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High-Variability Phonetic Training (HVPT) has demonstrated effectiveness in second language (L2) acquisition. This study utilizes a meta-analysis to explore the influence of high variability on learning L2 pronunciation and identifies the factors that moderate this impact. The studies were collected using a keyword search in the SCOPUS database. In total, our meta-analysis incorporated 18 primary studies that presented results obtained from experimental and control group designs, encompassing a total of 22 effect sizes. The results of our meta-analysis revealed that the overall effect size of HVPT on L2 pronunciation was medium (g = 0.77). Specifically, the effect size was large for consonant sounds and lexical tones, particularly pronounced when utilized by advanced learners. For beginners, the effect size was medium. The context in which the training was conducted also played a role, with a medium effect size observed when sentences were used. Additionally, the number of talkers involved in the study influenced the effect size, with a medium effect size found when 5 to 8 talkers were included. In other cases, the reported effect sizes were either small or non-significant.

Artificial intelligence (AI) is now affecting all aspects of our social lives. Without always knowing it, we interact daily with intelligent systems. They serve us invisibly. At least that is the goal we assign to them: to make our lives better, task by task. Artificial intelligence has the potential to make biology education more engaging, personalized, and effective by providing students with interactive simulations, personalized learning experiences, and other tools that help them understand complex biological concepts. In this paper, we discuss the integration of AI into the virtual classroom, which significantly enhances student learning experiences in various ways. The study shows that an effective integration of technology into the virtual classroom requires a thoughtful approach that aligns with educational goals and the specific needs of students. In fact, interactive simulations can help make biology more engaging and memorable for students. Besides, personalized learning AI algorithms can help biology students receive a more tailored and effective learning experience, helping them to better understand the course material and develop a deeper appreciation for the natural world. In this work, we will discuss the use of AI to enhance interactive simulation-based cellular processes, with additional application in anatomy, physiology, and ecology teaching. Moreover, this paper discusses how AI could be used to analyze student data and propose personalized learning using adaptive assessments, content recommendations, and data sciences. This paper illustrates examples of AI algorithms that could be useful for teaching biology.

This current study is to empirically validate the importance of student's behavioural engagement on online teaching during a coronavirus-2019 disease pandemic. The global spread of coronavirus-2019 disease has affected every aspect of business, including education, resulting in the shift of classroom to online teaching. Keeping in view the growing concern about students' attentiveness, connectivity, participation, and interaction in online classes, the authors underlined the critical need for paying empirical attention to this issue. While addressing a major empirical gap, the present study tested and found the significant role of e-learning efficacy, e-learning resilience, and teachers' instructional innovation in boosting students' online behavioural engagement. Additionally, the study found a thought-provoking direct and interacting role of teachers' instructional innovation. Therefore, the implications of the findings indicate that leaders in educational institutions need to invest in psychological resources that emphasize innovation and creativity in instructional methods for teachers to enhance student engagement in an online environment.

Speaking is considered an essential literacy skill and enjoys a superior status among other language skills. Thus, this current study aims at scrutinizing Saudi EFL trainees' speaking anxiety from their college instructors' perspectives. It adheres to qualitative approach and utilizes face-to-face interviews with four language instructors. Thematic analysis was used to analyze the data. The results showed that EFL instructors at Saudi colleges of technology are aware of their students' speaking anxiety. Thus, they reported several causes that lead to students' foreign language speaking anxiety (FLSA, hereafter) such as fear of making mistakes, the limited exposure to the language, low language proficiency, and fear of receiving negative evaluation from both their instructors and peers. In addition, the results revealed that the instructors use different strategies that help alleviating their students' FLSA such as building good relationships with students, creating positive and friendly atmosphere in the classroom, increasing students' engagement in the class and correcting students' erroneous beliefs about language learning. Encouraging and motivating students to participate in oral tasks was a significant strategy stated by the instructors, which help reduce students' FLSA in the classroom. The study concludes that the type of curriculum and overcrowding classes are factors that significantly affect the instructors' awareness of their students' FLSA.

Purpose: Chat Generative Pre-trained Transformer (ChatGPT) has become everyone's talk. It frightens many professionals, who worry about losing their jobs. ChatGPT may reconstruct some professions; some occupations may vanish while new ones may appear. Design/methodology/approach: This mixed-methods study explores whether and how the use of ChatGPT impacts English is taught as a foreign language (EFL) students' social and emotional learning (SEL). The study used a questionnaire and collected perception data from 57 EFL students. A discussion with seven EFL professors was also formulated to triangulate the findings. Findings: Results indicate that EFL students have high positive perceptions of using ChatGPT in their learning (M = 3.87). Results also showed that using ChatGPT has a moderate impact on EFL students' SEL (R = 514). This moderate effect was confirmed by the qualitative findings, which indicated that ChatGPT positively impacts EFL students' SEL by allowing them to practice conversation skills, aiding them in managing their emotional intelligence, providing them with feedback and reducing their anxiety. However, findings also indicated that ChatGPT reduces students' creativity and limits their emotional growth. Finally, the findings reported that for better use of ChatGPT, supervision is key. Originality/value: This study recommends the use of ChatGPT in a way that helps students' creativity and emotional growth.

This article performs bibliometric analysis to study the contributions of Saudi institutions in the education field in journals indexed in the Social Science Citation Index (SSCI) and Science Citation Index-Expanded (SCI-EXPANDED). Publications from 1991 to 2020 were assessed. Characteristics of document types, publication outputs, Web of Science categories and journals, and publication performances in terms of quantity for countries and institutes were investigated. To investigate performance quality, citation histories of the most frequently cited articles in the 30 years and the most frequently cited articles in 2020 were examined. The number of citations from the WoS Core Collection in the most recent year, total number of citations since the publication year 2020, and citations per publication were used to evaluate publication performances. Results showed that educational research articles were substantially published in the last decade. The most number of articles were published in the category of scientific disciplines education, followed by the education and educational research category. For international collaboration, Saudi Arabia had the most number of international collaborations with the US. However, articles that were collaborated with Germany had the highest impact. King Saud University was the most productive institution in terms of high-quantity and high-quality published articles.

Background: Using games as a medium to master certain learning outcomes enables students to explore and understand the world around, which is important for students with intellectual disabilities. The purpose of this study was to gain insight into the potential effects of online games on social interaction of adolescents with intellectual disability, and how parents view these effects. Method: This study employed a quantitative approach using a quasi-experimental, pre-test and post-test and follow up design. Descriptive approach is also employed to investigate how parents view effects of online games on social interaction of adolescents with intellectual disability. To test the third hypothesis, qualitative method through interview was employed. 40 adolescents with mild ID aged between 15 and 18 years and who were enrolled in the ID Inclusion program, as well as their parent/guardian were recruited. Results: On the basis of the statistical analysis, It was observed a significant effect on adolescents with ID's social interaction capability. Looking at between-group differences, the groups were statistically significantly different in their levels of social interaction at the end of the intervention, with participants in the experimental group exhibiting significantly higher levels of social interaction in comparison to the controls. Conclusion: This study provides a potential support to the effectiveness of online games on social interaction of adolescents with intellectual disability. The main conclusion arising from these findings is the need to broaden the study of online games and their possible benefits to other variables than social interaction, such as cognitive variables and diverse populations, especially those with ID and autism.

This study aims to analyze the research outputs of immersive technology in the field of education for the past two decades. To this end, we retrieved 2665 articles that contained 75674 valid references from the Scopus database for the period between 2001-2021. Several structural and temporal metrics were used to find out the emerging topics proposed by the literature of immersive technology in the field of education. Results recorded 869 clusters entailing 2561 nodes and 3372 links. The major clusters identified in our results were related to virtual reality, augmented reality, and virtual worlds. We found that immersion research was grounded on a robust theoretical framework such as constructivism, experiential learning, and cognitive load theory. We found diversified venues of publication in which the immersion literature appeared in 741 peer-reviewed journals. Our results indicate that seven educational technology journals were the most highly co-cited journals where "Computers and Education" and "British Journal of Educational Technology" were the most influential journals in terms of quantity and quality of the published articles, recording the highest h-index. Tips and suggestions for future research projects were also highlighted.

Multimedia glosses have been examined extensively by researchers for over three decades to determine their possible effects in second language (L2) vocabulary acquisition. Many meta-analytic studies aimed to determine the extent to which glosses can impact L2 vocabulary learning and the moderators that can mediate the results of meta-analytic studies. This study integrated meta-analytic studies with document co-citation analysis (DCA) to elicit a fine-grained view of the thematic associations of relevant citing studies with the issue of glosses and L2 vocabulary learning. To address this issue, 18 target studies (N = 2991 participants) were selected as the study sample. Results revealed that glosses had an overall large effect size on L2 vocabulary acquisition (Hedge's g = 1.27); however, the effect size varied from small to large, depending on the level of proficiency of the learners. Concerning the tests type moderator, the effect size was large for recognition test but medium for vocabulary recall test. Results of the DCA (18 cited articles and 802 citing articles) identified 10 core papers, with highly significant co-citations, and 257 citing references, indicating the highly thematic relatedness of the target studies, and citing references to the issue under investigation.

Abstract Background Socioeconomic status (SES) is a social classification factor that takes into account income, parental education and occupation. SES has been shown to play an important role in shaping students’ academic performance, including in medical schools, but there still remains significant variation in findings around SES and academic achievement worldwide. We aim to assess and explore socioeconomic disparities and their effects on medical school performance at Sudanese public and private universities. Objectives The objective of our study was to assess the effects of age, sex, living conditions, parental education and income level on the academic achievement of medical students from universities in Sudan. Methods This cross-sectional study was conducted among undergraduate medical students at ten public universities in Sudan between September and December 2023. Participants were included if they were older than 18 years and were studying in their 2nd year or older. The data were collected using an online questionnaire with open- and closed-ended questions measuring age, living conditions, parental income level and education. A convenience sampling method was used to recruit participants from universities. The data were analyzed using SPSS v28.0.0, and a p value less than 0.05 was used to indicate statistical significance. Results We received 832 responses, 516 (62%) from females and 307 (36.9%) from males. The median age was 23 years. Most students lived with their families (61.1%), followed by student housing (28.2%). This study revealed age (p = .024) (95% Cl: 0.025- 0.023) andhigh family income (p = .019) (95% Cl: 0.018- 0.02) are associated with academic achievement in the long term, as demonstrated through cumulative grade point average (cGPA). Conclusion The findings underscore the importance of targeted support systems to bridge the socioeconomic gaps that exist among medical students, allowing all students to thrive academically regardless of their background. Clinical trial number None.

Cloze tests are gap-filling tests designed to measure overall language ability and reading comprehension in a second language. Due to their ease of construction and scoring, cloze tests are widely used in the context of second and foreign language testing. Previous research over the past decades has shown the reliability and validity of cloze tests in different contexts. However, due to the interdependent structure of cloze test items, item response theory models have not been applied to analyze cloze tests. In this research, we apply a method to circumvent the problem of local dependence for analyzing cloze tests with the Rasch model. Using this method, we applied the Rasch model to a cloze test composed of eight passages each containing 8-15 gaps. Findings showed that the Rasch model fits the data and thus it is possible to scale persons and cloze passages on an interval unidimensional scale. The test had high reliability and was well-targeted to the examinees. Implications of the study are discussed.

Background: Brain oscillations in the delta frequency band have been linked with deep sleep and consolidation of declarative memory during sleep. However, the causal relationship of these associations remains not competely clarified, primarily due to constraints by technical limitations of brain stimulation approaches suited to induce and stabilize respective oscillatory activity in the human brain. The objective of this study was to establish a non-invasive brain stimulation protocol capable of reliably inducing, and stabilizing respective oscillatory activity in the delta frequency range. Hypothesis: We aimed to develop an efficient non-invasive brain stimulation (NIBS) protocol for delta frequency induction and stabilization via concurrent, phase-locked repetitive transcranial magnetic stimulation (rTMS) and transcranial alternating current stimulation (tACS). We hypothesized that rTMS induces oscillatory resting-state activity in the delta frequency and that tACS stabilizes this effect, as has been shown before for alpha and theta frequencies. Methods: 19 healthy participants took part in a repeated-measures experimental protocol. We applied rTMS pulses synchronized with the peak or trough phase of 0.75Hz tACS over the bilateral prefrontal cortex. Resting state EEG in eyes-open (EO) and eyes-closed (EC) conditions was recorded before, immediately after and every 10 min for up to 1 h after intervention. Results: rTMS phase-synchronized to the trough of the tACS waveform significantly increased delta frequency activity for up to 60 min in both EO and EC conditions after stimulation. The effects extended from frontal to temporal regions and this enhancement of oscillatory activity was shown to be specific for the delta frequency range. Conclusion: Concurrent, trough-synchronized 0.75 Hz rTMS combined with tACS may be a reliable protocol to induce long-lasting oscillatory activity in the delta frequency range. The results of the current study might perspectively be relevant for clinical treatment of sleep disturbances which are accompanied by pathologically altered brain oscillations, and enhancement of memory consolidation.

Abstract Background The most prevalent persistent parenchymatous liver alterations in healthy individuals are thought to be hepatic steatosis. The liver biopsy is the most crucial procedure for the identification and measurement of hepatic steatosis. By identifying the liver attenuation index (LAI) at CT image with fibroscan controlled attenuation parameter (CAP), hepatic steatosis can be evaluated without the risk of liver resection. Objective Using liver biopsy histological analysis as a reference standard, to examine the precision of the CT liver attenuation index (LAI) and fibroscan controlled attenuation parameter (CAP) for quantitative evaluation of macrovesicular steatosis in living related liver donors. Methods In this cross-sectional study, comparing the CT liver attenuation index & fibroscan controlled attenuation parameter with liver biopsy result for the detection of the steatosis in subject's candidate for liver living donors, 50 subjects were conducted at Ain Shams Specialized Hospital and other private hospitals over about 2 years. Results Our study reported that liver attenuation index of 9 is the cutoff value in post-contrast CT images with sensitivity 100% and specificity 80% that make it a very good method to exclude donor to have steatosis ≥ 15%, which mean that if donor had LAI index

Monkeypox is a highly infectious disease and spreads very easily, hence posing several health concerns or risks as it may lead to outbreak. This article proposes a new mathematical model to simulate the transmission rate of the monkeypox virus-infected fractional-order differential equations using the Caputo–Fabrizio derivative. The existence, uniqueness, and stability under contraction mapping of the fixed point of the model are discussed using Krasnoselskii’s and Banach’s fixed point theorems. To verify the model proposed, we employ data that record the actual dynamics, and based on these data, the model can capture the observed transmission patterns in Ghana. Also, the analytic algorithm is used to find the result applying the Laplace Adomian decomposition method (LADM). Performance analysis of LADM is made regarding Runge-Kutta fourth order, which is the most commonly employed method for solving second-order ordinary differential equations. This comparison therefore offers information on the truth and reliability of the two techniques toward modeling the transmission pattern of the monkey pox virus. The information obtained through this study provides a better understanding of the antibodies linked to monkeypox virus spreading and provides effective strategies to doctors and politicians. This article helps shape better strategies about combating the impact of monkeypox virus in public health since it makes it easy to predict and prevent the occurrence of the disease.

Abstract Background PPHN is a common cause of neonatal respiratory failure and is still a serious condition and associated with high mortality. Objectives To compare the demographic variables, clinical characteristics, and treatment outcomes in neonates with PHHN who underwent ECMO and survived compared to neonates with PHHN who underwent ECMO and died. Methods We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature for studies on the development of PPHN in neonates who underwent ECMO, published from January 1, 2010 to May 31, 2023, with English language restriction. Results Of the 5689 papers that were identified, 134 articles were included in the systematic review. Studies involving 1814 neonates with PPHN who were placed on ECMO were analyzed (1218 survived and 594 died). Neonates in the PPHN group who died had lower proportion of normal spontaneous vaginal delivery (6.4% vs 1.8%; p value > 0.05) and lower Apgar scores at 1 min and 5 min [i.e., low Apgar score: 1.5% vs 0.5%, moderately abnormal Apgar score: 10.3% vs 1.2% and reassuring Apgar score: 4% vs 2.3%; p value = 0.039] compared to those who survived. Neonates who had PPHN and died had higher proportion of medical comorbidities such as omphalocele (0.7% vs 4.7%), systemic hypotension (1% vs 2.5%), infection with Herpes simplex virus (0.4% vs 2.2%) or Bordetella pertussis (0.7% vs 2%); p = 0.042. Neonates with PPHN in the death group were more likely to present due to congenital diaphragmatic hernia (25.5% vs 47.3%), neonatal respiratory distress syndrome (4.2% vs 13.5%), meconium aspiration syndrome (8% vs 12.1%), pneumonia (1.6% vs 8.4%), sepsis (1.5% vs 8.2%) and alveolar capillary dysplasia with misalignment of pulmonary veins (0.1% vs 4.4%); p = 0.019. Neonates with PPHN who died needed a longer median time of mechanical ventilation (15 days, IQR 10 to 27 vs. 10 days, IQR 7 to 28; p = 0.024) and ECMO use (9.2 days, IQR 3.9 to 13.5 vs. 6 days, IQR 3 to 12.5; p = 0.033), and a shorter median duration of hospital stay (23 days, IQR 12.5 to 46 vs. 58.5 days, IQR 28.2 to 60.7; p = 0.000) compared to the neonates with PPHN who survived. ECMO-related complications such as chylothorax (1% vs 2.7%), intracranial bleeding (1.2% vs 1.7%) and catheter-related infections (0% vs 0.3%) were more frequent in the group of neonates with PPHN who died (p = 0.031). Conclusion ECMO in the neonates with PPHN who failed supportive cardiorespiratory care and conventional therapies has been successfully utilized with a neonatal survival rate of 67.1%. Mortality in neonates with PPHN who underwent ECMO was highest in cases born via the caesarean delivery mode or neonates who had lower Apgar scores at birth. Fatality rate in neonates with PPHN who underwent ECMO was the highest in patients with higher rate of specific medical comorbidities (omphalocele, systemic hypotension and infection with Herpes simplex virus or Bordetella pertussis) or cases who had PPHN due to higher rate of specific etiologies (congenital diaphragmatic hernia, neonatal respiratory distress syndrome and meconium aspiration syndrome). Neonates with PPHN who died may need a longer time of mechanical ventilation and ECMO use and a shorter duration of hospital stay; and may experience higher frequency of ECMO-related complications (chylothorax, intracranial bleeding and catheter-related infections) in comparison with the neonates with PPHN who survived.

Abstract Background The COVID-19 pandemic necessitated an abrupt transition to online learning in nursing education, presenting unprecedented challenges. This research aims to comprehensively assess the challenges faced by nursing students during this transition, exploring key issues, recommending strategies, and analyzing their impact on student perceptions. Methods Using a cross-sectional design, the study surveyed 941 nursing students across eight Arab countries—Jordan, Iraq, Lebanon, Palestine, Oman, KSA, UAE, and Egypt—to ensure a representative sample and enhance external validity. Data collection involved a thorough survey covering academic, technological, and administrative challenges. Reliability analysis, descriptive statistics, and variance analysis using Kruskal -Wallis and Mann–Whitney tests were conducted to examine differences between countries and sociodemographic variables. Results Descriptive statistics revealed significant demographic disparities. Single individuals in Jordan and those with lower family income in Palestine and Lebanon reported notably higher challenges. Female students in Iraq and Lebanon perceived greater challenges compared to males. Students pursuing diplomas in Jordan and bridging programs in Lebanon faced elevated difficulties. Governmental university students in Lebanon and private university students in Jordan encountered distinct challenges. Lack of available internet was particularly challenging in Jordan and Lebanon, whereas students using tablets in Lebanon and laptops in Palestine reported heightened challenges. Economic disparities, notably in family income, further hindered engagement with online learning materials. Across countries, academic challenges included managing coursework and accessing resources, exacerbated by administrative inefficiencies, especially in Palestine and Lebanon. Students in the UAE reported fewer challenges, facilitated by robust internet infrastructure and comprehensive institutional support. Conclusion This study provides critical insights into the challenges faced by nursing students during the Middle East's online learning transition. Key challenges encompass technological issues, academic workload, and administrative inefficiencies, with significant disparities across countries. The findings underscore the urgent need for targeted interventions, particularly in Palestine, to enhance online learning experiences. Policymakers and educational institutions can leverage these insights to advocate for student-centric approaches and policy development aimed at improving online learning across the region.

Abstract Clustering is widely used in cloud computing studies to extract vital information. These studies have ignored investigating the potential improvements in clustering quality from better selection of its dimensions and methods. Consequently, developing an automated technique to perform such a selection was not addressed thoroughly. Most of the recent attempts either relied on feature reduction or general non-automated techniques, which were deemed unreliable for sufficient selection. Therefore, we first conducted a comprehensive investigation to study the impact of selecting better clustering dimensions and methods. Our results indicate achieving significant improvement by 15–70% points through better selection. Then, we developed a novel technique (EFection) to detect the best selection in advance using a combination of internal validation metrics (Davies–Bouldin) and the Pearson correlation coefficient. We evaluate our technique’s accuracy by comparing the clustering quality of its suggestions with that of the optimal selection. We then compare EFection’s performance with recent attempts to measure its superiority. Finally, we validate its applicability when adopted in cloud clustering-based studies. The results show that EFection offers high accuracy, around 83%, and surpasses prior art by 11%.

Abstract Background Postoperative delirium (POD), an acute and variable disturbance in cognitive function, is an intricate and elusive phenomenon that occurs after cardiac surgery. Despite progress in surgical techniques and perioperative management, POD remains a formidable challenge, imposing a significant burden on patients, caregivers, and healthcare systems. Methods This prospective observational study involved 307 patients who underwent cardiac surgery. Data on the occurrence of delirium, clinical parameters, and postoperative characteristics were collected. A multivariate analysis was performed to assess the relationship between POH and POD. Results Sixty-one patients (21%) developed delirium, with an average onset of approximately 5 days postoperatively and a duration of approximately 6 days. On multivariate analysis, POH was significantly associated with POD, and the adjusted odds ratios indicated that patients with POH were more likely to develop delirium (OR, 5.61; p = 0.006). Advanced age (OR, 1.11; p = 0.002), emergency surgery (OR, 8.31; p = 0.001), and on-pump coronary artery bypass grafting were identified as risk factors of POD. Patients who developed delirium were typically older, more likely to be male, and had higher morbidity rates than those who did not. Conclusion POH is significantly associated with delirium in critically ill patients after cardiac surgery. Surgical complexity and advanced age contribute to the risk of developing POD and poor postoperative outcomes.

Background: Chronic kidney disease is the biggest problem in health care today, and the primary replacement therapy, hemodialysis, has a severe impact on both self-management and quality of life. This study aimed to evaluate the effect of educational nursing guidelines on self-management and health-related quality of life for hemodialysis patients. Materials and Methods: A quasi-experimental design was used. A convenience sample of 100 hemodialysis patients in the hemodialysis unit at Ismailia General Hospital, 50 patients for the study and 50 patients for the control groups. Data were collected using a patient demographic information questionnaire, hemodialysis self-management scale, and survey instrument on kidney disease quality of life 36-item (KDQOL-36). The intervention was conducted over 12 weeks in five sessions, from implementing the guidelines to the post-test phase. The control group received the usual care. SPSS version 23, descriptive statistics, and inferential statistics like independent t-test and Pearson Chi-square test were used. Results: Regarding self-management dimensions, a statistically significant difference was found between the study and control group regarding problem-solving and communications, fluid control, diet, self-advocacy, and emotional control with p < 0.001, and effect size 5.89,4.99, 5.06, and 4.54, respectively. Regarding the quality of life domains, a statistically significant difference was found between the study and control group regarding physical functioning, mental functioning, the burden of kidney disease, management of symptoms, and kidney disease effect with p < 0.001 and the effect size 9.39, 6.07, 1.86, 7.65, and 6.96, respectively. Conclusions: Educational guidelines are effective for improving self-management and quality of life.

In this paper, specific $ L^p $ estimates for generalized Marcinkiewicz operators correlated to surfaces of revolution are proved. These estimates and the extrapolation procedure of Yano are employed to confirm the $ L^p $ boundedness of the above-mentioned integrals under weaker assumptions on the singular kernels. Our findings generalize and improve several known results.

Abstract Background Usually, old age brings a poor quality of life due to illness and frailty. To prolong their lives and ensure their survival, all elderly patients with chronic diseases must adhere to their medications. In our study, we investigate medication adherence for elderly patients and its impact on the general health of the patient. Methods We implemented a cross-sectional survey‐based study with four sections in April 2022 in Saudi Arabia. Data about the participants’ demographic characteristics, the Morisky Medication Adherence Scale, Patient Activation Measure (PAM) 13, and EQ-5D-5 L. Results A total of 421 patients participated in this study, their mean age was 60.4 years, and most of them were males. Most of our population is living independently 87.9%. The vast majority of people have a low adherence record in the Morisky Medication Adherence Scale (8-MMAS) classes (score =