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Despite the continued improvements in pancreas transplant outcomes in recent decades, a subset of recipients experience graft failure and can experience substantial morbidity and mortality. Here, we summarize what is known about the failed pancreas allograft and what factors are important for consideration of retransplantation. The current definition of pancreas allograft failure and its challenges for the transplant community are explored. The impacts of a failed pancreas allograft are presented, including patient survival and resultant morbidities. The signs, symptoms, and medical and surgical management of a failed pancreas allograft are described, whereas the options and consequences of immunosuppression withdrawal are reviewed. Medical and surgical factors necessary for successful retransplant candidacy are detailed with emphasis on how well-selected patients may achieve excellent retransplant outcomes. To achieve substantial medical mitigation and even pancreas retransplantation, patients with a failed pancreas allograft warrant special attention to their residual renal, cardiovascular, and pulmonary function. Future studies of the failed pancreas allograft will require improved reporting of graft failure from transplant centers and continued investigation from experienced centers.

Institutionalization is a management strategy that differs from traditional management in that organizational structures are designed to be more flexible, participatory, and free of hierarchy and detail. Additionally, institutionalization emphasizes the efficient application of professional management strategies. In other words, institutionalization refers to creating a functional mechanism inside the firm. The textile industry in Yemen is vital to the nation's economy since it substantially contributes to economic development and creates jobs. Institutionalization, which is the process of establishing and adhering to formal rules, processes, and practices inside organizations, might affect its effectiveness. There are several other aspects as well. Within the framework of the Yemeni textile industry, the purpose of this research is to explore the influence that institutionalization has on the performance of employees. This research demonstrates the need to establish successful institutionalization within the Yemeni textile industry based on the literature review conducted before this study. Policymakers, managers, and industry stakeholders are urged to build and implement strong institutional frameworks that enable employee involvement, empowerment, and appreciation. These frameworks should be designed to maximize staff productivity. By doing so, businesses can improve their employees' performance, increase their productivity, and contribute to the continued expansion of the textile industry in Yemen.

Abstract Background Interstitial lung disease (ILD) is an increasingly recognized complication of rheumatoid arthritis (RA) and is associated with significant morbidity and mortality. Many risk factors for RA-related ILD were reported. The current study aims to explore the features and risk factors of Saudi patients with RA-ILD. Methods This is a multicenter, retrospective, observational study of patients with RA-ILD. Clinical and radiological data from patients with RA-ILD were obtained from electronic medical records, including demographics, clinical characteristics, laboratory tests, pulmonary function tests, ECHO, and HRCT images. Result Out of 732 patients, 57 had RA-ILD. The mean age at the time of ILD diagnosis was 61.9 (± 12.2) years. RA-ILD diagnosis was significantly less among females (p = 0.008). Patients who ever smoked had significantly more RA-ILD (p 0.05). The most common symptoms of RA-ILD were cough (55.6%) and dyspnea (30.2%), and the most common ILD pattern was Non-specific Interstitial Pneumonia (NSIP) (55.6%) followed by Usual Interstitial Pneumonia (UIP) (38.9%). Traction bronchiectasis (75.5%) and glass ground opacities (73.6%) were also observed. The mean FVC and DLCO at baseline were 64.6% and 53.3%, respectively. Conclusion In this cohort of patients, Saudi RA-ILD patients had a predominant NSIP pattern conversely to what is seen globally. These findings could be explained by the lower rates of smoking in our patient population. Future prospective national studies are needed to confirm the current findings and better evaluate RA-ILD epidemiology and risk factors.

Introduction: Carpal Tunnel Syndrome (CTS) presents with symptoms like numbness, tingling, and weakness along the median nerve pathway. Risk factors include prolonged wrist positions, repetitive muscle contractions, and exposure to vibrations. Aim: To determine the prevalence of CTS among healthcare practitioners at vaccine facilities in Saudi Arabia. Materials and Methods: A cross-sectional study on a total of 150 healthcare practitioners (aged 25-30 years) working in vaccination centres in Riyadh, Saudi Arabia were recruited. The study was conducted from November 2021 to March 2022. The authors collected demographic data, Body Mass Index (BMI) and work shift information, and administered two validated questionnaires, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and the Duruoz Hand Index (DHI). CTS symptoms were diagnosed using Phalen’s and Arm Raising Test (ART). Results: Of the 150 practitioners (aged 25-45 years), predominantly in the 25-30 age group, n=65 (44.0%) tested positive on the Phalen’s test, and n=65 (43.5%) on the ART. Females had higher BCTSQ scores, while DHI scores were similar across genders. Spearman's correlation analysis showed positive correlations between BCTSQ and DHI, and a moderate negative correlation between ART and DHI. Logistic regression analysed factors affecting the likelihood of CTS diagnosed by ART and Phalen’s Test. Higher BCTSQ and DHI scores increased the likelihood of CTS (ART: BCTSQ OR=0.843, DHI OR=1.064; Phalen’s Test: BCTSQ OR=0.830, DHI OR=1.069). Conclusion: During the Coronavirus Disease-2019 (COVID-19) pandemic, the prevalence of CTS among healthcare practitioners at vaccine centres in Riyadh, Saudi Arabia reached up to 43-44%. The present study highlights that day shift workers face a higher risk of CTS compared to night shift workers, likely due to heavier daytime workloads. This underscores the need for ergonomic interventions and workload management, especially during high-demand periods like the vaccination campaign, to safeguard healthcare workers’ health and productivity.

Algebra is a gatekeeper. For the 6% of students with dyscalculia (i.e., mathematical learning disabilities), an inability to pass algebra may significantly limit academic and career opportunities. Unfortunately, prior research on dyscalculia has focused almost exclusively on elementary-aged students' deficits in speed and accuracy in arithmetic calculation. This case study expands our understanding of dyscalculia by documenting how one college student with dyscalculia understood algebra during a one-on-one design experiment. A detailed case study of 19 video recorded sessions revealed that she relied upon unconventional understandings of algebraic quantities and notation, which led to persistent difficulties. The design experiment involved designing alternative tools to enable the student to reason about algebra, but the unconventional understandings persisted. This exploratory case study provides new insights into the character of difficulties that arose and persisted for one student with dyscalculia in the context of algebra and suggests the utility of documenting the persistent understandings that students with dyscalculia rely upon, particularly in understudied mathematical domains, like algebra.

أظهرت نتائج تحليل أوراق نبات الشاي الأخضر باستخدام جهاز GC-MSالمستخلصة بواسطة جهاز soxhlet باستخدام الإيتانول كمذيب وجود 24 مركب كيميائي من ثلاث مناطق مختلفة (بانياس – بستان الباشا - دمسرخو) مثلت نسبة 46.69% في بانياس، و17.66% في بستان الباشا، و33.65% في دمسرخو وكانت على النحو الآتي: في منطقة دمسرخو كانت نسبة المركبات النتروجينية 15.20%، ونسبة المركبات الهيدروكربونية 1.13%، ونسبة المركبات الفينولية 15.42%، وبلغت نسبة المركبات الأخرى 1.90%، أما في منطقة بانياس كانت نسبة المركبات النتروجينية 7.52%، ونسبة المركبات الهيدروكربونية 3.39%، ونسبة المركبات الفينولية 35.78%، وفي منطقة بستان الباشا كانت نسبة المركبات النتروجينية 12.62%، ونسبة المركبات الهيدروكربونية 2.35%، ونسبة المركبات الفينولية 2.69%. كما أظهرت نتائج تحليل أوراق نبات الشاي الأخضر باستخدام جهاز GC-MS المستخلصة بواسطة جهاز ultrasonic وجود 20 مركب كيميائي مثلت نسبة 38.17% في بانياس، و18.91% في بستان الباشا، و31.91% في دمسرخو وكانت على النحو الآتي: في منطقة دمسرخو كانت نسبة المركبات النتروجينية 12.19%، ونسبة المركبات الهيدروكربونية 14.74%، ونسبة المركبات الفينولية 4.98%، وفي منطقة بانياس كانت نسبة المركبات النتروجينية 6.24%، ونسبة المركبات الهيدروكربونية 1.46%، ونسبة المركبات الفينولية 30.47%، وفي منطقة بستان الباشا كانت نسبة المركبات النتروجينية 4.02%، ونسبة المركبات الهيدروكربونية 1.36%، ونسبة المركبات الفينولية 11.78%، وبلغت نسبة المركبات الأخرى 1.75%.

BackgroundChicken eggshells, a common poultry byproduct, are rich in calcium and provide a sustainable source for producing calcium oxide nanoparticles (CaO NPs). Their use in eco-friendly synthesis aligns with the growing emphasis on sustainable materials for environmental and biomedical applications. Objectives: This study develops an eco-friendly method for synthesizing CaO NPs from chicken eggshells, characterizes their physicochemical properties, and evaluates their antibacterial and antifungal activities. It also tests their effectiveness in removing heavy metal ions (Pb2⁺, Cr2⁺, Cd2⁺, and Hg2⁺) from aqueous solutions.MethodsCaO NPs were synthesized by calcining chicken eggshells at 700°C for 7 h. Comprehensive characterization included analysis of crystalline structure, morphology, optical properties, bandgap energy, chemical composition, and thermal stability. Antibacterial and antifungal activities were tested using the well-agar diffusion method. Batch adsorption experiments evaluated heavy metal ion removal under varying conditions of pH, temperature, stirring time, and adsorbent concentrationResultsThe synthesis produced spherical, single-crystal CaO NPs with diameters ranging from 5 to 30 nm and a crystalline size of approximately 20 nm. The nanoparticles had a bandgap energy of about 4.7 eV. Significant antibacterial activity was observed against Staphylococcus aureus, Klebsiella pneumoniae, and Escherichia coli, with increasing inhibition zones correlating with nanoparticle concentration. The CaO NPs also effectively inhibited Candida albicans. For efficient metal ion removal, the optimal conditions were found to be 30 min at pH 6 with 40 mg of CaO NPs at 25°C, achieving recovery rates of 98% for Pb2⁺, 97% for Cd2⁺, 97% for Cr2⁺, and 97% for Hg2⁺. For near-complete removal, extending the process to 70 min at pH 6 with 40 mg of CaO NPs at 45°C achieved the highest recovery rates: 99% for Pb2⁺, 98% for Cd2⁺, 99% for Cr2⁺, and 99% for Hg2⁺, though this approach involves higher energy and cost.ConclusionCaO NPs derived from chicken eggshells are effective antibacterial agents and adsorbents for heavy metal removal. These findings highlight their potential for sustainable applications in environmental and biomedical fields.

Though considerable research has been reported on COVID-19-related distance education, some dimensions of remote foreign language teaching experiences during the pandemic crisis remain to be explored. The study reported in this paper investigated Saudi university foreign language teachers' accumulated experiences and reflective beliefs of emergency remote instruction. The study focused specifically on: (a) the general educational challenges the teachers encountered and their attempts to overcome them; (b) the teachers' perceived difficulties in remotely teaching and assessing foreign language areas and their strategies for coping with them; and (c) their reflective evaluation of remote foreign language teaching after doing it for three academic terms. Questionnaire data was collected from 112 teachers of Arabic and English as foreign languages, and semi-structured interviews were conducted with 14 teachers. The analysis of both data types showed that the participants had a number of general educational and language-teaching-specific challenges in their COVID-19-related remote teaching. The teachers generally viewed the remote assessment of language areas is a more challenging task than teaching them. Reading was rated as the least difficult language area to teach and assess remotely, whereas writing was the most difficult one. The teachers reported using various coping strategies to overcome the educational and language teaching-specific challenges. They perceived their remote teaching experiences positively, but reported their needs for further training in developing better online assessment methods, using different teaching platforms and technological tools, and managing classroom interactions. The paper ends by discussing the results of the study and their implications.

Introduction Peritoneal dialysis (PD) is an alternative modality to hemodialysis (HD) for end-stage Kidney disease (ESKD) treatment. However, PD is underutilized, and patients’ knowledge about PD is crucial in making an informed decision about the dialysis modality. This study aims to evaluate the knowledge about PD among HD patients and explore the reasons for its underutilization.Materials and methods A cross-sectional study of 108 HD patients was conducted from August to November 2023, at Al-Jaber Dialysis Center in Al-Ahsa. They interviewed to assess the knowledge about PD and explore the reasons for its underutilization.Results The patients’ ages ranged from 20 to 80 years, with a mean age of 44.2 years. Regarding knowledge about PD, 81.5% of the ESKD patients had heard about other renal replacement modalities, with kidney transplant being the most commonly known option. Only 11.1% were aware of both kidney transplants and PD. 60.2% of patients reported that their nephrologists had discussed other treatment options with them. However, overall knowledge about PD among patients was relatively low, with 43.5% having good knowledge and 56.5% having poor knowledge. Lack of information, considering HD as a better method, and fear of complications were the primary reasons for not considering PD as the first treatment option.Conclusion This study highlights the inadequate knowledge about PD among HD patients and identifies factors contributing to the underutilization of PD. Lack of information, misconceptions about the effectiveness and safety of PD, and preference for HD were significant barriers. Enhancing patient education and addressing misconceptions are crucial in promoting PD as a viable treatment option for ESKD, thereby improving patients’ quality of life.

The management of failing kidney allograft and transition of care to general nephrologists (GN) remain a complex process. The Kidney Pancreas Community of Practice (KPCOP) Failing Allograft Workgroup designed and distributed a survey to GN between May and September 2021. Participants were invited via mail and email invitations. There were 103 respondents with primarily adult nephrology practices, of whom 41% had an academic affiliation. More than 60% reported listing for a second kidney as the most important concern in caring for patients with a failing allograft, followed by immunosuppression management (46%) and risk of mortality (38%), while resistant anemia was considered less of a concern. For the initial approach to immunosuppression reduction, 60% stop antimetabolites first, and 26% defer to the transplant nephrologist. Communicating with transplant centers about immunosuppression cessation was reported to occur always by 60%, and sometimes by 29%, while 12% reported making the decision independently. Nephrologists with academic appointments communicate with transplant providers more than private nephrologists (74% vs. 49%, p = 0.015). There are heterogeneous approaches to the care of patients with a failing allograft. Efforts to strengthen transitions of care and to develop practical practice guidelines are needed to improve the outcomes of this vulnerable population.