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Abstract Background COVID-19 is a global pandemic that has highly impacted the healthcare system and patients, especially patients with epilepsy, due to the fact that the success of their treatment depends on obtaining sustainable access to medical professions, diagnostic services, facilities, and medications. The epidemiology and presence of neuro-pediatric emergencies in the setting of COVID-19 in XXX have not been thoroughly described. This is a barrier to planning and providing quality emergency care within the local health systems. The objective of this study is to provide a comprehensive description of the epidemiology of neurological cases encountered in the pediatric emergency unit. Methods This is a retrospective study to analyze the flow pattern of Emergency Department (ED) visits among pediatric patients with neuro-related complaints. Participants were filtered, and a total of 108,000 visits were reduced to 960 patients with a neurological provisional diagnosis. Patients were grouped into pre- and post-pandemic visits according to their age group. We identified demographic and clinical variables. Results The study included 960 patients with a provisional neurological diagnosis, consisting of 542 (56.5%) males and 418 (43.5%) females. The mean age of admission was 5.29 ± 4.19 years. The majority of patients were triaged as “priority 1—resuscitation” (n = 332, 34.6%), and seizures were the most frequent chief complaint (n = 317, 33.0%). Statistical significance was observed for patients with vascular issues (p = 0.013) during the pre-COVID-19 period after adjusting for odds ratio. The most common outcome was discharge (n = 558, 58.1%). The mean length of stay during the pre-COVID-19 pandemic was 16.48 ± 33.53 h, which was significantly longer compared to a mean length of stay of 7.76 ± 7.27 h during the COVID-19 pandemic (P

Community pharmacists were recently authorized to provide vaccination services in Saudi Arabia. However, the implementation is still limited. Consequently, this study aimed to assess the knowledge, beliefs, and views of community pharmacists in the Qassim region regarding vaccines and vaccination services and to identify the barriers to providing such services. A total of 170 community pharmacists participated in the study (response rate = 73.91%). The mean overall knowledge of vaccines and vaccination was 10.25 ± 1.35 out of a maximum score of 14. The majority stated that vaccines are rigorously tested for their safety (92.94%), go through a stringent approval process to ensure their quality and efficacy (93.53%), and vaccines play a key role in preventing and controlling infectious disease outbreaks (97.06%). However, only 48.82% were aware that community pharmacists are legally authorized to provide adult vaccination services. Few participants were also aware of the dosing of the varicella vaccine (14.12%) and indications of the herpes zoster vaccine (21.18%). The overall mean score on beliefs/views was 31.91 ± 5.53 out of a maximum of 40, indicating positive beliefs/views regarding vaccination services. The study identified many barriers to implementing vaccination services. These included lack of support staff and technicians in community pharmacies (79.41%), lack of requirements and equipment to provide the service (74.11%), the service will add extra workload (72.94%), and lack of formal certification in pharmacy-based immunization delivery (66.48%). Consequently, a holistic strategy is required to improve pharmacists’ clinical knowledge of vaccines and to address the barriers to the implementation of vaccination services at community pharmacies.

RATIONALE: The prognosis of patients with lung cancer admitted to the intensive care unit (ICU) is often perceived as poor. We described the characteristics, management, and outcomes of critically ill patients with lung cancer and determined the predictors of mortality. METHODS: We retrospectively studied patients with lung cancer who were admitted to the ICU of a tertiary care hospital between 1999 and 2021 for the reasons other than routine postoperative care. We noted their characteristics, ICU management, and outcomes. We performed the multivariable logistic regression analysis to determine the predictors of hospital mortality. RESULTS: In the 23-year period, 306 patients with lung cancer were admitted to the ICU (median age = 63.0 years, 68.3% males, 45.6% with moderate/severe functional disability, most had advanced lung cancer, and median Acute Physiology and Chronic Health Evaluation II score = 24.0). Life support measures included invasive mechanical ventilation (47.1%), vasopressors (34.0%), and new renal replacement therapy (8.8%). Do-Not-Resuscitate orders were implemented during ICU stay in 30.1%. The hospital mortality was 43.8% with a significantly lower rate in patients admitted after 2015 (28.0%). The predictors of mortality were moderate/severe baseline disability (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.22, 5.78), advanced lung cancer (OR 8.36, 95% CI 1.81, 38.58), lactate level (OR 1.45, 95% CI 1.12, 1.88, invasive mechanical ventilation (OR 10.92, 95% CI 4.98, 23.95), and admission period after 2015 (OR 0.37, 95% CI 0.16, 0.85). CONCLUSIONS: The mortality rates in patients with lung cancer admitted to the ICU during a 23-year period decreased after 2015. Functional disability, advanced lung cancer stage, vasopressor use, and invasive mechanical ventilation predicted mortality.

Abstract Background Pleomorphic xanthoastrocytoma is a rare astrocytic tumor often diagnosed at a young age. Typically, they appear as supratentorial cortical tumors, frequently involving the temporal lobe with few reported rare locations. The prognosis is favorable following surgical excision; however, recurrence, dissemination, and anaplastic transformation occurred in some cases. Case presentation A 50-year-old female presented with convulsions and an altered consciousness. Imaging showed a periventricular mixed solid and cystic lesion. Histopathological examination revealed features of pleomorphic xanthoastrocytoma WHO grade 2 without necrosis or mitotic activity. Conclusions This report highlights the classic imaging findings of pleomorphic xanthoastrocytoma but in an atypical periventricular location. Although rare, pleomorphic xanthoastrocytoma should be considered in the differential diagnosis of mixed solid and cystic periventricular lesions.

Background/aim The coronavirus disease 2019 pandemic has forced governments around the world to impose national curfew measures, which in turn have changed the dietary and lifestyle habits and psychosocial health of the world’s population, especially children and adolescents. Thus, this study was conducted in an attempt to assess the impact of coronavirus disease 2019 pandemic on the nutritional and psychosocial behavior among children and adolescents during the curfew in Saudi Arabia. Patients and methods This cross-sectional analytical observational study was conducted through an online questionnaire using Google Forms with a total sample of 1000 Saudi children and adolescents aged from 8 to 19 years old. Chi-square was used to compare adolescents and children in terms of dietary habits and psychosocial changes. Multivariate logistic regression was used to predict the risk factors for depression, inattention, hyperactivity, and aggression using sociodemographic characteristics. Results In this study, a significant association was found between age groups and changes in dietary habits (P

Vascular closure devices (VCD) are frequently used after endovascular interventions to attain faster hemostasis, earlier mobilization, and patient comfort compared to manual compression. VCDs are safe. However, rare complications have been reported. We report a case of an inadvertent intravascular deployment of an Angio-Seal VCD causing limb ischemia and discussing management options from our experience and the previously published cases.

Abstract Recently, various advanced technologies have been employed to build smart cities. Smart cities aim at improving the quality of life through the delivery of better services. One of the current services that are essential for any smart city, is the availability of enough parking spaces to ensure smooth and easy traffic flow. This research proposes a new framework for solving the problem of parking lot allocation, which emphasizes the equitable allocation of people based on the overall count of people in each parking space. The allocation process is performed while considering the available parking lots in each parking space. To accomplish the desired goal, this research will develop a set of seven algorithms to reduce the gap in the number of people between parking spaces. Many experiments carried out on 2430 different cases to cover several aspects such as the execution time and the gap calculations, were used to explore the performance of the developed algorithm. Analyzing the obtained results indicates a good performance behavior of the developed algorithms. Also, it shows that the developed algorithms can solve the studied problem in terms of gap and time calculations. The MR algorithm gained excellent performance results compared to one of the best algorithms in the literature. The MR algorithm has a percentage of 96.1 %, an average gap of 0.02, and a good execution time of 0.007 s.

Introduction: Children at schools are at risk of getting injuries during their activities. In the absence of medical support and delays in ambulance arrival, teachers are the first responders to provide first aid when accidents occur. There is a lack of information about schoolteachers' awareness and knowledge about first aid administration. This study aimed to assess the current level of knowledge and attitude toward paediatric first aid among elementary schoolteachers in Jeddah of Saudi Arabia. Methodology: This is a cross-sectional study. An online questionnaire-based survey was administered to teachers in primary male schools in the Jeddah region. Statistical analysis was performed using JMP software, continuous variables were presented as mean and standard deviation (SD), data for categorical variables were presented as frequencies and percentages and statistical tests ANOVA and Chi Square were also used. The P values

Abstract Background Asthma is a chronic disease that exacerbates due to various risk factors, including the patient’s biosignals and environmental conditions. It is affecting on average 7% of the world population. Preventing an asthma attack is the main challenge for asthma patients, which requires keeping track of any risk factor that can cause a seizure. Many researchers developed asthma attacks prediction models that used various asthma biosignals and environmental factors. These predictive models can help asthmatic patients predict asthma attacks in advance, and thus preventive measures can be taken. This paper introduces a review of these models to evaluate the used methods, model’s performance, and determine the need to improve research in this field. Method A systematic review was conducted for the research articles introducing asthma attack prediction models for children and adults. We searched the PubMed, ScienceDirect, Springer, and IEEE databases from January 2000 to December 2020. The search includes the prediction models that used biosignal, environmental, and both risk factors. The research article’s quality was assessed and scored based on two checklists, the Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS) and the Critical Appraisal Skills Programme clinical prediction rule checklist (CASP). The highest scored articles were selected to review. Result From 1068 research articles we reviewed, we found that most of the studies used asthma biosignal factors only for prediction, few of the studies used environmental factors, and limited studies used both of these factors. Fifteen different asthma attack predictive models were selected for this review. we found that most of the studies used traditional prediction methods, like Support Vector Machine and regression. We have identified the pros and cons of the reviewed asthma attack prediction models and propose solutions to advance the studies in this field. Conclusion Asthma attack predictive models become more significant when using both patient’s biosignal and environmental factors. There is a lack of utilizing advanced machine learning methods, like deep learning techniques. Besides, there is a need to build smart healthcare systems that provide patients with decision-making systems to identify risk and visualize high-risk regions.

Cancer and bacterial infection are the most serious problems threatening people's lives worldwide. However, the overuse of antibiotics as antibacterial and anticancer treatments can cause side effects and lead to drug-resistant bacteria. Therefore, developing natural materials with excellent antibacterial and anticancer activity is of great importance. In this study, different concentrations of chitosan (CS), graphene oxide (GO), and graphene oxide-chitosan composite (GO-CS) were tested to inhibit the bacterial growth of gram-positive (Bacillus cereus MG257494.1) and gram-negative (Pseudomonas aeruginosa PAO1). Moreover, we used the most efficient natural antibacterial material as an anticancer treatment. The zeta potential is a vital factor for antibacterial and anticancer mechanism, at pH 3–7, the zeta potential of chitosan was positive while at pH 7–12 were negative, however, the zeta potential for GO was negative at all pH values, which (p < 0.05) increased in the GO-CS composite. Chitosan concentrations (0.2 and 1.5%) exhibited antibacterial activity against BC with inhibition zone diameters of 4 and 12 mm, respectively, and against PAO1 with 2 and 10 mm, respectively. Treating BC and PAO1 with GO:CS (1:2) and GO:CS (1:1) gave a larger (p < 0.05) inhibition zone diameter. The viability and proliferation of HeLa cells treated with chitosan were significantly decreased (p < 0.05) from 95.3% at 0% to 12.93%, 10.33%, and 5.93% at 0.2%, 0.4%, and 0.60% concentrations of chitosan, respectively. Furthermore, CS treatment increased the activity of the P53 protein, which serves as a tumor suppressor. This study suggests that chitosan is effective as an antibacterial and may be useful for cancer treatment.

Background: Despite the many studies that have been conducted on the learners of English as a foreign language (EFL) regarding grammar ability in various contexts, some gaps are still unbridged and need researching. Therefore, this study addresses the research gap in the Saudi context concerning the grammatical competence of Saudi EFL (English as foreign language) learners. Methods: This study described the Saudi EFL learners’ level of awareness in developing grammatical forms. It also assessed Saudi EFL students' level of performance in grammar learning. Finally, it quantitatively explored what, if any, gendered differences exist in the grammar acquisition of Saudi EFL learners. The study employed descriptive and inferential statistics to analyze the data. The study sample comprised 50 Saudi EFL students out of the population of 120 students enrolled in EFL programs at Qassim University, Saudi Arabia with sample size being determined using online sampling calculator Raosoft. Results: The results of the present study show that the Saudi EFL learners manifest a favorable level of awareness in developing grammatical forms while they still not having attained mastery of English grammar. Results also indicate that grammatical competence and level of awareness are more advanced among the Saudi EFL female learners compared to their male counterparts. Conclusions: The outcomes of this research imply that Saudi EFL learners have sufficient performance in grammar learning but need further nurturance. Implications of this study will serve as a basis for English language learning development interventions in the benefit of the students.

Abstract Silver(I) ethylxanthate [AgS2COEt] (1) and antimony(III) ethylxanthate [Sb(S2COEt)3] (2) have been synthesised, characterised and used as precursors for the preparation of AgSbS2 powders and thin films using a solvent-free melt method and spin coating technique, respectively. The as-synthesized AgSbS2 powders were characterized by powder X-ray diffraction (XRD), Raman spectroscopy, scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy. The crystalline AgSbS2 powder was investigated using XRD, which shows that AgSbS2 has cuboargyrite as the dominant phase, which was also confirmed by Raman spectroscopy. SEM was also used to study the morphology of the resulting material which is potentially nanostructured. EDX spectra gives a clear indication of the presence of silver (Ag), antimony (Sb) and sulfur (S) in material, suggesting that decomposition is clean and produces high quality AgSbS2 crystalline powder, which is consistent with the XRD and Raman data. Electronic properties of AgSbS2 thin films deposited by spin coating show a p-type conductivity with measured carrier mobility of 81 cm2 V−1 s−1 and carrier concentration of 1.9 × 1015 cm−3. The findings of this study reveal a new bottom-up route to these compounds, which have potential application as absorber layers in solar cells.

BackgroundData on SARS-CoV-2 in infants ≤ 90 days are limited with conflicting reports regarding its presentation and outcomes.MethodsWe conducted an ambispective cohort study using prospectively collected Health Electronic Surveillance Network Database by the Ministry of Health, Saudi Arabia. Infants of ≤ 90 days of age who had a positive RT-PCR test for SARS-CoV-2 virus were included. Patients were divided in Early neonatal (0–6 days), late neonatal (7–27 days), and post- neonatal (28–90 days) groups and were compared for clinical characteristics and outcomes by contacting parents and collecting information retrospectively.ResultsOf 1,793 infants, 898 infants were included for analysis. Most infants in the early neonatal group had no features of infection (tested based on maternal positivity), whereas most infants in the late and post- neonatal groups were tested because of clinical features of infection. Fever and respiratory signs were the most common presenting feature in the late and post-neonatal groups. Hospitalization was higher in the early neonatal group (80%), compared to the two other groups. The overall mortality in the cohort was 1.6%.ConclusionSARS-CoV-2 infection in infants ≤ 90 days might not be as rare as previously reported. The clinical presentation varies based on age at positive RT-PCR result.

Cobalt-doped potassium hexa-titanate (Cox:K2Ti6O13 (x = 0.05, 0.10, 0.15 mole%)) ceramics were synthesized by the solid-state reaction method. The XRD patterns confirmed single-phase development in a monoclinic symmetry of various samples, and they were used for different structural calculations of Cox:K2Ti6O13 ceramics. The dielectric constant, tanδ, electrical modulus, and ac conductivity of Co-doped K2Ti6O13 were studied in the temperature range of 100–500 °C. Anomalies were observed in graphs of the dielectric constant versus temperature, showing the transition phase in the studied samples. Dielectric peaks at transition temperature decreased with an increasing frequency, and the peaks shifted toward higher temperatures, illustrating the relaxation of the dielectric materials. The composition with x = 0.10 showed low dielectric loss and a higher dielectric constant and can be utilized for high-temperature dielectric material. Small doping of cobalt improved the ac conductivity of K2Ti6O13 ceramics due to the increase in the spin–phonon interaction and dominant electron hopping conduction; however, the conductivity diminished with substantial doping because of the contraction of the tunnel space and ambushing of conduction electrons. The uniqueness of this study is in the high dielectric optimization of lead-free ceramic Cox:K2Ti6O13 and the discovery of positive temperature coefficients of the resistivity of these ceramic samples.

Background This review focuses on reviewing the recent publications of swarm intelligence algorithms (particle swarm optimization (PSO), ant colony optimization (ACO), artificial bee colony (ABC), and the firefly algorithm (FA)) in scheduling and optimization problems. Swarm intelligence (SI) can be described as the intelligent behavior of natural living animals, fishes, and insects. In fact, it is based on agent groups or populations in which they have a reliable connection among them and with their environment. Inside such a group or population, each agent (member) performs according to certain rules that make it capable of maximizing the overall utility of that certain group or population. It can be described as a collective intelligence among self-organized members in certain group or population. In fact, biology inspired many researchers to mimic the behavior of certain natural swarms (birds, animals, or insects) to solve some computational problems effectively. Methodology SI techniques were utilized in cloud computing environment seeking optimum scheduling strategies. Hence, the most recent publications (2015–2021) that belongs to SI algorithms are reviewed and summarized. Results It is clear that the number of algorithms for cloud computing optimization is increasing rapidly. The number of PSO, ACO, ABC, and FA related journal papers has been visibility increased. However, it is noticeably that many recently emerging algorithms were emerged based on the amendment on the original SI algorithms especially the PSO algorithm. Conclusions The major intention of this work is to motivate interested researchers to develop and innovate new SI-based solutions that can handle complex and multi-objective computational problems.

Infliximab is a monoclonal antibody that works by inhibiting the proinflammatory cytokine and tumor necrosis factor-alpha. Systemic lupus erythematosus is an autoimmune disease that affects multiple organs, and its pathogenesis involves abnormal immune complexes, environment factors, and genetics. Several reports have documented a controversy regarding infliximab-induced lupus disease. This paper reports on infliximab-induced lupus in an 18-year-old Saudi female having short stature, hypogonadism, and Crohn's disease with ileocolonic fistula. The patient developed reactive arthritis, and serology showed positive anti-double strand DNA and antihistone antibodies after infliximab administration, suggesting drug-induced lupus. More cohort studies are recommended to monitor the presentation and reversibility of infliximab-induced lupus disease.

Foodborne infections and antibiotic resistance pose a serious threat to public health and must be addressed urgently. Pistacia lentiscus is a wild-growing shrub and has been utilized for medicinal applications as well as for culinary purposes. The antibacterial and antioxidant activities of P. lentiscus bark in vitro, as well as the phytochemical composition, are the focus of this inquiry. The bark extract of P. lentiscus showed significant antimicrobial activity in experiments on bacteria and yeast isolated from human and food sources. The exposure time for the complete inhibition of cell viability of P. aeruginosa in the extracts was found to be 5% at 15 min. Phytochemical inquiry of the methanol extract demonstrates the existence of carbohydrates, flavonoids, tannins, coumarins, triterpenes, and alkaloids. Deep phytochemical exploration led to the identification of methyl gallate, gallic acid, kaempferol, quercetin, kaempferol 3-O-α-rhamnoside, kaempferol 3-O-β-glucoside, and Quercetin-3-O-β-glucoside. When tested using the DPPH assay, the methanol extracts of P. lentiscus bark demonstrated a high free radical scavenging efficiency. Further, we have performed a molecular modelling study which revealed that the extract of P. lentiscus bark could be a beneficial source for novel flavonoid glycosides inhibitors against SARS-CoV-2 infection. Taken together, this study highlights the Pistacia lentiscus bark methanol extract as a promising antimicrobial and antiviral agent.

Congenital cervical teratomas are rare tumours arising from the neck and consist of three major tissue layers of an embryo: the ectoderm, endoderm, and mesoderm. A great majority of cervical teratomas are benign tumours. However, the clinical significance of these tumours arises from the complications they can cause during pregnancy due to the postnatal mass effect on the airway and oesophagus of the neonate. Diagnosis of a congenital cervical teratoma is possible during an early prenatal ultrasound evaluation. The appearance depends on the size of the tumour, but it is typically a large neck mass with solid and cystic components that causes hyperextension of the neck and is frequently associated with polyhydramnios. In the postnatal period, ultrasound helps in differentiating cervical teratoma from other common congenital cervical masses. MRI is the modality of choice to evaluate the consistency of the tumour, surrounding soft tissue extent of the tumour, and any mass effect on other cervical structures. In our case report, we present a case of a full-term baby that was delivered with a large cervical mass. MRI was helpful in demonstrating the complex content of the mass, surrounding soft tissue extension, and mass effect on other major cervical structures. The clear demarcation of the mass facilitated complete surgical removal without complications.

The neutron-rich dysprosium isotopes 168Dy102 and 169Dy103 have been investigated using the EURICA γ-ray spectrometer, following production via in-flight fission of a high-intensity uranium beam in conjunction with isotope separation through the BigRIPS separator at RIBF in RIKEN Nishina Center. For 168Dy, a previously unreported isomer with a half-life of 0.57(7) μs has been identified at an excitation energy of 1378 keV, and its presence affirmed independently using γ-γ-γ coincidence data taken with Gammasphere via two-proton transfer from an enriched 170Er target performed at Argonne National Laboratory. This isomer is assigned Jπ=Kπ=(4−) based on the measured transition strengths, decay patterns, and the energy systematics for two-quasiparticle states in N=102 isotones. The underlying mechanism of two-quasiparticle excitations in the doubly midshell region is discussed in comparison with the deformed QRPA and multi-quasiparticle calculations. In 169Dy, the B(E2) value for the transition de-exciting the previously unreported Kπ=(1/2−) isomeric state at 166 keV to the Kπ=(5/2−) ground state is approximately two orders of magnitude larger than the E2 strength for the corresponding isomeric-decay transition in the N=103 isotone 173Yb, suggesting the presence of a significant γ-vibrational admixture with a dominant neutron one-quasiparticle component in the isomeric state.

A detailed study of the structure of the doubly mid-shell nucleus Dy104166170 has been carried out, following isomeric and β decay. We have measured the yrast band up to the spin-parity Jπ=6+ state, the K=2 γ-vibration band up to the 5+ state, a low-lying negative-parity band based on a 2− state that could be a candidate for the lowest energy octupole vibration state within this nucleus, and a candidate for the Kπ=6+ two quasi-particle isomer. This state was determined to have an excitation energy of 1643.91(23) keV and a half life of 0.99(4) μs, with a reduced hindrance for its decay to the ground-state band an order of magnitude lower than predicted by NpNn systematics. This is interpreted as being due to γ-vibrational mixing from a near degeneracy of the isomer and the 6+ state of the γ band. Furthermore, the parent nucleus 170Tb has been determined to have a half-life of 0.91(−13+18) s with a possible spin-parity of 2−. Keywords: K isomer, Dysprosium, Mid-shell, γ-Ray spectroscopy

The level structure of 172Dy has been investigated for the first time by means of decay spectroscopy following in-flight fission of a 238U beam. A long-lived isomeric state with T1/2=0.71(5) s and Kπ=8− has been identified at 1278 keV, which decays to the ground-state and γ-vibrational bands through hindered electromagnetic transitions, as well as to the daughter nucleus 172Ho via allowed β decays. The robust nature of the Kπ=8− isomer and the ground-state rotational band reveals an axially-symmetric structure for this nucleus. Meanwhile, the γ-vibrational levels have been identified at unusually low excitation energy compared to the neighboring well-deformed nuclei, indicating the significance of the microscopic effect on the non-axial collectivity in this doubly mid-shell region. The underlying mechanism of enhanced γ vibration is discussed in comparison with the deformed Quasiparticle Random-Phase Approximation based on a Skyrme energy-density functional.

An integrated approach was adopted over Faifa Mountain and its surroundings, in Saudi Arabia, to identify landslide types, distribution, and controlling factors, and to generate landslide susceptibility maps. Given the inaccessibility of the area, we relied on remote sensing observations and GIS-based applications to enable spatial analysis of data and extrapolation of limited field observations. Susceptibility maps depicting debris flows within ephemeral valleys (Type I) and landslides caused by failure along fracture planes (Type II) were generated. Type I susceptibility maps were generated applying linear relationships between normalized difference vegetation index (NDVI) and threshold slope values (30°), both of which were extracted over known debris flow locations. For Type II susceptibility maps, landslides were predicted if fracture planes had strike values similar to (within 20°) those of the slope face strike and dip angles exceeding the friction, but not the slope angles. Comparisons between predicted and observed debris flows yielded success rates of 82% (ephemeral valleys); unverified predictions are interpreted as future locations of debris flows. Our approach could serve as a replicable model for many areas worldwide, in areas where field measurements are difficult to obtain and/or are cost prohibitive.