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This study aims to deepen the understanding of the role that "buy now pay later" (BNPL) services play in today's consumer culture among young adults. By focusing on the Klarna app and its BNPL feature, the study identifies patterns and behaviors of young adults regarding the use of this technology. The research question for this study is formulated as follows: what role does “buy now pay later” technology play in young adults' consumption behavior? The method used was semi-structured interviews with 10 young adults aged 18-25. The results showed that BNPL gives users greater consumption space, influences their consumption habits, and is perceived to have a negative impact on their finances. Additionally, poorer financial awareness among young adults leads to stronger financial concerns and a negative experience of the flexibility that the Klarna app offers. This study provides important insights into how technology, particularly BNPL services, shapes and affects young adults' consumption behaviors.

With increasing urban expansion and rising global demand for food production, integrating aquaponics within the urban contexts can be considered an alternative sustainable solution to enrich the local production and self-sufficiency. In this research, we aim to study the aquaponics system and provide a design guide for implementing the urban version of the system in the city of Malmo. The design guide will be also practically tested in a form of an architectural proposal at the end of the research. To reach the results, various case studies and academic research were investigated. In addition to other qualitative and quantitative methodologies, such as interviews, questionnaire, and ethnographic studies that contributed to making progress during the research’s different phases. The analysis of data was to generate sustainable bases for urban aquaponics that go in line with the city’s conditions and citizens’ aspirations. Accordingly, several methods and techniques were deducted to be used for the sustainable integration of the aquaponics system within the urban context of Malmo. Nevertheless, the integration process can contribute to including other operations with the aim of increasing aquaponics sustainability and solving urban issues within the context. However, the design guide produced in this paper is mainly for the city of Malmo, but it can be adjusted to other social and geographical contexts.

Mouhammad J Alawad,1 Mohammad Abu-Tineh,2 Awni Alshurafa,2 Alaa Al-Taie,3 Anil Yousaf,2 Mohamed A Yassin2 1Department of Medical Education, Internal Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar; 2Department of Medical Oncology, Hematology and BMT Section, National Center for Hamad Medical Corporation, Doha, Qatar; 3Clinical Imaging Department, Hamad Medical Corporation, Doha, QatarCorrespondence: Mouhammad J Alawad, Department of Medical Education, Internal Medicine Residency Program, Hamad Medical Corporation, PO Box 3050, Doha, Qatar, Tel +974 33078745, Fax +97444397857, Email www.wad7a123@gmail.comAbstract: Glanzmann thrombasthenia is a bleeding disorder with a low incidence. It typically manifests as superficial bleeding episodes, which tend to be mild. Deep organ involvement is not uncommon but remains rare due to the rarity of the disease itself and the unusual association between platelet disorders and deep organ implications. A 17-year-old boy with Glanzmann thrombasthenia since infancy developed ankle pain after a minor trauma. His initial workup was negative, but he continued to experience ankle pain. A magnetic resonance imaging (MRI) done after four weeks suggested siderotic synovitis. The patient was lost to follow-up after that and returned after two years with recurrent left ankle pain. Imaging and studies have shown evidence of chronic arthropathy. A specialized orthopedic team assessed the patient. The patient underwent intra-articular steroid injection for pain relief and was referred to continue physical therapy. In conclusion, hemarthrosis is more common in hemophilia than in platelet disorders and has potential morbidity and quality-of-life implications.Keywords: Glanzmann thrombasthenia, hemarthrosis, synovitis

Ghazwa B Korayem,1,* Omar A Alshaya,2– 4,* Nirvana Alnajjar,1 Ahad Alawad,1 Rand Alotaibi,1 Nader Bin Sheraim,5 Fatemah M Hakami,6 Ohud S Alsudyyes,6 Rahaf H Alsoghayer,6 Lina M Alhushan,6 Asma H Qudayr,6,7 Majed S Al Yami,2– 4 Omar A Almohammed6,8 1Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, 11671, Saudi Arabia; 2Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 4King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 5Pharmaceutical Care Division, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia; 6Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 7Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia; 8Pharmacoeconomics Research Unit, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia*These authors contributed equally to this workCorrespondence: Ghazwa B Korayem, Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, P.O.Box 84428, Riyadh, 11671, Saudi Arabia, Tel +966504161649, Email gbkorayem@pnu.edu.sa Omar A Almohammed, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2457, Riyadh, 11451, Saudi Arabia, Tel +966 555104065, Email oalmohammed@ksu.edu.saBackground: Although parenteral anticoagulation lead-in is not recommended with apixaban and rivaroxaban, parenteral anticoagulation is often used to replace apixaban or rivaroxaban lead-in doses for the initial phase treatment of VTE. Thus, our study compares the safety and effectiveness of lead-in parenteral anticoagulation to lead-in apixaban or rivaroxaban in patients who received apixaban or rivaroxaban for VTE treatment.Methods: A multi-center

In recent years, deep learning has shown promise in predicting hypertension (HTN) from fundus images. However, most prior research has primarily focused on analyzing a single type of data, which may not capture the full complexity of HTN risk. To address this limitation, this study introduces a multimodal deep learning (MMDL) system, dubbed HyMNet, which combines fundus images and cardiometabolic risk factors, specifically age and gender, to improve hypertension detection capabilities. Our MMDL system uses RETFound, a foundation model pre-trained on 1.6 million retinal images, for the fundus path and a fully connected neural network for the age and gender path. The two paths are jointly trained by concatenating the feature vectors from each path that are then fed into a fusion network. The system was trained on 5,016 retinal images from 1,243 individuals collected from the Saudi Ministry of National Guard Health Affairs. The results show that the multimodal model that integrates fundus images along with age and gender outperforms the unimodal system trained solely on fundus photographs, with an F1 score of 0.771 [0.747, 0.796], and 0.745 [0.719, 0.772] for hypertension detection, respectively. Additionally, we studied the effect underlying diabetes mellitus has on the model's predictive ability, concluding that diabetes is used as a confounding variable for distinguishing hypertensive cases. Our code and model weights are publicly available at https://github.com/MohammedSB/HyMNet.

In uniform-price markets, suppliers compete to supply a resource to consumers, resulting in a single market price determined by their competition. For sufficient flexibility, producers and consumers prefer to commit to a function as their strategies, indicating their preferred quantity at any given market price. Producers and consumers may wish to act as both, i.e., prosumers. In this paper, we examine the behavior of profit-maximizing prosumers in a uniform-price market for resource allocation with the objective of maximizing the social welfare. We propose a scalar-parameterized function bidding mechanism for the prosumers, in which we establish the existence and uniqueness of Nash equilibrium. Furthermore, we provide an efficient way to compute the Nash equilibrium through the computation of the market allocation at the Nash equilibrium. Finally, we present a case study to illustrate the welfare loss under different variations of market parameters, such as the market's supply capacity and inelastic demand., Comment: Corrected typos in the figures

Abdulrhman Fahad Aljouie,1,2 Ahmed Almazroa,2,3 Yahya Bokhari,1,2 Mohammed Alawad,1,2 Ebrahim Mahmoud,4 Eman Alawad,4 Ali Alsehawi,5 Mamoon Rashid,1,2 Lamya Alomair,1,2 Shahad Almozaai,6 Bedoor Albesher,6 Hassan Alomaish,5 Rayyan Daghistani,5 Naif Khalaf Alharbi,2,7 Manal Alaamery,2,8– 10 Mohammad Bosaeed,2– 4 Hesham Alshaalan5 1Bioinformatics Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 2King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3Department of Imaging Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4Department of Medicine, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; 5Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; 6College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 7Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 8Department of Developmental Medicine, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 9KACST-BWH Center of Excellence for Biomedicine, Joint Centers of Excellence Program, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia; 10King Abdulaziz City for Science and Technology (KACST)-Saudi Human Genome Satellite Lab at Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Riyadh, Saudi ArabiaCorrespondence: Mohammed AlawadBioinformatics Section, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaEmail malawad@sdaia.gov.saAhmed AlmazroaDepartment of Imaging Research, King Abdullah International Medical Research Center King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaEmail almazroaah@ngha.med.saBackground: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrom

Mohammed Alawad,1 Abdulrhman Aljouie,1 Suhailah Alamri,2,3 Mansour Alghamdi,4 Balsam Alabdulkader,4 Norah Alkanhal,2 Ahmed Almazroa2 1Department of Biostatistics and Bioinformatics, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Department of Imaging Research, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for health Sciences, Riyadh, Saudi Arabia; 3Research Labs, National Center for Artificial Intelligence, Riyadh, Saudi Arabia; 4Department of Optometry and Vision Sciences College of Applied Medical Sciences, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Ahmed Almazroa; Abdulrhman Aljouie, Email almazroaah@ngha.med.sa; aljouieab@NGHA.MED.SABackground: Globally, glaucoma is the second leading cause of blindness. Detecting glaucoma in the early stages is essential to avoid disease complications, which lead to blindness. Thus, computer-aided diagnosis systems are powerful tools to overcome the shortage of glaucoma screening programs.Methods: A systematic search of public databases, including PubMed, Google Scholar, and other sources, was performed to identify relevant studies to overview the publicly available fundus image datasets used to train, validate, and test machine learning and deep learning methods. Additionally, existing machine learning and deep learning methods for optic cup and disc segmentation were surveyed and critically reviewed.Results: Eight fundus images datasets were publicly available with 15,445 images labeled with glaucoma or non-glaucoma, and manually annotated optic disc and cup boundaries were found. Five metrics were identified for evaluating the developed models. Finally, three main deep learning architectural designs were commonly used for optic disc and optic cup segmentation.Conclusion: We provided future research directions to formulate robust optic cup and disc segmentation systems. Deep learning ca

A key component of deep learning (DL) for natural language processing (NLP) is word embeddings. Word embeddings that effectively capture the meaning and context of the word that they represent can significantly improve the performance of downstream DL models for various NLP tasks. Many existing word embeddings techniques capture the context of words based on word co-occurrence in documents and text; however, they often cannot capture broader domain-specific relationships between concepts that may be crucial for the NLP task at hand. In this paper, we propose a method to integrate external knowledge from medical terminology ontologies into the context captured by word embeddings. Specifically, we use a medical knowledge graph, such as the unified medical language system (UMLS), to find connections between clinical terms in cancer pathology reports. This approach aims to minimize the distance between connected clinical concepts. We evaluate the proposed approach using a Multitask Convolutional Neural Network (MT-CNN) to extract six cancer characteristics -- site, subsite, laterality, behavior, histology, and grade -- from a dataset of ~900K cancer pathology reports. The results show that the MT-CNN model which uses our domain informed embeddings outperforms the same MT-CNN using standard word2vec embeddings across all tasks, with an improvement in the overall micro- and macro-F1 scores by 4.97\%and 22.5\%, respectively.

The current research aimed to identify the relationship between psychological flow, optimism, and the level of ambition among faculty members at Prince Sattam bin Abdulaziz University Al-Kharj, Saudi Arabia. The study sample consisted of (150) faculty members from different colleges of the university, who were chosen randomly. The research tools included a scale (psychological flow, optimism scale, and level of ambition), which the researchers prepared. After confirming the psychometric characteristics, the application was applied to the research sample. The research had used the quantitative descriptive method. The results found a positive correlational relationship between (0.01) between psychological flow, optimism, and the level of ambition in favor of assistant professors. Furthermore, the research found statistically significant differences on the scale of the ambition level according to the different research variables in experience and nationality. There were no statistically significant differences between the mean scores of faculty members on the psychological flow scale (career title, gender). The constant variable was statistically significant, and the psychological flow cannot be predicted. The research had recommended conducting studies that measure psychological flow according to other variables of the research sample..

[ES] Actualmente se están implementando sistemas basados en sensores IoT para automatizar o monitorizar diferentes procesos en la agricultura. Una de las principales limitaciones de estos sistemas es la duración y tamaño de las baterías, lo que aumenta su coste de mantenimiento e implantación. La mayoría de estos sistemas funciona con una frecuencia de muestreo fijada a al inicio. El objetivo principal del trabajo es la creación de políticas de muestreo inteligentes aplicadas a este tipo de sensores usados en agricultura, así como métodos para evaluarlas. Estas políticas dejarás de ser una frecuencia de muestreo fija y tratarán de adaptarse al parámetro estudiado para así evitar mediciones sin aporte de información valiosa y ahorrar energía. Una vez establecidas las políticas y los métodos de evaluación, se tratará de definir una serie de pautas o acciones que sirvan como base de un sistema dotado de inteligencia artificial y machine learning capaz de desarrollar sus propias políticas inteligentes de muestreo. Este trabajo está enfocado principalmente a sensores de humedad de suelo., [EN] IoT technology is starting to play a key role in many fields, one of them is precision agriculture. Several kinds of sensors are helping farmers to check different parameters of their crops in real time, giving them a very useful decision support to know when irrigation is needed, detect plagues, etc. However, these sensors have a limited lifetime due to its battery or power supply limitations, moreover, in most cases the selection of the sampling rate (the parameter with highest influence in power consumption) is left to be set by the farmer, adding difficulty to the use. In general terms, this work aims to analyze moisture monitoring sensors and systems to obtain certain conclusions and rules to be used as base in the implementation of smart soil moisture sensors with adaptability and intelligence to auto determine when to measure, making them more efficient and easy to use. The first stage of this thesis will study the state of the art in smart agriculture, and more specifically the use of soil moisture sensors. Class, applications, price, autonomy and other qualities of the sensors will be studied, as well as opinions from farmers and smart irrigation companies to determine the ideal requirements in a possible smart system. After that, some experiments with commercial sensors and products will be held in order to obtain raw data to work with. The sensors will be placed in an experimental soil during several wet-dry cycles and configured with a high sampling rate storing all the data for future analysis, soil temperature will be studied at the same time. The analysis will reveal how to reduce the number of samples without reducing the utility of the system, presumably that means to reduce the sampling rate when moisture values are not significant and increase it when they are close to critical values for the farmer (irrigation threshold, over wetting, etc.) but conclusions won t be clear until the analysis

In 2002, vessel head wall thinning that was identified at the Davis Besse reactor in the US shaded the lights on the importance of SB-LOCA’s in the upper head of RPV. The lower rates of coolant discharge through the break and primary circuit depressurization are the main characteristics in which SB-LOCA’s differ from LB-LOCA’s, and throughout the transient, three distinct and independent occurrences of core heat-up’s can potentially take place. SB-LOCA’s are troublesome scenarios for the development of EOP’s and modelling capabilities to adequately predict the overall T-H system response. This thesis contributes to the nuclear reactor safety from the thermal-hydraulic perspective, and it aims to develop and enhance a computational model of the ATLAS IET facility for the T-H system code RELAP5/MOD3.3. By applying the UPC-ANT Uncertainty Analysis methodology for code assessment, thermal-hydraulic phenomenology analysis is performed to analyze the model adequacy and accuracy to reproduce the most relevant T-H phenomena involved in Test B5.1 at the ATLAS facility, which is an SB-LOCA in the upper head. The work presented in the thesis is within the framework of UPC participation to the OECD/NEA ATLAS joint project 2. A variety of verification procedures are applied which focus on the statistical characteristics of sampled populations, the validity and robustness of the developed ATLAS-RELAP5 model by performing “null-transient” calculations. The implemented code assessment procedure is based on the adequacy of both the base-case and BEPU analysis calculations. It is concluded that the base-case calculation reproduces all the relevant T-H phenomena, either totally or partially. In essence, core heat-up and uncovery takes place ealier as compared to the experiment, about 900 seconds, due to quick clearing and refilling of loop-seals; thus, later events are accelerated in the base-case calculation. The BEPU analysis is generally adequate to perturb the relevant T-H phenome

Due to the depletion of light crude oil reserves, heavy crude oil and residues are the alternatives to meet ‎the ‎increasing global demand for light oil products. Heavy crude oil and residues are characterized by the presence of heavy ‎hydrocarbon ‎compounds which contain high levels of impurities such as metals, nitrogen, and sulfur-containing compounds. ‎Methods of ‎upgrading are required to increase refining efficiencies and to obtain high-quality products.‎ Upgrading processes can be categorized into three categories; ‎carbon rejection processes, hydrogen addition processes, and a combination of the two. The catalyst can be used with any of these processes for better improvement. Many types of research have been carried out to develop a high-performance process which is stable, high commercial products yield, and low solids formation. In this work, recent advances on petroleum residues upgrading with catalyst, solvents, and thermal cracking were reviewed. Advantages and disadvantages of each process were discussed along with conditions and main features. Nanoparticles catalysts and supercritical fluids based-processes are the trends of upgrading due to the excellent performance of these processes.

Falling between seasonal cycle variability and the impact of local drivers, the sea level in the Red Sea and Gulf of Aden has been given less consideration, especially with large-scale modes. With multiple decades of satellite altimetry observations combined with good spatial resolution, the time has come for diagnosis of the impact of large-scale modes on the sea level in those important semi-enclosed basins. While the annual cycle of sea level appeared as a dominant cycle using spectral analysis, the semi-annual one was also found, although much weaker. The first empirical orthogonal function mode explained, on average, about 65 of the total variance throughout the seasons, while their principal components clearly captured the strong La Niña event (1999–2001) in all seasons. The sea level showed a strong positive relation with positive phase El Niño Southern Oscillation in all seasons and a strong negative relation with East Atlantic/West Russia during winter and spring over the study period (1993–2017). We show that the unusually stronger easterly winds that are displaced north of the equator generate an upwelling area near the Sumatra coast and they drive both warm surface and deep-water masses toward the West Indian Ocean and Arabian Sea, rising sea level over the Red Sea and Gulf of Aden. This process could explain the increase of sea level in the basin during the positive phase of El Niño Southern Oscillation events.

Placental mesenchymal stem cells from maternal decidua basalis tissue (DBMSCs) are promising cells for tissue repair because of their multilineage differentiation and ability to protect endothelial cells from injury. Here, we examined DBMSC interaction with macrophages and whether this interaction could modulate the characteristics and functions of these macrophages. We induced monocytes to differentiate into M1-like macrophages in the presence of DBMSCs. DBMSC effects on differentiation were evaluated using microscopy, flow cytometry, and ELISA. DBMSC effects on M1-like macrophage induction of T cell function were also examined. The culture of DBMSCs with monocytes did not inhibit monocyte differentiation into M1-like inflammatory macrophages. This was confirmed by the morphological appearance of M1-like macrophages, increased expression of inflammatory molecules, and reduced expression of anti-inflammatory molecules. In addition, DBMSCs did not interfere with M1-like macrophage phagocytic activity; rather, they induced stimulatory effects of M1-like macrophages on CD4⁺ T cell proliferation and subsequent secretion of inflammatory molecules by T cells. We showed that DBMSCs enhanced the differentiation of M1-like inflammatory macrophages, which function as antitumor cells. Therefore, our findings suggest that DBMSCs are inflammatory cells that could be useful in cancer treatment via the enhancement of M1- like macrophages.

Introduction: Mental problems have become increasingly important public health issue globally. This study aimed to determine the prevalence and factors associated with depression, anxiety, and stress among medical students in a public university in Malaysia. Methods: A total of 447 medical students were sampled by stratified proportion-ate to size sampling according to year of study. Validated self-administered questionnaire was used consisted of 5 sections namely, socio-demographic factors, social support received from family members and friends, presence of co-morbidity, previous history of resolved mental problem and Depression Anxiety Stress Scale DASS- 21. Data was analysed by using the statistical computer software ‘Statistical Package for Social Science (SPSS)’ version 22 involving three levels of analysis (descriptive, chi square and multiple logistic regression). Results: Only 31.1% of the respondents were found to be depressed with mainly within the moderately depressed category, 53.9% had anxiety and 26% were having stress. Perceived social support received from family members was a significant predicting factor for depression, anxiety and stress. Conclusion: High proportion of depression, anxiety and level of stress among medical students were found. The stressful medical program is putting medical students at risk of mental problems. Parents and family members should be encouraged to be more involved in any related programs to promote better mental health and well-being of medical students.

Code readability and software complexity are important software quality metrics that impact other software metrics such as maintainability, reusability, portability and reliability. This paper presents an empirical study of the relationships between code readability and program complexity. The results are derived from an analysis of 35 Java programs that cover 23 distinct code constructs. The analysis includes six readability metrics and two complexity metrics. Our study empirically confirms the existing wisdom that readability and complexity are negatively correlated. Applying a machine learning technique, we also identify and rank those code constructs that substantially affect code readability., Comment: 7 pages, 2 figures, 3 tables

BACKGROUND: Human decidua basalis mesenchymal stem/multipotent stromal cells (DBMSCs) inhibit endothelial cell activation by inflammation induced by monocytes. This property makes them a promising candidate for cell-based therapy to treat inflammatory diseases, such as atherosclerosis. This study was performed to examine the ability of DBMSCs to protect endothelial cell functions from the damaging effects resulting from exposure to oxidatively stress environment induced by H2O2 and monocytes. METHODS: DBMSCs were co-cultured with endothelial cells isolated from human umbilical cord veins in the presence of H2O2 and monocytes, and various functions of endothelial cell were then determined. The effect of DBMSCs on monocyte adhesion to endothelial cells in the presence of H2O2 was also examined. In addition, the effect of DBMSCs on HUVEC gene expression under the influence of H2O2 was also determined. RESULTS: DBMSCs reversed the effect of H2O2 on endothelial cell functions. In addition, DBMSCs reduced monocyte adhesion to endothelial cells and also reduced the stimulatory effect of monocytes on endothelial cell proliferation in the presence of H2O2. Moreover, DBMSCs modified the expression of many genes mediating important endothelial cell functions. Finally, DBMSCs increased the activities of glutathione and thioredoxin reductases in H2O2-treated endothelial cells. CONCLUSIONS: We conclude that DBMSCs have potential for therapeutic application in inflammatory diseases, such as atherosclerosis by protecting endothelial cells from oxidative stress damage. However, more studies are needed to elucidate this further.

BACKGROUND: Human decidua parietalis mesenchymal stem/multipotent stromal cells (DPMSCs) have unique phenotypic and functional properties that make them promising candidates for cell-based therapy. Here, we investigated DPMSC interaction with natural killer (NK) cells, and the effects of this interaction on NK cell phenotypic characteristics and functional activities. METHODS: DPMSCs isolated from the decidua parietalis of human fetal membranes were cultured with interleukin (IL)-2-activated and IL-2-unactivated NK cells isolated from healthy human peripheral blood. NK cell proliferation and cytolytic activities were then examined using functional assays. NK cell expression of receptors mediating the cytolytic activity against DPMSCs, and the mechanism underlying this effect on DPMSCs, were also examined using flow cytometry and light microscopy, respectively. RESULTS: DPMSCs stimulated IL-2-induced proliferation of resting NK cells and the proliferation of activated NK cells. Moreover, IL-2-activated NK cells, but not freshly isolated NK cells, efficiently lysed DPMSCs. The induction of this NK cell cytolytic activity against DPMSCs was mediated by the activating NK cell receptors NKG2D, CD69, NKp30, and NKp44. However, DPMSCs showed a direct induction of NK cell cytolytic activity through CD69. We also found that DPMSCs expressed the ligands for these activating NK cell receptors including Nectin-2, ULBP-2, MICA, and MICB. Although DPMSCs expressed HLA class I molecules, they were susceptible to lysis by NK cells, suggesting that HLA class I antigens do not play a significant role in NK cell cytolytic action. In addition, DPMSCs did not inhibit NK cell cytolytic activity against cancer cells. Importantly, DPMSCs significantly increased NK expression of inflammatory molecules with anticancer activities. CONCLUSIONS: We conclude that DPMSCs have potential for therapeutic application in cancer therapy, but not in transplantation or immunological diseases.

Fahad D Alosaimi,1 Hossam S Alawad,2 Ayedh K Alamri,2 Abdullah I Saeed,2 Khalid A Aljuaydi,2 Alwaleed S Alotaibi,2 Khalid M Alotaibi,2 Eiad A Alfaris3 1Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; 3King Saud University Chair for the Development of Medical Education, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia Background: Physicians experience several work-related stressors that have been mounting up in recent decades. This study aimed to examine perceived stress and its risk factors and consequences among consultant physicians in Saudi Arabia. Methods: A cross-sectional study was conducted from November 2014 to March 2015 among physicians who were assigned rank of consultant. The stress level was assessed using perceived stress scale (PSS).Results: A total of 582 consultants participated. The average age was 46.9±7.9 years, 71% were males, 56% were Saudi, 15% were smokers, and 68% slept ≤6 hours per night. The median PSS score was 17 (interquartile range of 14–21), which represented 44% of maximum possible PSS score. The upper tertile of PSS score (represents a high stress level) was significantly associated with being younger, female, and Saudi. The majority (85%) considered job environment to be stressful and ~50% attributed that to a high workload and a noncooperative administration. In the year preceding this study, half of consultants frequently contemplated or even worked toward changing their medical institutes or even moving to work outside Saudi Arabia because of perception of a stressful working environment. Over the previous year, encountering life stressors, considering job environment as stressful and experiencing passive suicidal ideation, were significantly associated with higher levels of st

This paper examines how and why migrants remit through unauthorized remittance channels (namely the hawala or hundi) and investigates the hawala's developmental roles and effects on migrants’ socioeconomic status. Applying a qualitative case study of 30 low-income Pakistani migrants in Dubai, we argue that the thriving yet unauthorized status of the hawala system is a unique product of global migration process. In contrast to the dominant literature on the nexus between the hawala and terrorist and criminal-related financing, we assert that the sustainability of the hawala is the result of an ongoing effort of low-income migrants to increase their remitting power, providing money that is crucial to their families’ socioeconomic status within the con-text of rapidly globalizing forces. This study provides both important empirical and theoretical insights into the hawala's complex relevance for low-income migrants, governments, and international organizations in global migration context.

The evaluation of the normal measurements of the cerebral ventricles in the living human has great importance in the diagnosis and monitoring of several pathologies, some previous studies reported variable results concerning the measurements of ventricles. But, and to best of our knowledge, and what was found in the open literature; there is no enough data concerning normative Sudanese measurement for cerebral ventricles. The aim of the study to analyze the morphometric measurements of the Lateral Ventricles of the brain, in different age group individuals of both genders by MR imaging. descriptive analytical studywere done to show the sizes of brain lateral ventricles on Axial Brain MRI section, in which 80 normal adult Sudanese patients(40 male, 40female), were measured(1.5 Tesla).MR Image were acquired in T1weighted image using axial view of the cerebral hemisphere, the following vertical and longitudinal dimensions of both lateral ventricles, Anterior Horn (A.H), body, Posterior Horn(PH), Brain Width (B.W), Brain Length(B.W), Lateral Ventricle Length( V.L), were measured. Data statistical analyzed were conducted using SPSS (Statistical Presentation System Software) for windows version 14.0 Evaluation, where student test and chi-square test was used for analysis for statistical significance and an ?-level of 0.05were considered with a 95% confidence level and intervals.The results revealed that sex-related difference was detected between genders where the body was found to be larger in male than female, while the age related changes seen in all parts of lateral ventricle when it was increase with increasing age.This study concluded that regarding sex related difference in Sudanese population our finding reported there is significant statistical difference between genders where the body of lateral ventricle was found to be larger in male than female .Thus, no significant statistical difference between genders concerning the anterior horn and posterior horn. Reg

Background: The Republic of the Sudan located in north-east of Africa and is considered to be a lower-middle income country. The country has well established healthcare system with many drawbacks mainly due to economic and managerial reasons followed by prolonged political instability and sanctions. Objective: The aim of this study is to give an insight over the health services system in Sudan and to analyze the strength, weakness, opportunities, and threats (SWOT). Materials and Methods: The search was done from two electronic databases: MEDLINE/Pubmed and from public search engines: Google Scholar and Google with key Search words used mainly as “Healthcare system in Sudan“. Additionally, SWOT analysis of healthcare system in Sudan was carried out based on the Roemer's model of health service system. Results: The Sudanese healthcare system was analyzed for different components of the system: The system in Sudan has full package of strategic plans and policies be it in a long term or short. Despite this there is poor implementation and organization along with frail health information system. The main external factors that drawback the system is the overall economic instability which resulted in cutting of the health expenditure. Conclusion: The Sudan is a rich country in terms of natural resources and population. Its health service system has strengths and weaknesses. It needs to build on its qualified human work force, stress on its well-designed short and long-term strategies on health care system and the partnership with external funding institutions, while overcoming the challenges on creating the proper health information system, economic support system and centralization of health service and professionals.

Background: Policy analysis is the process of identifying problem, defining and analyzing process, qualitative and quantitative analysis, evaluation, recommendation, aiming to inform choices leading to an improved healthcare system. In developing country, the analysis of health policy has been given limited attention. As health is influenced by many external sectors and the dynamic in healthcare system, it is a challenging task in health policies analyses. The aim of this manuscript is focusing on health policy analysis in developing countries using the methodological approaches of theories, frameworks and study designs. Materials and Methods: Scoping systematic review was used for this manuscript writing. Recent ten year articles were searched from public domains with keywords of “health policy”, “developing countries”, “theory”, “framework” and “study design”. A total of 18 articles were finalized to be included, six for each methodological approaches. Result: Theories such as Group Theory, Multiple Implementation Theory, and Kingdon Multiple Stream Theory are among the commonest theories used in policy analysis. In translating framework approach into health policy analysis, Policy Triangle Framework, 3-i Framework (idea, interest and institution) and Social Determinant of Health Framework are also widely used. The mixed method of qualitative and secondary data based quantitative; and cross-country comparative case study are frequently adopted for study design approach. Conclusion: A common methodological approaches in health policy analyses were used an established theoretical approach, a feasible approach of study design and a comprehensive framework. However evidenced based approach is also use as a fundamental approach in health policy analysis especially in developing countries with limited resources.

Introduction: Depression, anxiety and stress have become increasingly important public health issue globally. The nature of the medical program makes medical students more vulnerable to mental health problems including, depression, anxiety and stress. Objective: This study aimed to determine the prevalence and factors associated with depression, anxiety, and stress among medical students in UPM-Serdang. Methodology: A cross-sectional study was conducted among 447 medical students studying in the faculty of Medicine and health sciences UPM Serdang. Simple random sampling proportionate to size was adopted for the purpose of data collection. Data was collected by using self-administered and validated questionnaire consisted of 5 sections namely, socio-demographic factors, social support received from family members and friends, presence of co-morbidity, previous history of resolved mental problem and Depression Anxiety Stress Scale DASS- 21. The questions were in the form of open ended questions, likert and nominal scales. The data was analyzed by using the statistical computer software ‘Statistical Package for Social Science (SPSS)’ version 22. Three types of analysis were involved, descriptive, bivariate and multivariate analysis. The bivariate analysis (Chi-square or (Fisher’s Exact test) was used to determine the association between mental health (depression, anxiety and stress) and the independent variables. Meanwhile, multiple logistic regression was used to determine the predictive model for depression, anxiety and stress among the respondents. The level of significance was set at p<0.05. Results: The median age of the respondents was 22 (IQR=3). Majority of them were female (72.3%), Malay (66.9%), had family income of 5000RM (IQR=5000) and tertiary paternal (54.6%) and maternal (48.8%) education. The prevalence of depression, anxiety and stress were (31.1%), (53.9%), (26.0%) respectively. The final predictive model showed that the occurrence of depression among

Mesenchymal stem cell (MSC) therapies for the treatment of diseases associated with inflammation and oxidative stress employ primarily bone marrow MSCs (BMMSCs) and other MSC types such as MSC from the chorionic villi of human term placentae (pMSCs). These MSCs are not derived from microenvironments associated with inflammation and oxidative stress, unlike MSCs from the decidua basalis of the human term placenta (DBMSCs). DBMSCs were isolated and then extensively characterized. Differentiation of DBMSCs into three mesenchymal lineages (adipocytes, osteocytes, and chondrocytes) was performed. Real-time polymerase chain reaction (PCR) and flow cytometry techniques were also used to characterize the gene and protein expression profiles of DBMSCs, respectively. In addition, sandwich enzyme-linked immunosorbent assay (ELISA) was performed to detect proteins secreted by DBMSCs. Finally, the migration and proliferation abilities of DBMSCs were also determined. DBMSCs were positive for MSC markers and HLA-ABC. DBMSCs were negative for hematopoietic and endothelial markers, costimulatory molecules, and HLA-DR. Functionally, DBMSCs differentiated into three mesenchymal lineages, proliferated, and migrated in response to a number of stimuli. Most importantly, these cells express and secrete a distinct combination of cytokines, growth factors, and immune molecules that reflect their unique microenvironment. Therefore, DBMSCs could be attractive, alternative candidates for MSC-based therapies that treat diseases associated with inflammation and oxidative stress.

Background: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagonlike peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. Methods: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallelgroup, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. Results: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m2, and duration of T2DM was 9.3±8.2 years. The qualifying ACS wasamyocardial infarctionin83% and unstableangina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. Conclusion: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk. © 2015 Elsevier Inc. All rights reserved.

Objective: The objective of the present study was to find out the approximateepidemiology of cancer burden in the adults' population of Hail region, North KSA. Methodology: A cross-sectional survey among 3326 Saudi civilianswas conducted. A purposeful form was used to obtain cancer-related data. Results : About 3281 participants had responded. Of the 3281(100%), respondents,1057/3281 (32.2%) had relatives with cancer. The most commonstated cancers were breast, leukemia, each (lung and stomach), colon, and cervix, representing, 261/1057 (24.7%), 198/1057 (18.7%), (101/1057 (9.6%)), 94/1057 (8.9%), and 79/1057 (7.4%), respectively. Conclusion : The prevalence of cancer was higher among adultspopulation in Hail Region, North KSA. The full burden of cancer in KSAstill shadowy, since there no unique cancer registry.

This paper presents the results of using ground dune sand (GDS) and ground granulated blast furnace slag (slag) as high volume cement replacement materials. In this study, plain and four blended mixtures were fabricated and cured under normal and autoclave conditions. For the blended mixtures, 40% GDS by weight of the total binder materials and different percentages of slag (15%, 30% and 45%) were incorporated as partial cement replacement materials. The effect of curing conditions (normal and autoclave) on the compressive strength of prepared mixtures was studied. The results showed that, for the autoclave cured mixture, up to 85% of cement can be replaced by GDS and slag without significant drop in the compressive strength. Microstructure analyses using scanning electron microscope (SEM) and X-ray diffraction analysis (XRD) were carried out to examine the microscale changes of the hydrated mixtures. The SEM revealed the formation of thin plate-like calcium silicate hydrate and compacted microstructure of autoclave cured mixture. XRD showed the elimination of calcium hydroxide and existence of residual crystalline silica of all blended mixtures.

Pozzolan materials (e.g. fly ash, slag, silica fume, rice husk ash) have been used successfully as a partial ordinary Portland cement (OPC) replacement material. However, there are some technical and economic drawbacks associated with the use of the existing pozzolan materials. Therefore, there is a growing interest to find an alternative material to be used as a source of siliceous materials for concrete production. This research aims to determine the potential of using ground dune sand (GDS) as partial cement replacement in binary (OPC-GDS) and ternary combinations of OPC-GDSslag and OPC-GDS-lime. The proposed combinations of blended cement system are expected to save large amounts of OPC. The primary objective of this study is to develop naturally available dune sand as an effective partial cementing material for use in the concrete industry. To achieve this objective, different treatment methods, namely, mechanical, chemical and thermal methods (autoclave curing) have been applied to determine the reactivity of GDS. For the ternary blended combinations, low (15%), moderate (30%) and high (45%) amounts of slag or lime were incorporated into a binder system containing 40% of GDS. Compressive strength, drying shrinkage and durability properties of the cast mixtures were investigated. Moreover, microstructure analyses were carried out using SEM, EDX, XRD, DTA and TGA analyses to characterize the hydrated products. A correlation between CaO/SiO2 and compressive strength was then carried out. The results revealed that autoclave curing is a promising curing system to utilize the GDS as partial cement replacement. The optimum level of replacement of OPC by GDS was found to be 30%, and up to 40% of GDS can be used without significant loss in the compressive strength. The inclusion of slag or lime as the ternary binder element to the mixture containing 40% of GDS yielded a compressive strength higher or comparable to the control mixture. The drying shrinkage and durabilit

In this study, SEM, EDX, XRD, DAT and TGA are used to perform microstructure analyses of autoclaved ground dune sand–ordinary Portland cement (GDS–OPC) pastes. Pastes containing 0%, 10%, 20%, 30% and 40% GDS as cement replacement were prepared for this purpose. The microstructure analyses were used to examine the microscale changes that occur in the GDS–OPC pastes with increasing GDS replacement levels. The SEM and EDX results showed the clear formation of dense and newly formed thin crystalline calcium silicate hydrate with a low CaO/SiO2 ratio. The XRD, DTA and TGA analyses revealed that the portlandite phase had been eliminated. The microstructure analyses reveal how GDS contributes to the strength and physical properties of concrete.

There has been a great interest throughout the past years, in using the natural fibres to reinforcement the polymeric composites. A comprehensive study of the tribology science of the fibre composites is essential to ensure its capability to stand any given task. The main objective of the research is to obtain empirical equations for the temperature and friction of the studied Kenaf fibre. Minitab software was implemented in the research to conduct all the needed tests also to produce the figures. The key findings of this research are that, the frictional behavior of composites has a high frictional coefficient at the begging of the tribology test because of the high shear force in the contact zone, friction coefficient and temperature increases when the applied load is increased, friction coefficient decreases with the increment of the rotating speed and the high influence of rotating speed on temperature so that temperature increases when rotating speed increases, in other words temperature will increase 5 co for every 0.1 m/s increment in the rotating speed. [Author's abstract]

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive and medically refractory lung disease with a grim prognosis. Although the etiology of IPF remains perplexing, abnormal adaptive immune responses are evident in many afflicted patients. We hypothesized that perturbations of human leukocyte antigen (HLA) allele frequencies, which are often seen among patients with immunologic diseases, may also be present in IPF patients. Methods/Principal Findings: HLA alleles were determined in subpopulations of IPF and normal subjects using molecular typing methods. HLA-DRB1*15 was over-represented in a discovery cohort of 79 Caucasian IPF subjects who had lung transplantations at the University of Pittsburgh (36.7%) compared to normal reference populations. These findings were prospectively replicated in a validation cohort of 196 additional IPF subjects from four other U.S. medical centers that included both ambulatory patients and lung transplantation recipients. High-resolution typing was used to further define specific HLA-DRB1*15 alleles. DRB1*1501 prevalence in IPF subjects was similar among the 143 ambulatory patients and 132 transplant recipients (31.5% and 34.8%, respectively, p = 0.55). The aggregate prevalence of DRB1*1501 in IPF patients was significantly greater than among 285 healthy controls (33.1% vs. 20.0%, respectively, OR 2.0; 95%CI 1.3-2.9, p = 0.0004). IPF patients with DRB1*1501 (n = 91) tended to have decreased diffusing capacities for carbon monoxide (DLCO) compared to the 184 disease subjects who lacked this allele (37.8±1.7% vs. 42.8±1.4%, p = 0.036). Conclusions/Significance: DRB1*1501 is more prevalent among IPF patients than normal subjects, and may be associated with greater impairment of gas exchange. These data are novel evidence that immunogenetic processes can play a role in the susceptibility to and/or manifestations of IPF. Findings here of a disease association at the HLA-DR locus have broad pathogenic implications, illustrate a s