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Anwar E Ahmed,1,2 Abdulrahman G Alharbi,3 Mohannad A Alsadhan,4 Alaa S Almuzaini,5 Hanin S Almuzaini,5 Yosra Z Ali,6 Abdul-Rahman Jazieh6 1King Abdullah International Medical Research Center (KAIMRC), 2College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, 3College of Medicine, Imam Abdulrahman Al Faisal University, Dammam, 4College of Medicine, King Saud University, 5College of Medicine, King Saud bin Abdulaziz University for Health Sciences, 6Department of Oncology, King Abdulaziz Medical City, Riyadh, Saudi Arabia Background: The protocols for treatment, along with many adverse effects, can strongly affect cancer patients’ quality of life (QoL). As there is limited research on the QoL of Saudi Arabian women being treated for breast cancer, the purpose of this study was to identify the predictors of poor QoL in a sample of Saudi women with breast cancer. Methods: A cross-sectional study was conducted on 145 Saudi women with breast cancer who attended the Oncology Outpatient Clinic at King Abdulaziz Medical City, Riyadh for routine follow-up. Sociodemographic and clinical data were collected for each patient, and a Medical Outcome Study Health Survey 36-Item Short Form (SF-36) instrument was used to assess QoL. Results: Of 145 breast cancer patients studied, 42.1% had a family history of cancer and 52.4% were newly diagnosed cancer patients (first-year-after-cancer diagnosis). According to linear regression analyses, cancer patients with metastasis tended to have pain, along with poor physical function, little vitality, and poor general health (a decrease in SF-36 scores of 22.9, 15.0, 19.4, and 16.9, respectively). Regular exercise was a positive predictor of poor general health (an increase in the SF-36 score of 8.2). Patients with first-year-after-cancer diagnoses tended to have poor emotional well-being (a decrease in the SF-36 score of 8.5). Conclusion: In breast cancer patients, regular exercise was a significant positive predictor of better general health. Breast cancer patients with multiple tumors, metastasis, or fever tended to experience significantly poor QoL in several SF-36 domains. Clearly, a routine assessment of QoL in breast cancer patients is important. Keywords: multiple tumors, fever, metastasis, regular exercise, SF-36

Oleuropein (OLP) is a naturally occurring phenolic compound in olive plant with antioxidant and anti-inflammatory potential and can possibly be used in treating pancreatic injuries. This investigation aimed to follow the molecular mechanism behind the potential therapeutic effect of OLP against pancreatic injury persuaded by ischemia-reperfusion (I/R). Pancreatic I/R injury was induced by splenic artery occlusion for 60 min followed by reperfusion. Oral administration of OLP (10 and 20 mg/kg) for 2 days significantly alleviated I/R-persuaded oxidative damage and inflammatory responses in pancreatic tissue as indicated by the decreased malondialdehyde (MDA) content and increased glutathione peroxidase (GPx) activity, accompanied by the suppression of myeloperoxidase (MPO) activity and reduced levels of interleukin-1beta (IL-1β), nuclear factor kappa B (NF-κB), and tumor necrosis factor alpha (TNF-α) in pancreatic tissues. Furthermore, OLP treatment markedly restored the serum levels of amylase, trypsinogen-activated peptide (TAP), and lipase, with concurrent improvement in pancreatic histopathological alterations. Moreover, treatment with OLP regulated the pancreatic expression of inducible nitric oxide synthase (iNOS) and high-mobility group box 1 (HMGB1) relative to rats of the pancreatic IR group. Thus, OLP treatment significantly alleviates the I/R-induced pancreatic injury by inhibiting oxidative stress and inflammation in rats through downregulation of HMGB1 and its downstream NF-κB signaling pathway.

Epidermodysplasia verruciformis (EV) is a rare, lifelong, autosomal recessive genodermatosis characterized by susceptibility to certain human papillomavirus (HPV) types and increased risk of skin cancer. This report describes a 22-year-old male presenting with multiple flat erythematous papules on the trunk and extremities. Histopathological examination of a skin biopsy revealed features consistent with EV, including hypergranulosis, hyperkeratosis, and acanthosis, with notable keratohyalin granules and perinuclear vacuolization of keratinocytes. No mitotic activity or cellular atypia was observed. This case underscores the importance of early diagnosis and management of EV, which includes genetic counseling, photoprotection, and regular monitoring for premalignant lesions. Treatment options, ranging from pharmacologic interventions to surgical excision, aim to mitigate the risk of malignant transformation. This report highlights the clinical and histopathological presentation of EV, contributing to the understanding and management of this rare genodermatosis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alenazi et al.)

Saudi Arabia guarantees citizens the right to receive medical care and treatment during emergencies or sickness and aging. However, with the consistent increase in expenditure and inability to provide access, the transformation was an unavoidable action. Therefore, this paper aims to address the potential and risks behind the National Transformation Program (NTP) in Saudi Arabia through the lens of the Value Transformation Framework. Multiple research databases (PubMed, Web of Science, UpToDate, Google Scholar, and Summon) were searched between 2016 and 2024. Relevant articles were selected by scanning the title and abstract, yielding 34 references after the screening, exclusion, and inclusion criteria were met. Citation software was used to identify additional sources as analysis proceeded, in accordance with the hermeneutic approach in mapping and classification. The most cited concerns were the sustainability and workforce of the healthcare system. In terms of care delivery, the literature was extensive. In contrast, insufficient studies have been conducted on infrastructure and people. Furthermore, limited information is available on how to assess the transformation, which remains an unaddressed research question. NTP could meet several hurdles. However, through the measurement, assessment phases, and development tracking, success could be achieved., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alkhurayji et al.)

Introduction The advent of mRNA-based vaccines has been a pivotal milestone in the global response to the pandemic, prompting widespread vaccination campaigns, including in Saudi Arabia. This study investigates self-reported physician-diagnosed cardiac complications post mRNA vaccination in Saudi Arabia, recognizing the need to monitor these rare events. The research aimed to study the self-reported physician-diagnosed incidence, nature, and associated factors of cardiac complications in this distinctive demographic group of post-mRNA vaccinations. Due to the scarcity of specific vaccine safety data, the study sought to provide data supporting public awareness and recommendations for global public health practices. Emphasizing ethical considerations, the study focuses on local factors, contributing valuable insights into the safety profile of mRNA vaccines, and aiding informed decision-making for public health strategies in Saudi Arabia and globally. Material and methods In a cross-sectional design, the study employs a culturally adapted questionnaire covering demographic details, vaccination history, health conditions, and perceptions. A rigorous development and validation process ensured the reliability of the questionnaire. A sample size of 804 participants was collected through an online survey link distributed via social media through the groups. Statistical analyses explored associations between demographic variables, vaccination behaviors, health diagnoses, and perceptions using IBM SPSS version 23 and Microsoft Excel. Results Significant associations were found among demographic variables, vaccination behaviors, health diagnoses, and perceptions of self-reported physician-diagnosed cardiac complications post mRNA vaccination in Saudi Arabia. Key findings included a high mRNA vaccine uptake with a frequency of 747 (92.79%) and a mere frequency of 218 (27.11%) reporting cardiac complications post vaccination. The study highlighted diverse influences on vaccine decisions, with a frequency of 384 (47.76%) expressing neutral confidence in vaccine safety. The study contributes to the global understanding of mRNA vaccine safety, emphasizing the unique Saudi demographic context. Methodological rigor, ethical considerations, and acknowledgment of limitations enhance credibility. Collaborative efforts and tailored recommendations for public health policies and communication strategies are underscored. Conclusion This study on self-reported physician-diagnosed cardiac complications post mRNA vaccination in Saudi Arabia is a crucial addition to global vaccine safety research. Providing insights shaped by local factors, the study aids in informed decision-making for public health strategies in Saudi Arabia and globally. It addresses the scarcity of specific vaccine safety data, fostering a nuanced understanding of mRNA vaccine-related cardiac complications worldwide., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Sheriff et al.)

FFA1 and FFA4, two G protein-coupled receptors that are activated by long chain fatty acids, play crucial roles in mediating many biological functions in the body. As a result, these fatty acid receptors have gained considerable attention due to their potential to be targeted for the treatment of type-2 diabetes. However, the relative contribution of canonical G protein-mediated signalling versus the effects of agonist-induced phosphorylation and interactions with β-arrestins have yet to be fully defined. Recently, several reports have highlighted the ability of β-arrestins and GRKs to interact with and modulate different functions of both FFA1 and FFA4, suggesting that it is indeed important to consider these interactions when studying the roles of FFA1 and FFA4 in both normal physiology and in different disease settings. Here, we discuss what is currently known and show the importance of understanding fully how β-arrestins and GRKs regulate the function of long chain fatty acid receptors.

The main objective of this work is to develop a variety of hybrid high-density polyethylene (HDPE) micro- and nanocomposites and to investigate their thermal, mechanical, and morphological characteristics as a function of number of fillers and their contents percentage. In this study, 21 formulations of the composites were prepared using fillers with different sizes including micro fillers such as talc, calcium carbonate (CaCO 3 ), as well as nano-filler (fumed silica (FS)) though the melt blending technique. The morphological, mechanical, and thermal properties of the composite samples were evaluated. The morphological study revealed negligible filler agglomerates, good matrix-filler interfacial bonding in case of combined both CaCO 3 and FS into the composites. Sequentially, improvements in tensile, flexural and Izod impact strengths as a function of fillers loading in the HDPE matrix have been reported. The maximum enhancement (%) of tensile, flexural and impact strengths were 127%, 86% and 16.6%, respectively, for composites containing 25% CaCO 3 and 1% FS without any inclusion of talc filler; this indicates that the types/nature, size, quantity and dispersion status of fillers are playing a major role in the mechanical properties of the prepared composites more than the number of the used fillers.

This article presents a novel metamaterial (MTM) with a mirror symmetric resonator that exhibits multiple resonances of transmission coefficient covering the L, S, C, and X bands. The resonating patch is constructed on a low-loss Rogers (RT5880) substrate with a dimension of 20 × 20 × 1.575 mm 3 . It consists of four equal quartiles with each quartile made with interconnected split-ring resonators; the quartiles are in mirror symmetry with each other. The proposed MTM exhibits resonances at 1.98 GHz, 3.67 GHz, 4.74 GHz, 8.38 GHz, and 10.8 GHz, and electromagnetic characterization is performed through studies of permittivity, permeability, refractive index, and impedances. Power analysis is also performed, and the effect of polarized incident waves is studied. An electromagnetic characterization study reveals that the proposed MTM shows negative permittivity with near-zero permeability and refractive index. It also reveals very little power consumption in the vicinity of the resonances. The dielectric-based frequency tuning is studied by using different dielectric layers over the patch that provides good frequency tuning; this method provides flexibility for adjusting the resonance frequencies in accordance with the application demand. The measured result of the proposed unit cell with the dielectric layer is extracted using a vector network analyzer, and the results exhibit good similarity with the simulated ones. The above-mentioned properties, along with a good effective medium ratio (EMR) of 7.57 indicate that this MTM is suitable for frequency selective applications in microwave devices such as antenna performance improvement and sensing., (© 2022. The Author(s).)

In this paper, we present an analytical study for the investigation of the effects of the magnetoelectric elements of a reciprocal and nonreciprocal bianisotropic grounded substrate on the input impedance, resonant length of a dipole antenna as well as on the mutual coupling between two element printed dipole array in three configuration geometries: broadside, collinear and echelon printed on the same material. This study examines also the effect of the considered bianisotropic medium on the electric and magnetic field distributions that has been less addressed in the literature for antenna structures. Computations are based on the numerical resolution, using the spectral method of moments, of the integral equation developed through the mathematical derivation of the appropriate spectral Green's functions of the studied dipole configuration. Original results, for chiral, achiral, Tellegen and general bi-anisotropic media cases, are obtained and discussed with the electric and magnetic field distributions for a better understanding and interpretation. These interesting results can serve as a stepping stone for further works to attract more attention to the reciprocal and non-reciprocal Tellgen media in-depth studies., (© 2022. The Author(s).)

This study provides an eight-component multiple-input multiple-output (MIMO) antenna architecture for fifth-generation (5G) mobile communication systems. The single antenna element is comprised of an L-shaped radiating component, an L-shaped parasitic element, and a ground plane with a rectangular slot. The main element with a slot-loaded ground plane helps to draw current from a coaxial feed from the other side of the board, while the parasitic element helps to elongate the current path and improve the impedance of the system. This enables the system to radiate at two different frequency ranges: 3.34-3.7 GHz and 4.67-5.08 GHz, with 360 MHz and 410 MHz bandwidths, respectively. For MIMO configuration, the radiating elements are designed on either side of a 0.8 mm thick FR-4 substrate, allowing space to accommodate a battery, radio frequency (RF) systems and subsystems, and camera and sensor modules. The corner and the middle elements are arranged in such a manner so that they can provide spatial and pattern diversity. Furthermore, at least 12 dB of isolation is established between any two radiating elements. Various MIMO performance parameters were evaluated, e.g., mean effective gain (MEG), channel capacity (CC), envelope correlation coefficient (ECC), realized gain, far-field characteristics, and efficiency. Single- and double-hand mode evaluations were performed to further demonstrate the capability of the proposed MIMO antenna. A prototype of the proposed MIMO antenna was manufactured and assessed to verify the simulated data. The measured and simulated results were found to be in good agreement. On the basis of its performance characteristics, the designed MIMO system could be used in 5G communication systems.

Background: Magnetic Resonance Imaging (MRI) is considered a vital in depicting multiple sclerosis (MS) lesions. Current studies demonstrate that proton density (PD) weighted images (WI) are superior to T2 WI in detecting MS lesions (plaques) in the spinal cord., Purpose: To evaluate the diagnostic value of filtered fused PD/T2 weighted images in detecting cervical spinal cord MS lesions., Material and Methods: In this retrospective study, we selected a sample size of 50 MS patients. Using contrast limited adaptive histogram equalization (CLAHE), a digital image processing filter was used on the (PD/T2) fused images. The produced images were inspected and compared to the original PD images by two experienced neuroradiologists using interobserver and intraobserver. An ROI analysis was also performed on the processed and original PD images., Results: The repeatability measurement of the match between the two examinations was highly consistent for both neuroradiologists. The repeatability for both neuroradiologists was 96.05%, and the error measurement was 3.95%. The reproducibility measurement of the neuroradiologist's evaluation shows that the processed images could help to identify lesions better [excellent (84.87%)] than PD images [good (61.19%)]. ROIs analysis was performed on 113 MS lesions and normal areas in different images within the sample size. It revealed an enhanced ratio of 2.2 between MS lesions and normal spinal cord tissue in processed fused images compared to 1.34 in PD images., Conclusion: The processed images of the fused images (PD/T2) have superior diagnostic sensitivity for MS lesions in the cervical spine than PD images alone., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

A couple ring enclosed circular geometric resonator (CRECGR) based dual-band polarization insensitive metamaterial (MM) with high effective medium ratio (EMR), and excellent absorptance is proposed in this study, which can be utilized as a sensor and absorber in the 5G sub-6 GHz frequency range. A circular geometry-based unique patch has been introduced in the proposed unit cell to achieve high polarization insensitive properties with excellent absorption for the 5G sub-6 GHz spectrum. The distinctive feature of this proposed CRECGR unit cell is its simple and unique structure with a high EMR of 11.13, polarization insensitive up to 180°, and epsilon negative (ENG) properties, including a negative refractive index and near-zero permeability for 5G sub-6 GHz applications. Furthermore, this designed unit cell yields excellent absorption properties with high quality factor. The designed MM unit cell is fabricated on low loss Rogers RT5880 printed media with an electrical dimension of 0.089λ × 0.089λ × 0.017λ. The performance of the designed CRECGR metamaterial is determined using Computer Simulation Technology (CST), Advanced Design Software (ADS), and measurements. The CRECGR unit cell offers dual resonances at 3.37 GHz and 5.8 GHz, covering the 5G sub-6 GHz band with ENG, near-zero permeability and negative index. The polarization insensitive properties of the unit cell were also investigated for maximum angle of incidence, which confirmed the identical response. The simulated outcome is verified by experiment with excellent accordance. Moreover, the unit cell performance with a complete backplane is explored, noting a maximum absorption of 99.9% for all normal and oblique incidence waves, suitable for sensing and antenna systems. In addition, the suggested unit cell sensing performance is evaluated using the permittivity-based sensing model. The proposed MM outperforms recent related studies in terms of polarization insensitivity up to 180°, high insensitive absorptivity, high EMR, and sensing applications. These features prove that the proposed CRECGR metamaterial is perfect for 5G Applications., (© 2022. The Author(s).)

In this work, graphite nanoplatelets (GNP) were incorporated into poly (ethylene terephthalate) (PET) matrix to prepare PET-GNP nanocomposites using a melt compounding followed by compression moulding and then quenching process. Both static and dynamic mechanical properties of these quenched materials were characterized as a function of GNP contents using dynamic mechanical thermal analysis (DMTA) and tensile machine, respectively. The results demonstrated that the addition of GNP improved the stiffness of PET significantly. Additionally, the maximum increase in the storage modulus of 72% at 6 wt.% GNP. The incorporation of GNP beyond 6 wt.% into PET decreases the storage moduli, but they remain higher than pure PET. The observed reduction could be due to agglomeration, resulting in poorer dispersion and distribution of higher levels of GNP into the PET matrix. In contrast to the results for moduli, tensile strength and elongations at break reduce with increasing the GNP content. For example, tensile strength reduced from ∼46 MPa (neat PET) to ∼39 MPa (-15%) for the nanocomposites containing 2 wt.% GNP. This reduction is accompanied by a decline in elongation at break from ∼6.3 (neat PET) to ∼3.4 (-46%) for the same nanocomposites. Such reductions are followed by a gradual decrease in upon further addition of GNP. These reductions indicate that increasing GNP loadings, results in brittleness in nanocomposites. In addition, it was found that quenched PET and composite samples were not fully crystallized after processing and therefore (cold) crystallized during the first heating cycle DMTA, as indicated by a rise in storage moduli above the glass transition temperature during the DMTA first heat. Furthermore, mathematical models based on non-linear theories are developed to capture the experimental data. For this, a set of mechanical stress-strain data is used for model parameters' identification. Another set of data is used for the model validation that demonstrates good agreements with the experimental study.

Amphetamine is one of the most abuser drugs in Saudi Arabia. The aim of this study was to evaluate health status outcome at baseline and after detoxification in amphetamine users through the evaluation of the body mass index, renal function tests, cardiac biomarkers, gonadal hormonal levels, and oxidative stress markers. A cross-sectional study was conducted on 90 participants. Sixty participants were hospitalized patients for treatment of addiction and 30 participants were healthy volunteers. This study was performed at a psychiatric and rehabilitation center, in Qassim region, in the Kingdom of Saudi Arabia. Participants were divided into: group I = control; group II = amphetamine users and group III = amphetamine plus cannabis users. Socio-demographic data was collected. The urinary amphetamine level, Severity Dependence Scale (SDS), body mass index (BMI), vital signs; serum levels of troponin T (TnT), immunoglobulin M (IgM), immunoglobulin G (IgG), luteinizing Hormone (LH), testosterone Hormone (TSTS), urea, creatinine, malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) were measured on admission and after detoxification. The results showed that the BMI was significantly decreased while, vital signs such as heart rate, blood pressure and respiratory rate were significantly increased in all abusers and returned to normal values after the detoxification period. The cardiac biomarker troponin T was significantly increased and reversed after detoxification. The immune system was evaluated through assessing serum levels of immunoglobulin (Ig) M and IgG. The immune system remained immunocompromised in drug users, and IgM and IgG levels did not reach the level of control group after treatment. Luteinizing and testosterone hormones were evaluated. Both hormones were increased on admission and improved after the detoxification period. Renal function showed no significant differences between drug users and the control group. In the evaluation of the antioxidant system, there was a significant increase in serum MDA, SOD, GPx, and CAT levels compared to healthy controls. After the detoxification phase, these oxidative stress biomarkers still remained elevated. The current results have shown the addiction of amphetamine and cannabis exert detrimental effects on different body organs and the exert major consequences on the health status of drug users. The present study showed that, there was no improvement in the levels of oxidative stress biomarkers, although an improvement was observed in the other parameters after the detoxification phase., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Carbon felt (CF) is an inexpensive carbon-based material that is highly conductive and features extraordinary inherent surface area. Using such a metal-free, low-cost material for energy storage applications can benefit their practical implementation; however, only limited success has been achieved using metal-free CF for supercapacitor electrodes. This work thoroughly studies a cost-effective and simple method for activating metal-free self-supported carbon felt. As-received CF samples were first chemically modified with an acidic mixture, then put through a time optimization two-step electrochemical treatment in inorganic salts. The initial oxidative exfoliation process enhances the fiber's surface area and ultimately introduced oxygen functional groups to the surface, whereas the subsequent reduction process substantially improved the conductivity. We achieved a 205-fold enhancement of capacitance over the as-received CF, with a maximum specific capacitance of 205 Fg -1 , while using a charging current density of 23 mAg -1 . Additionally, we obtained a remarkable capacitance retention of 78% upon increasing the charging current from 0.4 to 1 Ag -1 . Finally, the cyclic stability reached 87% capacitance retention after 2500 cycles. These results demonstrate the potential utility of electrochemically activated CF electrodes in supercapacitor devices.

Purpose: This review presents the current methods used for determining ethyl glucuronide (EtG) and ethyl sulfate (EtS) concentrations in postmortem specimens, including sample preparation, analysis and the role of EtG and EtS in the postmortem assessment of the extent of alcohol abuse., Methods: Papers pertaining to postmortem investigation were collected from scientific databases and reviewed. The papers were published between January 2006 and October 2020., Results: Most of the analyses involved postmortem blood and urine samples, with a few reports using other bodily specimens and tissues. The method validation was not conducted for all applications. These reports were mostly intended to present data rather than interpret them, and the lack of effort in relating these ethanol biomarkers with the cause of death and/or determination of the time of deaths due to ethanol intoxication might decrease the applicability of these makers after a promising start between 2006 and 2010. Nevertheless, by the beginning of 2020, papers investigating ethanol biomarkers were still increasing. A considerable number of methods used liquid chromatography coupled with mass spectrometry (LC-MS) techniques that require less sample preparation (e.g., protein precipitation extraction, dilution, filtration, and centrifugation). Although solid-phase extraction can be applied, only three applications were reported., Conclusions: Matrix effects can be a substantial challenge in analytical methods based on LC-MS because they directly affect the ionization of analytes. However, these problems can be avoided due to the high cutoff values used to identify positive results for these ethanol biomarkers, which are often above 0.1-1 mg/L, and using internal standards. Research on using tissue specimens is recommended as most of the reported results on this type of specimen were promising., (© 2021. Japanese Association of Forensic Toxicology.)

Background The COVID-19 pandemic is one of the largest global healthcare crises in nearly a century. To face this global health emergency, health institutions have had to readjust their functioning while ensuring the continuity of care and protecting medical staff and patients. Our aim in this study was to assess the consequences of the COVID-19 outbreak on family medicine and its practice in Saudi Arabia. Methods This cross-sectional study was conducted during the period from June 30, 2020, to July 20, 2020, by posting an online survey on social media platforms (WhatsApp and Twitter) and emailing physicians individually to collect data on the impact of the COVID-19 pandemic on family medicine and primary care practices during the period of lockdown in Saudi Arabia. Results A total of 382 primary healthcare (PHC) providers participated in the study (males: 213 (55.8%); females: 169 (44.2%)). The mean age and standard deviation of the population were 38.27±7.46. Most participants were from governmental health sectors. Participants revealed that they have a good level of knowledge regarding COVID-19. However, they indicated confusion regarding the knowledge due to changing recommendations or multiple-source information. Only 57.3% of respondents received relevant training on the use of personal protective equipment (PPE). The most frequently used PPE were surgical masks (100%) and gloves (98.4%). The highly protective N95 masks were used by only 55.7%. Many health care workers indicated a high rate of stress and anxiety about the COVID-19 pandemic. Data obtained are suggestive that there was a reduction in outpatient visits and a reduction in consultation time. Canceled physical examinations of the patients during the consultation were encountered most of the time. There was no shortage of medications, nasopharyngeal swabs, or sanitizers. However, an occasional lack of PPEs occurred. 64.4% of the respondents used online consultations with their patients. A shortage of health care workers during the pandemic in family medicine clinics was encountered by 63.3% of the participants. Conclusion Family medicine practices are adversely affected by pandemics and lockdowns following them. It has been reported that COVID-19 interferes with preventive, chronic, and acute care visits and increases mental health visits. Outpatient visits have also decreased as well as the amount of time spent in consultations. In addition, the transition from in-person clinics to telemedicine has happened. Perhaps these changes will delay the diagnosis and prescription refills., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Shatla et al.)

Carbon fiber-reinforced polymers are considered a promising composite for many industrial applications including in the automation, renewable energy, and aerospace industries. They exhibit exceptional properties such as a high strength-to-weight ratio and high wear resistance and stiffness, which give them an advantage over other conventional materials such as metals. Various polymers can be used as matrices such as thermosetting, thermoplastic, and elastomers polymers. This comprehensive review focuses on carbon fiber-reinforced thermoplastic polymers due to the advantages of thermoplastic compared to thermosetting and elastomer polymers. These advantages include recyclability, ease of processability, flexibility, and shorter production time. The related properties such as strength, modulus, thermal conductivity, and stability, as well as electrical conductivity, are discussed in depth. Additionally, the modification techniques of the surface of carbon fiber, including the chemical and physical methods, are thoroughly explored. Overall, this review represents and summarizes the future prospective and research developments carried out on carbon fiber-reinforced thermoplastic polymers.

Background: Estimated seroprevalence of Coronavirus Infectious Disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is a critical evidence for a better evaluation of the virus spread and monitoring the progress of COVID-19 pandemic in a population. In the Kingdom of Saudi Arabia (KSA), SARS-CoV-2 seroprevalence has been reported in specific regions, but an extensive nationwide study has not been reported. Here, we report a nationwide study to determine the prevalence of SARS-CoV-2 in the population of KSA during the pandemic, using serum samples from healthy blood donors, non-COVID patients and healthcare workers (HCWs) in six different regions of the kingdom, with addition samples from COVID-19 patients., Methods: A total of 11,703 serum samples were collected from different regions of the KSA including; 5395 samples from residual healthy blood donors (D); 5877 samples from non-COVID patients collected through residual sera at clinical biochemistry labs from non-COVID patients (P); and 400 samples from consented HCWs. To determine the seroprevalence of SARS-CoV-2, all serum samples, in addition to positive control sera from RT-PCR confirmed COVID-19 patients, were subjected to in-house ELISA with a sample pooling strategy, which was further validated by testing individual samples that make up some of the pools, with a statistical estimation method to report seroprevalence estimates., Results: Overall (combining D and P groups) seroprevalence estimate was around 11% in Saudi Arabia; and was 5.1% (Riyadh), 1.5% (Jazan), 18.4% (Qassim), 20.8% (Hail), 14.7% (ER; Alahsa), and 18.8% in Makkah. Makkah samples were only D group and had a rate of 24.4% and 12.8% in the cities of Makkah and Jeddah, respectively. The seroprevalence in Saudi Arabia across the sampled areas would be 12 times the reported COVID-19 infection rate. Among HCWs, 7.5% (4.95-10.16 CI 95%) had reactive antibodies to SARS-CoV-2 without reporting any previously confirmed infection. This was higher in HCWs with hypertension. The study also presents the demographics and prevalence of co-morbidities in HCWs and subset of non-COVID-19 population., Interpretation: Our study estimates the overall national serological prevalence of COVID-19 in Saudi Arabia to be 11%, with an apparent disparity between regions. This indicates the prevalence of asymptomatic or mild unreported COVID-19 cases., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: Patients with vitiligo experience emotional and psychological stress as they undergo long-term therapy. The debilitating psychosocial effects of this disease on patients' quality of life is well-documented. This study evaluates the effect of the introduction of narrow-band ultraviolet-B (NB-UVB) therapy on the quality of life of patients with vitiligo in Almadinah Almunawwarah, KSA., Methods: Thirty-eight patients from the main dermatology center of Ohud Hospital, Almadinah Almunawwarah, were interviewed between June 2017 and March 2019 using the Dermatology Life Quality Index (DLQI) questionnaire. The interviews were conducted before and one year after the course of NB-UVB therapy, which was added as a new treatment modality to the basic therapeutic regimen of topical medications., Results: The patients' response to vitiligo therapy was positive. The overall patient satisfaction score regarding the NB-UVB therapy was as high as 9.1 out of 10. The initial overall DLQI score (5.67 ± 0.90) markedly decreased after the NB-UVB therapy (3.08 ± 0.56), indicating a significant improvement. The patients' adherence to the follow-up visits also improved., Conclusion: NB-UVB therapy is effective in alleviating psychological stress and improving the quality of life of patients with vitiligo., (© 2021 The Authors.)

Introduction: The Affordable Care Act (ACA) expanded the coverage of Medicaid to include entire population with income below 138% of federal poverty line. It remains unclear whether this policy change has improved access to and utilization of health care, particularly use of mammography and Pap tests among poor women., Methods: We used a difference-in-difference (DID) design to estimate the impact of Medicaid expansion on mammography and Pap tests utilization among low-income women. Expansion states are the treatment group and non-expansion states are the control group. The years 2012-13 are the pre-expansion period and 2015-16 are the post-expansion period for the purpose of estimating the DID parameters., Results: The difference-in-difference estimate show that likelihood of utilizing mammograms did not change significantly among low-income women after the implementation of Medicaid expansion (DID coefficient -0.0476 with t-statistics at -1.26), Pap test decreased (coefficient -0.0615, t-statistics -2.76), and Medicaid enrollment has increased significantly among low-income women living in expansion states (coefficient 0.0889 with t-value of 3.68)., Conclusion: Expansion of Medicaid was associated with increased Medicaid enrollment but did not yield near-term improvement in use of mammography and Pap tests among low-income women. Factors beyond health insurance coverage may be important in determining the likelihood of obtaining these screenings. Policy makers should try to identify other barriers to cancer screenings among low-income women in the USA., Competing Interests: The authors have declared that no competing interests exist.

Research on Saudi Arabian cancer patients is a priority at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Because there is limited research on the quality of life (QoL) of Saudi Arabian cancer patients, the aim of this study was to identify the predictors of the QoL in a sample of Saudis with cancer. In August 2016, a cross-sectional study was conducted on 438 patients with a variety of cancer types (145 breast, 109 colorectal, 38 leukemia, 45 lymphoma, and 99 other types) who attended the Oncology Outpatient Clinics at KAMC. Sociodemographics, clinical symptoms, and cancer treatments were collected for each patient. We used the SF-36 instrument to assess QoL. Of the cancer patients studied, 28.4% had a family history of cancer, and, according to subgroup analyses, the elderly, those lacking formal education, the unemployed, those diagnosed with Stage III/IV, and those with metastasis had significantly worse physical functions than the other cancer patients. According to multiple linear regression analyses, cancer patients who exercised regularly tended to have better physical function, emotional role function, vitality, social function, and general health (increase in SF-36 scores of 8.82, 9.75, 5.54, 6.66, and 4.97, respectively). Patients with first-year-after-cancer diagnosis tended to have poor emotional wellbeing, social function, and general health (decrease in SF-36 scores of 5.20, 7.34, and 6.12, respectively). Newly diagnosed cancer patients and patients who did not exercise tended to experience significantly poor QoL in several domains; thus, the effectiveness of exercise must be assessed in Saudi cancer patients as an intervention to improve QoL.