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Abstract Background and objective Health literacy is the cognitive and social abilities that influence a person’s motivation and capacity to learn, comprehend, and use information to improve and maintain good health. We aimed to investigate Healthcare Students’ knowledge, attitudes, and practices regarding Health Literacy in the Riyadh Province of Saudi Arabia. Methods This study used prevalidated electronic questionnaires among healthcare undergraduates from colleges affiliated with Saudi University in Riyadh, Saudi Arabia, from December to April 2024. Healthcare students were asked to answer a self-designed online questionnaire sent to them through social media platforms. Results The response rate was 560 out of 600 (93.3%); 293 of the 560 students (52.3%) were aged between 23 and 24 years (mean age was 21.29 SD = 1.852). The mean GPA among the students was 4.31(± 0.682). The average overall score for health literacy among healthcare students was 100.92 ± 11.80. The mean scores for knowledge were 24.17 ± 4.67, attitudes were 38.65 ± 4.20, and practice in health literacy was 38.09 ± 5.09. Among all healthcare students, 50.2% reported good knowledge, 54.1% had good attitudes, and 50.1% exhibited good practices in health literacy. However, students’ knowledge (p = 0.019) and training (p = 0.024) in health literacy were significantly associated with smoking cigarettes. Additionally, smoking shisha was significantly associated with students’ knowledge (p = 0.022), attitudes (p = 0.001), and practices (p = 0.001) in health literacy. Conclusion Our study highlights that half of the healthcare students reported limited knowledge, attitude, and practice in health literacy. Age, gender, and course of study did not show significant differences. Rather, students who did not smoke cigarettes or shisha were found to have higher knowledge, attitudes, and practice in health literacy compared to smokers. However, to improve health literacy, additional education and increased awareness are needed. Further investigation is warranted to address the factors related to poor health literacy.

Abstract This study examines the effects of environmental, social, and governance disclosure (ESG) components on the financial performance (FP) of firms listed on the Palestine Stock Exchange (PEX) from 2016 to 2022, focusing on the moderating role of corporate governance. This study used primary data from 44 PEX-listed companies. A context analysis technique was used through company websites and disclosures, the entire population (308 observations) was used for this study, and the study used STATA utilizing the required statistical analysis for this research. The study finds that environmental, social, and governance disclosures significantly influence the Return on Equity and Return on Assets. Testing for the moderating role of Corporate Governance, especially board diversity and size, shows that board diversity moderates the association between social and governance disclosure and firm performance. Board size moderates the relationship between social disclosure and firm performance. By contrast, Board Size and Diversity do not moderate the relationship between environmental disclosure and firm performance. The study contributes to the literature as the first of its kind conducted in Palestine, examining the moderating effects of board size and diversity on the association between ESG disclosure and firm performance.

Digital beamforming (DBF) has emerged as a pivotal technology for large-scale antenna arrays, offering precise beam steering control. This study presents an innovative approach to enhance millimeter wave transmission by integrating DBF with long short-term memory (LSTM)-based deep learning. Departing from conventional analog beamforming, our proposed system leverages digital signal processing and LSTM networks to optimize beamforming parameters, particularly in the presence of imperfect Channel state information. The primary objective is to achieve heightened spectral efficiency and increased robustness to channel uncertainties. Implemented in MATLAB, our methodology demonstrates significant performance enhancement through simulation results. The findings highlight the potential of DBF with LSTM for future communication systems. Furthermore, the study incorporates LSTM network training on historical data and its integration within the DBF process, offering a comprehensive perspective. This provides a clearer overview of the research issue, key findings, and contributions, setting the stage for the subsequent detailed exploration in the study.

In an era where digital technologies significantly influence children’s lives globally, promoting responsible digital citizenship is crucial to equip them with the skills to navigate the digital world safely and responsibly. This study examines the integration and current state of Digital Citizenship Education (DCE) in Saudi Arabian elementary schools, assessing its alignment with international standards and identifying local challenges faced by educators, and pedagogical strategies used. Employing a mixed-methods approach, quantitative data was collected through surveys from 398 teachers and qualitative insight gained from semi-structured interviews with 15 teachers. Quantitative analysis employed descriptive statistics and multivariate analysis of variance (MANOVA) to explore demographic influences on DCE practices. The findings reveal a strong emphasis on Digital Emotional Intelligence and Digital Security, Privacy, and Health and Wellness; however, significant gaps exist in Digital Participation and Agency, and Digital Footprint and Identity. These gaps are attributed to factors such as insufficient teacher training, lack of effective structured guidelines, and insufficient resources. Significant interaction effects between teachers’ demographics and DCE perceptions highlight the need for targeted professional development. The study concludes with actionable recommendations for enhancing curriculum integration, teacher training, and policy development to promote digital citizenship among elementary school students aligned with global standards.

This study analyzes Biden’s political speech on raising governmental funds as a macro speech act which instantiates the speaker’s purpose behind this discourse. It draws insights from some pragmatics and discourse analysis theories, developed by Austin, Searle, and Van Dijk, as a point of departure to develop an analytical framework with two levels (micro and macro levels) to analyze this political discourse. Despite a great deal of research conducted on speech acts from a pragmatic perspective, very few studies examined speech acts existing in a connected manner (a sequence of speech acts) in political discourse. This study bridges pragmatics and discourse analysis claiming that directives complement expressives, assertives, and commissives. This complementary between these classes built the speaker’s authoritative, affective, persuasive, responsible, and supportive identity that enables him to present his perspective effectively and appealingly. These acts blend into this discourse to form a macro speech act. This macro act represents the intended speaker’s purpose behind this discourse.

This bibliometric study examines translation and interpreting research within the Gulf Cooperation Council (GCC) states, leveraging data from the Web of Science: the Social Sciences Citation Index (SSCI), the Science Citation Index Expanded (SCI-E), and the Arts and Humanities Citation Index (AHCI). It identifies publication trends, citation patterns, journal affiliations, historical developments, prominent research themes, and funding sources across academic institutions in the Gulf region. The results, processed through CiteSpace, Excel, and VOSviewer for data analysis and visualisation, indicate that GCC states contribute a relatively considerable number of publications. Kingdom of Saudi Arabia leads in contributions, followed by Qatar and the United Arab Emirates. Among institutions, the Qatar Foundation and King Saud University are the most prolific, with significant contributions also from Kuwait University and UAE University. King Fahd University, the Qatar Foundation, and King Abdulaziz University are particularly notable for their strong citation impact. Key research themes include the use of technology in translation, empirical studies, Arabic proficiency and translation theory. The study marks 2023 and 2022 as significant years for publication volume, indicating a growing interest in the field. Despite this growth, funding is relatively modest, with only 45 out of the 159 articles that were reviewed receiving financial support.

Food security has always been the main goal of Syrian agricultural strategy. Therefore, the main objective of this study is to examine the dynamic relationship between selected climatic and non-climatic variables and food security in Syria from 1961 to 2018. The autoregressive distributed lag (ARDL) bounds testing approach is applied to estimate the association among the study variables with evidence of long-run and short-run analysis. The long-run estimates revealed that non-climatic variables including crop production, agricultural land, land under cereal production, and population, positively affected food security. Moreover, climatic variables including temperature and CO2 emissions positively affected food security in the long-run. The findings revealed that in the short-run, fertilizer affected food security positively. However, in the long run, the effect of fertilizer consumption turned out to be negative and significant. This study suggests that governments may consider measures to improve food security in Syria. Governments should focus on the issue of using climate-adapted plant varieties. Increasing the area under cereal crops and reducing agricultural land degradation could be an important long-term strategy for the government. There is a need to properly train farmers regarding fertilizer usage and switch from chemical fertilizer to organic fertilizer.

The purpose of this study is to Design of a robust controller for the VEGA TVC using the L1-Adaptive Control. The performance of the system with an L1 adaptive controller has been compared with that of a classical controller. The L1 adaptive controller optimization is an efficient as well as an effective approach for the design of a robust controller. The L1 adaptive controller ensures the robustness of the system against uncertainties, noise, and disturbances[10]. In a launch vehicle parameters like mass, thrust, and aerodynamic properties are time-varying. Due to the time-varying nature of these parameters gain scheduling is necessary with the classical control design methods otherwise the closed-loop system might become unstable for some values of these parameters. This procedure is costly and has no robustness. In addition to this, there are external disturbances also which can make the control system unstable. This is the reason why robust control is necessary. There is a trade-off between achievable performance and robustness. So, we need to compromise between required performance and robustness as per the requirement.

This paper investigates the use of an L1-adaptive controller to improve the performance of the Vega launch vehicle because the classical controller does not guarantee stability and tracking of the system in the transient. The L1-AC ensures uniformly bounded transient and steady-state tracking for both systems’ signals, input, and output. In this paper, we used the equations of the adaptation and the L1-norm with two filters, the first one is first-order order and the second filter is third-order, we used the large adaptive gain with the first filter, also used the low adaptive gain with the second filter, and after the analysis the result numerically we found the lambda with the first filter less than 1 and the lambda with second filter larger than lambda with the first filter. The L1 adaptive controller can generate a stable system response to track the control input and the system output, both in transient and steady-state because we selected the adaptive gain large with minimize lambda. It is noted that the system response for the L1 adaptive control configuration with the first filter, as compared with the system response with the second filter, has much better performances, both from the point of view of the overshoot and rise time.

Background: The selection between Zirconia crowns and metal crowns for anterior teeth restorations is pivotal in prosthodontics due to their distinct properties. However, a comprehensive investigation into their effectiveness in anterior tooth restorations is warranted. Materials and Methods: This in vitro study aimed to compare the effectiveness of Zirconia crowns and metal crowns in anterior teeth restorations. A total of thirty extracted human maxillary central incisors were prepared to receive crowns and randomly allocated into two groups: group A, zirconia crowns; and group B, metal crowns. The crowns were fabricated following standardized protocols and cemented onto the prepared teeth. Various tests, including fracture resistance, marginal adaptation, and color-matching assessment, were conducted on the samples. Results: The mean fracture resistance of Zirconia crowns (Group A) was determined to be 320 N (SD ± 25), whereas it was 280 N (SD ± 30) for metal crowns (Group B). Marginal adaptation assessment revealed a mean gap width of 50 microns (SD ± 10) for Zirconia crowns and 70 microns (SD ± 15) for metal crowns. Evaluation of color matching showed a higher percentage of acceptable matches for Zirconia crowns compared to metal crowns. Conclusion: Zirconia crowns exhibited superior fracture resistance, marginal adaptation, and color matching in comparison to metal crowns for anterior teeth restorations. These findings advocate for Zirconia crowns as a more effective choice for restoring anterior teeth, offering both strength and esthetic appeal.

Abstract Background The Malaysian Allied Health Profession Act (Act 774) regulates the practice of allied health practitioners in Malaysia, with two described professions viz. allied health profession (AHP) and profession of allied health (PAH). While AHPs have been clearly identified by the law, comprehensive implementation of the act requires development of specific criteria in defining any profession as PAH in the Malaysian context. Hence, the research aims to explore and identify the criteria for defining such professions for healthcare policy direction in Malaysia. Methods This research utilised two methods of qualitative research (document review and focus group discussions (FGDs) involving 25 participants from four stakeholders (higher education providers, employers, associations and regulatory bodies). Both deductive and inductive thematic content analysis were used to explore, develop and define emergent codes, examined along with existing knowledge on the subject matter. Results Sixteen codes emerged from the FGDs, with risk of harm, set of competency and skills, formal qualification, defined scope of practice, relevant training and professional working within the healthcare team being the six most frequent codes. The frequencies for these six codes were 62, 46, 40, 37, 36 and 18, correspondingly. The risk of harm towards patients was directly or indirectly involved with patient handling and also relates to the potential harms that may implicate the practitioners themselves in performing their responsibilities as the important criterion highlighted in the present research, followed by set of competency and skills. Conclusions For defining the PAH in Malaysia, the emerged criteria appear interrelated and co-exist in milieu, especially for the risk of harm and set of competency and skills, with no single criterion that can define PAH fully. Hence, the integration of all the empirically identified criteria must be considered to adequately define the PAH. As such, the findings must be duly considered by policymakers in performing suitable consolidation of healthcare governance to formulate the appropriate regulations and policies for promoting the enhanced framework of allied health practitioners in Malaysia.

AbstractCertain poisons and drugs can influence the growth and developmental patterns of necrophagous species, possibly affecting the accuracy of the postmortem interval (PMI) estimation. Since an accurate PMI estimate may prove an alibi (a critical aspect in criminal investigations), failure to consider factors that may affect the growth of necrophagous insects can subsequently result in the miscarriage of justice. In addition, the use of entomological specimens for diagnosing causes and circumstances surrounding death has been suggested for highly decomposed bodies, whereby conventional toxicological specimens are unavailable and/or unsuitable for analysis. In these two aspects, having the ability to determine poisons and drugs in entomological specimens appears imperative. Hence, this paper reviews pertinent articles on the analysis of poisons and drugs in entomological specimens published between 1977 and 2022, emphasizing on advantages/disadvantages of the reported instrumental analytical methods and their applications. It is organized according to the different classes of poisons and drugs, their extraction and analytical methods, as well as the results reported. Where available, information on the validation parameters of the published methods is duly discussed. This review aims to provide suitable references and guidance for future investigators wanting to carry out experiments concerning entomotoxicology for forensic applications.

The study aimed to become acquainted with the special training for striking and the effect it inflicts on some planning skills for The Force of Al-Jawiya for men in football. The researcher used the training curriculum of the two experimental groups and the before and after control of the tests. The research sample consisted of 20 youth players who were divided into two groups equally. The researcher used a set of personal interviews, test, measurements and information and data collection. The statistical data were processed by the following mathematical means, the standard deviation, tests (t) of the associated samples, and the test (T) of the independent samples, and the conclusions were. the competitive exercises that were applied had a positive room in developing accuracy and time, competing for offensive planning skills. The overlap of basic skills and physical qualities when the planning skills lent to an increase in the ability of the player when preforming the overall plan. The recommendations were to choose more realistic and more capable exercises to respond to similar play condition to its requirements. The need to use different methods and diversify different planning performance, trainings and not rely on one style.

Aims: To determine the prevalence and predictors of diabetic retinopathy (DR) in Saudi males and females with diabetes. Methods: This cross-sectional study enrolled 507 patients with diabetes between May and August 2018. The data extracted from patients’ records included demographic and clinical information and laboratory investigations. The retinopathy data were based on fundus photography graded into five categories: no DR, NPDR, MNPDR, SNPDR, and PDR. Results: The patients’ mean age was 47.3 years, the majority (59.3%) being female and T2DM being the most common type (52.4%). The prevalence of no DR was 51.4%; NPDR, 4.4%; MNPDR, 7.7%; SNPDR, 3.7%; and PDR, 5.1%. The duration of DM, as well as the severity of hypertension and neuropathy values rose significantly as DR progressed, underlining the pivotal role of hyperglycemia as the primary driver of diabetic complications. The odds ratio for the presence of hypertension was 1.8 (95% CI 0.9–3.5); hypertension showed the highest risk of DR. Stratification according to gender showed a significantly higher DR risk in females than males. Interestingly, nephropathy played a significant role in the DR risk in T1DM. Conclusions: Among T1DM and T2DM patients, the severity of DR is associated with risk factors including the DM duration, hyperglycemia, hypertension, and neuropathy. The impact of these factors varies with gender and diabetes type. Therefore, the severity of DR could define patients at a high risk of macro/microvascular complications and enable earlier interventions to reduce morbidity and mortality among T1DM and T2DM patients.

Abstract Background Patients with diabetic ketoacidosis (DKA), a potentially fatal complication of type 1 diabetes, have hyperglycemia, ketonemia and metabolic acidosis. Blood glucose and blood ketone results are often used to triage patients with suspected DKA. This study aimed to establish how effective blood glucose and blood ketone (beta-hydroxybutyrate, BOHB) measurements are in identifying patients with significant acidosis and sought to validate existing diagnostic BOHB thresholds. Methods Initial Emergency Department results on 161 presumptive DKA episodes in 95 patients (42 F, 53 M, age range 14–89 years) containing a complete dataset of D (glucose), K (BOHB) and A (Bicarbonate [HCO3] and pH) results. Results Blood glucose correlated poorly with BOHB (r = 0.28 p = 0.0003), pH (r= -0.25, p = 0.002) and HCO3 (r= -0.17, p = 0.04). BOHB, though better, was still limited in predicting pH (r = -0.44, p 13.9mmol/L, n = 8), ketonemic (≤ 3mmol/L, n = 9) or either (n = 5). Conclusions The commonly employed BOHB diagnostic cutoff of 3mmol/L could not be verified. Since acid-base status was poorly predicted by both glucose and BOHB, this highlights that, regardless of their results, pH and/or HCO3 should also be tested in any patient suspected of DKA.

This present research characterized the proximate nutrient, fatty acids and amino acids compositions of the wild third instar blowfly larvae collected from fish and chicken wastes as well as its mixture, in view of aquaculture feeding for Asian sea bass (Lates calcarifer). Analyses of crude protein, crude lipids, crude fiber, ash, carbohydrates, amino as well as fatty acids were performed. Results revealed that the larvae that fed on the mixed substrates (chicken and fish, 50:50 ratio) had significantly the highest nutritional values (51.47 ± 0.32% of crude protein, 29.4 ± 1.47% of crude fat, 4.81 ± 0.83% of crude fiber, 4.85 ± 0.01% of ash and 12.71 ± 1.67% of carbohydrate) for formulating feeds for Asian sea bass when compared with that of chicken and fish wastes alone (P < 0.05). Similarly, significantly higher percentages of fatty acids (DHA and EPA) and amino acids (Arg, Lys, Met, Trp, His, Val, Ile, Leu and Phe) were observed in the larvae from mixed-substrates when compared with that of the remaining two substrates (P < 0.05). The findings supported the utilization of blowfly larvae harvested on mixed substrate as a possible candidate of nutrients for Asian sea bass feed formulations

Abstract Background Eating disorders, including anorexia, bulimia, and binge eating, have become a significant health concern among young children and adolescents worldwide. The objective of this study is to examine the probable eating disorder prevalence and associated risk factors among obese and normal-weight children and adolescents aged (5–16 years) in Al Ain, United Arab Emirates (UAE). Methods This observational case–control study utilized data obtained from electronic medical records (age, gender, body measurements). SCOFF questionnaire and Patient Health Questionnaire-2 (PHQ-2) were used to estimate the probable prevalence of eating disorders and depression, respectively, in children and adolescents. The study was conducted in Al Ain Ambulatory health services clinics from 2018 to 2019. Descriptive statistics and linear regression analysis were employed for data analysis. Results A total of 551 subjects participated in the study, with 288 (52%) categorized as normal-weight and 263 (48%) as obese. Among the obese participants, there was an equal distribution of males and females. Screening for eating disorders using the SCOFF questionnaire revealed that approximately 42% of the obese participants had a positive SCOFF result, indicating abnormal eating behaviors. In contrast, only 7% of the normal-weight participants had a positive SCOFF result. A significant positive correlation was observed between a positive SCOFF screening result, PHQ-2 score, and the participants' weight at the age of 6 years. Conclusion This study represents the first attempt to assess the probable prevalence of the risk of eating disorders in children and adolescents in the UAE. This young population have high risk of eating disorders and it was significantly higher in obese children than normal weight children. These results highlight the importance of addressing eating disorders in this population and the need for early detection and intervention strategies.

The study aimed to determine the degree of the school administration’s practice of its role in activating the English language laboratory in the secondary schools of Anbar Governorate from the English language teachers’ point of view, as well as identifying whether there are statistically significant differences in the average scores of English language teachers’ appreciation of the school administration’s role in activating the English language laboratory in Anbar province middle schools from the English language teachers' point of view (gender, experience, educational stage).The study followed the descriptive analytical approach, identifying the study population in all middle and high schools that contain the fourth and fifth preparatory grades in Anbar Governorate, which numbered (140) schools distributed over 8 districts, and the study sample members amounted to (64) teachers and schools, including (27) teachers and ( 37) School.A questionnaire was prepared in its final form of (49) items divided into three areas (administrative, educational, and societal) and the questionnaire was verified for validity and reliability. Appropriate statistical methods were used and the results showed: The presence of the school administration's role in activating the English language laboratory in middle schools, as well as in the administrative and educational sub-domains, but the societal field came to a weak degree.

BackgroundDisconnected consciousness describes a state in which subjective experience (i.e., consciousness) becomes isolated from the external world. It appears frequently during sleep or sedation, when subjective experiences remain vivid but are unaffected by external stimuli. Traditional methods of differentiating connected and disconnected consciousness, such as relying on behavioral responsiveness or on post-anesthesia reports, have demonstrated limited accuracy: unresponsiveness has been shown to not necessarily equate to unconsciousness and amnesic effects of anesthesia and sleep can impair explicit recollection of events occurred during sleep/sedation. Due to these methodological challenges, our understanding of the neural mechanisms underlying sensory disconnection remains limited.MethodsTo overcome these methodological challenges, we employ a distinctive strategy by combining a serial awakening paradigm with auditory stimulation during mild propofol sedation. While under sedation, participants are systematically exposed to auditory stimuli and questioned about their subjective experience (to assess consciousness) and their awareness of the sounds (to evaluate connectedness/disconnectedness from the environment). The data collected through interviews are used to categorize participants into connected and disconnected consciousness states. This method circumvents the requirement for responsiveness in assessing consciousness and mitigates amnesic effects of anesthesia as participants are questioned while still under sedation. Functional MRI data are concurrently collected to investigate cerebral activity patterns during connected and disconnected states, to elucidate sensory disconnection neural gating mechanisms. We examine whether this gating mechanism resides at the thalamic level or results from disruptions in information propagation to higher cortices. Furthermore, we explore the potential role of slow-wave activity (SWA) in inducing disconnected consciousness by quantifying high-frequency BOLD oscillations, a known correlate of slow-wave activity.DiscussionThis study represents a notable advancement in the investigation of sensory disconnection. The serial awakening paradigm effectively mitigates amnesic effects by collecting reports immediately after regaining responsiveness, while still under sedation. Ultimately, this research holds the potential to understand how sensory gating is achieved at the neural level. These biomarkers might be relevant for the development of sensitive anesthesia monitoring to avoid intraoperative connected consciousness and for the assessment of patients suffering from pathologically reduced consciousness.Clinical trial registrationEuropean Union Drug Regulating Authorities Clinical Trials Database (EudraCT), identifier 2020-003524-17.

Abstract Aim To examine the e‐learning motivation mediating role on the relationship between technology access and satisfaction with e‐learning among nursing students during COVID‐19 pandemic. Design This is a cross‐sectional, descriptive design. Methods A convenience sample of students (N = 139) from public and private nursing colleges was recruited in this study. Data were collected using students' satisfaction, motivation and access to technology tools. Results Nursing students in the study were somewhat satisfied with e‐learning, had access to the required technology for e‐learning and had moderate levels of e‐learning motivation. The multiple regression analysis showed that technology access and e‐learning motivation influenced and explained 30.4% of the variance in satisfaction with e‐learning. Previous experience with e‐learning was associated with satisfaction with e‐learning. A series of regression analyses revealed that e‐learning motivation partially mediated the relationship between technology access and satisfaction with e‐learning.

Background: Tumor lysis syndrome (TLS) is a well-recognized medical emergency in patients with cancer diagnosis. The diagnostic criteria of TLS have been revised many times since it was recognized, but still have many drawbacks that limit diagnosis accuracy. Summary: Autopsy studies in patients with perimortem diagnoses of TLS have shown that they may not have actually had TLS. Therefore, in many cancer patients who are at risk for TLS, clinical and laboratory criteria may be fulfilled due to other causes of acute kidney injury. In this review, we aimed to cast a spotlight on the shortcomings and pitfalls of the current diagnostic criteria for TLS, and propose a roadmap for developing more rigorous criteria that improve on the diagnostic accuracy. Key Messages: Causes of AKI in patients with cancer other than TLS should be considered. Because current diagnostic criteria may miss those differential diagnosis, specific biomarkers that can tell when TLS is the underlying process are an important need, besides appropriate criteria that can jump over the pitfalls in the current criteria and enhance the recognition of TLS among other causes.

Objectives: To assess the outcome of cigarette smoking and non-smoking on the healing of bone around dental implants. Materials and Method: A retrospective analysis was made over 6 years of the clinical and radiographic findings corresponding to 60 consecutive patients (25 women and 35 men) who had received a total of 100 implants. Patients were divided into two groups: smokers, 32 patients (received 50 implants); and non-smokers (NSs), 28 patients (received 50 implants). Smokers were identified as people smoking >15 cigarettes per day. The success and failure cases were evaluated and studied. The data were analyzed using descriptive statistics. Result: Smokers and NSs received 50 implants in each group with 5 (10%) and 2 (4%) failures and 90% and 96% of success in smokers and NSs, respectively. Smokers had a higher failure rate than NSs. The difference was statistically significant. Conclusion: The results indicated a higher success of implants in NSs compared to smokers.

Commonly, herpes simplex virus (HSV) causes infectious encephalitis among children. A neurological relapse after primary HSV encephalitis in the weeks or months after presentation is well recognized. Relapsing symptoms of post-HSV encephalitis can present either as a true relapse or an immune-mediated disorder. A relationship is predicted between immune-mediated disorder and N-methyl-D-aspartate receptor (NMDAR) antibodies. This study presents two cases of patients suffering from anti-NMDAR encephalitis that appeared after treatment for proven HSV encephalitis. The first patient was treated immediately after the presentation as autoimmune encephalitis and had an excellent outcome. The second patient had delayed initiation of treatment and suffered from intractable epilepsy and severe global developmental delay. An important role is played by recognizing anti-NMDAR encephalitis symptoms and its variable presentation for timely diagnosis and quick initiation of treatment for anti-NMDAR encephalitis, thus, improving the outcome for those patients.

The forensic DNA profiling technique has tremendously contributed to forensic human identification, an important aspect in forensic investigations. In instances whereby comparison samples are unavailable, utilization of short tandem repeats of X chromosome (X-STRs) may prove useful to resolve complex kinship investigations involving missing persons and mass disasters. Despite such evidential values, the use of X-STRs during investigations remains scarce in many Southeast Asian countries including Malaysia, requiring concerted efforts for establishing forensic statistical support for its diverse populations (especially the admixture populations), standardizing core loci and procedure, improving the knowledge among practitioners as well as developing suitable standard operating procedure for incorporating X-STRs analysis in the overall DNA profiling framework. Hence, this review paper aims to highlight the developments, applications and population data of X-STRs, as well as its challenges and future insights for forensic casework.

This research was conducted to assess the influence of microbial inoculant (EM.1®) on the initial oviposition and developmental pattern of two prevalent necrophagous flies (Chrysomya megacephala and Chrysomya rufifacies) in Malaysia. Nine rabbit carcasses were equally divided into control and two treated groups. The control carcasses were sprayed with deionized water (about 100 mL), whereas the two other treated groups were individually sprayed with two concentrations of EM.1® at 1:500 and 1:100, respectively. Results revealed that the single application of EM.1® on both treated carcasses did not statistically impede oviposition by both necrophagous species, as well as their subsequent developmental patterns (P > 0.05) when compared with that of controls. Therefore, estimating the minimum post-mortem interval (mPMI) using empirical baseline data for the control animal model would remain appropriate for estimating mPMI in cases involving carcasses with a single application of EM.1®

The aim of the research is to identify the relationship between self-awareness and cognitive style (risk-caution) among a sample of graduate students at the University of Anbar, and to reveal the differences in self-awareness and cognitive style risk-caution according to the gender variable (male - female) and specialization (scientific - human). The study sample consisted of (420) male and female students, and the scale of self-awareness prepared by the researcher was applied to them according to the theory (Bas, 1976). . The researcher also adopted the cognitive style scale (risk - caution), which was prepared by (Abdul-Majid, 2008), and based on the theory of Kagan & Wallach (Kagan & Wallach, 1964), and the scale consisted in its final form on (23) items. After applying the appropriate statistical procedures, the results of the study showed that there is a direct correlation between self-awareness and cognitive style (risk - caution), as postgraduate students at the university use the cognitive method (risk) or graduate students with low self-awareness use the method. Cognitive (caution), and there are no differences in self-awareness among graduate students in the variable of gender and specialization, while it was found that male graduate students are distinguished by the cognitive style (risk) more than female students, and there are no differences in the cognitive style (risk - caution) Among the postgraduate students in the specialization (scientific - human), and in light of the results, the researcher made a number of recommendations and suggestions.

Abstract Background Syria is a developing country whose economy is still dominated by the agricultural sector. The agricultural sector is considered as the main source of food in Syria and a major source of employment and income generation. Food and agricultural policies in Syria focus heavily on achieving food security and improving its four pillars (availability, accessibility, stability and utilization). As a result, until 2011, a good progress has been attained in food availability. The food security situation deteriorated in Syria after 2011 crisis, with the number of people facing acute food insecurity rising from 7.9 million in 2020 to a staggering 12.4 million in 2021. This is the result of many shocks that the agricultural sector has been exposed to, such as the relative decrease in cultivated areas, high costs of production, reduced input availability including labour, prevailing violence, related damage to farm equipment, and abandoned land. In view of the changes that the agricultural sector has been exposed to in Syria as a result of the crisis, the study concerns measuring the technical efficiency of production of some rain-fed cereal and legume crops in Syria and comparing it in the pre and post-crisis period, which has started in 2011. A non-parametric (DEA) method is applied for measuring technical efficiency during the time period 2003–2010 (pre-crisis) and the period 2011–2018 (post-crisis) with censored regression (the tobit model) to investigate the determinants of technical efficiency. A t test is used to test the null hypothesis (H0) that there was no difference in technical efficiency of the production of studied crops before and after the crisis in Syria and the alternative hypothesis (Ha) that there was a significant difference in technical efficiency. Results The findings show low level of technical efficiency in the post-crisis period. The results verified differences in the technical efficiency of pre- and post-crisis period. The use of censored regression with dummy for crisis has shown negative and significant effect on technical efficiency of each of the durum wheat and lentil crops, while it had no significant effect on the other studied crops. Conclusions This study can provide important information to the government to pursue a new policy for recovery and improving the agricultural production and productivity. There is an urgent need to adopt new policies that focus on providing production requirements in the form of low-interest loans, sustainable use of resources, providing support for the marketing process, and focusing on the export markets of some study crops (chickpeas and lentils). Government should improve agricultural extension services for farmers and encouraging them to adopt new technologies.

Abstract Aims/Introduction This study determined the prevalence and risk factors for diabetic peripheral neuropathy (DPN), painful DPN and diabetic foot ulceration (DFU) in patients with type 2 diabetes in secondary healthcare in Qatar, Kuwait and the Kingdom of Saudi Arabia. Materials and Methods Adults aged 18–85 years with type 2 diabetes were randomly enrolled from secondary healthcare, and underwent clinical and metabolic assessment. DPN was evaluated using vibration perception threshold and neuropathic symptoms and painful Diabetic Peripheral Neuropathy was evaluated using the Douleur Neuropathique 4 questionnaire. Results A total of 3,021 individuals were recruited between June 2017 and May 2019. The prevalence of DPN was 33.3%, of whom 52.2% were at risk of DFU and 53.6% were undiagnosed. The prevalence of painful DPN was 43.3%, of whom 54.3% were undiagnosed. DFU was present in 2.9%. The adjusted odds ratios for DPN and painful DPN were higher with increasing diabetes duration, obesity, poor glycemic control and hyperlipidemia, and lower with greater physical activity. The adjusted odds ratio for DFU was higher with the presence of DPN, severe loss of vibration perception, hypertension and vitamin D deficiency. Conclusions This is the largest study to date from the Middle East showing a high prevalence of undiagnosed DPN, painful DPN and those at risk of DFU in patients with type 2 diabetes, and identifies their respective risk factors.

Abstract Background Proper pain assessment is fundamental to effective pain management. Training nursing staff is critical for improving pain assessment competence and patient clinical outcomes. However, there is a dearth of research examining interventions that can enhance nurses’ knowledge and attitudes toward pain management, especially in Saudi Arabia. Thus, this study aimed to evaluate the effectiveness of a structured education program on nurses’ knowledge and attitudes towards pain management. Methods A quasi-experimental design was used. The study sample included 124 registered nurses working in intensive care or inpatient units in Saudi Arabia. Data were collected between March and September 2021 using a knowledge and attitudes survey regarding pain, satisfaction with and self-confidence in learning, and the learning self-efficacy scale for clinical skills. Results Nurses showed moderate levels of knowledge and attitudes regarding pain before (M = 20.3, SD = 4.80) pain management education, which were significantly higher after the intervention (M = 22.2, SD = 5.09, t = 2.87, p .05), indicating that the education was effective in enhancing nurses’ knowledge and attitudes, regardless of nursing education level. Nurses in this study had high mean scores for self-confidence in learning (M = 35.6, SD = 4.68, range = 18–40), self-learning efficacy (M = 52.9, SD = 7.70, range = 25–60), and satisfaction with learning (M = 22.2, SD = 3.24, range: 10–25). Conclusion Regular pain education programs can improve nurses’ knowledge and attitudes. Increasing the breadth and depth of educational courses, alongside appropriate training, competency-based assessment, and pain education programs, is also recommended. Future research should consider the subjectivity and individualized nature of nursing by including patient satisfaction surveys to measure the improvement in nurses’ knowledge and attitudes from the patient perspective.

This study aimed to explore the level of perceived clinical competence among undergraduate nursing students. This was a cross-sectional, comparative, study. Data were collected using the Clinical Competence Questionnaire. Study participants included fourth year and internship nursing students attending 1 of 39 public and private nursing programs in Saudi Arabia. A total of 244 nursing students completed the clinical competence questionnaire. Students reported the ability to perform some clinical skills in clinical settings under supervision. Intern students had higher clinical competence than fourth year students ( t = 2.792, p

Objective This study explores the effectiveness of a comprehensive licensure review and adaptive quizzing assignments intervention in improving the performance of undergraduate senior nursing students on the end-of-programme exit exam.Design A quasi-experimental single-group design was used to compare pretest and post-test scores through computerised adaptive tests.Setting The setting was a nursing college in Saudi Arabia.Participants The study included 292 senior nursing students enrolled in the Bachelor of Science in Nursing programme.Intervention A comprehensive licensure review bundled with adaptive quizzing assignments was delivered over 15 weeks in the academic year 2021–2022. The bundle was guided by the elaboration theory, and it included 3-hour synchronous lectures every week and 23 adaptive quizzing assignments that covered weekly content.Primary and secondary outcome measures Students’ mastery scores and the percentage of correct answers were the primary and secondary measures, respectively. Both measures were collected in the pretest and post-test (exit examination). Additionally, demographic characteristics were collected in the pre-test using an online survey.Results The overall mean of the mastery score was statistically significantly higher in the exit exam (M=2.51, SD=1.70) than in the pretest (M=1.45, SD=0.44; p

BackgroundDietary intake is widely known to play a crucial role in achieving peak bone mass among children and adolescents. Unfortunately, this information is lacking among Arab adolescents, an understudied demographic that has recently been observed to have a high prevalence of abnormal mineralization markers [low serum 25(OH)D, high serum alkaline phosphatase (ALP), low calcium (Ca) and/or inorganic phosphate (Pi)] suggestive of biochemical osteomalacia (OM, defined as any 2 of the 4 parameters). In order to fill this gap, we aimed to evaluate the associations of serum markers of biochemical OM with dietary intake of macronutrients, vitamins and trace minerals.MethodsSaudi adolescents (N = 2,938, 57.8% girls), aged 12–17 years from 60 different schools in Riyadh, Saudi Arabia were included. Dietary intake of nutrients was calculated following a semi-quantitative 24 h dietary recall over 3 weekdays and 1 weekend-day using a validated food frequency questionnaire. Compliance to reference daily intake (RDI) of macronutrients, vitamins and trace minerals were calculated. Fasting blood samples were collected and circulating levels of 25(OH)D, ALP, Ca, and Pi were analyzed.ResultsA total of 1819 (1,083 girls and 736 boys) adolescents provided the dietary recall data. Biochemical OM was identified in 175 (9.6%) participants (13.5% in girls, 3.9% in boys, p 50 nmol/L) but they exceed the RDI for dietary Pi. Interpreting these data in the light of the increased prevalence of rickets in Arab countries, food fortification to optimise vitamin D and Ca intake in Saudi adolescents should be considered.

The building sector faces critical challenges such as negative impacts on the environment, high energy consumption, and cost inflation. With the development of digital technologies, BIM is increasingly being used in cooperation with other techniques to achieve sustainable building goals. This research aims to evaluate the current status of the sustainable building design strategies associated with BIM technologies. The most frequently cited sustainable building design strategies were identified by a comprehensive relevant literature review. A survey is conducted, focusing on a group of professionals in the sustainable construction sector, to measure the effectiveness of selected strategies. The results indicated that the “BIM-Based Life Cycle Assessment Method” and “BIM-Based Sustainability Rating Systems Method” were the most effective strategies. BIM can reduce the effort of performing various kinds of sustainability assessments. Thus, improving the performance of sustainable buildings during the design, construction, operation, and maintenance stages.

Due to a variety of reasons, including increased service loads, environmental impacts, construction errors, and mechanical impediments, the strengthening process was becoming necessary for many concrete buildings worldwide. The strengthening process is carried out in several ways, the most common of which are the Near-Surface mounted (NSM) technique and the External Bonded Reinforcement (EBR) technique. The main object of the strengthening process is to increase the strength and durability of reinforced concrete structures and reducing early failure. This research discussed the most important papers that dealt with strengthening deep beams due to their exposure to heat or extreme loads using two techniques (NSM) and (EBR). Several results were reached through experimental testing of the specimens of each research, especially the most important of them: First, making openings, when necessary, away from the loading path because the opening in the loading path reduces the capacity of the beam. Secondly, resorting to using the mechanical method when installing the fiber-reinforced polymer externally, as it greatly reduces the tearing and collapse of the sheets. Third, the number of layers must be less than three when using (GFRP) sheets in the strengthening process, as violating this will cause a decrease in the final capacity of the beam. Fourth, resorting to inclined schemes when strengthening deep beams or repairing them with various materials made of carbon fiber-reinforced polymer (FRP). Finally, it is possible to use (CFRP) bars with (NSM) technology, as this option can be relied upon to rehabilitate damaged structures.

As the world seeks sustainable energy solutions, Internet of Things (IoT) applications demand consistent and efficient power sources. This paper presents an innovative hybrid renewable energy system, seamlessly integrating solar photovoltaic panels, wind turbines, and hydrogen fuel cells, tailored for IoT applications. Through machine learning algorithms, our proposed system not only optimizes energy generation in real-time but also ensures uninterrupted energy supply to IoT devices and consumers, even in fluctuating environmental conditions. This universal approach markedly diminishes the dependence on non-renewable energy sources, promoting a greener and more resilient energy infrastructure. The incorporation of hydrogen fuel cells uniquely positions our system as a reservoir for excess energy, ensuring consistent power even when solar or wind outputs diminish. Moreover, by synchronizing IoT devices with our energy system, we have procured real-time data on energy dynamics, facilitating unparalleled optimization and reduced wastage. The presented system shows the way for a sustainable future through the efficient green energy generation with the ever-evolving landscape of IoT applications and machine learning techniques.

The study evaluated the implant bone loss and stability of implant changes with diverse designs with early placement at eight weeks and eight months' time. The subjects for the current study had partial tooth loss in the posterior mandibular arch. A total of 30 samples were split into two groups of 15, one with a flared crest module and a buttress thread design, the other with a parallel crest module and a V-shaped thread design. Ostell assessed each subject's implant stability four times, at baseline, eight weeks, four months, and eight months. At intervals of eight weeks, four months, and eight months, intraoral periapical radiographs were examined using ImageJ software to measure crestal bone loss. When Group I and Group II's implant stability quotient (ISQ) values at baseline, eight weeks, four months, and eight months were compared; Group I's ISQ values at each of the four measured time periods were statistically significant. At eight weeks in Group I, the ISQ value was very considerable. At eight weeks, four months, and eight months, there was a statistically significant bone loss in Group II in comparison to Group I. At eight months, Group II's bone loss value was very considerable. In contrast to Group II implant designs, it was found that Group I implants demonstrated enhanced implant-less bone loss and stability.

Abstract The discovery of forensic evidence (e.g. weapons) during forensic underwater investigations has seen an increasing trend. To date, small particle reagent (SPR) has been one of the routinely used methods for visualising fingerprints on wet, non-porous substrates. However, the long term use of SPR is detrimental to humans and environment due to the use of toxic chemicals. Although previously we have successfully developed and optimised a greener nanobio-based reagent (NBR), its suitable practical use in a more realistic scene (e.g. outdoor pond) was not evaluated. Therefore, this present research is aimed at (1) investigating the performance of NBR against the benchmark SPR in visualising fingerprints immersed in a natural outdoor pond and (2) evaluating the greenness of NBR against the analytical Eco-Scale. Results showed that the performance of the optimised NBR was mostly comparable (University of Canberra (UC) comparative scale: 0) with SPR at visualising fingerprints on three different non-porous substrates immersed in a natural outdoor pond. Observably, the NBR had higher preference towards aged fingerprints (up to 4 weeks of immersion). In addition, its greenness assessment revealed 76 points, indicating ‘excellent green analysis’. The findings gathered here further supported the practical use of the NBR in forensic investigations.

Soil is considered an essential component of the factors that are affecting the structures. Due to the problems that are faced under various conditions while the structure is in use, the behavior of the soil is complex. The presence of cavities inside various types of soil, such as gypsum soil and the soil of some old towns, is one of its difficult problems. The formation of these cavities is due to natural and industrial causes, one of the natural causes being the dissolve of salts inside them. As for the industrial one, it is due to the presence of some old buildings. The presence of this type of cavities affects the life of the structures and as a result, it creates cracks in the foundation, therefore reducing the life of the structures.

Summary: Brain states are frequently represented using a unidimensional scale measuring the richness of subjective experience (level of consciousness). This description assumes a mapping between the high-dimensional space of whole-brain configurations and the trajectories of brain states associated with changes in consciousness, yet this mapping and its properties remain unclear. We combine whole-brain modeling, data augmentation, and deep learning for dimensionality reduction to determine a mapping representing states of consciousness in a low-dimensional space, where distances parallel similarities between states. An orderly trajectory from wakefulness to patients with brain injury is revealed in a latent space whose coordinates represent metrics related to functional modularity and structure-function coupling, increasing alongside loss of consciousness. Finally, we investigate the effects of model perturbations, providing geometrical interpretation for the stability and reversibility of states. We conclude that conscious awareness depends on functional patterns encoded as a low-dimensional trajectory within the vast space of brain configurations.

Anchor is a structural element as part of foundation that can take a variety of forms. Over the past four decades a wide variety of foundation anchor systems have been developed to satisfy the increasing demand for foundations with ever-higher pullout resistance. Some kind of soils have problem of cavity deforms inside it, and the reason of these cavities belong to two main reasons, natural cavities because of some chemical actions inside the soil and artificial reasons as human made like old building inside the soils. Experimental modeling was carried to study the capacity of anchor plate under effect of cavity inside the soil, small scale anchor embedded in sandy soil was carried in laboratory to study the capacity and the displacement for loaded plate anchor, the result for test shows reduced capacity for the plate capacity under appearance of cavity inside the effective soil area for the anchor.

Abstract Counterfeiting, in particular, the forgery of banknotes is a serious crime problem and has become a great challenge to the global economies. The forensic science experts have been utilizing chemical technique such as infrared spectroscopy to analyze genuine and counterfeit banknotes. Nevertheless, chemometrics techniques are required to further discriminate the banknotes. In this paper, an advanced fuzzy graph chemometrics method is used to discriminate genuine and counterfeit fifty Ringgit Malaysian (RM50) banknotes. The development of the technique, namely chemometrics fuzzy autocatalytic set (c-FACS) is presented in this paper, together with the results and its comparison to principal component analysis (PCA) method. The results from the c-FACS analysis showed distinct patterns and features of the counterfeit banknotes in the c-FACS plot. Furthermore, the new method is faster than PCA in authentication analysis of counterfeit banknotes. Hence, the c-FACS provides better performance in terms of computing time as compared to PCA, and has the potential in assisting the investigation involving counterfeit banknotes.

Objectives To explore the relationship between patient activation, adherence to hypertension treatment plans, blood pressure control and other important demographic factors.Design A cross-sectional study.Setting Primary healthcare centres in Riyadh province, Saudi Arabia.Participants A total of 114 adults with hypertension, including 68 men and 46 women.Outcome measurements Blood pressure control is achieved if (a) patients under 80 years of age with treated hypertension have blood pressure under 140/90 mm Hg or (b) patients aged 80 years or over with treated hypertension have blood pressure under 150/90 mm Hg. Secondary outcomes included patient activation, adherence to hypertension treatment plans and demographic factors (age, gender, education, income and comorbidity). Data were analysed using Pearson’s correlation and multiple regression models.Results 57% (n=66) of participants did not achieve the ideal blood pressure target. Perfect adherence to hypertension treatment plans was significantly associated with lower systolic (r=−0.38, p

Objectives: This present research evaluated the concentrations of metal contaminants (As, Pb, Cd and total Hg) and chloramphenicol as prescribed by the Malaysian Food Act (1983) and Regulations (2021) in Penaeus silasi and Litopenaeus vannamei shrimps sampled from the different supply chain stages (landing sites, major markets and grocers) in Johor Bahru, Johor, Malaysia at six sampling intervals. Methods: Graphite furnace atomic absorption spectrometer and flow injection mercury/hyride system were used to determine the concentration of As, Pb and Cd as well as total Hg, respectively. Enzyme-linked immunosorbent assay was used to determine the concentration of chloramphenicol. Results: The median As and Cd concentrations during the six sampling intervals ranged between below detection limit-167.5 mg/kg and 0.46 mg/kg, respectively. The total Hg concentrations ranged between 0.02 and 1.13 mg/kg. Although Pb and chloramphenicol were not detected, As and total Hg concentrations varied significantly across sampling intervals (P

The COVID-19 pandemic has caused a sudden shift to distance learning. For many nursing students, distance learning is a new experience and an essential requirement if they hope to complete their programs. Two challenges that nursing students could face during e-learning are the lack of social presence and low satisfaction. This study aimed to assess students’ sense of community and satisfaction during e-learning and determine their impacts on academic achievement. This cross-sectional descriptive study used convenience sampling to collect data via a student satisfaction survey and a classroom community scale. There was a positive and significant correlation between the sense of community, total satisfaction with e-learning (p < .001), and academic achievement (p < .001). Academic achievement was positively and strongly correlated with satisfaction with teaching (p < .001), assessment (p < .001), generic skills and learning experiences (p < .001), and total satisfaction with e-learning (p < .001). Students who worked collaboratively with their classmates and were more engaged in their learning were more satisfied with e-learning and had higher academic achievement (p < .01). Female participants reported a strong sense of community and satisfaction with e-learning and greater academic achievement than males. Junior students perceived higher satisfaction scores and greater academic achievement (p < .01) than senior students. The findings of this study suggest that failing to meet student expectations can lead to low levels of student involvement. Students’ engagement and satisfaction are good indicators of the quality and effectiveness of online programs.

Introduction: Determining students’ readiness for e-learning is critical to implementing more effective education and performance. Nursing education in Saudi Arabia continues to struggle with a shortage of technical tools to enable teaching and acquiring critical nursing skills. Aim: To assess the level of e-learning readiness and academic performance and their association in nursing students and to determine the factors associated with e-learning readiness and academic performance. Materials and Methods: A cross-sectional, multisite study was conducted on a convenience sample of nursing students (N=139) attending nursing programs from multiple public and private universities in Saudi Arabia. A structured questionnaire was used for data collection from May 2020 to August 2020. Multivariate analyses were run using Statistical Package for Social Sciences (SPSS). Results: The mean age of the study participants was 27.3±6.34 years. The total average of e-learning readiness was 4.16 (SD=0.54). Bivariate analyses showed that age was associated with both e-learning readiness (r=0.175, p=0.03) and academic performance (r=0.341, p

Among various calamities, conflagrations stand out as one of the most-prevalent and -menacing adversities, posing significant perils to public safety and societal progress. Traditional fire-detection systems primarily rely on sensor-based detection techniques, which have inherent limitations in accurately and promptly detecting fires, especially in complex environments. In recent years, with the advancement of computer vision technology, video-oriented fire detection techniques, owing to their non-contact sensing, adaptability to diverse environments, and comprehensive information acquisition, have progressively emerged as a novel solution. However, approaches based on handcrafted feature extraction struggle to cope with variations in smoke or flame caused by different combustibles, lighting conditions, and other factors. As a powerful and flexible machine learning framework, deep learning has demonstrated significant advantages in video fire detection. This paper summarizes deep-learning-based video-fire-detection methods, focusing on recent advances in deep learning approaches and commonly used datasets for fire recognition, fire object detection, and fire segmentation. Furthermore, this paper provides a review and outlook on the development prospects of this field.