisting comorbidities except for Group 1b, in which the rate of hypertension was greater (32.6% vs. 14.7%; p = 0.025). This group also had higher rates of old stroke (8.7% vs. 0%, p = 0.011) and higher creatinine clearance (127.62 (108.82–150.23) vs. 110.02 (84.87–144.49) mL/min; p = 0.026) than Group 1b. Patients in Group 1a were significantly older than Group 2a (64 (58–71) vs. 58 (54–67) years; p = 0.002). There was no significant difference in the NYHA class between the groups. The preoperative ejection fraction and other echocardiographic parameters did not differ significantly between the groups. Re-exploration for bleeding was more common in patients older than 50 years who underwent mechanical valve replacement (p = 0.021). There was no difference in other postoperative complications between the groups. The groups had no differences in survival, stroke, or bleeding rates. Aortic valve reintervention was significantly greater in patients ≤ 50 years old with bioprosthetic valves. There were no differences between groups in the changes in left ventricular mass, ejection fraction, or peak aortic valve pressure during the 5-year follow-up. Conclusions: The outcomes of mechanical and bioprosthetic valve replacement were comparable in patients older than 50 years. Using bioprosthetic valves in patients younger than 50 years was associated with a greater rate of valve reintervention, with no beneficial effect on the risk of bleeding or stroke. more...

Azacitidine, a hypomethylating agent, has caused a paradigm shift in the outcomes of patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) who are not eligible for stem cell transplantation, particularly in combination with BCL2 and IDH inhibitors. Azacitidine and Azacitidine-based combinations have been widely considered a safe low-intensity therapy when compared to traditional conventional treatments. The development of lung toxicity from azacitidine is not a well-characterized adverse event. However, if it happens, it can be fatal, especially if not recognized and treated promptly. In this review, we aim to familiarize the reader with the presentation of azacitidine-induced lung injury, provide our suggested approach to management based on our experience and the current understanding of its mechanism, and review the literature of 20 case reports available on this topic. more...

Web-based applications are popular in demand and usage. To facilitate the development of web-based applications, the software engineering community developed multiple web application frameworks, one of which is Flask. Flask is a popular web framework that allows developers to speed up and scale the development of web applications. A review of the software engineering literature revealed that the Stack Overflow (SO) website has proven its effectiveness in providing a better understanding of multiple subjects within the software engineering field. This study aims to analyze SO Flask-related questions to gain a better understanding of the stance of Flask on the website. We identified a set of 70,230 Flask-related questions that we further analyzed to estimate how the interest towards the framework evolved over time on the website. Afterward, we utilized the Latent Dirichlet Allocation (LDA) algorithm to identify Flask-related topics that are discussed within the set of the identified questions. Moreover, we leveraged a number of proxy measures to examine the difficulty and popularity of the identified topics. The study found that the interest towards Flask has been generally increasing on the website, with a peak in 2020 and drops in the following years. Moreover, Flask-related questions on SO revolve around 12 topics, where Application Programming Interface (API) can be considered the most popular topic and background tasks can be considered the most difficult one. Software engineering researchers, practitioners, educators, and Flask contributors may find this study useful in guiding their future Flask-related endeavors. more...