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Background Prediabetes refers to a clinical condition in which blood glucose levels are elevated but do not meet the threshold for diabetes. Prediabetes is now thought to be reversible; lifestyle changes and other interventions can be successfully implemented during the prediabetes phase to avoid the development of type 2 diabetes. This study aims to improve health outcomes among Saudi community members who are at risk of developing prediabetes by assessing their knowledge, attitudes, practices, and barriers using a validated prediabetes questionnaire. Methods This study employed a cross-sectional design across various regions of Saudi Arabia. It included patients who were all non-diabetic Saudi adults over 18 years old and visited outpatient clinics. Structured questionnaires, which included participants' demographic information, knowledge, attitudes, practices, and barriers related to prediabetes, were employed. The collected data were analyzed using Statistical Product and Service Solutions (SPSS; IBM SPSS Statistics for Windows, Armonk, NY) software program. Results Data from 641 patients were collected in this survey. The respondents were predominantly female (330, 51.5%), with the mean ± SD of age being 36.3 ± 12.3. The participant knowledge levels of prediabetes were found to be good (399, 62.2%), moderate (193, 30.1%), and poor (49, 7.6%). The knowledge scores were significantly associated with age (P = 0.027), educational level (P < 0.001), education in the medical field (P = 0.019), and monthly family income (P = 0.009). The overall attitude of the participants toward prediabetes was generally positive (468, 73%). The practices related to diet and lifestyle among the participants were generally poor (538, 84%). Some participants did not take blood sugar tests because they were not available (121, 18.9%), lacked time (179, 27.9%), and were afraid of learning the test results (130, 20.3%). Conclusion The study found that, despite possessing an adequate level of knowledge and positive attitudes, Saudi patients poorly practice prevention methods for prediabetes. It highlights the need for targeted interventions to improve prediabetes awareness, promote healthier lifestyles, and address screening barriers. Prioritizing evidence-based strategies that cater to diverse demographic needs can prevent the progression of type 2 diabetes and enhance public health. The findings emphasize the importance of health education in Saudi Arabia and suggest that future research should focus on overcoming barriers, such as management complexity, diagnosis apprehension, and time constraints for check-ups., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Fahad Hospital-Hofuf issued approval 64-EP-2023. To allow admission to all hospitals, further ethical approval was obtained from King Fahad Hospital-Hofuf (64-EP-2023). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alsalman et al.)

Background Patients with subclinical hypothyroidism (SCH) have a high serum concentration of thyroid-stimulating hormone (TSH), whereas their serum-free thyroxine concentrations are normal. Lipid metabolism is regulated in large part by thyroid hormones. It could be connected to a changed lipid profile. This study aimed to evaluate the relationship between SCH and alterations in the lipid profile. Methodology Data from 99 patients with SCH and 109 euthyroid cases were collected from King Abdulaziz Medical City, Jeddah, Saudi Arabia, from 2016 to 2022. Patients older than 18 years were included in the study. The groups were matched in terms of gender, age, and body mass index. SCH was defined as a TSH value of 4.5 to 10 mIU/L, and normal T4 as 5 to 18 μg/dL. Control cases had a normal TSH ranging from 0.45 to 4.5 mIU/L. The total serum cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride (TG) levels in both groups were examined and the results were recorded. Results In comparison to the control group, SCH patients had greater median glycated hemoglobin (HbA1C) (p = 0.001) and lower median vitamin D levels (p = 0.004) before therapy. Before therapy, SCH patients also showed considerably lower HDL levels and significantly higher LDL and TG levels (p < 0.001). Conclusions There is a substantial correlation between SCH and reduced HDL and vitamin D levels. It was linked to increased TG, LDL, and HbA1c levels. Only vitamin D and LDL were pathologically high. Treatment with levothyroxine raised total and LDL cholesterol levels. Future research should look into the affordability of treating SCH., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board, King Abdullah International Medical Research Center issued approval NRJ23J/228/09. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alzahrani et al.)

Background: Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. It may be attributed to certain placental hormones during pregnancy which render insulin less effective. Our study aimed to focus on the levels of insulin in gestational diabetic women in the Kingdom of Bahrain as compared with non-diabetic pregnant women. Furthermore, we studied the correlation between insulin levels by ethnicity and age of the pregnant women.  Methods: A cross-sectional study was conducted on 75 pregnant participants: 41 with GDM (test group) and 34 without GDM (control group). Insulin levels were determined in patients with GDM and compared to non-diabetic pregnant women. A comparison between Bahraini and non-Bahraini women was carried out in two different age groups: below and above 30 years of age. P values < 0.05 were considered significant., Results: The results showed higher mean values of fasting blood glucose (FBG), random blood glucose (RBG), and insulin levels in the test group when compared to the control group. There was no significant difference in FBG, RBG, and insulin levels among Bahraini women with GDM and non-Bahraini women (Indian, Pakistani. Bengali, and Filipino) with GDM. Age, less than 30 vs more than 30 years, had no significant effect on women with GDM., Conclusion: Insulin levels were higher in pregnant women with GDM irrespective of their ethnicity or age. The lack of blood glucose control in GDM even in the presence of high insulin secretion may suggest loss of insulin effectiveness due to other factors such as stress and lactogenic placental hormones., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research and Ethics Committee at the College of Medicine and Medical Sciences, Arabian Gulf University, Kingdom of Bahrain issued approval E1-P1-10-22. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, AlShaibani et al.)

Recent studies suggest a role for anthocyanins in the treatment of non-alcoholic fatty liver disease (NAFLD). The purpose of the present review was to assess the effect of anthocyanins as an adjuvant treatment in patients with NAFLD. The literature search was conducted on MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), the Web of Science, and Scopus without language or time limits up to March 27, 2024. The primary outcomes included the severity of liver fibrosis and the level of liver transaminases. Secondary outcomes included obesity and lipid profile assessments. Standardized mean differences (SMDs) with 95% CIs were calculated for numerical outcomes. Five studies were included. The pooled effect sizes showed lower levels of liver fibrosis and liver transaminases in the anthocyanin group, but the difference was nonsignificant and small in size. The same result was obtained with anthropometric measurements of total cholesterol, low-density lipoprotein, and serum triglycerides, where effect sizes ranged from negligible to medium in magnitude but were all nonsignificant. The anthocyanin group showed a significantly lower body fat percentage (SMD = -0.41 (95%CI: -0.76; -0.06), P = 0.021). Currently, no evidence is available on the efficacy of anthocyanins in improving liver fibrosis or dyslipidemia in patients with NAFLD. There is limited evidence that anthocyanins can lower body fat percentages, but the effect was not reflected in the pooled results of other obesity indices. The few available clinical trials showed several limitations and variations regarding the doses of anthocyanins. Future clinical trials should avoid the limitations of the current studies and provide evidence supporting or refuting the use of anthocyanins in NAFLD patients., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Khan et al.)

Applying extracts from plants is considered a safe approach in biomedicine and bio-nanotechnology. The present report is considered the first study that evaluated the seeds of Lasiurus scindicus and Panicum turgidum as biogenic agents in the synthesis of silver nanoparticles (AgNPs) which had bioactivity against cancer cells and bacteria. Assessment of NPs activity against varied cell lines (colorectal cancer HCT116 and breast cancer MDA MBA 231 and MCF 10A used as control) was performed beside the antibacterial efficiency. Different techniques (DLS, TEM, EDX and FTIR) were applied to characterize the biosynthesized AgNPs. The phytochemicals from both L. scindicus and Panicum turgidum were identified by GC-MS analysis. Spherical monodisperse NPs at average diameters of 149.6 and 100.4 nm were obtained from seed extract of L. scindicus (L-AgNPs) and P. turgidum, (P-AgNPs) respectively. A strong absorption peak at 3 keV is observed by the EDX spectrum in the tested NPs. Our study provided effective NPs in mitigating the tested cell lines and the lowest IC 50 were 7.8 and 10.30 for MDA MB231 treated by L-AgNPs and P-AgNPs, respectively. Both fabricated NPs might differentially target the MDA MB231 cells compared to HCT116 and MCF10A. Ultrastructural changes and damage for the NPs-treated MDA MB231 cells were studied using TEM and LSM analysis. Antibacterial activity was also observed. About 200 compounds were identified in L. scindicus and P. turgidum by GC-MS analysis might be responsible for the NPs reduction and capping abilities. Efficient NPs against cancer cells and microbes were obtained, however large-scale screening is needed to validate our findings., (© 2024. The Author(s).)

Soybean is an important oilseed crop worldwide; however, it has a high sensitivity to temperature variation, particularly at the vegetative stage to the pod-filling stage. Temperature change affects physiochemical and genetic traits regulating the soybean agronomic yield. In this regard, the current study aimed to comparatively evaluate the effects of varying regimes of day and night temperatures (T1 = 20°C/12°C, T2 = 25°C/17°C, T3 = 30°C/22°C, T4 = 35°C/27°C, and T5 = 40°C/32°C) on physiological (chlorophyll, photosynthesis, stomatal conductance, transpiration, and membrane damage) biochemical (proline and antioxidant enzymes), genetic ( GmDNJ1 , GmDREB1G;1 , GmHSF-34 , GmPYL21 , GmPIF4b , GmPIP1;6 , GmGBP1 , GmHsp90A2 , GmTIP2;6 , and GmEF8 ), and agronomic traits (pods per plant, seeds per plant, pod weight per plant, and seed yield per plant) of soybean cultivars (Swat-84 and NARC-1). The experiment was performed in soil plant atmosphere research (SPAR) units using two factorial arrangements with cultivars as one factor and temperature treatments as another factor. A significant increase in physiological, biochemical, and agronomic traits with increased gene expression was observed in both soybean cultivars at T4 (35°C/27°C) as compared to below and above regimes of temperatures. Additionally, it was established by correlation, principal component analysis (PCA), and heatmap analysis that the nature of soybean cultivars and the type of temperature treatments have a significant impact on the paired association of agronomic and biochemical traits, which in turn affects agronomic productivity. Furthermore, at corresponding temperature regimes, the expression of the genes matched the expression of physiochemical traits. The current study has demonstrated through extensive physiochemical, genetic, and biochemical analyses that the ideal day and night temperature for soybeans is T4 (35°C/27°C), with a small variation having a significant impact on productivity from the vegetative stage to the grain-filling stage., 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 © 2024 Ding, Alghabari, Rauf, Zhao, Javed, Alshamrani, Ghazy, Al-Doss, Khalid, Yang and Shah.)

Objectives The objective of the study is to explore the correlation between handedness and footedness and various demographic factors, including sex, age, faith, ethnicity, and perceived social pressures on limb use, among Muslims and non-Muslims. Methods This is an analytical cross-sectional study conducted in Saudi Arabia from September 2020 to February 2021. This research involved healthy community members aged 18 and above. An electronic survey was administered to collect demographic information on age, sex, faith, ethnicity, and the perceived degree of social pressure favoring the use of the right hand. The Waterloo handedness questionnaire (WHQ-Ar) and Waterloo footedness questionnaire (WFQ-Ar) were utilized for the assessments. Results A total of 728 respondents completed the survey. The mean (SD) age was 34.54 (11.53). Among them, 454 (62.4%) were ethnically Arab, and 507 (69.64%) identified as Muslims. The mean (SD) WHQ-Ar and WFQ-Ar scores were 42 (31.6) and 10.51 (8.1), respectively, with higher scores indicating "right" preference. Older age was associated with higher scores (p = 0.01) and men with lower handedness scores (p = 0.003). Participants who did not perceive social pressure had significantly lower scores (p < 0.001). Footedness was associated with slightly lower scores in Muslims (p = 0.001). Conclusion The degree of pressure perceived to use a particular hand has a major influence on handedness scores in Muslims and non-Muslims alike; this was true even when comparing populations with different levels of permissiveness to specific hand use due to varying religious or cultural backgrounds. Social pressure, regardless of routine religious practices, is more likely to influence handedness scores. Age and sex influence the scores similar to international reports, and footedness appears less likely to fall under the influence of cultural pressures., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Muayqil et al.)

Mutation breeding is one of the effective techniques used for improving desired traits such as yield quality and quantity in economic crops. The present study aims to develop oil and protein contents in addition to high yield attributes in soybean using gamma rays as a mutagen. Seeds of the soybean genotypes Giza 21, Giza 22, Giza 82, Giza 83 and 117 were treated with gamma rays doses 50, 100, 200 and 300 Gy. Plants were then scored based on morphological parameters correlated with yield quantity including plant height, seed weight and valuable protein and oil contents. Mutant lines exhibiting the highest yield attributes were selected and used as parents for M2 generation. The M2 progeny was further assessed based on their ability to maintain their yield attributes. Twenty mutant lines were selected and used as M3 lines. The yield parameters inferred a positive effect of gamma irradiation on the collected M3 mutant lines compared to their parental genotypes. 100 Gy of gamma rays gave the highest effect on the number of pods, branches and seeds per plant in addition to protein content, while 200 Gy was more effective in increasing plant height, number of pods per plant, and oil content. Six mutant lines scored the highest yield parameters. Further assessment inferred an inverse relationship between oil and protein content in most of the tested cultivars with high agronomic features. However, four mutant lines recorded high content of oil and protein besides their high seed yield as well, which elect them as potential candidates for large-scale evaluation. The correlation among examined parameters was further confirmed via principal component analysis (PCA), which inferred a positive correlation between the number of pods, branches, seeds, and seed weight. Conversely, oil and protein content were inversely correlated in most of yielded mutant lines. Together, those findings introduce novel soybean lines with favorable agronomic traits for the market. In addition, our research sheds light on the value of using gamma rays treatment in enhancing genetic variability in soybean and improving oil, protein contents and seed yield., Competing Interests: Elsayed Mansour and Diaa Abd El-Moneim are Academic Editors for PeerJ., (©2023 Mohsen et al.)

Durum and bread wheat are well adapted to the Mediterranean Basin. Twenty-three genotypes of each species were grown to evaluate the intra- and inter-genetic diversity based on omega ( ω ), gamma ( γ ) and alpha ( α )-gliadin profiles. To achieve this purpose, the endosperm storage proteins (both gliadins and glutenins) were extracted from wheat grains and electrophoresed on sodium dodecyl sulfate (SDS)-polyacrylamide gels. The results of SDS-Polyacrylamide Gel Electrophoresis (SDS-PAGE) revealed nine polymorphic loci out of 16 loci with durum wheat genotypes and nine polymorphic loci out of 18 loci with bead wheat genotypes. The polymorphisms revealed by the SDS-PAGE were 56% and 50% in durum and bread wheat genotypes, respectively. Using the cluster analysis, the durum wheat genotypes were clustered into five groups, while the bread wheat genotypes were grouped into six clusters using un-weighed pair group mean analyses based on ω , γ , and α -gliadins profiles. The 46 durum and bread wheat genotypes were grouped into seven clusters based on the combined ω , γ , and α -gliadins profiles revealed by the SDS-PAGE. The in silico analysis determined the intra-genetic diversity between bread and durum wheat based on the sequences of ω , γ , and α -gliadins. The alignment of ω -gliadin revealed the highest polymorphism (52.1%) between bread and durum wheat, meanwhile, the alignment of γ and α -gliadins revealed very low polymorphism 6.6% and 15.4%, respectively. According to computational studies, all gliadins contain a lot of glutamine and proline residues. The analysis revealed that the bread wheat possessed ω and γ -gliadins with a lower content of proline and a higher content of glutamine than durum wheat. In contrast, durum wheat possessed α -gliadin with a lower content of proline and a higher content of glutamine than bread wheat. In conclusion, the SDS-PAGE, in silico and computational analyses are effective tools to determine the intra- and inter-genetic diversity in tetraploid and hexaploid wheat genotypes based on ω , γ , and α -gliadins profiles., Competing Interests: Diaa Abd El-Moneim is an Academic Editor for PeerJ., (©2023 Al-Khayri et al.)

Introduction: The Capsicum annuum nuclear factor Y subunit B (CaNFYB) gene family plays a significant role in diverse biological processes, including plant responses to abiotic stressors such as salinity. Methods: In this study, we provide a comprehensive analysis of the CaNFYB gene family in pepper, encompassing their identification, structural details, evolutionary relationships, regulatory elements in promoter regions, and expression profiles under salinity stress. Results and discussion: A total of 19 CaNFYB genes were identified and subsequently characterized based on their secondary protein structures, revealing conserved domains essential for their functionality. Chromosomal distribution showed a non-random localization of these genes, suggesting potential clusters or hotspots for NFYB genes on specific chromosomes. The evolutionary analysis focused on pepper and comparison with other plant species indicated a complex tapestry of relationships with distinct evolutionary events, including gene duplication. Moreover, promoter cis-element analysis highlighted potential regulatory intricacies, with notable occurrences of light-responsive and stress-responsive binding sites. In response to salinity stress, several CaNFYB genes demonstrated significant temporal expression variations, particularly in the roots, elucidating their role in stress adaptation. Particularly CaNFYB01 , CaNFYB18 , and CaNFYB19 , play a pivotal role in early salinity stress response, potentially through specific regulatory mechanisms elucidated by their cis-elements. Their evolutionary clustering with other Solanaceae family members suggests conserved ancestral functions vital for the family's survival under stress. This study provides foundational knowledge on the CaNFYB gene family in C. annuum , paving the way for further research to understand their functional implications in pepper plants and relative species and their potential utilization in breeding programs to enhance salinity tolerance., 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 Abd El Moneim, Mansour, Alshegaihi, Safhi, Alwutayd, Alshamrani, Alamri, Felembam, Abuzaid and Magdy.)

Anthropogenic cadmium (Cd) in arable soils is becoming a global concern due to its harmful effects on crop yield and quality. The current study examined the role of exogenously applied low molecular weight organic acids (LMWOAs) including oxalic acid (OxA), tartaric acid (TA) and high molecular weight organic acids (HMWOAs) like citric acid (CA) and humic acid (HA) for the bioavailability of Cd in wheat-rice cropping system. Maximum increase in root dry-weight, shoot dry-weight, and grain/paddy yields was recorded with HA for both crops. The HA significantly decreased AB-DTPA Cd in contaminated soils which remained 41% for wheat and 48% for rice compared with their respective controls. The minimum concentration of Cd in roots, shoots and grain/paddy was observed in HA treatment in both crops. The organic acids significantly increased the growth parameters, photosynthetic activity, and relative leaf moisture contents for both wheat and rice crops compared to that with the contaminated control. Application of OxA and TA increased the bioavailability of Cd in soils and plant tissues while CA and HA decreased the bioavailability of Cd in soils and plants. The highest decrease in Cd uptake, bioaccumulation, translocation factor, immobilization, translocation, harvest, and health risk indices were observed with HA while maximum increase was recorded with OxA for both wheat and rice. The results concluded that use of HMWOAs is effective in soil Cd immobilization being maximum with HA. While LMWOAs can be used for the phytoextraction of Cd in contaminated soils having maximum potential with OxA., 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 Ltd. All rights reserved.)

Calotropis procera ( C. procera ) was evaluated as a pharmaceutically useful plant and for its therapeutic effects in the most significant studies. Uzarigenin and Calotropagenin are significant components of this plant that have pharmacological effects on certain systems, including the digestive, immunological, and focal, and peripheral sensory systems. In this study, pathway genes are extracted from high throughput data acc.no. SRR1554320. Seven critical enzymes are involved in studying the effects of sunlight on the formation of Uzaragenin and Calotropagenin in C. procera before and after irrigation. Molecular identification and NCBI submission of six enzyme genes were successful; HSD (acc.no. OQ091761) for 3β-hydroxystroid dehydrogenase, OR (acc.no. OQ091762) for 5beta-pregnan oxidoreductase, MO (acc.no. OQ091763) for Pregnan monooxygenase, HOX (acc.no. OQ091764) for Steroid hydroxylase, MAT (acc.no. OQ091765) for Melonyletransferase, UHOX (acc.no. OQ091766) for Uzarigenin hydroxylase. During dawn after irrigation, the Uzargenin pathway showed the highest activity, however midday after irrigation was the lowest. The most period that showed high activity for the Uzargenin pathway was dawn after irrigation, however, midday after irrigation was the lowest. This data is confirmed by chromatography analysis (UPLC) to calculate the accumulation of Uzarigenin and Calotropagenin in different periods., 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., (© 2023 The Author(s).)

Cadmium (Cd) contamination is considered as a widespread concern at global scale which is serious threats to human health. Phytoremediation is an eco-friendly approach which can remove or immobilize Cd from the soil. Different organic and inorganic amendments can potentially enhance Cd phytoremediation efficiency but the comparison of farmyard manure (FM), elemental sulphur (S) and ethylenediaminetetraacetic acid (EDTA) for Cd phytoremediation through spider plants (Chlorophytum comosum L.) remained unanswered. The present study evaluated the efficiency of S (0.1 and 0.2%), EDTA (0.1 and 0.2%, represented as EDTA-0.1 and EDTA-0.2) and FM (0.5 and 1%, represented as FM-0.5 and FM-1) for remediation of Cd contaminated soils (50 and 100 mg kg-1, represented as Cd-50 and Cd-100) through spider plants. Results depicted that the highest shoots and roots dry biomass was found in FM treated plants followed by S, EDTA and control except in EDTA-0.2 treatment in which the lowest values of these parameters were observed. Application of FM-1 significantly increased the shoot dry weight (120%), root dry weight (99%), as well as photosynthetic attributes in Cd-50 as compared to control. Application of EDTA-0.2 increased the bioavailable fraction of Cd than control and the maximum increase was observed in Cd-100. The highest Cd concentrations in shoot and roots were found in EDTA treated plants followed by S, control and FM irrespective of Cd and amendment levels. Maximum Cd in roots (109%) and shoots (156%) was recorded in plants grown in Cd-100 with EDTA-0.2 than control. The maximum bioaccumulation factor, translocation index, harvest index and root to shoot translocation were observed with EDTA than control and other treatments. EDTA along with spider plants may enhance the uptake of Cd but lower biomass production in the highest dose of EDTA may questioned the efficiency of EDTA., 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 © 2022 Elsevier Ltd. All rights reserved.)

Background: Annual influenza vaccine is recommended among health professionals especially, health science undergraduates; although, studies suggest that there is a low level of vaccine coverage among health care undergraduates. Thus, the study aimed to investigate students' knowledge, attitudes, and practices regarding the seasonal influenza vaccine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah, Saudi Arabia., Methods: A cross-sectional, unicentral study was carried out during the period of April to November 2021. A total of 341 validated questionnaires that included four sections were distributed in all four different colleges of KSAU-HS. Data management and analyses were carried out using Statistical Software for Social Sciences (SPSS) version 25., Results: Out of 341 respondents, 336 participants completed the full survey (98.53% completion rate). The majority of participants were males (67.6% and the most participants were from the college of medicine (60.4%). The mean knowledge score of students was found to be (11.3 ± 2.0) out of 14 points. The most common barrier to vaccination among healthcare students was not having enough time to take the vaccine (23.8%), while the second one was the COVID-19 pandemic (22.32%). The vaccination rate in 2020 was 103 (30.7%), while 235 (80.4%) students stated that they have received the vaccine previously. School/work requirements and the student's awareness of the vaccine's importance were the most common reasons for taking the influenza vaccine., Conclusion: Even though students showed a high level of knowledge and a positive attitude towards the influenza vaccine, they generally had a low level of vaccine uptake. To enhance immunization rates, we encourage vaccine campaigns in all healthcare colleges. Further studies are needed to identify influences on students' attitudes and practices regarding influenza vaccination., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Education and Health Promotion.)

Background: The long-term use of earphones at high volume levels is a major risk factor for noise-induced hearing loss., Aim: To compare the hearing of university students who use personal listening devices (PLDs) at extremes (upper & lower quartiles) with respect to a) Duration of use/day b) The number of years since use c) Volume level., Methods: This cross-sectional study was conducted in the Department of Physiology, College of Medicine, at Imam Abdulrahman bin Faisal University (IAU), from September 2021 to April 2022. An online survey was distributed among IAU medical students on the subjects' patterns of earphone use. Forty participants volunteered to participate in the hearing tests: Pure Tone Audiometry (PTA), Tympanometry, and Transient Evoked Otoacoustic Emission (TEOAEs) at the ENT clinic of the King Fahd Hospital of the University (KFHU)., Results: The pure tone audiometry and TEOAE showed no significant differences in the hearing thresholds/levels of participants in upper quartiles vs lower quartiles of both ears, in any of the PLD use pattern categories. However, in the TEOAE two observation were detected: a) Significantly lower amplitude in the upper quartile of the category "duration of PLD use/day" at a frequency of 1.0 kHz in the left ear (p-value 0.04) b) Significantly lower amplitude in the upper quartile of the category "volume of PLD use" at a frequency of 1.0 kHz in the left ear (p-value 0.03)., Conclusion: The present findings suggest that hearing threshold/level and cochlear outer hair cells' functions do not differ significantly in the participants belonging to the upper and lower quartiles of PLD use pattern (volume level, duration of use/day, and the number of years since use)., Competing Interests: There are no conflicts of interest., (© 2022 Reem Alshamrani, Fatimah Altheeb, Haya Almasaoud, Asma Alghamdi, Rabia Latif, Nazish Rafique, Amal AlShaikh Sulaiman.)

The major reports on Calotropis procera ( C. procera ) indicated the importance of this plant as a resource of pharmaceutically active ingredients as well as its medical advantages. β-amyrin (BA) is a significant substance in this plant and has a pharmacological effects in some frameworks, like focal and fringe sensory system, digestive and immune systems. In this study, the impact of sunlight before and after irrigation on the BA production in C. procera is studied its pathway with involved eight key enzymes. The eight enzymes' genes were characterized and successfully submitted to NCBI; AAS (acc.no. KU997645) for α-amyrin synthase, BAS (acc.no. MW976955) for β-amyrin synthase, SE (acc.no. MW976956) for squalene epoxidase, SS (acc.no. MW976957) for squalene synthase, GPPS, (acc.no. MW976958) for geranyl pyrophosphate synthase, FPPS (acc.no. MW976959) for farnasyl pyrophosphate synthase, CAS1 , (acc.no. MZ00598) for cycloartenol synthase1 and LS (acc.no. MZ005982) for lupeol synthase. qRT-PCR analysis revealed high expression levels of GPPS, FPPS, SS, SE , and BAS genes at all times specially midday. Otherwise, CAS1, LS and BAS expression levels were very low at all daylight periods. The UPLC β-amyrin data are in accordance with qRT-PCR results. This indicates that triterpenes biosynthetic pathway in C. procera is going to β-amyrin accumulation with the highest level at midday., 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., (© 2022 The Author(s).)

Physids belong to Class Gastropoda; belong to Phylum Mollusca and being bioindicators, intermediate hosts of parasites and pests hold a key position in the ecosystem. There are three species of Genus Physa i.e. P. fontinalis, Physa acuta and P. gyrina water bodies of Central Punjab and were characterized on the basis of molecular markers High level of genetic diversity was revealed by polymorphic RAPD, however SSR markers were not amplified. The multivariate analysis revealed polymorphism ranging from 9.09 percent to 50 percent among the three Physid species. Total number of 79 loci were observed for the three species under study and 24 loci were observed to be polymorphic. These RAPD fragment(s) can be developed into co dominant markers (SCAR) by cloning and can be further sequenced for the development of the Physa species specific markers to identify the introduced and native species in Pakistan.

Physids belong to Class Gastropoda; Phylum Mollusca have important position in food web and act as bio indicators, pests and intermediate host. Being resistant these are called cockroaches of malacology. Physid snails were collected from different water bodies of Faisalabad (Punjab) and were identified up to species using morphological markers. The morphometry of the specimens was carried out with the help of a digital Vernier caliper in millimeters (mm) using linear measurement of shell characters. Linear regression analysis of the AL/SW ratio vs AL and SL/SW ratio vs AL indicated that allometric growth exists only in Physa acuta when compared with P.gyrina and P. fontinalis. This study will lead to assess the status of the Physid species in Central Punjab. The Principal component analysis shows that the Component 1 (Shell Length) and component 2 (Shell Width) are the most prolific components and nearly 80 percent of the identification. The distance between P. acuta and P. fontinalis is 5.4699, P. acuta and P. gyrina is 7.6411, P. fontinalis and P. gyrina is 16.6080 showing that P. acuta resembles with P. fontinalis, and both these specimens donot resemble with P. gyrina. P.acuta is an invasive species and shows bioactivity making it a potent candidate for bioactive substances.

Multiple sclerosis (MS) is a neurological disorder that strikes the central nervous system. Due to the complexity of this disease, healthcare sectors are increasingly in need of shared clinical decision-making tools to provide practitioners with insightful knowledge and information about MS. These tools ought to be comprehensible by both technical and non-technical healthcare audiences. To aid this cause, this literature review analyzes the state-of-the-art decision support systems (DSSs) in MS research with a special focus on model-driven decision-making processes. The review clusters common methodologies used to support the decision-making process in classifying, diagnosing, predicting, and treating MS. This work observes that the majority of the investigated DSSs rely on knowledge-based and machine learning (ML) approaches, so the utilization of ontology and ML in the MS domain is observed to extend the scope of this review. Finally, this review summarizes the state-of-the-art DSSs, discusses the methods that have commonalities, and addresses the future work of applying DSS technologies in the MS field., (© 2020 The Authors.)

Study Objectives: The pathophysiology of restless legs syndrome (RLS) may be related to abnormalities in central dopamine pathways. Vitamin D may play a role in the pathophysiology of RLS by modulating the dopaminergic system. The aim of our study is to examine the possible link between RLS and vitamin D deficiency., Methods: The total number of subjects enrolled was 201, including 78 patients with RLS based on the International RLS Study Group (IRLSSG) diagnostic criteria and 123 controls. Serum 25-hydroxy vitamin D levels were measured in both groups. RLS severity was assessed in all cases using the IRLSSG symptom severity rating scale., Results: Fifty-nine patients with RLS (75.6%) and 52 controls (42.3%) had a diagnosis of vitamin D deficiency, P < .001. The odds ratio (OR) of the development of RLS was 4.24 for those with a vitamin D level < 50 nmol/L compared to those with a vitamin D level ≥ 50 nmol/L ( P < .001, 95% confidence interval [CI] 2.3-7.9). After adjusting for all other significant factors in the multivariate logistic model, vitamin D was significantly associated with RLS (OR 3.1, P < .002, 95% CI 1.51-6.38). Moreover, a dark or black skin color (OR 3.4, P < .001, 95% CI 1.5-6.3) and working as a teacher (OR 8.8, P < .001, 95% CI 3.4-23.5) were also independently significantly associated with RLS., Conclusions: Our study identified an association between vitamin D deficiency and RLS. Consequently, vitamin D deficiency should be considered in the management of RLS. However, further studies are needed to evaluate the causality relationship between vitamin D level and RLS., (© 2018 American Academy of Sleep Medicine.)