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Amani M Alqarni,1 Leila A Boubshait,1 Dana Ahmed Alnufaily,2 Sajidah J Alalwan,2 Hassn Reda Al Fardan,2 Marwah Foud Alabdulmhsin,2 Malak Abdulrahman Alotaibi,3 Nadeen A Boubshait4 1Family and Community Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 3Population Health Management, Ministry of Health, Riyadh, Saudi Arabia; 4College of Medicine, King Faisal University, Al-Ahsa, Saudi ArabiaCorrespondence: Leila A Boubshait, Email laboubshait@iau.edu.saBackground: Internet addiction is increasing worldwide. Internet addiction (IA) refers to excessive Internet usage in an uncontrolled and time-consuming manner, causing loss of time and disruption of daily life. However, the prevalence of IA may vary according to age, sex, and ethnicity, and is more prevalent among college students. There is a strong link between problematic Internet usage and an increased risk of developing Post Traumatic Stress Disorder PTSD and depression symptoms. Medical students were chosen for this study due to their unique stressors, including rigorous academic demands, extensive study hours, and clinical practice requirements. It is critical to address behavioral addictions and their psychological effects in this group, as they are linked to the future quality of healthcare provision compared with their non-medical peers.Objective: To estimate the prevalence of Problematic Internet Use (PIU) in medical students and explore their correlation with the medical students’ PTSD and Patient Health Questionnaire − 9 (PHQ9) scores.Methods: A cross-sectional online survey was conducted including 506 medical students in the second year of medical school up to internship year at Imam Abdulrahman bin Faisal University (IAU) between June 2021 and January 2022. The questionnaire consisted of consent forms, sociodemographic data, and screening tools for PTSD, the GPIU, and PHQ-9.Results: The prevalence of problematic internet usage (PIU) was 30.6% in the sample group. Students with moderate-to-moderately severe PTSD were 1.7 times more likely to have PIU OR (95% CI): 1.7 (1.091, 2.879). Students with moderate to severe depression were 2.2 times more likely to have PIU OR (95% CI); 2.2 (1.333, 3.950).Having a Saudi nationality, lower income, and being single was significantly associated with PIU.Conclusion: Single Saudi medical students with lower income are at risk of developing more problematic internet use. Especially those who score moderate to high on PTSD and PHQ-9 scales.Keywords: university students, academic performance, internet addiction, mental health

Mazyad A Alotaibi,1 Ahmed S Alhowimel,1 Faris A Alodaibi,2 Mohammed Aloraifi3 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; 2Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia; 3Salamat Medical Hospital, Department of Physiotherapy, Hail, Saudi ArabiaCorrespondence: Mazyad A Alotaibi, Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Saudi Arabia, Tel +966115886354, Email maz.alotaibi@psau.edu.saPurpose: Shared decision-making (SDM) may be interpreted as a set of core values rather than as a consensus definition. This study aimed to explore how SDM between patients and physiotherapists may lead to patient satisfaction.Patients and Methods: A cross-sectional study was conducted to examine the relationship between SDM and patient satisfaction. The study targeted physiotherapists and patients with musculoskeletal pain or disorders. A structured questionnaire (the nine-item Shared Decision-Making Questionnaire) was developed to show the extent to which patients felt involved in the process by scoring nine items from 0 to 5 on a six-point scale. t-tests were performed to estimate differences in SDM perceptions between patients and physiotherapists, and regression analyses were performed to estimate the best predictors of SDM.Results: The questionnaire was completed by a total of 106 patients and nine physiotherapists. The demographic information of the samples was presented with frequency analysis. This study’s findings demonstrate no variations in the final SDM perceptions between patients and physiotherapists, but when SDM was contrasted step-by-step (as items), many variances were discovered. These distinctions reinforce the notion that regardless of the end outcome, the process of reaching a consensus has a distinct profile depending on the type of medical care. Therapists emphasize the first steps, possibly because there is sufficient evidence to make a therapeutic decision. However, patients highlight the final steps, perhaps because the moment for a decision based on the consultation’s nature is approaching.Conclusion: This study demonstrates that SDM is a complex process that must be examined in multiple stages. However, in physiotherapy contexts, this process exhibits extremely different patterns, reflecting a significantly different perspective of the decision-making process.Keywords: physical therapy, decision-making, patient preference, musculoskeletal disorders

Mohammed S Almizani,1 Manar A Alotaibi,1 Modhi F Bin Askar,1 Nuha M Albaqami,1 Reema S Alobaishi,1 Mostafa A Arafa,2,3 Mohammad I Jumaa4,5 1College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Kingdom of Saudi Arabia; 2Kingdom of Saudi Arabia; 3High Institute of Public Health, Alexandria University, Alexandria, Egypt; 4Anatomy Department, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Kingdom of Saudi Arabia; 5College of Medicine, Al-Azhar University, Assiut, EgyptCorrespondence: Mohammed S Almizani, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), 6889 Ibn Rashiq, King Faisal District, Riyadh, Kingdom of Saudi Arabia, Tel +966 532314692, Email M7mdsajdi@gmail.comBackground: In both the preclinical and clinical sciences, anatomy is considered as the foundation of medical education. Anatomy education serves as a foundation for clinical application and future practice of medicine. Health practitioners and students are interested in the adequacy of anatomical knowledge in clinical years since it has a direct impact on medical education and professional clinical practice.Objective: To examine the opinions and attitudes of medical students and clinicians regarding the preclinical and clinical years’ teaching of anatomy and anatomical knowledge to medical students.Methods: Participants in the study, including clinicians and medical students, were required to answer an 8-question, 5-point Likert scale questionnaire to assess their attitudes regarding anatomical knowledge. The maximum score was 40, and the higher the score, the more the positive attitude towards anatomical knowledge. The difference in the mean attitude score between males and females was investigated using the Independent sample t-test.Results: A total of 327 clinicians and 423 students participated in the study. Clinicians and students showed moderately high positive attitude towards anatomical knowledge. The mean statements score for clinicians’ attitudes was 31.4(± 3.4). There was no significant difference between total attitude score means for clinicians and students, p=0.83. Attitude statements attained a significantly higher percentages and were in favor to clinicians in comparison to students, particularly for clinical significance of anatomical knowledge to students in the clinical years, the importance of anatomical knowledge to surgical and non-surgical specialties, and re-teaching special anatomy for students in the clinical years would improve their clinical background. Both clinicians and students expressed low agreement regarding anatomical educational style and quality of study materials.Conclusion: Teaching anatomy to medical students is a continuous process. Therefore, we recommend reforming the anatomy curriculum by vertical integration of anatomy into the clinical rotations, clerkship, and specialist training.Keywords: anatomy, medical education, clinicians, students, Saudi Arabia

Faris A Alodaibi,1 Mazyad A Alotaibi,2 Mohammad A Almohiza,1 Ahmed S Alhowimel2 1Health Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia; 2Department of Health and Rehabilitation Science, Sattam Bin Abdulaziz University, Al-Kharj, Saudi ArabiaCorrespondence: Faris A Alodaibi, Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, PO Box 22480, Riyadh, 11495, Kingdom of Saudi Arabia, Tel +966 14676176, Fax +966 14676162, Email falodaibi@KSU.EDU.SABackground: Chronic non-communicable diseases and musculoskeletal disorders are primarily associated with poor lifestyle behaviors and underestimated public health issues. Physical therapists have an essential role in promoting health. Still, few studies have described the current role of physical therapy in health promotion to lessen the impact of public health issues and chronic musculoskeletal conditions. Therefore, this study aimed to explore physical therapists’ health promotion in the musculoskeletal practice setting and investigate potential barriers and needed education.Design and Methods: A cross-sectional descriptive study was conducted, using an electronic survey distributed among physical therapists practicing in Saudi Arabia who managed patients with musculoskeletal disorders.Results: A total of 150 physical therapists participated in this survey. The physical therapists dealing with musculoskeletal disorders were, to a fair degree, aware of the importance of lifestyle risk factors related to health and wellness, particularly those relating to physical aspects. However, participants’ knowledge and experience (according to their report) were relatively limited in other lifestyle behaviors such as smoking, nutrition, sleep, and stress management. Participants believed further education/training would be needed to address these behaviors.Conclusion: The participants appreciated the importance of addressing lifestyle factors. Nonetheless, knowledge and experience in health promotion were limited. To optimize the outcome of musculoskeletal patients through health promotion, more training will be needed.Keywords: lifestyle behaviors, health promotion, physical therapy, education and training, musculoskeletal disorders

Ahmed S Alhowimel,1 Mazyad A Alotaibi,1 Dalyah M Alamam,2 Faris A Alodaibi,2 Julie M Fritz3 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia; 2Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia; 3Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, USACorrespondence: Ahmed S AlhowimelDepartment of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, 11942, Saudi ArabiaTel +966 115886354Email aalhowimel@gmail.com; a.alhowimel@psau.edu.saIntroduction: Healthcare professionals’ beliefs and attitudes towards low back pain management play a significant role during treatment. This is a crucial aspect of primary care physicians working as a first point of contact for people seeking healthcare for low back pain.Aim: To identify the beliefs and behaviors of frontline healthcare professionals (primary care physicians) working in the Riyadh region with regard to low back pain management.Methods: A cross-sectional design was implemented, in which the Pain Attitude and Beliefs Scale (PABS) questionnaire was used along with a low back pain clinical vignette with some questions. The PABS assesses healthcare provider orientations toward low back pain with two subscales: biomedical and behavioral. In total, 400 primary care physicians working in the Riyadh region of Saudi Arabia were invited to participate.Results: The responding primary care physicians (n = 72, response rate = 18%) provided an average score on the behavioral subscale (mean = 31.5± 7.1) that was lower than that on the biomedical subscale (36.5± 7.8) of the PABS. The lower scores in the biomedical subscale are associated with the using of clinical guidelines for low back pain management (χ2 (1) = 4.7, p = 0.03). Moreover, providing guideline-based advices regarding activity and work was more likely to come from those scoring above the mean in the behavioral subscale.Conclusion: The results of this study show that Saudi Arabian primary care physicians manage their patients within a biomedical framework; there is some compliance to the current low back pain clinical guidelines among these physicians, with under/post-graduate education being needed for these professionals to adopt a more biopsychosocial framework during low back pain management.Keywords: low back pain, attitude, behavior, primary care physician, biomedical management, biopsychosocial management, primary care, guidelines adherence, pain, healthcare professional

Ahmed S Alhowimel,1 Mazyad A Alotaibi,1 Aqeel M Alenazi,1 Bader A Alqahtani,1 Mansour A Alshehri,2,3 Dalyah Alamam,4 Faris A Alodaibi4 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; 2Physiotherapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia; 3NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia; 4Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Ahmed S AlhowimelDepartment of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, AlKharj, 11942, Saudi ArabiaTel +966115886354Email aalhowimel@gmail.com; a.alhowimel@psau.edu.saObjective: Previous evidence has recommended conservative interventions as the best treatment in individuals with chronic low back pain (CLBP). However, the influence of psychosocial factors on the treatment outcomes is unclear. Therefore, this systematic review aimed to address the psychosocial factors that influence changes in pain and disability in patients with CLBP after a guideline-based conservative intervention.Methods: Four electronic databases were systematically searched from inception until September 2020 for prospective studies examining the relationship between psychosocial factors and the outcomes of pain and disability after conservative intervention. All included studies were selected, extracted, and critically evaluated by two independent reviewers.Results: In total, 15 studies were included in this systematic review. The results support the link between the baseline fear of movement, depression, self-efficacy, and catastrophizing with future functional disability outcomes after conservative interventions. However, these factors were less likely to predict changes in pain intensity outcomes after conservative interventions. Self-efficacy seems to mediate between some of the baseline psychosocial factors (eg, fear) and future pain and disability.Conclusion: Fear of movement, self-efficacy, catastrophizing and depression were consistently reported to predict disability outcomes irrespective of the type of conservative intervention. This highlights the importance of addressing these factors in conservative management of CLBP.Keywords: chronic low back pain, outcomes, conservative interventions, psychosocial

Selenium (Se) as a bioactive micronutrient could be augmented via transforming into nanoparticles (NPs), especially using biogenic protocols, for usage as an antimicrobial element. The reducing power of costus (Saussurea costus) root extract (SCE) was employed for phytosynthesis of Se-NPs through a simple and rapid protocol that included stirred mixing of 10 mM Na2SeO3 with 1.0% SCE solution for 4 h. The phytosynthesized SCE/Se-NP composite was obtained with a mean diameter of 6.13 nm and a zeta potential of −42.8 mV. Infrared analyses revealed the involvement of many SCE phytogroups in Se-NP synthesis, whereas transmission microscopy displayed well distribution and spherical shapes of the phytosynthesized NPs. The antibacterial assessments against foodborne pathogens (Escherichia coli, Salmonella typhimurium and Staphylococcus aureus) revealed the superior powers of SCE/Se-NPs and the elevated potentialities of SCE and Se-NPs for inhibition of bacterial pathogens. The scanning micrographs indicated that SCE/Se-NPs were attached to bacterial cells and led to their complete lysis/explosion with exposure prolongation. The SCE/Se-NP composites are recommended for the effective control of foodborne bacterial pathogens, applying a simple and eco-friendly phytosynthesis protocol.

Trimethylamine N-oxide (TMAO) is a small colorless amine oxide generated from choline, betaine, and carnitine by gut microbial metabolism. It accumulates in the tissue of marine animals in high concentrations and protects against the protein-destabilizing effects of urea. Plasma level of TMAO is determined by a number of factors including diet, gut microbial flora and liver flavin monooxygenase activity. In humans, a positive correlation between elevated plasma levels of TMAO and an increased risk for major adverse cardiovascular events and death is reported. The atherogenic effect of TMAO is attributed to alterations in cholesterol and bile acid metabolism, activation of inflammatory pathways and promotion foam cell formation. TMAO levels increase with decreasing levels of kidney function and is associated with mortality in patients with chronic kidney disease. A number of therapeutic strategies are being explored to reduce TMAO levels, including use of oral broad spectrum antibiotics, promoting the growth of bacteria that utilize TMAO as substrate and the development of target-specific molecules with varying level of success. Despite the accumulating evidence, it is questioned whether TMAO is the mediator of a bystander in the disease process. Thus, it is important to undertake studies examining the cellular signaling in physiology and pathological states in order to establish the role of TMAO in health and disease in humans.

Biogas, a sustainable alternative to fossil fuels, addresses issues of non-renewability and accessibility. Its structural similarity to fossil fuels makes it a potent option for energy systems. With this in mind, this paper discusses a novel trigeneration system that utilizes biogas and Liquefied natural gas cooling to produce methanol, electricity, cold water, hot water, oxygen, and natural gas. The system integrates various components such as a biogas burner, Kalina cycle, organic Rankine cycle, liquefied natural gas liquid gasification cycle, proton exchange membrane electrolyzer, and methanol synthesis unit. Simulation via Aspen HYSYS software includes an analysis of energy, exergy, economic, and environmental aspects. Efficiency assessment in single generation, cogeneration, trigeneration, and chemical trigeneration modes concludes chemical trigeneration as most efficient, with the proton exchange membrane electrolyzer being the most efficient subsystem. Key variables like Kalina cycle evaporator temperature, gas flow rate to the methanol reactor, and organic Rankine cycle working fluid pressure are assessed. Predictions on thermodynamic, environmental, and economic behaviors, along with their fluctuations, are made. Using a thermoeconomic approach, the economic analysis determines an exergy unit cost of 59.79 $/GJ and a total cost rate of 2764 $/h. Overall, this work presents a novel and efficient chemical trigeneration system that utilizes biogas and LNG cooling to produce multiple products., (Copyright © 2024. Published by Elsevier B.V.)

Background: The human cytochrome P450 (CYP) superfamily encompasses different categories of isoenzymes that contribute to multiple metabolic processes involving drug detoxification, cellular signaling, and the proliferation of malignant tissues. Using genetic technology, customized bioinformatic analysis, and meta-analysis design, the main goal of this study was to identify the association between the CYP1A2*rs762551 variant and the susceptibility to breast carcinoma (BRCA)., Methods: The case-control study was conducted based on 104 BRCA women and 102 healthy controls. Using the TaqMan allelic discrimination assay, the CYP1A2 (rs762551; c.-9-154 C>A) variant was genotyped. Bioinformatic frameworks and logistic regression analysis were used to assess the involvement of this genetic variant in BRCA development. A meta-analysis design was accomplished based on our case-control study and other previously published records. Publication bias, heterogeneity between studies, and trial sequential analysis (TSA) were analyzed., Results: The CYP1A2*rs762551 variant conferred protection against BRCA development under allelic (OR = 0.48, p-value < 0.001), dominant (OR = 0.34, p-value < 0.001), and recessive (OR = 0.44, p-value = 0.011) models. However, this intronic variant was correlated with a decreased risk of BRCA among late-onset menopause women compared to other cases. Bioinformatic analysis confirmed that this genetic variant has a functional impact on the progression of tumorgenesis. Moreover, this meta-analysis design included 12922 BRCA women and 15603 healthy controls. Our findings disclosed the contribution of the CYP1A2*rs762551 variant with protection against cancer development among Caucasian females under allelic (OR = 0.75, p-value = 0.025), and dominant (OR = 0.58, p-value = 0.015) models., Conclusions: This case-control study confirmed the contribution of the CYP1A2*rs762551 variant with decreased risk of BRCA development among Egyptian subjects. Moreover, BRCA women with late-onset menopause conferred protection against cancer progression compared to other subjects. Our findings identified that this meta-analysis design achieved protection against BRCA development among Caucasian women compared to other ethnicities., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest regarding this research., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Here we report the synthesis of Sm-doped Na 0.5 Bi 4.5 Ti 4 O 15 (Na 0.5 Sm 0.5 Bi 4 Ti 4 O 15 ) lead-free ceramics via a conventional solid-state technique. Investigations of Na 0.5 Bi 4.5 Ti 4 O 15 (NBT) and Na 0.5 Sm 0.5 Bi 4.5 Ti 4 O 15 (NSBT) ceramics were demonstrated in detail to understand the composition-based structure-property of Aurivillius compounds and related functional material. Dielectric properties for frequency and temperature in a wide range were analyzed. The conduction activation energy values of NSBT ceramics are obtained to be 1.40 eV, whereas, the NBT ceramics get the value to be 1.31 eV. At higher temperatures, the conduction activation energy value of NSBT ceramics is 1.32 eV for both frequencies of 100 Hz and 1 kHz, whereas, for NBT compounds, the calculated value is 1.27 eV for both frequencies. The simulation performed on the impedance data for capacitive and resistance elements shows well-fitting curves which indicates a single relaxation behavior in the material. Similarly, the AC -conductivity data were analyzed which gives different conduction processes and relaxation activation energies in the NSBT ceramics., 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., (© 2024 The Authors.)

A rare neuroendocrine skin cancer called Merkel cell carcinoma (MCC) primarily affects elderly people. The objective of this study is to comprehensively review the impact of immunosuppressive medications, particularly TNF inhibitors, on the emergence of MCC., Methods: PubMed, Web of Science, Science Direct, and Cochrane Library were searched. Study articles were screened by title and abstract at Rayyan Qatar Computing Research Institute, then a full-text assessment was implemented., Results: A total of eight case reports with 9 patients were included. Of the total population, seven were women and only two were men. Their age ranged from 31 to 73 years. More than half the population (5 cases) were being treated for rheumatoid arthritis. All received TNF inhibitors that were associated with the induction of MCC., Conclusion: We found that it is essential for physicians to explain potential cancer risks to patients before starting long-term immunosuppressive therapy and to conduct routine checks for MCC and other side effects. TNF inhibitors (infliximab, adalimumab, etanercept, and golimumab) were all associated with MCC development. Women constituted the majority of cases and most were elderly.

Objective: The objectives of this study were to (1) translate the short version of the Injustice Experience Questionnaire (IEQ-SF) from English to Arabic and (2) test the validity and reliability of the translated Arabic version of the IEQ-SF., Subjects and Methods: A cross-sectional study in which the original English version of the IEQ-SF was translated into Arabic was conducted in accordance with Beaton's translation process. Internal consistency, reproducibility (retest within 5 days), and validity of the translated Arabic version of the IEQ-SF were tested in Arabic-speaking participants (n = 20). Individuals with chronic pain (n = 99) completed the Arabic versions of the IEQ-SF and the Musculoskeletal Health Questionnaire (MSK-HQ) from June to August 2021. The main analyses included Cronbach's alpha (α), Intraclass Correlation Coefficients (ICC), and Spearman's rank correlations (ρ)., Results: The internal consistency (α = 0.74) and test-retest reliability (ICC = 0.88, 0.83-0.92 95% CI) for the translated Arabic version of IEQ-SF were high. There was also a high correlation between the translated Arabic version of the IEQ-SF and different health-related questionnaires such as the MSK-HQ (ρ = -0.738; p < 0.001), Hospital Anxiety and Depression Scale (ρ = 0.701-0.791; all, p < 0.001), and Pain Catastrophizing Scale (ρ = 0.762; p < 0.001)., Conclusions: The Arabic version of the IEQ-SF demonstrated high reliability and validity and would be useful for clinicians and researchers studying Arabic-speaking individuals with chronic pain.

Objective: Mental health plays an important role in educational performance. The present study aimed to determine the relationship between depression symptoms, depression literacy, and quality of life in undergraduate and postgraduate medical students in the Kingdom of Saudi Arabia., Subjects and Methods: This cross-sectional survey was conducted in 2023 in Riyadh with 263 medical students. Data were obtained using three different sets of questionnaires (a demographic section, the Depression Literacy Scale, and a quality-of-life questionnaire)., Results: In total, 134 men (51%) and 129 women (49%) participated in the study; out of these, 142 participants reported depression, while 109 individuals reported family-related depression. Only 25% of the participants attended depression seminars and workshops in the last year, while 83% felt that depression was an illness. Students with a family history of depression also reported higher levels of depression. Depression was lowest among students who attended depression management seminars or workshops. Marital status did not affect depression among medical students., Conclusions: These findings reveal that depression is widespread among medical students and that counseling and frequent depression assessments are required. There is a need for greater awareness of different aspects of depression among medical students, parents, and medical educators. Health education programs and interventions targeting mental health care can be implemented at the individual, family, and community levels.

Establishing preventive measures and treatment strategies for adolescents with low back pain (LBP) may be greatly enhanced by fully grasping the complex interaction between LBP and lifestyle behaviors. The key objective of this study was to explore the possible associations between lifestyle behaviors and LBP among adolescents in Saudi Arabia. A cross-sectional study was conducted among high school students from 5 major regions in Saudi Arabia. Participants were enlisted for the research project between May and November 2021. To evaluate the presence/severity of LBP, physical activity, sedentary duration, sleep quality, nutrition, health responsibility, interpersonal relationships, spiritual growth, and stress management, a well-established web-based survey was employed. A total of 2000 students participated, with 57.9% reporting LBP. Students with LBP had lower scores on overall health-promoting lifestyle behaviors and all subscales, including physical activity, compared to those without LBP. Linear regression analysis revealed significant associations between sedentary duration and global sleep quality with pain severity among students with LBP. This study highlights the association between lifestyle behaviors and LBP among adolescents in Saudi Arabia. Promoting physical activity, reducing sedentary behavior, and improving sleep quality may be crucial in preventing and managing LBP in this population. Comprehensive strategies targeting lifestyle behaviors should be implemented to improve the well-being of adolescents and reduce the burden of LBP. Further research is needed to better understand the underlying mechanisms and develop effective preventive and treatment strategies for LBP among adolescents., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: This study sought to find out if a 6-week accommodating variable-resistance (AcVR) training might enhance muscle architecture, peak torque, and functional performance in patients with juvenile idiopathic arthritis (Juv-IA)., Methods: Fifty-eight patients with polyarticular Juv-IA (aged 12-18 years) were involved in a randomized controlled trial. They were allocated into two groups: the AcVR group ( n  = 29; underwent AcVR training, and the control group ( n  = 29; received the usual exercise regimen). Interventions were applied three times a week over six consecutive weeks. Measurements were done at baseline and after the intervention. The primary outcome measures were muscle architecture and peak torque, with functional capacity being the secondary measure., Results: Compared to the control group, the AcVR group showed favorable pre-to-post changes in muscle architecture [fascicle length ( P  = 0.0007, η 2 p  = .18), pennation angle ( P  = 0.0004, η 2 p  = .20), and muscle thickness ( P  = 0.001, η 2 p  = .17)]. Further, the AcVR group revealed a greater increase in peak concentric torque of knee extensors at angular speeds of 120°/sec [right side ( P  = 0.0032, η 2 p  = .08); left side ( P  = 0.039, η 2 p  = .07)] and 180°/sec [right side ( P  = 0.01, η 2 p  = .11); left side ( P  = 0.014, η 2 p  = .10)]. Furthermore, The AcVR group achieved more conducive changes in functional performance [6-min walk test ( P  = 0.003, η 2 p  = .15), timed up and down stair test ( P  = 0.009, η 2 p  = .12), and 4 × 10 m shuttle run test ( P  = 0.036, η 2 p  = .08)]., Conclusion: A 6-week AcVR training is potentially effective for improving muscle architectural qualities, enhancing peak muscle torque, and boosting functional performance in patients with Juv-IA without experiencing any detrimental side effects., 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., (© 2024 The Authors.)

Introduction Chronic periodontal diseases can lead to bone defects and tooth loss, making accurate diagnosis essential for treatment. Various methods are used for diagnosing furcation involvement, with clinical examination and cone-beam computed tomography (CBCT) being the most effective. CBCT produces reliable images with submillimeter resolution, revealing marginal bone contours and furcation defects. Limited studies show that CBCT is more precise than clinical detection for diagnosing furcation involvement. Therefore, CBCT technology can be considered as an adjunct method for furcation involvement detection. This study tests the accuracy and efficiency of CBCT and clinical examination in detecting furcation involvement. Material and methods The study included 25 patients (68 molars) with generalized periodontitis of stage II to IV, Grade B and C. Inclusion criteria required at least two intrabony defects with probing depth > 6mm in both jaws and criteria of periodontitis in at least 30% of the teeth present. Results The study compared clinical examination and CBCT readings for measuring maxillary and mandibular teeth furcation involvement. The results show significant differences between clinical and CBCT measurements of maxillary teeth furcation involvement, particularly in specific areas and types of furcation involvement. In contrast, there were significant differences between clinical and CBCT readings for only a few measurements of mandibular teeth furcation involvement. Therefore, the study suggests that CBCT imaging may be beneficial for accurate diagnosis and treatment planning in cases of furcation involvement in maxillary teeth. Conclusion CBCT imaging is a reliable adjunct method for detecting furcation involvement in maxillary teeth, while clinical examination alone may not be sufficient. Therefore, the use of CBCT technology should be considered in cases where accurate detection of furcation involvement is necessary for successful treatment outcomes. However, further studies with larger sample sizes are needed to confirm these findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alotaibi et al.)

The paradigm of comprehensive treatment approaches for children with cerebral palsy has gained traction, prompting clinicians to deliberate between independent and integrated treatment delivery. However, this decision-making process is often hindered by the dearth of empirical evidence available to inform optimal therapeutic strategies. This study, therefore, sought to compare the effects of Pilates-based core strengthening (PsCS), plyometric-based muscle loading (PlyoML), and their combination on postural control, balance, and mobility in children with unilateral cerebral palsy (ULCP). Eighty-one children with ULCP (age: 12-18 years) were randomized to PsCS ( n = 27), PlyoML ( n = 27), or a combined intervention ( n = 27; equated for total sets/repetitions) group. The three interventions were applied twice/week over 12 successive weeks. Postural control (directional and overall limits of stability-LoS), balance, and mobility (Community Balance and Mobility Scale-CB&M; Functional Walking Test-FWT; Timed Up and Down Stair test-TUDS) were assessed pre- and post-intervention. The combined group exhibited greater increases in directional LoS compared to PsCS and PlyoML including the backward ( p = 0.006 and 0.033, respectively), forward ( p = 0.015 and 0.036, respectively), paretic ( p = 0.017 and 0.018, respectively), and non-paretic directions ( p = 0.006 and 0.004, respectively)], and this was also the case for overall LoS ( p < 0.001 versus PsCS and PlyoML). In addition, the combined group displayed greater improvements compared to the PsCS and PlyoML groups regarding CB&M ( p = 0.037 and p = 0.002, respectively), FWT ( p = 0.012 and p = 0.038, respectively), and TUDS ( p = 0.046 and p = 0.021, respectively). In conclusion, the combined PsCS and PlyoML exercise program promotes considerably greater improvements in postural control, balance, and mobility compared to unimodal training in children with ULCP.

Background: Emergency departments (EDs) are vital to the timely and necessary care that a significant percentage of patients get. Emergency medicine places a high priority on quality, and to deliver patient-centered care, it is crucial to first investigate patient expectations from ER visits., Methodology: This is a cross-sectional study of all visits to the King Abdulaziz University Hospital Emergency Department in Jeddah. The study included adult patients who visited the emergency department and were willing to complete a survey and participate in an interview. Data was collected through face-to-face questionnaires. Patient's expectations during their visit to the emergency department were correlated to different parameters using univariate and bivariate analysis., Results: The study included 291 patients. The majority of patients believed that their medical condition required admission to the hospital and agreed that it would be easier to receive treatment if admitted to the hospital. Results showed that 65.6% (n=191) of patients reported that the most serious patients should be seen first, and 65.3% (n=190) reported that a doctor should determine the seriousness of their health problem upon arrival. There was no significant difference found between age groups in relation to other items of expectations., Conclusion: It is clear that a sizable percentage of patients place a high value on seeing the most urgent cases first and having a doctor assess each patient's condition when they arrive. Our results show that, in order to guarantee the best patient happiness and care, healthcare practitioners must meet patients' expectations and modify their strategies accordingly., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bakhribah et al.)

Pure and manganese-doped titanium dioxide nanoparticles (MnTiO 2 -NPs) were synthesized by the defect-oriented hydrothermal approach. The synthesized material was then characterized by X-ray diffraction (XRD), Scanning electron microscopy (SEM), Energy dispersive X-ray spectroscopy (EDX), and UV-visible spectroscopy (UV-Vis). The agar well diffusion method assessed the antibacterial efficiency of TiO 2 and MnTiO 2 -NPs against E. coli and S. aureus . Zone of inhibition (ZOI) formed by pure TiO 2 was observed as 12 mm and 11.5 mm against E. coli and S. aureus , while for MnTiO 2 -NPs it was observed as 19 mm ( E. coli ) and 21 mm ( S. aureus ). The concentration of synthesized nanoparticles (10 mg/ml, and 20 mg/ml) was used for antibacterial studies. The efficacy of the pure and MnTiO 2 -NPs as an active photocatalyst for the degradation of methylene blue (MB) dye was also assessed using a UV light. It was observed that the photodegradation efficiency of 1 g of MnTiO 2 -NPs was higher than the same amount of pure TiO 2 . The results suggest that the photocatalyst concentration directly impacts the photodegradation of MB dye. The pH value was found to influence the photodegradation of MB dye at higher pH values. Based on the obtained results, MnTiO 2 -NPs were observed as a promising agent for microbial resistance and water remediation., 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. The author is an Editorial Board Member/Editor-in-Chief/Associate Editor/Guest Editor for [Journal name] and was not involved in the editorial review or the decision to publish this article. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests., (© 2024 The Authors.)

Background: Five-fifths of all incidents of blindness in Saudi Arabia may be attributed to cataracts. Cataracts are the second major cause of blindness, responsible for 35.5% of cases. Therefore, the purpose of the research was to measure the visual acuity improvement after cataract surgery in children., Materials and Methods: This systematic review followed PRISMA guidelines for reporting systematic reviews. All procedures followed the recommendations of the Cochrane handbook. Studies of varying study designs, both published and unpublished, are included. Retrospective studies with outcomes of pediatric cataract surgery were identified from various databases., Result: After an initial screening, 108 out of 167 items were deemed unsuitable for publication. There were 59 full-text papers assessed for inclusion, and only seven matched the criteria. All the articles included were of a very high standard. Both the duration of therapy and the target population varied widely between the studies., Conclusion: The results indicated that the majority of childhood cataracts are hereditary. Primary posterior capsulectomy and anterior vitrectomy combined with cataract extraction and intra-ocular lens implantation is the treatment of choice for pediatric cataracts. It is recommended that surgery be performed in a properly equipped facility staffed by trained, cooperative personnel and that different procedures be used to enhance post-operative follow-up., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Objectives: Complementary and integrative medicine (CAM) is a prevalent approach often used with conventional medical practices The study aims to understand the factors influencing breast cancer (BC) survivors' decisions regarding CAM therapy and the drivers behind their use., Setting: This research was conducted at an academic hospital in Saudi Arabia. The study used cross-sectional research with a questionnaire. Participants were enrolled in the study through BC survivors' groups on WhatsApp. Individuals who were actively following up at the clinic were also interviewed. Informed consent was obtained., Results: The study surveyed 211 BC survivors, aged 34-49 (50.2%), who had undergone surgery (93.4%), hormonal therapy (66.4%), and chemotherapy (87.7%). Less than half (44.5%) had chronic conditions such as diabetes and hypertension. CAM users were 43.6%. The most used CAM modalities were Zamzam water, honey, and water read-upon Quran. A significant motivator for CAM use was to boost the immune system. More than half of patients used less than 100 SAR per month on CAM modalities. Exactly 80.4% of CAM users perceived benefits from CAM use. Predictors of CAM use included higher family monthly income, radiation therapy, and being diagnosed from 1 to 5 years. BC survivors without medical conditions after diagnosis were less likely to use CAM., Conclusion: The study highlights the prevalence, predictive factors, motivations, and perceived benefits of CAM use among BC survivors in Saudi Arabia, emphasizing the need for understanding and integration into cancer care plans and the need for further research on CAM safety and efficacy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Abusanad et al.)

Aim: To explore how plyometric-based hydro-kinesiotherapy (Plyo-HKT) would affect pain, muscle strength, postural stability, and functional performance in a convenience sample of children with hemophilic knee arthropathy (HKA)., Methods: Forty-eight children with HKA (age: 8-16 years) were randomly allocated to the Plyo-HKT group ( n  = 24; underwent the Plyo-HKT for 45 min, twice/week over 12 wk in succession) or the comparison group ( n  = 24; performed the standard exercise rehabilitation at an equivalent frequency and duration). Pain, peak concentric torque of quadriceps and hamstring (produced at two angular velocities: 120 and 180 o /sec), dynamic limits of postural stability (DLPS), and functional performance [Functional Independence Score in Hemophilia (FISH) and 6-Minute Walk Test (6-MWT)] were assessed pre- and post-intervention., Results: In contrast with the comparison group, the Plyo-HKT group achieved more favorable pre-to-post changes in pain ( p = .028, η 2 p = 0.10), peak torque of quadriceps [120°/sec ( p = .007, η 2 P = 0.15); 180°/sec ( p = .011, η 2 P = 0.13)] and hamstring [120°/sec ( p = .024, η 2 P = 0.11); 180°/sec ( p = .036, η 2 P = 0.09)], DLPS directional [forward ( p = .007, η 2 P = 0.15); backward ( p = .013, η 2 P = 0.12); affected side ( p = .008, η 2 P = 0.14); non-affected side ( p = .002, η 2 P = 0.20)], DLPS overall ( p < .001, η 2 P = 0.32), and functional performance [FISH ( p < .001, η 2 p = 0.26); 6-MWT ( p = .002, η 2 p = 0.19)]., Conclusion: Plyo-HKT is likely helpful for reducing pain, improving strength, enhancing postural stability, and boosting functional capabilities in children with HKA. Physical rehabilitation practitioners should, therefore, consider this intervention strategy.

Chemoresistance and chemotherapy-related ovarian damage are well-reported in breast cancer (BC) young patients. Herein, the inhibition of the mitochondrial fission was invested to explore its chemosensitizing role in Paclitaxel (PTX)-resistant cells, and its ability to restore the ovarian integrity in mice receiving PTX or cisplatin chemotherapy. To establish these aims, PTX-resistance was generated in BC cells, which were treated with PTX in combination with Drp1 deficiency, via mdivi-1, or Drp1-specific siRNA transfection. Furthermore, the alterations in the ovarian structure and the endocrine-related hormones were explored in mice receiving repetitive doses of PTX or cisplatin. We found that combining PTX with mdivi-1 improved cell responsiveness to PTX, induced apoptosis- and autophagy-mediated cell death, and relieved cellular oxidative stress. Additionally, the expression of PCNA1 and cyclin B1 genes were downregulated, meanwhile, p53, p21, and mitochondrial fusion proteins (Mfu1&Mfu2) were increased. The in vivo investigations in mice demonstrated that PTX induced gonadotoxic damage similar to cisplatin, whereas dual treatment of mice with PTX+ mdivi-1 failed to restore their normal follicular count and the circulating levels of E2 and AMH hormones. These results suggested that combining Drp1 inhibition with PTX resensitized breast cancer cells to PTX but failed to offer enough protection against chemotherapy-related gonadotoxicity., (© 2023. The Author(s).)

Objectives: This study aimed to assess fall prevalence, identify related risk factors, and establish cut-off scores for fall risk measures among community-dwelling adults in Riyadh region of Saudi Arabia., Methods: A cross-sectional study was conducted in community, Riyadh city, Saudi Arabia. A sample of 276 Saudi citizens aged ≥40 years who were able to read and write in Arabic. Fall history and number of falls in the past 12 months were determined via self-reports. Variables assessed included demographic information, self-reported chronic diseases, depressive symptoms, and back pain severity., Results: Participants were classified as either fallers ( n  = 28, 10.14%) or non-fallers. Fallers were more likely to have arthritis (odds ratio [OR]: 7.60, p  = 0.001), back pain (OR: 5.22, p  = 0.002), and higher depressive symptom scores (OR: 1.09, p  = 0.013) than non-fallers. The number of reported falls was significantly associated with an elevated body mass index (incidence rate ratio [IRR]: 1.09, p  = 0.045), arthritis (IRR: 8.74, p  < 0.001), back pain (IRR: 4.08, p  = 0.005), neurological diseases (IRR: 13.75, p  < 0.007), and depressive symptoms (IRR: 1.08, p  = 0.005). Cut-off scores predictive of falls associated with back pain and depressive symptoms were 1.5 (sensitivity: 0.61; specificity: 0.79; area under the curve [AUC]: 0.70) and 11.5 score (sensitivity: 0.57; specificity: 0.76; AUC: 0.66), respectively., Conclusions: The prevalence of falls was relatively low among the individuals considered in this study. Chronic conditions, back pain severity, and depressive symptoms were determined to be associated with falls among community-dwelling individuals in Saudi Arabia., Competing Interests: The authors declare there are no competing interests., (©2023 Alenazi et al.)

Background Isotretinoin is a commonly prescribed agent mainly used to treat acne vulgaris. Since its Food and Drug Administration (FDA) approval, the subject of its associations with various medical conditions has become a growing interest in many investigational studies. Methodology A retrospective study was conducted using the validated Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire. All statistical calculations were performed using the Statistical Package for the Social Sciences (SPSS) version 27.0.1 (IBM SPSS Statistics, Armonk, NY). Results The research study involved 107 participants, predominantly Saudi nationals (98.1%), with an average age of 22 years. Regarding the total cumulative dose (TCD), 40.2% had less than 50 mg/kg, 33.6% had between 50 and 100 mg/kg, and 15.9% had more than 100 mg/kg. The majority (73.8%) did not stop using isotretinoin. The average Ocular Surface Disease Index (OSDI) score, indicating ocular surface disease symptoms, was 26.78. There was no significant association between gender, dose/duration of isotretinoin, TCD, and age, and OSDI scores. However, participants with severe OSDI scores were more likely to have worsened pre-existing eye symptoms compared to those with non-severe OSDI scores (35.1% versus 11.4%, p = 0.011). Conclusions This study contributes to the understanding of the impact of isotretinoin usage on ocular surface health. While no significant associations were found between gender, dose, duration, TCD, and age, and OSDI scores, participants with pre-existing eye symptoms were more likely to experience worsened symptoms during isotretinoin treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alfouzan et al.)

The SARS-CoV-2 virus gains entry into human cells by exploiting the angiotensin-converting enzyme 2 (ACE2), a key component known as the spike protein (S), as a point of entry. Initially, SARS-CoV-2 suppresses the natural function of ACE2, leading to a gradual decline in cell health. Additionally, individuals with cancer are considered more susceptible to COVID-19. This study investigates the expression patterns of ACE2 in colorectal cancer (CRC) patients with and without a history of COVID-19 infection. RT-PCR was used to analyze samples from both cancerous and adjacent non-affected colorectal tissues of 47 CRC patients, comprising two groups: 24 CRC patients with no history of COVID-19 and 23 CRC patients with a recent history of COVID-19 infection. Epithelial CR cells were isolated from both types of tissues and cultured to evaluate cell adhesion. Immunohistochemistry analyses were conducted to examine ACE2 protein expression using various ACE2 antibodies for both cell types. The study revealed ACE2 mRNA expression in all CRC tissues of patients with and without a history of COVID-19. ACE2 expression was significantly higher in CRC patients without a history of COVID-19. Notably, the non-affected colorectal cancer (NACRC) tissues of patients without a history of COVID-19 also showed ACE2 expression, whereas no ACE2 expression was detected in the biopsies of CRC patients with a positive COVID-19 history. ACE2 antibodies were employed to validate ACE2 protein expression at the mRNA level. COVID-19 appears to downregulate ACE2 expression in both CRC and NACRC tissues of CRC patients with a positive history of COVID-19 infection., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Lifestyle factors, including smoking, have been linked to neoplastic diseases, and reports suggest an association between smoking and overexpression of FGFR (fibroblast growth factor receptor) in certain neoplasms. This study aims to assess the expression of FGFR3 and FGFR4 genes in patients with and without a history of smoking.A total of 118 participants were recruited, including 83 Juvenile Nasopharyngeal Angiofibroma (JNA) patients and 35 healthy participants, the JNA patients were further stratified as smokers and nonsmokers. Total RNA was extracted from the blood & saliva sample by using TRIzol reagent, and quantified using a Nanodrop, and then subjected to gene expression analysis of FGFR3/4 using RT-PCR. Immunohistochemistry analysis was employed using fresh biopsies of JNA to validate the findings. All experiments were performed in triplicates and analysed using the Chi-Square test (P < 0.05). Smokers exhibited significantly lower total RNA concentrations across all sample types (P < 0.001). The study revealed significant upregulation of both FGFR3/4 genes in JNA patients (P < 0.05). Moreover, FGFR3 expression was significantly higher among smokers 66% (95% CI: 53-79%) compared to non-smokers 22% (95% CI: 18-26%). Immunohistochemistry analysis demonstrated moderate to strong staining intensity for FGFR3 among smokers. The study highlights the overexpression of FGFR3/4 genes in JNA patients, with a stronger association observed among smokers. Furthermore, medical reports indicated higher rates of recurrence and bleeding intensity among smokers. These findings emphasize the potential role of FGFR3 as a key molecular factor in JNA, particularly in the context of smoking., (© 2023. The Author(s), under exclusive licence to Institute of Plant Genetics Polish Academy of Sciences.)

Background: The most prevalent cause of hair loss is androgenetic alopecia. Improved therapeutic modalities may result from knowing how stress affects hair growth, incorporating stress-coping methods into the treatment of hair loss disorders, and developing new pharmacotherapeutic approaches. This study aimed to examine the psychosocial burden of androgenetic alopecia in Saudi Arabia., Materials and Methods: A cross-sectional online survey study was conducted among patients with androgenetic alopecia in Saudi Arabia in February 2023. A previously developed questionnaire was adapted from a previously published tool and used in this study. This association between patients' characteristics and the level of psychosocial disease was identified using binary logistic regression analysis., Results: This study included 1230 patients. The majority of the patients (78.0%) reported that they felt embarrassed by their androgenetic alopecia. The median score of the psychosocial impact of androgenetic alopecia on the patients was 1.00 (0.00-2.00), which is equal to 10.0%, reflecting a low level of psychosocial burden on the patients by their condition. Binary logistic regression analysis identified that patients without a family history of androgenetic alopecia were 36.0% less likely to be affected psychosocially by their condition ( P < 0.01)., Conclusions: A low-level psychosocial effect was seen in our study among individuals with androgenetic alopecia. Further research should be done to determine how the type of alopecia affects patients' psychological results, as well as the influence of the disease's duration on those outcomes. Dermatologists are recommended to raise patients' knowledge of their disease and lessen stigmatization in the meantime., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Family Medicine and Primary Care.)

This study presents a novel method for the photocatalytic synthesis of 4-aryl-6-(3-coumarinyl) pyrimidin-2 (1H)-ones (a coumarin derivative) using strawberry dye-sensitized TiO 2 (SD-TiO 2 ) under visible light. The synthesis of 4-aryl-6-(3-coumarinyl) pyrimidin-2 (1H)-ones was achieved through a three-component, one-pot condensation reaction involving 3-acetyl coumarin, aldehydes, and urea, utilizing SD-TiO 2 as a reusable and innovative photocatalyst at room temperature. The resulting SD-TiO 2 photocatalyst was thoroughly characterized using FT-IR, XPS, XRD, SEM, and BET. The efficacy of SD-TiO 2 was evaluated by comparing it to pristine TiO 2 in terms of photocatalytic activity, and the optimal conditions for the synthesis process were determined. Notably, the SD-TiO 2 photocatalyst exhibited a maximum yield of the compound, reaching up to 96% in just 30 min with a catalyst concentration of 1 mg/mL. This yield surpasses traditional thermal procedures employing reflux conditions, where 1 mg/mL of SD-TiO 2 is sufficient to complete the reaction. The resulting 4-aryl-6-(3-coumarinyl) pyrimidin-2 (1H)-ones were further characterized using 1 H-NMR and 13 C-NMR. Moreover, the stability of the SD-TiO 2 photocatalyst was confirmed through recyclability experiments and spectroscopic characterization, demonstrating its practicality for up to three consecutive reaction cycles.

Class IV sirtuin ( SIRT6 and SIRT7 ) played essential roles in biometabolism processes via deacetylating specific transcription factors. The present study was conducted to search for mutations in SIRT6 / 7 and determine their associations with growth traits in black Tibetan sheep. Via DNA sequencing methods, three single-nucleotide polymorphisms (SNPs) were identified in 427 ewes, including a mutation (g.3724C > T) in the intron 1 of SIRT6 and two mutations (g.3668G > T and g.4223C > G) in SIRT7 intron 6 and 8, respectively. Based on the χ 2 test, both g.3724C > T and g.4223C > G loci fitted with Hardy-Weinberg equilibrium ( p  > 0.05). Compared with animals with genotype TT, the CC genotype at g.3724C > T locus ( SIRT6 ) exhibited the highest mean for body weight ( p  < 0.05) and heart girth ( p  < 0.05). At g.3668G > T locus ( SIRT7 ), individuals carrying the GG genotype tended to have heavier body weight than those of TT genotype ( p  < 0.05). With the exception of body weight, body measurement traits not affected by combinative genotype ( p  > 0.05). Our results could be used as genetic markers for marker-assisted selection and maybe guide sheep breeding in economic traits.

Structural reorganization of chromosomes by genomic duplications and/or deletions are known as copy number variations (CNVs). Pathogenic and disease susceptible CNVs alter gene dosage and its phenotypic expression that often leads to human genetic diseases including Neurological disorders. CNVs affecting same common genes in multiple neurodevelopmental disorders can better explain the shared clinical and genetic aetiology across brain diseases. Our study presents the novel copy number variations in a cohort of five multiplex consanguineous families with intellectual disability, microcephaly, ASD, epilepsy, and neurological syndromic features. Cytoscan HD microarray suite has revealed genome wide deletions, duplications and LOH regions which are co-segregating in the family members for the rare neurodevelopmental syndromic phenotypes. This study identifies 1q21.1 microduplication, 16p11.2 microduplication, Xp11.22 microduplication, 4p12 microdeletion and Xq21.1 microdeletion that significantly contribute to primary disease onset and its progression for the first time in Pakistani families. Our study has potential impact on the understanding of pathogenic genetic predisposition for appearance of complex and heterogeneous neurodevelopmental disorders with otherwise unexplained syndromic features. Identification of altered gene dosage across the genome is helpful in improved diagnosis, better disease management in day-to-day life activities of patients with cognitive impairment and genetic counselling of families where consanguinity is a tradition. Our study will contribute to expand the knowledge of genotype-phenotype expression and future gateways in therapeutics and precision medicine research will be open in Pakistan., Competing Interests: The authors declare that they have no competing financial interests or relationships that could influence the work presented in the study., (© 2023 Published by Elsevier Ltd.)

Thermocatalytic methane decomposition (TCMD) involving metal oxides is a more environmentally friendly and cost-effective strategy for scalable hydrogen fuel production compared to traditional methane steam reforming (MSR), as it requires less energy and produces fewer CO/CO 2 emissions. However, the unsupported metal oxide catalysts (such as α-Fe 2 O 3 ) that would be suited for this purpose exhibit poor performance in TCMD. To overcome this issue, a novel strategy was developed as a part of this work, whereby oxygen vacancies (OVs) were introduced into unsupported α-Fe 2 O 3 nanoparticles (NPs). Systematic characterization of the obtained materials through analytical techniques demonstrated that mesoporous nanostructured unsupported α-Fe 2 O 3 with abundant oxygen vacancies (OV-rich α-Fe 2 O 3 NPs) could be obtained by direct thermal decomposition of ferric nitrate at different calcination temperatures (500, 700, 900, and 1100 °C) under ambient conditions. The thermocatalytic activity of the resulting OV-rich α-Fe 2 O 3 NPs was assessed by evaluating the methane conversion, hydrogen formation rate, and amount of carbon deposited. The TCMD results revealed that 900 °C was the most optimal calcination temperature, as it led to the highest methane conversion (22.5%) and hydrogen formation rate (47.0 × 10 -5 mol H 2 g -1 min -1 ) after 480 min. This outstanding thermocatalytic performance of OV-rich α-Fe 2 O 3 NPs is attributed to the presence of abundant OVs on their surfaces, thus providing effective active sites for methane decomposition. Moreover, the proposed strategy can be cost-effectively scaled up for industrial applications, whereby unsupported metal oxide NPs can be employed for energy-efficient thermocatalytic CH 4 decomposition into hydrogen fuel and carbon nanomaterials.

Various research pieces of evidence have been published in recent years, establishing the increasing prevalence of early colon cancer among young people. In this background, the current study aimed to analyze the reasons behind colon cancer recurrence among endogamous consanguineous cases in four generations of a single Saud family. For this study, the authors conducted the whole-exome sequencing analysis to screen for germline mutations in DNA samples from consanguineous cases within the family. After collecting the colon samples, it was analyzed histologically and immunohistochemically with the help of Breast Cancer antibodies (BRCA2 and 1 correspondingly) and H&M staining (hematoxylin and eosin). For this study, 26 at-risk consanguineous cases were considered. Three cases were diagnosed with malignant colon cancer, two with breast cancer, and 17 with germline mutations, yet remain unaffected by cancerous tumors. The rest, four consanguineous cases, are healthy and non-carriers of the mutations. However, as per the exome analysis outcomes, 15 cases inherited germline mutations in nine genes. Nine substitution mutations were present in six of the nine inherited genes in these inherited germline mutations. Furthermore, it also presented six insertion and deletion frameshift mutations in five of nine inherited genes. The immunohistochemical staining process achieved positive staining outcomes for BRCA1 and 2. Therefore, germline mutations inherited from the nine genes of endogamous consanguineous cases of mutation carriers remain the primary reason behind colon cancer recurrence in the same family.

The coronavirus disease 2019 (COVID-19) pandemic imposes an urgent and continued need for the development of safe and cost-effective vaccines to induce preventive responses for limiting major outbreaks around the world. To combat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we repurposed the VSV∆51M oncolytic virus platform to express the spike receptor-binding domain (RBD) antigen. In this study, we report the development and characterization of the VSV∆51M-RBD vaccine. Our findings demonstrate successful expression of the RBD gene by the VSV∆51M-RBD virus, inducing anti-RBD responses without attenuating the virus. Moreover, the VSV∆51M-RBD vaccine exhibited safety, immunogenicity, and the potential to serve as a safe and effective alternative or complementary platform to current COVID-19 vaccines., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Alkayyal, Darwish, Ajina, Alabbas, Alotaibi, Alsofyani, Bokhamseen, Hakami, Albaradie, Moglan, Hala, Alsahafi, Zakri, Almuzaini, Alsharari, Kaboha, Taher, Zein, Alroqi and Mahmoud.)

There is growing concern among healthcare providers worldwide regarding the prevalence of multidrug-resistant Acinetobacter baumannii ( A. baumannii ). Some of the worst hospital-acquired infections, often in intensive care units (ICUs), are caused by this bacterial pathogen. In recent years, the rise in multidrug-resistant A. baumannii has been linked to the overuse of antimicrobial drugs and the lack of adequate infection control measures. Infections caused by this bacterial pathogen are the result of prolonged hospitalization and ICU stays, and they are associated with increased morbidity and mortality. This review outlines the epidemiology, risk factors, and antimicrobial resistance associated with A. baumannii in various countries, with a special focus on the Kingdom of Saudi Arabia. In response to the growing concern regarding this drug-resistant bacteria, fundamental information about its pathology has been incorporated into the development of vaccines. Although these vaccines have been successful in animal models, their effectiveness in humans remains unproven. The review will discuss the development of A. baumannii vaccines, potential related obstacles, and efforts to find an effective strategy against this pathogen.

Introduction: Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused by a novel coronavirus (CoV), was reported at the end of 2019 and caused a severe public health concern. It caused high mortalities by respiratory failure among infected people and was declared a pandemic by the World Health Organization (WHO) in March 2020. This virus caused infections through air or direct contact which documented a huge number of fatalities., Aim: This study aims to examine the impact of the COVID-19 pandemic on skin eczema of the general public in the Riyadh region of Saudi Arabia., Methods: This is a descriptive, cross-sectional, survey-based study, that was conducted via an online survey distributed to the general population of Riyadh for the period between January and February 2023. Data was collected through a questionnaire which was distributed through the social media websites., Results: A total of 697 participants were involved in this study. Around one-fifth of the study participants (19.5%) reported that they suffer from some form of allergy and have family history of allergy (21.8%). Eczema was the most common type of allergy among the study participants accounting for 32.4%. A total of 116 participants (16.6%) reported that they have personal history of hand eczema or other skin disease on the hands. Cleaning and sterilization materials were reported as the most common cause of dryness and irritation of eczema (62.1%). Around 41.0% of the participants reported that they noticed a worsening of their symptoms after the pandemic, of which dryness was the most commonly reported sign noticed getting worse by 68.1% of the participants. The vast majority of the participants (89.7%) reported that new skin symptoms emerged on their hands after the beginning of the pandemic, of which dryness was reported by all the participants., Conclusion: A considerable proportion of participants, particularly those with a history of hand eczema, experienced dermatological difficulties, including skin damage, due to the usage of COVID-19 preventive strategies. Thus, we recommend increasing the use of innovative infection prevention approaches and skin protection measures, such as regular hand hydration and maybe the use of less toxic skin disinfectants., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alwadany et al.)

&lt;b&gt;Background and Objective:&lt;/b&gt; Chronic Lymphocytic Leukaemia (CLL) is a frequent type of leukaemia disease. This study was focused on investigating the role of prognostic indicators, such as CD180 and MD-1 for Chronic Lymphocytic Leukaemia (CLL) pathogenesis because they involve cell signalling and proliferation. &lt;b&gt;Materials and Methods:&lt;/b&gt; A total of 12 normal controls and 52 patients were taken to determine the expressions of CD180 and MD-1 with different variations in comparison with the IgVH (Immunoglobulin Heavy Chain variable region gene) mutational status, FISH (fluorescence &lt;i&gt;in situ&lt;/i&gt; hybridization) and Rai staging. &lt;b&gt;Results:&lt;/b&gt; The quantitative data findings were evident that CD180 and MD-1 expressions showed insignificant differences among CLL patients at the protein level based on SPSS results. On the contrary, they resulted in significant differences for subgroups of established biomarkers like Rai staging (stages 0, I, II and III), FISH (13q and non-13q deletions) and IgVH (mutated and unmutated). &lt;b&gt;Conclusion:&lt;/b&gt; The CD180 and MD-1 have been used as prognostic indicators to evaluate the outcomes relevant to the cell cycle and survival rate of CLL cells.

(1) Background and Objectives : Pneumonia is a major cause of morbidity and mortality worldwide, including in Saudi Arabia, and the prevalence and etiology of the disease varies depending on the setting. The development of effective strategies can help reduce the adverse impact of this disease. Therefore, this systematic review was conducted to explore the prevalence and etiology of community-acquired and hospital-acquired pneumonia in Saudi Arabia, as well as their antimicrobial susceptibility. (2) Materials and Methods : The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 recommendations were followed for this systematic review. Several databases were used to perform a thorough literature search, and papers were then assessed for eligibility by two independent reviewers. The Newcastle-Ottawa Scale (NOS) was used to extract the data from the relevant research and evaluate its quality. (3) Results : This systematic review included 28 studies that highlighted the fact that gram-negative bacteria, particularly Acinetobacter spp. and Pseudomonas aeruginosa , were the common cause of hospital-acquired pneumonia, while Staphylococcus aureus and Streptococcus spp. were responsible for community-acquired pneumonia in children. The study also found that bacterial isolates responsible for pneumonia showed high resistance rates against several antibiotics, including cephalosporins and carbapenems. (4) Conclusions : In conclusion, the study found that different bacteria are responsible for community- and hospital-acquired pneumonia in Saudi Arabia. Antibiotic resistance rates were high for several commonly used antibiotics, highlighting the need for rational antibiotic use to prevent further resistance. Moreover, there is a need to conduct more regular multicenter studies to assess etiology, resistance, and susceptibility patterns of pneumonia-causing pathogens in Saudi Arabia.

The chemical industry is one of the main fossil fuel consumers, so its reliance on sustainable and renewable resources such as wind and solar energy should be increased to protect the environment. Accordingly, solar-driven thermocatalytic synthesis of octahydroquinazolinone using polyvinylchloride (PVC)-supported aluminum oxide (Al 2 O 3 ) as a catalyst under natural sunlight is proposed in this work. The Al 2 O 3 /PVC catalysts were characterized by FT-IR, SEM, BET, XRD, and XPS techniques. The obtained results indicate that the yield and reaction time can be modified by adjusting the molar ratio of the catalyst. To investigate the stability of the catalyst, the spent catalyst was reused in several reactions. The results indicated that, when a 50% Al 2 O 3 catalyst is employed in an absolute solar heat, it performs exceptionally well in terms of yield (98%) and reaction time (35 min). Furthermore, the reaction times and yield of octahydroquinazolinone derivatives with an aryl moiety were superior to those of heteroaryl. All the synthesized compounds were well characterized by FT-IR, 1 H-NMR, and 13 C-NMR. The current work introduces a new strategy to use solar heat for energy-efficient chemical reactions using a cost-effective, recyclable environmentally friendly PVC/Al 2 O 3 catalyst that produces a high yield.

With the advancement in 3D bioprinting technology, cell culture methods can design 3D environments which are both, complex and physiologically relevant. The main component in 3D bioprinting, bioink, can be split into various categories depending on the criterion of categorization. Although the choice of bioink and bioprinting process will vary greatly depending on the application, general features such as material properties, biological interaction, gelation, and viscosity are always important to consider. The foundation of 3D bioprinting is the exact layer-by-layer implantation of biological elements, biochemicals, and living cells with the spatial control of the implantation of functional elements onto the biofabricated 3D structure. Three basic strategies underlie the 3D bioprinting process: autonomous self-assembly, micro tissue building blocks, and biomimicry or biomimetics. Tissue engineering can benefit from 3D bioprinting in many ways, but there are still numerous obstacles to overcome before functional tissues can be produced and used in clinical settings. A better comprehension of the physiological characteristics of bioink materials and a higher level of ability to reproduce the intricate biologically mimicked and physiologically relevant 3D structures would be a significant improvement for 3D bioprinting to overcome the limitations., Competing Interests: Declaration of competing interest 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., (Copyright © 2023 Elsevier B.V. All rights reserved.)

3-D Bioprinting is employed as a novel approach in biofabrication to promote skin regeneration following chronic-wounds and injury. A novel bioink composed of carbohydrazide crosslinked {polyethylene oxide-co- Chitosan-co- poly(methylmethacrylic-acid)} (PEO-CS-PMMA) laden with Nicotinamide and human dermal fibroblast was successfully synthesized via Free radical-copolymerization at 73 °C. The developed bioink was characterized in term of swelling, structural-confirmation by solid state 13C-Nuclear Magnetic Resonance (NMR), morphology, thermal, 3-D Bioprinting via extrusion, rheological and interaction with DNA respectively. The predominant rate of gelation was attributed to the electrostatic interactions between cationic CS and anionic PMMA pendant groups. The morphology of developed bioink presented a porous architecture satisfying the cell and growth-factor viability across the barrier. The thermal analysis revealed two-step degradation with 85 % weight loss in term of decomposition and molecular changes in the bioink moieties By applying low pressure in the range of 25-50 kPa, the optimum reproducibility and printability were determined at 37 °C in the viscosity range of 500-550 Pa. s. A higher survival rate of 92 % was observed for (PEO-CS-PMMA) in comparison to 67 % for pure chitosan built bioink. A binding constant of K ≈ 1.8 × 10 6  M -1 recognized a thermodynamically stable interaction of (PEO-CS-PMMA) with the Salmon-DNA. Further, the addition of PEO (5.0 %) was addressed with better self-healing and printability to produce skin-tissue constructs to replace the infected skin in human., Competing Interests: Declaration of competing interest 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., (Copyright © 2023 Elsevier B.V. All rights reserved.)

This research explores DNA consistency and attempts to detect STR profiles from the degrading menstrual blood samples (MBS) as reliable forensic evidence. Peripheral (PBS) and MBS of 30 healthy fertile females were taken on the menstrual cycle's second day. They were obtained at different time periods (0, 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 24, and 48 h) at 25 °C. DNA evaluation was fulfilled to analyze DNA profiles. A considerable elevation in the median concentrations of DNA between 0 and 14-h intervals were documented, whereas decreased extents were registered between 16 and 48 h. Moreover, complete STR profiles (24/24) for DNA were discovered in all the intervals (0, 2, and 48 h). Periods of 0-8 h demonstrated the maximum extents of DNA materials. Full STR were discovered in all the intervals (0, 2, and 48 h). Eventually, MBS can be utilized as forensic evidence., Competing Interests: Conflicts of interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)