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The sudden loss of columns due to abnormal loads demonstrates a remarkable example of a localized failure that might ultimately result in the progressive collapse of the complete steel-framed structures. In this study, finite element (FE) simulations are implemented by utilizing ABAQUS-Explicit to investigate the progressive collapse of two-storey steel reduced beam section (RBS) frames with web openings. The reliability and accuracy of the FE models are validated by comparing the obtained results with currently available experimental test results. A numerical investigation is conducted on twenty-eight RBS frames, each with a distinct web opening form (i.e. circular, square, and hexagon holes), different sizes of (D = 75, 90, and 105 mm), and varying distances of (25, 50, and 100 mm) from the center of the flange-reduced to the web opening. The failure modes, load-displacement characteristics, and development of catenary action are evaluated. The results showed that the specimens with square holes showed a greater degree of damage and lower load-carrying capacity compared with the specimens that have circle and hexagonal holes. In addition, an increased opening size resulted in a decrease in load-bearing capacity at small distances, thereby resulting in an increased capacity at a large distance.

Laila Salah Aldokhail,1 Abdulaziz Mohammad Alhadlaq,2 Lujain Mohamed Alaradi,1 Lamees Mohamed Alaradi,1 Fatimah Yaseen AlShaikh1 1Department of Ophthalmology, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 2Division of Ophthalmology, Security Forces Hospital, Riyadh, Saudi Arabia, Ophthalmology Department, College of Medicine, Qassim university, Qassim, Saudi ArabiaCorrespondence: Laila Salah Aldokhail, Department of Ophthalmology, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, Email Aldokhail.laila@gmail.comBackground: Anti-vascular endothelial growth factor (anti-VEGF) therapy has revolutionized the management of various ocular conditions, including diabetic macular edema (DME), retinal vein occlusion (RVO)-related macular edema (ME), and neovascular age-related macular degeneration (nAMD). However, there remains a need to systematically assess its effectiveness across these distinct conditions.Methodology: A systematic review was conducted to identify studies evaluating the efficacy of anti-VEGF therapy in improving ocular outcomes in patients with DME, RVO-related ME, and nAMD. PubMed, Embase, and Cochrane Library databases were searched for relevant articles published up to 2024. Studies meeting the inclusion criteria were critically appraised, and data on the proportion of patients gaining ≥ 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in best-corrected visual acuity (BCVA), mean change in BCVA (ETDRS letters), and reduction in central macular thickness (CMT) (μm) were extracted and synthesized.Results: The systematic review identified 18 studies comprising randomized controlled trials, prospective studies, retrospective analyses, and observational studies. Anti-VEGF therapy demonstrated efficacy across all three conditions, with varying proportions of patients experiencing improvements in BCVA and reductions in CMT. Notably, the proportion of patients gaining ≥ 15 ETDRS letters ranged from 18.1% to 44.8% in DME, while mean changes in BCVA ranged from +4.2 letters to +21.4 letters in RVO-related ME and nAMD. Reductions in CMT ranged from 183.1 μm to 294 μm in DME and RVO-related ME.Conclusion: Anti-VEGF therapy represents a cornerstone in the management of DME, RVO-related ME, and nAMD, with significant improvements observed in BCVA and reductions in CMT across diverse patient populations. While our findings support the effectiveness of anti-VEGF therapy in improving ocular outcomes, further research is warranted to compare its efficacy with alternative treatment modalities and to elucidate its long-term safety profile.Keywords: outcomes, anti-VEGF, diabetic macular edema, retinal vein occlusion, neovascular AMD

Quantum-secure cryptography is a dynamic field due to its crucial role in various domains. This field aligns with the ongoing efforts in data security. Post-quantum encryption (PQE) aims to counter the threats posed by future quantum computers, highlighting the need for further improvement. Based on the learning with error (LWE) system, this paper introduces a novel asymmetric encryption technique that encrypts entire messages of n bits rather than just 1 bit. This technique offers several advantages including an additive homomorphic cryptosystem. The robustness of the proposed lightweight public key encryption method, which is based on a new version of LWE, ensures that private keys remain secure and that original data cannot be recovered by an attacker from the ciphertext. By improving encryption and decryption execution time—which achieve speeds of 0.0427 ms and 0.0320 ms, respectively—and decreasing ciphertext size to 708 bits for 128-bit security, the obtained results are very promising.

This study investigated the flow characteristics, entropy generation, and thermal transfer of convection in a vertical and horizontal three-dimensional square duct filled with ferrofluid. The influence of periodic transverse and partial magnetic fields (MFs) along the walls of a duct having a constant flux density on the flow pattern is explored. The analysis is carried out by examining various geometric and physical parameters, i.e., the Grashof number (Gr) (40 ≤ Gr ≤ 4 × 105), the Hartmann number (Ha) ranged from 0 to 50, Reynolds number (Re = 200) and volume fraction of Fe3O4 nanoparticles (Ø = 0.02). The effect of the various factors in the problem on heat transfer presented by Nusselt number (Nu) and the friction coefficient along the entropy generation have been discussed graphically. Findings show that when the magnetic force is applied transversely (γ = π/2, γ = π/4) under both full and partial circumstances, the total entropy generation decreases with rising Ri and Ha. On the other hand, when it is applied longitudinally (γ = 0), it grows. The opposite tendency is noted for the Nusselt number and therefore the heat exchange. Using the horizontal position leads to accelerated heat transfer, while entropy production is reduced.

Objective Duchenne muscular dystrophy (DMD) is a rare X-linked neurodegenerative disorder caused by mutations in the DMD gene. This study examined the efficacy and safety of ataluren, the first oral treatment for DMD with nonsense mutations (nmDMD), in patients in the Middle East. Methods This retrospective longitudinal study assessed the outcomes of seven boys with nmDMD who received treatment with ataluren and follow-up at a single center since 2016. Results The median patient age at treatment initiation was 8.04 years (range: 3.3–9.92), and the median duration of exposure was 3.95 years (interquartile range = 4.42 years). Five patients were still ambulatory at the last follow-up. Ataluren was more effective in individuals with baseline 6-min walking distance (6MWD) ≥300 m, as these patients had smaller declines in 6MWD and North Star Ambulatory Assessment scores. Pulmonary function was well preserved in all patients, with no patients having forced vital capacity

Lip print identification is one of the forensic identification tools recognized a long time ago. Few studies investigated the stability of lip prints, particularly the changes attributed to time or aging. To our knowledge, no previous studies speculated the changes in lip print following lip augmentation therapy, which has increased over the last few years. Therefore, the current study aimed to investigate the effect of lip augmentation therapy on lip print stability. The current study was a prospective longitudinal study that enrolled female volunteers who underwent a filling procedure for labial augmentation. A total of 24 volunteers' prints were analyzed using Suzuki and Tsuchihashi classification. Participants showed a mean age of 27.5 ± 6.0 years. The current study showed that no two lips exhibited the same pattern. Moreover, although the filling procedure for labial augmentation (FPLA) therapy preserved the predominant groove pattern, it significantly influenced the frequency of lip patterns in all lip quadrants. A significant decline in the number of lip grooves, notably Types I and I' was noticed. However, the predominant groove pattern was preserved. Quadrants A and D were the least affected lip parts. Type I′ was the predominant lip pattern over the study population, representing 83.3 %, followed by Type I, representing 16.7 % before and 12.5 % after augmentation without a statistically significant difference (p = 0.317). On the other side, Type III was the least presented pattern. The upper lip score had decreased significantly after augmentation from 71.5 ± 10.8–65.8 ± 10.2, and the lower lip score had decreased significantly from 67.4 ± 13.7–64.9 ± 13.5. Consequently, the overall lips score had decreased significantly from 139.0 ± 22.9–130.7 ± 21.1 after augmentation (p < 0.001). So, we recommend adopting more than one criterion to report a reliable, repeatable lip print, including the frequency of lip lines besides the predominant pattern. However, we advise giving more attention to the distinguished lip patterns (Types II, III, IV, and V) and considering the FPLA as one of the lip print modifiers.

This study evaluated the thermokinetic and thermodynamic properties of Dracaena draco fibers (DDFs) through thermogravimetric analysis (TGA). The DDFs underwent non-isothermal heating in a nitrogen atmosphere, with 5, 10, and 20 °C/min heating rates starting at 20 °C and reaching 800 °C. TGA analysis demonstrated that the pyrolysis of DDFs took place in three clearly defined phases: dehydration, devolatilization, and solid biochar. The thermokinetic and thermodynamic properties were computed for the devolatilization phase of mass reduction. The Coats-Redfern technique employed twenty-one separate kinetic equations derived from four fundamental solid-state reaction processes. Out of all the diffusivity models (DMs), the Ginstlinge-Brounshtein (DM5), Jander (3D diffusion) (DM7), and Ginstling models (DM8) had the best fit, as indicated by their highest coefficient of regression values (R2 > 0.990) across all the three heating rates. The activation energy values found by the DM5, DM7, and DM8 models are 76.5, 82.32, and 76.47 kJ/mol, respectively, for the 5 °C/min heating rate. The thermodynamic variables, including the entropy, free energy, and enthalpy change, were calculated based on the kinetic data. The study’s findings are significant for evaluating the DDFs' potential as an energy source, constructing reactors, producing chemicals, and understanding the DDFs’s features for composite synthesis.

Background: Allergic rhinitis (AR) is a highly prevalent disease. We aimed to assess the symptoms that physicians who see patients with AR perceive as the most bothersome in their patients. Methods: We performed a cross-sectional study based on an online questionnaire sent to all members of the Allergic Rhinitis and its Impact on Asthma (ARIA) initiative. The survey included questions on the physicians' perceptions of patients’ AR symptoms as well as of their own AR symptoms. Results: Among 401 respondents, 155 (38.7%) reported having AR. ARIA members reported nasal symptoms to be the most frequent (89.7%) and bothersome (80.0%) symptoms experienced by themselves. Likewise, nasal symptoms were reported by ARIA members as the most frequent (94.8% in members with AR vs 96.0% in members without AR) and bothersome (57.0% in members with AR vs 67.9% in members without AR) in their patients. We found a significant association (p = 0.001) between physicians’ own symptoms and those perceived as the most bothersome in their patients. Conclusion: Physicians perceive nasal symptoms to be the most frequent and the most bothersome symptoms in AR patients. The physicians' personal experiences with AR may influence their perception of patients’ symptoms.

This study examines the tensile characteristics of Chamaerops humilis (ChF) fibers by testing them for the first time on samples with N = 30 to 210. This study examined the quasi-static traction properties on 50 mm gauge length ChFs. Tensile tests with an average diameter of 12.381 ± 1.23 mm and a twisting angle of 13° were conducted on 10 twisted ecological yarns to determine the effect of variation on plant fiber tensile properties for textile yarns. Furthermore, seven groups (N = 30, 60, 90, 120, 150, 180, and 210) had 210 fibers analyzed. The dispersion was examined using variance analysis and Weibull distribution analysis because of the inherent heterogeneity in the mechanical properties of ChFs. The samples of Ch yarns exhibited a tensile stress σ of 68.52 ± 7.89 MPa, ε of 7.14 ± 0.32%, and E of 380.23 ± 145.33 MPa. Tensile testing on ChFs revealed that N raises the fibers’ σ, E, and ε values between 30 and 150 tests, while N = 180 and 210 caused a drop. Also, The Kaplan–Meier estimator offers a better fit for the ChFs, according to the statistical study’s estimating techniques employing LS and ML approaches.

Green composites consisting of renewable or biodegradable materials are becoming more popular as environmental awareness of global waste issues grows. Among them, natural composites made of polymers have proven to work exceptionally well because of their high strength, rapid breakdown after disposal, and simplicity in processing using standard techniques. In particular, competitive mechanical performances have been demonstrated by green composites having a polymer matrix reinforced with sisal, luffa, and maize fibers at different fiber percentages of 10%, 15%, and 25%. The tensile characteristics of polymer composites reinforced with these fibers are optimized in this study by the application of Taguchi and response surface methodology. By assessing characteristics such as section size, fiber content, and fiber type simultaneously, the study attempts to produce optimal biocomposite qualities, which are then experimentally tested. Tensile tests show considerable gains: the biocomposite containing 15% corn fiber showed a 21.04% increase in tensile strength. Similarly, sisal, luffa, and corn fibers all showed notable improvements in Young’s modulus, with the biocomposite showing 22.77%, 31.77%, and 20.25% increases, respectively.

This study aims to enhance the mechanical properties of date palm fibers (DPFs) by implementing a targeted treatment technique. The response surface methodology (RSM) is utilized for modeling and optimizing. The study seeks to identify the optimal Alkaline treatment settings for improving the mechanical properties of DPFs by carefully analyzing parameters such as average diameter, time, and NaOH concentration. The analytical results offer valuable insights into the possible use of DPFs in many engineering applications, contributing to the industrial advancement of sustainable and eco-friendly materials. The experimental findings are analyzed using a full-factorial design (43), incorporating analysis of variance and RSM. Combining RSM and desirability function is used to get the best mechanical properties, including stress, strain, and Young’s modulus. The model appropriateness is evaluated by analyzing residual values. The findings suggest that the sodium hydroxide concentration (%NaOH) has the most significant impact on strain (11.63%), stress (12%), and Young’s modulus (11.72%) besides the time t (h) also significantly influences 6.01%, 6.26%, and 5.79% strain, stress, and Young’s modulus, respectively.

Manufacturing composites using natural fibers support the development of more ecologically friendly applications in many industrial areas, including sports equipment, wind turbine blades, construction materials, packaging, medical devices, and prosthetics. To investigate the tests’ number (N) impact on the fibers’ tensile behavior, newly developed fibers from the Strelitzia juncea (SJ) plant are being studied for their mechanical properties using various statistical laws. This study aims to assess the SJ fibers’ performance with a gauge length of 50 mm under quasi-static stress conditions. 150 SJ fibers were tensile tested in five groups (30, 60, 90, 120, and 150) to determine the N impact on the fibers’ tensile strength, break deformation, and Young’s modulus. Weibull and log-normal distributions were used to study statistically the mechanical properties results, and their dispersion was investigated and quantified using least squares and maximum likelihood prediction model with a confidence level of 95%.

This study proposes locally available and environment-friendly Algerian palm (Washingtonia filifera) waste fibers to develop biocomposites. Waste palm fibers (WPFs) were chosen as an effective high-intensity polyethylene (HDPE) reinforcement material to create WPF/HDPE biocomposites. WPFs were treated with sodium hydroxide (NaOH) solution to improve their adhesion to the HDPE matrix. Tensile strength and Young’s modulus were evaluated using mixes generated by the response surface methodology (RSM). Based on RSM, the central composite design was used to investigate the effect of various parameters on the tensile properties of cured WPF/HDPE biocomposites. The tensile properties of cured WPF/HDPE biocomposites were influenced by variables such as NaOH (0–3%), fiber treatment duration (0–24 h), and WPF content (0–30% (wt.)). RSM shows that tensile strength increases significantly with a NaOH concentration of 3%, a fiber treatment duration of 10.12 h, and a maximum content of 30% (wt.) in WPFs. The experimental validation reveals that these values correlate with predicted values with an error of less than 3.55%.

In Saudi Arabia, some e-learning initiatives such as the Future Gate Project (FGP) and Madrasati (MySchool) have been in place since 2018 and 2020, respectively. Amid the COVID-19 pandemic, they were used as a means of distance learning for students across the country. This paper investigates the willingness of students to use the e-learning platforms and whether it varies across different sex and age group. Primary data in the form of a survey of 265 secondary school students across the Makkah region was analysed with Structural Equation Modelling (SEM) by using the Technology Acceptance Model (TAM) as a theoretical framework. We found that students' self-efficacy, which is strongly influenced by their previous experience with the underlying technology used in the e-learning platforms, has a positive effect for older students in high school, yet surprisingly, a negative one for younger students in middle school. We also found that perceived ease of use and social influence to be the most important factors behind the students' acceptance of e-learning platforms and that the effects are stronger for female students than for male students. While this study was conducted in Saudi Arabia, the findings from this study provide a first-hand insight that can help ensure the continuity of the e-learning platforms if they are to be implemented permanently as distance learning platforms even after the end of the pandemic that is also applicable to any other countries.

Mohammed Almuqbil,1– 3 Fatimah Yaseen Alshaikh,4 Waleed Altwaijri,1– 3 Duaa Baarmah,5 Raid Harb Hommady,2,3 Maryam Yaseen Alshaikh,1 Fares Alammari,6 Meshal Alhussain,7 Reem Almotawa,8 Faris Alqarni,9 Amna Kashgari,1,10 Rayan Alkhodair,1,2,11 Jumanah N Alkhater,1 Lujeen Nasser Alkhater,6 Sawsan A Alharthi,11 Mada Abdulkarim Alsadi,12 Ahmed AlRumayyan1– 3 1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard, Riyadh, Saudi Arabia; 3Division of Pediatric Neurology, Department of Pediatrics, King Abdullah Specialist Children’s Hospital (KASCH), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia; 4Collage of Medicine, Princess Nora University, Riyadh, Saudi Arabia; 5Department of Pediatrics, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 6College of Medicine, Almaarefa University, Riyadh, Saudi Arabia; 7College of Medicine, King Khalid University, Abha, Saudi Arabia; 8Royal College of Surgeons, Dublin, Ireland; 9College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 10Department of Radiology, King Abdullah Specialist Children’s Hospital (KASCH), National Guard Health Affairs (NGHA), Riyadh, Saudi Arabia; 11Division of Dermatology, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 12Division of Otolaryngology, Head and Neck Surgery, King Abdulaziz University Hospital, Riyadh, Saudi ArabiaCorrespondence: Mohammed Almuqbil, College of medicine, King Saud bin Abdulaziz University for health Sciences (KSAU-HS), Prince Mutib Ibn Abdullah Ibn Abdulaziz, Ar Rimayah, P.O. Box 22490, MC 1940, Riyadh, 11426, Saudi Arabia, Tel +966-11-8011111 ext 53594, Email muqbilm@ksau-hs.edu.sa; almuqbilmo@ngha.med.saPurpose: The aim of this manuscript was to assess the epidemiology and clinical features of Neurofibromatosis type 1 (NF-1) based on the newly published revised NF-1 diagnostic criteria and to evaluate complications of NF-1 including neurodevelopmental disorders.Patients and methods: A retrospective cross-sectional observational study was conducted in the Ministry of National Guard Health Affairs (MNGHA) healthcare organization branches including four tertiary hospitals and 51 primary health care centers in different regions in Saudi Arabia. This study included all patients diagnosed with NF1 using the revised NIH diagnostic criteria published in 2021 that were registered at the electronic medical records (EMR) from 2015 to 2021.Results: A total of 184 patients fulfilled the diagnostic criteria and were included in this study. The median age at diagnosis was 11 years (IQR: 4.00– 20.25). The most encountered diagnostic criteria in this study were Café-au-lait macules (85.3%), and (42.9%) were found to have two or more neurofibromas with plexiform neurofibroma being the most common subtype (23.36%), approximately (36.4%) of the patient with optic pathway glioma. Nearby (26.6%) of the patients displayed different type of tumors. Iris Lisch nodules were presented in 36.4% of patients at a median age of 12 years (IQR: 9.0– 21.8). Cardiovascular abnormality was encountered in 9.8% of the patients. Around 27.7% of the patients reported headache and 11.4% of the patient suffered from different type of epilepsy. Besides, 10.5% of the patients had intellectual disability, 33.8% suffered from communication disorders, and 4.9% patients had ADHD.Conclusion: The results of this study will enable practitioners to adopt a more holistic approach and prioritize numerous attributes, which they can subsequently incorporate into their therapeutic methodologies. Furthermore, the identification of these attributes will facilitate an expeditious and accurate diagnosis. Hence, the implementation of intervention during its nascent phase may result in a more advantageous consequence.Keywords: neurofibromatosis type 1, café-au-lait macule, glioma, neurofibromas

Ghadeer S Aljuraiban,1 Fahad J Alharbi,2 Ali O Aljohi,2 Abdullah Z Almeshari,2 Sara Ibrahim Al-Musharraf,1 Madhawi M Aldhwayan,1 Fahdah Alshaikh,1 Mahmoud Abulmeaty1 1Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11362, Saudi Arabia; 2Department of Central Military Laboratory & Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi ArabiaCorrespondence: Ghadeer S Aljuraiban, Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11362, Saudi Arabia, Email galjuraiban@ksu.edu.saBackground: High blood pressure (BP) is a major risk factor for cardiovascular disease. The triglyceride-glucose (TyG) index is a useful tool for identifying insulin resistance at an early stage and has been proposed as a cost-effective predictor for hypertension. However, available studies are limited. This study aims to investigate the association between the TyG index and BP.Methods: Retrospective hospital data of a large cohort (n=1596) of adults aged ≥ 18 in Saudi Arabia were analyzed. The TyG index was calculated. Lipid markers, systolic BP (SBP), diastolic BP (DBP), and body mass index (BMI) were included.Results: Across quartiles of the TyG index, SBP was significantly higher in those with higher vs lower TyG (p< 0.03). No significant association was observed for DBP. A 2-SD higher SBP was significantly associated with a TyG difference of 1.7 (95% CI: 0.1, 3.3). In subgroup analysis, the relationship prevailed in females only [1.8 (95% CI: 0.3, 3.3)]. Across BMI categories (normal, overweight, obesity), the association between SBP and TyG was observed in participants with obesity only.Conclusions: The TyG index may act as a cost-effective predictive marker for high blood pressure, especially among specific subgroups. Future prospective studies are needed to confirm this relationship.Keywords: triglyceride-glucose index, blood pressure, hypertension, hyperlipidemia, cardiovascular disease

Dana Aldabeeb,1 Ebtihag O Alenzi,2 Maysoon Alhaizan,3 Mashael Alkhattabi,3 Mazin Barry,4,5 Nouf Khalid Alalshaikh,6 Mohamad-Hani Temsah,7,8 Jaffar A Al-Tawfiq,9– 11 Ghadeer Alshaikh1 1Department of Obstetrics and Gynecology, King Saud University, Riyadh, 11587, Saudi Arabia; 2Family and Community Medicine Department, College of Medicine, Princess Nourah bint Abdulrahman University 11671, Riyadh, Saudi Arabia; 3Department of Obstetrics and Gynecology, King Saud University Medical City, King Saud University, Riyadh, 11587, Saudi Arabia; 4Department of Internal Medicine College of Medicine, King Saud University, Riyadh, 11587, Saudi Arabia; 5Department of Internal Medicine, College of Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada; 6College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, 6660, Saudi Arabia; 7Pediatric Department, College of Medicine, King Saud University, Riyadh, 11587, Saudi Arabia; 8Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, 11587, Saudi Arabia; 9Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; 10Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA; 11Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USACorrespondence: Dana Aldabeeb, Department of Obstetrics and Gynecology, King Saud University, Riyadh, Saudi Arabia, PO Box 2549-12434, Tel +966505375606, Email Danaaldabeeb@gmail.com Mohamad-Hani Temsah, Evidence-Based Health Care & Knowledge Translation Research Chair, Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh, 11362, Saudi Arabia, Tel +966554124457, Email mtemsah@ksu.edu.saBackground: Recurrent urinary tract infections (rUTIs) are common complaints that burden the healthcare system. Reporting perceived knowledge and guidelines in concordance regarding the management of (rUTI) is essential for providing better healthcare and higher treatment rate. This study assesses the perceived knowledge, guidelines concordance, and physicians’ practices toward treatment of (rUTI) among physicians with different specialties.Study Design: This questionnaire-based survey included residents, fellows, and consultants of various specialties across several regions in Saudi Arabia.Results: A total of 419 physicians were included in the final analysis. In terms of age distribution, the majority were 28– 38 years of age (159, 37.9%), followed by 18– 28 years (99, 23.6%). Gender distribution was nearly balanced. The sample included a significant number of residents (182, 43.4%), consultants (173, 41.3%), and fellows (64, 15.3%). OBS/GYNE shows a significant presence of females (40.6%) and is notably represented in private hospitals or clinics (52.5%) and among fellows (40.6%) and consultants (32.4%). Infectious disease physicians had the highest perceived knowledge scores (3.83 ± 0.09), followed closely by urologists/urogynecologists (3.67 ± 0.48). Urologists/urogynecologists also reported the highest satisfaction (4.24 ± 0.83) and familiarity (2.89 ± 1.11) with new rUTI guidelines. Infectious disease physicians were most confident (3.50 ± 0.71) in communicating with patients about rUTI treatment options. In terms of practices and guideline adherence, obstetricians/gynaecologists were more likely to repeat urine sample tests for suspected contamination (3.73 ± 1.00) and less likely to treat asymptomatic bacteriuria (1.33 ± 0.59) the same as UTIs compared to other physicians. They also scored highest in conducting post-treatment tests for asymptomatic patients (3.21 ± 1.37) and recommending vaginal estrogen therapy for peri- and post-menopausal women to prevent UTIs (3.59 ± 1.06) among all specialties. Conversely, urologists and urogynecologists were more likely to discuss antibiotic prophylaxis (3.79 ± 0.89) and cranberry prophylaxis (3.71 ± 0.73) with their rUTI patients.Conclusion: The findings highlight variations in knowledge, satisfaction, familiarity with guidelines, confidence in communication, and guideline concordance among different physician specialities regarding the management of UTIs and rUTIs.Keywords: recurrent urinary tract infection, urologist, Saudi Arabia, gynecologists

Salma S AlSharhan,1 Wasan F AlMarzouq,1 Hamzah K Alshaikh,2 Hussain J Aljubran,3 Rizam Alghamdi,4 Sarah M AlQahtani,4 Aseel F Almarzouq,5 Naheel A AlAmer6 1Department of Otorhinolaryngology Head & Neck Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Otorhinolaryngology Head & Neck Surgery, King Fahd Military Medical Complex, Dhahran, Saudi Arabia; 3College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Otorhinolaryngology Head & Neck Surgery, Dammam Medical Complex, Dammam, Saudi Arabia; 5College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia; 6Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Salma S AlSharhan, Department of Otorhinolaryngology Head & Neck Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Saudi Arabia, Tel +966505951801, Email ssalsharhan@iau.edu.saPurpose: Otolaryngology has experienced notable advancements and growth in the application of artificial intelligence (AI). However, otolaryngologists’ perception of these tools are lacking. This study aims to assess the knowledge and attitudes of otolaryngologists toward AI.Patients and Methods: A cross-sectional study was conducted among 110 otolaryngologists in the Eastern Province of Saudi Arabia. A piloted questionnaire was used to gather information on knowledge, attitude, and opinions regarding AI. Data analysis was conducted using SPSS version 26.Results: Of the sample, 60% indicated average perceived knowledge of AI, while approximately 44.5% perceived their AI knowledge in the field of otolaryngology to be below average. A significant positive correlation was identified between knowledge and attitude scores. It was found that a higher knowledge score was more closely associated with seeing more than 15 patients per day, while a higher attitude score was more closely associated with being older, being a consultant, and having more years of professional experience. Of the sample, 38.2% strongly agreed that the application of AI in scientific research should be included in the residency training program.Conclusion: These findings underscore the importance of incorporating AI tools into certain aspects of the otolaryngology residency training program, highlighting their significance.Keywords: otolaryngology, artificial intelligence, machine learning, knowledge, attitude

Ayoub Ali Alshaikh,1,&ast; Syed Esam Mahmood,1,&ast; Fatima Riaz,1,&ast; Ahmed Shubayli Assiri,2,&ast; Majdoleen A Abdulrahman,3,&ast; Mohammed Yahya Althwabi Asiri,3,&ast; Ghadeer Redha Abdullah Alnakhli,4,&ast; Mohanad Qasem A Alshabab,3,&ast; Saud Saeed Abdullah Alsaleh,5,&ast; Majed Yahya Alshahrani,6,&ast; Amnah Saad H Alharthi,7,&ast; Amar Abdullah Al Qahtani7,&ast; 1Department of Family & Community Medicine, College of Medicine, King Khalid University, Abha, 62529, Saudia Arabia; 2Consultant Family Medicine, Ministry of Health, Aseer Region, Abha, Saudia Arabia; 3Saudi Board of Family Medicine, Abha, Saudi Arabia; 4Saudi Board of Pediatric Neurology, Abha, Saudi Arabia; 5Saudi Board of Internal Medicine, Abha, Saudi Arabia; 6Saudi Board of General Medicine, Abha, Saudi Arabia; 7College of Medicine, King Khalid University, Abha, 62529, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Syed Esam Mahmood, Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia, Email smahmood@kku.edu.saIntroduction: Many studies report a lack of public awareness of the risk factors and complications of Diabetes Mellitus. Adequate glycemic control is crucial in preventing or delaying the onset of type 2 diabetes complications, and medication adherence is one of the key factors in achieving this goal. This study aimed to measure the knowledge about diabetes mellitus and practices regarding lifestyle factors and diabetes management in the study population in the Aseer region, of Saudi Arabia.Material and Methods: A descriptive cross-sectional survey was conducted in Abha, a city in the Aseer region of Saudi Arabia. The general population of 18 years of age and above, who were residing in the study area during the period of study, ie, January 2023 to June 2023, were included. The questionnaire was distributed through social media and e-mail for data collection. The descriptive variables were presented using frequency, percentage, and graphs. Pearson’s chi-square test was used at a 5% level of significance. Multivariate tests were applied to further explore the findings of univariate analysis. The data were analyzed using SPSS version 20.0.Results: Out of the total 348 participants, a higher proportion was males (56.3%). About 78.7% of the participants were ever diagnosed with diabetes mellitus and 21.3% were never diagnosed with diabetes mellitus. Nearly 31.6% knew that the major cause of diabetes mellitus was obesity and 31.3% knew that it was a hereditary disease. About 42.2% of respondents exercised regularly and 27.6% were smokers. Adherence to prescribed anti-diabetic medications was seen in 63.2% of the respondents. Self-alterations in the timing and dose of prescribed anti-diabetic drugs were seen in 36.5% and 34.8%, respectively. About 60.1% had a moderate level of self-rated knowledge about Diabetes Mellitus, and 27.6% and 12.4% had good and poor self-rated knowledge levels of Diabetes mellitus, respectively. On multivariate analysis, the age group 60– 69 years had significant variations as compared to the other age groups on DM, bachelor’s degree holders had significant variations as compared to other education variables, being married had significant differences as compared to those unmarried, those employed had significant variations as compared to the other occupation categories, and smokers had a significant impact on DM as compared to non-smokers.Conclusion: Findings indicated less number of respondents exercised regularly, low adherence to prescribed anti-diabetic medications and low levels of self-rated knowledge of diabetes mellitus. Enhancing the patients’ knowledge of diabetes mellitus and improving their self-management and adherence to its medications is necessary through public health education.Keywords: adherence, diabetes mellitus, management, aseer region

Background: The global increasing prevalence of obsessive-compulsive disorders and symptoms among various age groups and nationalities is considered a great clinical challenge. However, limited data are available on this topic in the Middle East and Gulf Council Countries. This study aimed to raise awareness of obsessive-compulsive symptoms among adults in Bahrain by determining its prevalence and risk factors among patients attending primary healthcare centers Materials and Methods: A cross-sectional study was conducted among adult patients attending primary healthcare centers in Bahrain. A self-administered online questionnaire using Google form, a free online survey-creating website, was distributed through WhatsApp messages. A snowball sampling technique was used. The questionnaire consisted of three parts: the socio-demographic data of participants, the Maudsley Obsessional-Compulsive Inventory, and the Yale-Brown Obsessive-Compulsive Scale. Descriptive and inferential analyses were conducted. Results: A total of 614 participants were included with a mean age of 30.04 ± 13.04 years. Most participants were females (82.5%) and single (n = 347, 56.5%). The estimated prevalence of obsessive-compulsive symptoms among the participants was 15%; most of them reported mild symptoms (85%). Significantly higher obsession and compulsion symptoms were found among non-Bahraini (P < 0.001 and P < 0.002), single (P < 0.001 and P < 0.033), and student participants (P < 0.001 and P = 0.002) compared to their counterparts, respectively. In addition, undergraduates reported higher obsessions compared to other participants (P = 0.005). Conclusions: Approximately, one in every eight people in Bahrain were found to suffer from obsessive-compulsive symptoms, especially single, students, and non-Bahraini participants. These findings highlight the need for raising awareness of obsessive-compulsive disorder and its symptoms as well as the importance of early detection and management of obsessive-compulsive disorder.