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Majed Alomar,1 Aljohara S Almeneessier,1,2 Awad H Olaish,1 Abdulrahman Alshiban,1 Abdullah Alomar,1 Ahmed S BaHammam1,31The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Family and Community Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, King Saud University, Riyadh, Saudi ArabiaBackground: Autoimmunity has been proposed as a cause of narcolepsy. A few studies have assessed comorbid autoimmune diseases in patients with narcolepsy, with conflicting results; however, no study has assessed autoimmune diseases in Arab narcolepsy patients. This study aimed to assess the coexistence of immune-mediated conditions such as allergies, autoimmune diseases, and autoinflammatory diseases in patients with narcolepsy type 1 (with cataplexy) (NT1) and narcolepsy type 2 (without cataplexy) (NT2).Methods: Personal and family history of autoimmune/autoinflammatory and allergic disorders was collected using a questionnaire in 80 consecutive Saudi patients with narcolepsy (46 NT1 and 24 NT2), who were diagnosed according to the International Classification of Sleep Disorders, Third Edition. The control group comprised 222 adults from the general population.Results: Comorbid autoimmune/autoinflammatory diseases were reported by 21.4% of the NT1 patients, and 12.2% of the controls, with no significant difference between cases and controls in a model adjusted for confounding covariates. However, allergic disorders were significantly more prevalent among NT1 patients. Both comorbid autoimmune/autoinflammatory and allergic disorders were significantly more prevalent among NT2 patients compared to controls. No differences in demographic and clinical characteristics were detected between narcolepsy patients with and without autoimmune/autoinflammatory diseases.Conclusion: NT1 is not associated with increased comorbid autoimmune diseases in the studied sample of Saudi patients. However, autoimmune diseases are associated with NT2, and allergic disorders are associated with both NT1 and NT2. These findings suggest the existence of dysregulation in the immune system of narcolepsy patients that requires further research.Keywords: cataplexy, hypersomnolence, hypersomnia, allergy, narcolepsy

In the past two decades, the world has witnessed devastating pandemics affecting the global healthcare infrastructure and disrupting society and the economy worldwide. Among all pathogens, viruses play a critical role that is associated with outbreaks due to their wide range of species, involvement of animal hosts, easily transmitted to humans, and increased rates of infectivity. Viral disease outbreaks threaten public health globally due to the challenges associated with controlling and eradicating them. Implementing effective viral disease control programs starts with ongoing surveillance data collection and analyses to detect infectious disease trends and patterns, which is critical for maintaining public health. Viral disease control strategies include improved hygiene and sanitation facilities, eliminating arthropod vectors, vaccinations, and quarantine. The Saudi Ministry of Health (MOH) and the Public Health Authority (also known as Weqayah) in Saudi Arabia are responsible for public health surveillance to control and prevent infectious diseases. The notifiable viral diseases based on the Saudi MOH include hepatitis diseases, viral hemorrhagic fevers, respiratory viral diseases, exanthematous viral diseases, neurological viral diseases, and conjunctivitis. Monitoring trends and detecting changes in these viral diseases is essential to provide proper interventions, evaluate the established prevention programs, and develop better prevention strategies. Therefore, this review aims to highlight the epidemiological updates of the recently reported viral infections in Saudi Arabia and to provide insights into the recent clinical treatment and prevention strategies.

For decades, "societal reaction theory" or "labelling theory" has provided the most significant explanation for deviant behaviour, particularly in the case of juveniles. The theory argues that once a stigma is attached to an individual, an irreversible process occurs whereby the labelled individual begins to identify as deviant and to embark on a deviant career. Hence, rather than deter bad behaviour, stigmatisation and shaming serve only to amplify it. Although the labelling perspective is rooted in sociology, we find proponents of some version of labelling theory in other disciplines, even in literature. The present study posits that in the short stories of Irish-American writer James Thomas Farrell entitled "Big Jeff," "The Fastest Runner on Sixty-First Street," "Young Convicts," and "The Scarecrow," labelling processes emerge as essential elements in a comprehensive understanding of each story. All four stories are the least critically acknowledged works by the author even though they demonstrate the author's remarkable talent for illuminating the social and psychological factors associated with deviant behaviour among juveniles.

• What is the primary question addressed by this study? What are the available evidence for the efficacy and safety of dual orexin receptor antagonist (DORA) use in dementia population with sleep disturbance. • What is the main finding of this study? The current limited evidence suggest efficacy of using suvorexant for insomnia and Lemborexant for Irregular Sleep-Wake Rhythm disorder in Alzheimer's patients. Suvorexant and Lemborexant were found to be relatively safe. • What is the meaning of the finding? Using DORA for sleep disturbance in Alzheimer disease patient might be a promising new treatment but further studies are warranted. The rising prevalence of Alzheimer's disease (AD) and related dementia worldwide underscores the urgent need for effective interventions, particularly for managing neuropsychiatric symptoms (NPS) such as sleep disturbance. This review explores the emerging role of Dual Orexin Receptor Antagonists (DORA) in addressing sleep disturbance in patients with Alzheimer's disease dementia. A comprehensive literature search identified four relevant publications between 2014 and 2024, detailing the use of DORA medications, including suvorexant and lemborexant, in patients with Alzheimer's disease. Findings suggest that suvorexant may improve total sleep time (TST), wakefulness after sleep onset (WASO), and sleep efficiency (SE) in Alzheimer's patients with insomnia. Lemborexant demonstrated potential in improving circadian rhythm parameters, particularly in patients with irregular sleep-wake rhythm disorder (ISWRD). Safety profiles of DORA medications appeared favorable, with mild to moderate adverse events reported. However, concerns over potential adverse events, such as falls, underscore the need for careful monitoring. While the evidence suggests promise for DORA medications in addressing sleep disturbance in Alzheimer's disease, limitations in study populations and duration highlight the need for further investigation. Future clinical trials should aim for broader inclusion criteria, encompassing diverse dementia subtypes and severity levels, to enhance generalizability. Additionally, longer-term trials are essential to assess the sustained efficacy and safety of DORA interventions in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Patient safety is a critical focus in healthcare, aiming to minimize risks and harm through systemic efforts involving leadership, teamwork, and a culture of safety. Radiology departments face unique challenges due to their complex, heightech nature, making safety culture essential. This study assesses Radiology and Nursing Specialists perceptions of patient safety culture, identifies areas for improvement, and raises awareness about safety practices in radiology. Methods: A descriptive cross-sectional design was used, employing a self-reported questionnaire based on the Survey on Patient Safety Culture. Data were collected from 171 Radiology and Nursing Specialists in public radiology departments, achieving a response rate of 46.5%. Positive perception percentages for 14 safety culture dimensions were calculated, with thematic analysis performed on qualitative feedback. Results: Positive perception rates varied from 34% to 81% across the dimensions. Strengths included "Teamwork within the unit" (81%), while areas for improvement included "Executive management support for patient safety" (34%), "Frequency of error reporting" (40%), and "Staffing" (44%). Qualitative feedback highlighted issues such as insufficient feedback mechanisms and staffing concerns. The overall safety rating averaged 2.45, indicating a "good" level of patient safety. Conclusion: The findings underscore the need for stronger management support, improved error reporting systems, and enhanced staffing to foster a robust patient safety culture. Addressing these areas could significantly enhance safety practices in radiology departments, benefiting both staff and patients. Future research should explore strategies for implementing these improvements effectively. [ABSTRACT FROM AUTHOR]

Background: The epidemic of nonalcoholic fatty liver disease (NAFLD) and its metabolic effects present a serious public health concern. We hypothesized that the Ramadan fasting model (RFM), which involves fasting from dawn to dusk for a month, could provide potential therapeutic benefits and mitigate NAFLD. Accordingly, we aimed to validate this hypothesis using obese male rats. Methods: Rats were split into two groups (n = 24 per group), and they were given either a standard (S) or high-fat diet (HFD) for 12 weeks. During the last four weeks of the study period, both S- and HFD-fed rats were subdivided into eight groups to assess the effect of RFM with/without training (T) or glucose administration (G) on the lipid profile, liver enzymes, and liver structure (n = 6/group). Results: The HFD+RFM group exhibited a significantly lower final body weight than that in the HFDC group. Serum cholesterol, low-density lipoprotein, and triglyceride levels were significantly lower in the HFD+RFM, HFD+RFM+T, and HFD+RFM+G groups than those in the HFDC group. Compared with the HFDC group, all groups had improved serum high-density lipoprotein levels. Furthermore, HFD groups subjected to RFM had reduced serum levels of aspartate transaminase and alanine transaminase compared with those of the HFD-fed group. Moreover, the liver histology improved in rats subjected to RFM compared with that of HFD-fed rats, which exhibited macro- and micro-fat droplet accumulation. Conclusion: RFM can induce positive metabolic changes and improve alterations associated with NAFLD, including weight gain, lipid profile, liver enzymes, and hepatic steatosis. [ABSTRACT FROM AUTHOR]

Background: Happiness is considered as an important part of people's lives, and it has become part of Saudi Arabia's 2030 vision. Objective: Measure the levels and identify the demographic, family status, and academic factors associated with happiness among students in Princess Nourah Bint Abdulrahman University (PNU). Methods: A cross-sectional study with 771 participants selected from health, humanities, and science colleges by quota-sampling techniques. The data were collected by an online questionnaire consisting of four sections including the Oxford happiness questionnaire. Inferential analysis was done using Chi-square, ANOVA test, and logistic regression. Results: The average mean of happiness between the three colleges were found to be 3.97 using the Oxford questionnaire. In the demographic factors, only household income and mother employment were found to be significantly associated with students' happiness. Regarding family status, only family type and the number of family members were found to be statistically significant. However, in the academic factors, all variables were found to be significant, except the field of study and academic level. Multivariable analysis found that household income, mother employment, family number, satisfaction with specialty, environment and classmates can successfully predict the level of happiness. Conclusion: The mean level of happiness among all colleges is nearly similar, but slightly higher among health colleges. The most associated domain with happiness was found to be academic. Six variables were found to be predictive of students' happiness. This study recommends conducting regular screening to identify any variations of students' happiness levels. [ABSTRACT FROM AUTHOR]

The article discusses Saudi Arabia's advancement of the comics medium by way of its parody of Saudi culture and society that are different from Western concerns. Topics covered include influential graphic observations on such issues as the status of women, early marriages, polygamous unions, and loss of heritage, and the country's hosting of comics-related events. Also noted is the common exploration of the male/female union in Eastern and Western gag cartoons.

When English novelist, poet, and essayist John Fowles published his first novel The Collector in 1963, little was known about the phenomenon of stalking, and even less about abduction in stalking relationships. Fowles nonetheless provides a comprehensive scholarly view of obsessional pursuit by exploring demographic, clinical, and forensic characteristics of stalkers via his fictional one. Frederick Clegg is an unattractive, unloved, angry, twenty-five-year-old entomologist with no real friends, who becomes fixated on a girl named Miranda Grey. For two years Miranda is stalked relentlessly by Clegg, who then abducts her and forces her to live in his cellar for months until she dies. Clegg, however, is unfazed by her death, as there are plenty of other women for him to stalk, abduct, and ultimately kill. Accordingly, this interdisciplinary study surveys the research and theories about the nature, epidemiology, classification, and origins of stalking, and applies the findings to Fowles' stalker. Although the current research on the topic is based on actual stalkers, it can also provide a better understanding of The Collector, given that the author based it on a real-life case. The primary objective of the study is to make this twentieth-century novel relevant in the twenty-first century. [ABSTRACT FROM AUTHOR]

Psychiatrists define folie à deux as communicated insanity; a rare psychotic disorder that may be transmitted from the sufferer to a person or persons closely related to him/her. The disorder is often described in the context of schizophrenia, but different varieties of folie à deux have been noted in other conditions. In criminology, the term is used in the framework of team killers and seldom involves false or delusional beliefs, but rather deviant behaviour shared by two. Examples of notorious folie à deux unions include Ian Brady and Myra Hindley, Fred and Rosemary West, Charles Ng and Leonard Lake, and Angelo Buono and Kenneth Bianchi. In fiction, folie à deux with a criminal intent appears in Truman Capote's In Cold Blood (1966), where a dominant leader unites with a passive follower to commit felonies. The novel, based on the real-life massacre of the Clutter family in Holcomb, Kansas in 1959, centres on the two men responsible for the carnage, Richard Eugene Hickock and Perry Edward Smith. Capote introduces the process that brings these two warped individuals together, the early stages of their friendship, their personalities, why they are attracted to each other, and how, over time, their relationship becomes more sinister. By exposing the inner workings of their criminal minds the author enters the domain of criminologists and psychologists who are only now beginning to understand the true dynamics behind couples that kill. [ABSTRACT FROM AUTHOR]

In January 2021, the Gulf Health Council (GHC), established the Gulf Centre for Disease Prevention and Control (Gulf CDC) in Riyadh, marking a pivotal step in harmonizing health strategies, enhancing knowledge generation, and promoting evidence-based approaches to both communicable (CD) and non-communicable diseases (NCD). The Gulf CDC’s mission includes consolidating the region’s health information systems, crucial for monitoring disease burden and shaping effective public health policies. An initial assessment of public health surveillance systems across the Gulf Cooperation Council (GCC) member states was conducted by the Gulf CDC. This revealed strong national surveillance coverage of CDs but identified areas for improvement, particularly in data quality and representativeness. These findings informed the development of the Gulf CDC’s health information strategy and confirmed the need for a regional surveillance system. Prior to the introduction of this system, senior experts in this field from all GCC member states were surveyed and a consensus process launched to agree on the first steps. This led to the strategic selection of a small number of priority communicable and non-communicable diseases for the pilot phase of the system. The final agreed list of diseases and conditions for the pilot are the CDs: acute respiratory infection (ARI), endemic dengue, brucellosis, measles and pulmonary tuberculosis together with the NCDs: cancer (registry) and road traffic injuries. The initiative will showcase the potential benefits of regional collaboration to improve health outcomes and will ultimately also contribute to global health security efforts.