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Bullous pemphigoid is an autoimmune blistering disease that is characterized by pruritus, cutaneous urticarial plaques, and tense bullae, with mucosal involvement. On histopathology, a subepidermal blister is predominantly evident with eosinophilic inflammatory infiltrates in the upper dermis. In a few bullous dermatoses, milia can manifest at the scar of blistering lesions or in non-lesional skin. Milia are classically associated with epidermolysis bullosa acquisita, porphyria cutanea tarda, and mucous membrane pemphigoid. We report a case of bullous pemphigoid with milia manifesting within healing blistering lesions.

The practices of sorting things out and bringing things together, which I summarise under the term relanguaging, sit between fluid, situated languaging practices and the administrative standard grid in education that relies on bounded, named languages. Relanguaging, I argue, was invisible to socio- and applied linguists' analytical vision because of a tendency to set named languages as the norm. This led to questions about switching between or transcending languages but not about producing and dissolving them. Together with two English teachers in Khayelitsha, South Africa, I instead set fluid languaging practices as the analytical norm to then investigate the relationship between such fluidity and (administratively) fixed languages. The language classrooms I focus on then emerge as one of the production sites of named languages - here of English. English teachers (sometimes in collaboration with their students) sort out extremely complex spatial repertoires with various heterogeneous linguistic resources to produce English as a recognisable, teachable and learnable entity. The reflections I present suggest a different idea of how language classrooms work (also in settings beyond Khayelitsha) but they also open up (language) philosophical questions about the ontology of linguistic features and how they come to be English (or not).

ABSTRACTFractional calculus is extremely important and should not be undervalued due to its critical role in the theory of inequalities. In this article, different generalized Hermite-Hadamard type inequalities for functions whose modulus of first derivatives are [Formula: see text]-convex are presented, via Caputo-Fabrizio integrals. Graphical justifications of main results are presented. Graphs enable us to support our conclusions and show the reliability of our findings. Additionally, some applications to probability theory and numerical integration are also established. As special cases, certain established outcomes from different articles are recaptured. This study acts as a stimulant for future studies, inspiring researchers to investigate more thorough results by utilizing generalized fractional operators and broadening the idea of convexity.

This research study explored EFL teachers' instructional practices (e.g., adaptation, selection, elaboration, and simplification) in using authentic texts for teaching reading comprehension. In fact, a considerable amount of research has been devoted to investigate the use of authentic texts in teaching reading comprehension. However, there is an academic and professional need to explore how teachers exploit authentic texts while teaching reading comprehension. The study employed a mixed method research design. Teachers' instructional practices were explored through a self-reported questionnaire. Also, the study examined teachers' perspectives on these practices and how their Personal Practical Knowledge (PPK) affects their practices by conducting semi-structured interviews. From two Saudi universities, 50 female EFL teachers responded to the questionnaire, while additional five teachers were interviewed. The questionnaire results revealed that EFL teachers adapt authentic texts for advanced students more than beginners. In contrast, most of the teachers in the interviews highlighted that authentic texts are applicable in teaching beginners with the use of technology. The quantitative and qualitative results showed that teachers select authentic texts that match students' language level, their cultural background, and course book objectives. It was also found that the aspects of PPK knowledge affected teachers' instructional practices in using authentic texts. Based on the research findings, several suggestions and recommendations were presented to enhance the effectiveness of authentic texts in the EFL classrooms.

IntroductionMusculoskeletal disorders (MSDs) are rapidly rising in Saudi Arabia, reaching levels similar to those in the Western world. Hence, we aimed to assess the prevalence of neck, shoulder, and lower back pains (musculoskeletal pain, MSP) among students at King Khalid University in Abha, Saudi Arabia.MethodsThis cross-sectional study was conducted at King Khalid University in Abha, Saudi Arabia, from March 2023 to August 2023. Inclusion criteria were: university students aged 18 years and older of both sexes who agreed to participate in the study. The modified Nordic questionnaire was used, which comprised three parts.ResultsOut of 536 respondents, 337 were women and 199 were men. The average body mass index (BMI) of the study population was 25.3 ± 4.01. In total, 223 (41.60%) had a history of MSDs. Only 232 (43.28%) of the population did regular exercise. According to multiple logistic regression analysis, factors associated with MSDs are mobile device use (with both hands) with a large neck tilt below the horizon line position (OR = 2.276, CI 1.178–4.397, p = 0.014), family history of trauma (OR = 5.450, 95% CI 3.371–8.811, p = 0.000), family history of MSDs (OR = 4.241, 95% CI 2.296–7.835, p = 0.000), coffee consumption (OR = 1.967, CI 1.281–3.020, p = 0.002), and time spent on electronic devices: 1–3 h (OR = 0.252, 95% CI 0.124–0.511, p = 0.0001), 4–6 h (OR = 0.455, 95% CI 0.237–0.873, p = 0.018), and 6–9 h (OR = 0.348, 95% CI 0.184–0.660, p = 0.001).ConclusionThe present study concludes that MSP among university students is high. A history of trauma, a family history of MSDs, the hand and neck position when using electronic devices, the amount of time spent using them, and regular exercise are risk factors that are strongly associated with MSP. There is strong evidence to suggest that increasing physical activity plays a significant role in enhancing the functionality of the musculoskeletal (MSK) system and alleviating pain. It is recommended that universities implement educational programs to raise awareness and health screenings about the impact of device usage on MSK health and the benefits of regular exercise.

One of the fastest growing fields of study in nonlinear optics is optical solitons. This article investigates the optical soliton solutions of the coupled Kaup-Newell equation in birefringent fibers without four wave mixing. This model helps explain how modified structures, particularly Alfven waves, propagate in optical fiber and plasma physics. The results presented in this research clearly show how well the new mapping method handle nonlinear Kaup-Newell equation in coupled vector form, in birefringent fiber without four-wave mixing, to extract the analytical soliton solutions. Four-wave mixing expresses a nonlinear optical effect in which four waves interact each other as a result of the third order nonlinearity. As a valuable outcome of this article, a variety of solitons are discovered including bright, dark, periodic, singular bell-shaped, gap, flat-kink, dark-singular, and w-shaped. The existence criteria for these solitons are also obtained that are presented as constraint conditions. The constraint relations guarantee the existence of such solitons. Furthermore, graphs in 2D, 3D and contour are created to show the physical characteristics of the solutions that are produced. The new mapping method is clear and effective, and the solutions provide a wealth of avenues for additional research. The technique can also be functional to other sorts of nonlinear evolution equations in contemporary areas of research. The outcomes presented in this work are new versions which have never been observed before in existing literature.

In this paper, we introduce an innovative approach that merges linguistic prompting with reinforcement learning to improve the quality of text summarization models. The primary focus is on enhancing the human-centered evaluation of these models, which is crucial for ensuring that the generated summaries are both useful and understandable. Our framework uses linguistic prompts as a guiding tool in the summarization process, providing more precise control over the resulting summaries. This method allows the summarization model to produce outputs that are not only accurate but also reflective of specific human-like cues, such as tone and context. By doing so, we can steer the model's behavior toward generating summaries that are more aligned with human expectations. To further refine the model's performance, we integrate reinforcement learning into our framework. This technique involves iterative improvement based on feedback from human evaluators, allowing the model to learn from its mistakes and continuously adapt to human preferences. This reinforcement-based approach ensures that the summarization model evolves over time, achieving greater accuracy and relevance with each iteration. Our methodology addresses a key challenge in text summarization: creating summaries that are concise yet sufficiently informative. By leveraging linguistic prompting and reinforcement learning, we aim to develop a system that produces summaries that are not only shorter but also more meaningful from a human perspective. This work contributes to the advancement of natural language processing by offering a novel way to balance brevity and informativeness, ultimately leading to more interpretable and human-friendly text summarization tasks.

This study presents a new approach for characterizing the 3D printing electromagnetic properties in Polylactic Acid (PLA) using a novel cross-fractal sensor. The CST Studio Suite simulation, employing the finite element method (FEM), and the ADS simulation software, based on the equivalent circuit of this novel sensor, are utilized to enhance confidence in the convergence of simulation and measurement results. The analysis confirms that the real sensor, based on a cross-sectional fractal resonator, exhibits excellent sensitivity, selectivity, and linearity. Sensor performance is evaluated through two methods: the frequency-based approach and the S11 parameter analysis. In the frequency-based method, the sensor demonstrates a typical sensitivity of 0.0302 GHz/cm3, while in the S11 parameter analysis, it exhibits a typical sensitivity of 0.3065 dB/cm3. These results underscore the high sensitivity and linearity of this innovative sensor. The using of this novel cross fractal sensor, it promises to show how to properly adjust 3D printer parameters, potentially setting the “infill percentage” of the 3D print, this is because the proportion of air present changes when the printing percentage is changed, which can lead to ( $\varepsilon \text{r}$ ) and loss-tangent (tan ( $\delta$ )) with varying the infill percentage, by the resonance frequency (fr) approach demonstrates a characteristic sensitivity of 0.1822 GHz/RIU. The experimental study confirmed that the fabricated sensor exhibits miniaturization (with an electrical size of $\lambda 0$ /8), high sensitivity, and excellent linearity in the frequency approach, with a typical sensitivity of 0.004615 GHz/%. The suggested biosensor demonstrated its capability to detect low concentrations of ethanol. These aqueous solutions, containing known alcohols like ethanol in low concentrations, enables identification of Halal and alcohol-free products in food sensing applications.

Nowadays, it is very tough to differentiate between real news and fake news due to fast-growing social networks and technological progress. Manipulative news is defined as calculated misinformation with the aim of creating false beliefs. This kind of fake news is highly detrimental to society since it deepens political division and weakens trust in authorities and institutions. Therefore, the identification of fake news has emerged as a major field of research that seeks to validate content. The proposed model operates in two stages: First, TF-IDF is applied to an entire document to obtain its global features, and its spatial and temporal features are simultaneously obtained by employing Bidirectional Encoder Representations from Transformers and Bidirectional Long Short-Term Memory with a Gated Recurrent Unit. The Fast Learning Network efficiently classifies the extracted features. Comparative experiments were conducted on three easily and publicly obtainable large-scale datasets for the purposes of analyzing the efficiency of the approach proposed. The results also show how well the model performs compared with past methods of classification.

In this research, resorbable phosphate-based glass (PBG) compositions were developed using varying modifier oxides including iron (Fe2O3), copper (CuO), and manganese (MnO2), and then processed via a rapid single-stage flame spheroidisation process to manufacture dense (i.e., solid) and highly porous microspheres. Solid (63–200 µm) and porous (100–200 µm) microspheres were produced and characterised via SEM, XRD, and EDX to investigate their surface topography, structural properties, and elemental distribution. Complementary NMR investigations revealed the formation of Q2, Q1, and Q0 phosphate species within the porous and solid microspheres, and degradation studies performed to evaluate mass loss, particle size, and pH changes over 28 days showed no significant differences among the microspheres (63–71 µm) investigated. The microspheres produced were then investigated using clinical (1.5 T) and preclinical (7 T) MRI systems to determine the R1 and R2 relaxation rates. Among the compositions investigated, manganese-based porous and solid microspheres revealed enhanced levels of R2 (9.7–10.5 s−1 for 1.5 T; 17.1–18.9 s−1 for 7 T) and R1 (3.4–3.9 s−1 for 1.5 T; 2.2–2.3 s−1 for 7 T) when compared to the copper and iron-based microsphere samples. This was suggested to be due to paramagnetic ions present in the Mn-based microspheres. It is also suggested that the porosity in the resorbable PBG porous microspheres could be further explored for loading with drugs or other biologics. This would further advance these materials as MRI theranostic agents and generate new opportunities for MRI contrast-enhancement oral-delivery applications.

Linguistic heterogeneity and fluidity--prominently captured in the notion of 'translanguaging'-- are starting to be seen as normative and natural. In turn, homogeneity and fixity, instantiated for example in standard languages, are becoming the 'odd-ones-out.' I challenge the dichotomy between linguistic fluidity (languaging) and fixity (named languages), in a situated conceptual account of translingual writing practices in English classrooms in a Khayelitshan primary school. These spaces fold the linguistic fluidity typical of South African townships, and the fixity of two standard languages, into one complex spatial repertoire. Operationalizing this spatial perspective, I suggest that students are constantly engaged in "relanguaging," recursively "sorting out" the classroom repertoire according to the various linguistic norms enfolded in the space, and of "bringing together" linguistic resources in various combinations. Relanguaging systematically unsettles the dichotomy between fluid languaging and fix institutional language norms retained in dominant conceptualizations of translanguaging. This way it opens up new conceptual and analytical perspectives with possible pedagogical implication for writing instruction and testing. Standard English could, for example, be assessed beyond its own confines, using writing tasks that can make visible increasingly sophisticated linguistic sorting skills as students.

Enterotoxaemia is a severe disease caused by Clostridium perfringens and render high mortality and huge economic losses in livestock. However, scanty information and only few cases are reported about the presence and patho-physiology of enterotoxaemia in camels. The bacterium induces per-acute death in animals due to rapid production of different lethal toxins. The necropsy of camels (per-acute = 15, acute = 3) was conducted at 18 outbreaks of enterotoxaemia in camels in the desert area of Bahawalpur region. At necropsy, the serosal surfaces of visceral organs in the abdominal, peritoneal and thoracic cavities were found to have petechiation with severe congestion. Moreover, both the cut-sections of different visceral organs and the histo-pathological analysis revealed the pathological lesions in heart, lungs, kidneys, spleen, small and large intestines. Grossly, the kidneys were severely congested, hyperemic, swollen and softer in consistency. Under the microscope, different sections of kidneys indicated that the convulated and straight tubules were studded with erythrocytes. In the intestines, there were stunting fusion of crypts and villi. Similarly, various histo-pathological ailments were also observed in the heart, lungs and spleen. At blood agar, the collected samples showed beta hemolytic colonies of C. perfringens that appeared as medium sized rods microscopically and stained positively on Gram staining. Multiplex PCR revealed C. perfringens type A (α and β2 genes) and D (epsilon gene) and the deaths were found to be significantly higher due to C. perfringens type D compared to those by C. perfringens type A. Hence, it has been concluded that enterotoxaemia in camel affects multiple organs and becomes fatal, if occurred due to C. perfringens type D.

The precise solutions of the (2+1)-dimensional modified KdV-KP equation are examined in this study. Three reliable methods, namely, the modified auxiliary equation scheme, extended rational sine–cosine methodology, and extended rational sinh–cosh technique, are utilized for the first time to extract multiple soliton solutions for the governing model. These types of solutions have applications in plasma, solid state, neuronal, biological production, and diffusion processes. Graphical simulations of the obtained solutions are included in the form of 3 dimensional surface plots to reveal their physical structure and dynamical features.

Saad Abbas Aldawsari,1 Nazih Alzaidi,2 Maram EA Abdalla Elsayed,3 Abdullah Ahmed Alhammadi,4 Hadeel Khaled Alharthi,1 Abdulrahman Alosaimi,5 Yahya Al-Najmi6 1Ophthalmology Department, King Faisal Medical Complex, Taif, Saudi Arabia; 2Ophthalmology Department, Alhada Military Hospital, Taif, Saudi Arabia; 3Ophthalmology Department, Jeddah Eye Hospital, Jeddah, Saudi Arabia; 4Ophthalmology Department, Asir Central hospital, Abha, Saudi Arabia; 5Ophthalmology Department, College of Medicine, Majmaah University, Majmaah, Saudi Arabia; 6Ophthalmology Department, Saggaf Eye Center, Jeddah, Saudi ArabiaCorrespondence: Yahya Al-Najmi, Ophthalmology Department, Saggaf Eye Center, Abdullah Salman St., Al Faiha’a Dist., P.O. Box: 31903, Jeddah, 21418, Saudi Arabia, Tel +966 564844281, Email dr.alnajmi@gmail.comPurpose: To estimate the prevalence and determinants of Ocular Surface Disease Index (OSDI) score based dry eye disease (DED) among the adult urban population of four cities located at high altitudes in Southwest Saudi Arabia.Methods: This cross-sectional survey was held in 2023. OSDI questionnaire was used to collect the responses of the adult participants. The score was further graded into none, mild, moderate, and severe DED to estimate age-sex-adjusted DED prevalence. The OSDI score was correlated to demographic (age group, gender, education, occupation, city) and risk factors like smoking and co-morbidities.Results: Of the 401 adults, 388 (response rate of 97.8%) participated. The age-sex-adjusted prevalence of mild, moderate, and severe DED was 21.7%, 13.1%, and 32%, respectively. The median ODSI score was 22.9 [Interquartile range (IQR) 10.4; 47.9)]. The score was significantly higher in females (Mann–Whitney U-test P = 0.038), residents of Taif city (KW P = 0.05), those with primary/middle school education (Kruskal–Wallis P = 0.004), comorbidities like hypertension, asthma (KW P < 0.001) and risk factors like past refractive surgeries, arthritis (KW P = 0.013). Education status (P < 0.001) [B = − 9.0 95%] and presence of comorbidity (P = 0.022), [B = − 0.823] were significant predictors of DED.Conclusion: The prevalence of DED and severe grade was high. The level of education and presence of comorbidities significantly influenced DED in the adult urban Saudi population of cities at high altitudes.Keywords: dry eye disease, Ocular Surface Disease Index

A 3D problem in linear elasticity is considered for a thin inhomogeneous layer subject to transverse compression. For the first time, the effect of arbitrary vertical inhomogeneity is elucidated. Two sets of boundary conditions along the faces of the layer are adapted for modelling transverse compression. Robust asymptotic formulae involving repeated integrals across the thickness are derived for displacements and stresses. As an illustration, numerical results are presented for the elastic moduli having a transverse parabolic variation. The obtained results have a potential to be implemented in modern technology, including manufacturing and design of functionally graded materials.

In this work, non-linear elastic deformations of beams are investigated. The kinematics of the beam is derived based on an element with four-parameter containing a through-the-thickness stretch parameter to avoid Poisson locking. Moreover, the Kirchhoff-Saint Venant model is used to derive kinetic quantities. Next, a non-linear FE formula in Total Lagrangian form is obtained, and three-node beam element with two-node reduced integration is employed to avoid shear locking. Finally, to evaluate the performance of the derived formulations, some examples are provided. The results prove that the current formulation is in very good agreement with those available in the literature. More importantly, the formulation is capable of predicting the experimental results with high accuracy.

This study aims to investigate nursing interns’ training experiences in emergency departments (EDs) in Saudi Arabia and explore the factors influencing their experiences. A descriptive research design was employed utilizing a survey distributed to nursing interns who completed their ED rotation within the last three months. The data were analyzed using SPSS version 27, and principal component analysis (PCA) was conducted to identify the challenges encountered by the interns. This study analyzed the responses of 126 nursing internship students in various regions of Saudi Arabia to assess their training experiences in emergency departments. The principal component analysis revealed two significant factors: (1) “Emergency Department Training and Skill Development”, which focused on challenges faced during training, and (2) “Integrated Emergency Department Training and Competence Development”, which provided a holistic view of nursing internship students’ experiences and preparedness for their careers. The results indicated moderately below-average challenges and a moderately positive overall training experience. The findings suggest a need to address these challenges to improve the training experience and better prepare nursing internship students for careers in emergency departments. This study recommends enhancing the nursing curricula alignment with practical training objectives, focusing on technical and interpersonal skills development. A supportive learning environment in emergency departments is crucial, including effective communication and collaboration. Diverse clinical experiences and reflection on training can guide students in exploring potential career paths in emergency departments or other specialized nursing areas.

Currently, Value Engineering (VE) has become one of the important and necessary matters to ensure the fair distribution of resources without waste or extravagance. It is an analytical study with a specific method conducted by a multidisciplinary team on the product, service, or project to identify and classify the functions performed to achieve those required functions in a better way at a lower cost, or both, through innovative alternatives without compromising the essentials. The aim of this study to assess the impact of applying (VE)dimensions (quality, cost, job performance(JPF)) on quality management of engineering laboratories at the College of Engineering. quantitative and qualitative methodologies were used for collecting the data. A questionnaire was created based on the literature studies and structured interviews, Where (77) questionnaires were analyzed, the study reached several conclusions, which are the quality management of service has a good correlation with factors of Value Engineering, the high one with quality standard that means a requirement of the owner (0.526), as well as continuously improving functional performance with correlation (0.342), reducing costs, and encouraging proposals that enhance the quality management of engineering laboratories. Based on applying value ANOVA result that the regression is significant with value equals 0.001, that could be taken into consideration as an indicator of a Statistically Significant Relationship between Value Engineering and quality management of service of engineering laboratories, the result shows that the regression is significant with value equals to 0.038 that is less than 0.05 which could be taken in consideration as an indicator of a Statistically important Relationship between the JPF with quality management of service factor This indicates the effective role of Value Engineering in enhancing service quality. Therefore, it is clear that prioritizing Engineering standards have a positive effect on the quality management of the engineering industry

The current research was carried out to devise a biological strategy to remediate dyes and metal ions from textile wastewater. For this purpose, Citrobacter sp. M41 was isolated from a textile wastewater sample. This strain efficiently decolorized > 90 % of the added reactive black-5 (RB5) dye using yeast extract as a C source at 8.5 pH and 30 °C in mineral salt medium containing a mixture of metals (Pb2+, Ni2+ and Cd2+). Moreover, M41 showed > 90 % decolorization of RB5 beside > 80 % concurrent removal of hexavalent Chromium [Cr(VI)]. Furthermore, the granulated corncob and its biochar bioaugmented with M41 and filled within packed bed column based bioreactors efficiently (>90 %) removed the RB5 and Cr(VI) from a textile wastewater. The M41 bioaugmented corncob biochar resulted into a 60.8 %, 57.8 % and 68.7 % decrease in chemical oxygen demand (COD), electrical conductivity (EC) and total dissolved solids (TDS) of the wastewater, respectively. A phytotoxicity study conducted by using mung bean (Vigna radiata) as a test crop indicated that the treated synthetic wastewater was relatively less toxic as compared with the untreated wastewater. Therefore, it can be concluded that Citrobater sp. M41 is an important bio-resource for treatment of textile effluent polluted with azo dyes and Cr(VI).

The time fractional Schrödinger equation contributes to our understanding of complex quantum systems, anomalous diffusion processes, and the application of fractional calculus in physics and cubic B-spline is a versatile tool in numerical analysis and computer graphics. This paper introduces a numerical method for solving the time fractional Schrödinger equation using B-spline functions and the Atangana-Baleanu fractional derivative. The proposed method employs a finite difference scheme to discretize the fractional derivative in time, while a θ-weighted scheme is used to discretize the space directions. The efficiency of the method is demonstrated through numerical results, and error norms are examined at various values of the non-integer parameter, temporal directions, and spatial directions.