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Jefferson Garcia Guerrero,1 Ayidah Sanad Alqarni,1 Rock Parreno Cordero,2 Imad Aljarrah,3 Mohsen Ali Almahaid4 1College of Nursing, King Khalid University, Abha, Aseer Region, Saudi Arabia; 2Emergency Health Services Department, Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates; 3Faculty of Nursing, Philadelphia University, Amman, Jordan; 4Nursing Department, King Khalid Hospital, Najran, Saudi ArabiaCorrespondence: Jefferson Garcia Guerrero, College of Nursing, King Khalid University, Building C, Gate 2, Al-Qureiger Campus, Abha, Aseer Region, 62529, Saudi Arabia, Email jgarcia@kku.edu.saPurpose: Emergency department (ED) overcrowding is a significant concern in many hospitals in Saudi Arabia, resulting in long waiting times, delays in treating patients who need urgent care, and, consequently, decreased patient satisfaction. Additionally, ED overcrowding has been linked to increased nurse turnover rates. Therefore, this study aimed to assess nurses’ perceived causes and effects of overcrowding in the EDs of five tertiary hospitals in Saudi Arabia.Methods: This study used a descriptive cross-sectional design. We surveyed 311 nurses working in the EDs of five tertiary hospitals in Saudi Arabia using the convenience sampling technique. The self-administered questionnaires used in the study were developed by the researchers. The study was conducted from October 16 to November 10, 2022. Consensus-Based Checklist for Reporting of Survey Studies was followed.Results: The results revealed that the primary perceived causes of ED overcrowding in five tertiary hospitals were unnecessary visits due to a lack of standard procedures (mean = 2.70; SD = 0.58) and lack of inpatients beds (mean = 2.69; SD = 0.65). The perceived effect of overcrowding was stress and burnout among nurses (mean = 2.85; SD = 0.47). The perceived causes and effects of overcrowding in the ED were found to be highly significant (p < 0.001) based on Pearson correlation and Spearman’s rank correlation.Conclusion: Unnecessary visits due to a lack of standard procedures lead to overcrowding. In addition, a lack of inpatient beds in the ED affects the care provided to patients seeking immediate medical attention. This may prolong patient waiting time, causing their conditions to deteriorate and prolonging hospital stay. Overcrowding leads to increased stress and burnout among nurses. The results of this study can be used to develop a comprehensive action plan to address ED overcrowding and its effects on patients, staff, and ED flow.Keywords: nurses, overcrowding, patient safety, quality of care, stress, burnout, staff turnover

Lizy Sonia Benjamin,1 Eddieson Pasay-an,2 Petelyne Pangket,3 Aidah Sanad Alqarni,4 Ferdinand Gonzales,4 Lailani Sacgaca,5 Dawlat Ahmed Mahmoud,1 Maysa M Mohsen,4 Yahya Showkan Ali Hamdi,6 Sumathi Robert Shanmugam7 1Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 2Department of Nursing Administration, College of Nursing, King Khalid University, Abha, Saudi Arabia; 3Department of Medical Surgical Nursing, University of Hail, Hail City, Saudi Arabia; 4Department of Fundamental of Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 5Department of Nursing, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia; 6Nursing Service, Aseer Central Hospital, Aseer, Saudi Arabia; 7Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Sumathi Robert Shanmugam, Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, Email srshanmugm@pnu.edu.saIntroduction: Nursing students frequently encounter the challenge of balancing their studies with the demanding requirements of hands-on practice and this can greatly affect their mental wellbeing. This study aimed to investigate the impact of sleep and psychological well-being on the academic and clinical performance of nursing students in Saudi Arabia.Methods: This study used a cross-sectional approach with 218 student nurses selected through convenience sampling from King Khalid University, Abha, Saudi Arabia. The sleep quality, psychological wellbeing, academic performance and clinical performance questionnaires were adopted to measure the variables. The Google Forms survey was used to gather the data, which were collected in August through October 2023. t-test and chi-square were used to analyze the data.Results: The sleep quality was higher with good/very good performers (p < 0.001). There was a significant difference with academic performance on positive relations (p < 0.007) and purpose in life (p < 0.004). Additionally, there was a significant difference in autonomy (p < 0.01), environmental mastery (p < 0.026), positive relations (p < 0.001), and purpose in life (p < 0.001) with clinical performance. Among students with good academic performance, those who were older than 25 years of age (p < 0.043) and level 3 students (p < 0.001) were found to have a significant correlation. Furthermore, those who were 25 years of age (p < 0.012) and level 3 students (p < 0.001) were also found to have a significant correlation with clinical performance.Conclusion: The sleep quality, positive relations, purpose in life, autonomy, and environmental mastery are all important factors for academic and clinical success. Moreover, older students and level 3 students may be more likely to have the skills and knowledge necessary to succeed in these areas. Further research exploring factors influencing academic and clinical success must be conducted.Keywords: sleep quality, psychological well-being, academic performance, clinical performance, nursing students, Saudi Arabia

Yousef D Alqurashi,1 Abdullah S Alqarni,1 Faisal Maher Albukhamsin,1 Abdullah Abdulaziz Alfaris,1 Bader Ibrahim Alhassan,1 Waleed Khalid Ghazwani,1 Abdulaziz Abdulrahman Altammar,1 Mutlaq Eid Aleid,1 Hayfa Almutary,2 Abdulelah M Aldhahir,3 Saleh A Alessy,4 Rayyan Almusally,5 Abir Alsaid,5 Mahmoud Ibrahim Mahmoud,5 Hatem Othman Qutub,5 Tunny Sebastian,6 Suliman Alghnam,7 Michael I Polkey8 1Respiratory Care Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Medical Surgical Nursing Department, King Abdulaziz University, Jeddah, Saudi Arabia; 3Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia; 4Department of Public Health, College of Health Sciences, Saudi Electronic University, Jeddah, Saudi Arabia; 5Internal Medicine Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia; 6Clinical Nutrition Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 7Population Health Section-King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia; 8Royal Brompton Hospital, Guy’s and St Thomas’ NHS Foundation Trust, London, UKCorrespondence: Yousef D Alqurashi, Respiratory Care Department, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, 34221, Saudi Arabia, Email ydalqurashi@iau.edu.saIntroduction: Sleepy driving is associated with Motor Vehicles Accidents (MVAs). In Saudi Arabia, previous studies have addressed this association among men only. Therefore, the aim of this study was to compare the prevalence of sleepy driving and associated factors between genders.Methods: In a cross-sectional study design, we offered a self-administered online questionnaire to 3272 participants from different regions of Saudi Arabia. The questionnaire included 46 questions covering sociodemographics, driving habits, sleeping habits, Epworth Sleepiness Scale, and Berlin questionnaire to assess the risk of sleep apnea. Univariable and multivariable logistic regression analyses were used to determine the significant factors associated with self-reported sleepy driving, defined as operating a motor vehicle while feeling sleepy in the preceding six months.Results: Of the 3272 invitees, 2958 (90%) completed the questionnaire, of which 1414 (48%) were women. The prevalence of sleepy driving in the preceding six months was 42% (men: 50% and women 32%, p< 0.001). Specifically, participants reported the following: 12% had had to stop their vehicle due to sleepiness (men: 16.2% and women 7%, p< 0.001), 12.4% reported near-miss accidents (men: 16.2% and women: 8.2%, p< 0.001) and 4.2% reported an accident due to sleepiness (men: 4.3% and women: 4%, p=0.645). In multivariable analysis, being male, younger age, use of any type of medications, shift working, working more than 12 hours per day, driving duration of 3– 5 hours per day, driving experience of more than 2 years, excessive daytime sleepiness and risk of having obstructive sleep apnea were all associated with increased likelihood of falling asleep while driving in the preceding 6 months.Conclusion: Sleepy driving and MVA are prevalent in both gender but was higher in men. Future public health initiatives should particularly focus on men, since men reported a greater likelihood of both sleep-related MVA and “near miss” events.Keywords: sleepiness, driving, obstructive sleep apnea, OSA, gender differences

This systematic literature review investigates the adoption and impact of English Medium Instruction (EMI) in Saudi Arabian higher education. It synthesizes findings from 18 empirical studies, primarily in applied sciences such as engineering, medicine, and computer science, while noting a dearth of research in social sciences. The review reveals a uniformity in student perceptions of EMI across disciplines, highlighting its widespread acceptance and challenges in cultural and linguistic adaptation. It also emphasizes the diversity of research methodologies used, offering insights into both teacher and student perspectives. This comprehensive analysis not only maps the current landscape of EMI in Saudi Arabia but also identifies critical areas for future research, particularly in understanding its long-term educational and socio-cultural implications.

The study aimed to reveal the degree of special education teachers' employment of electronic educational games in teaching the disabled. It also showed statistical differences according to the variables of gender, academic qualification, and years of experience. To achieve the objectives of the study, the descriptive survey method was used. The study sample consisted of (96) male and female teachers, of whom (47) male and (47) female teachers were chosen in a stratified random manner from the Directorate of Education for Najran region in the Kingdom of Saudi Arabia in the academic year 2022/2023. A questionnaire consisting of (30) items was used, distributed in three domains: planning, implementation, and evaluation. The results showed that the degree of special education teachers' employment of electronic educational games in teaching students with disabilities obtained a mean of (2.57), with a low degree. The results also showed that there are statistically significant differences in the responses of the study sample about the degree of special education teachers' employment of electronic educational games in teaching students with disabilities due to the variables of academic qualification in favor of postgraduate studies, and years of experience in favor of more than ten years. However, there was no statistically significant difference due to the gender variable. The study recommended that the Ministry of Education should pay attention to holding and organizing various specialized training programs to develop the capabilities of special education teachers to employ electronic educational games in teaching, especially in planning, implementation, and evaluation.

Environmental awareness has become an urgent and indispensable necessity to protect the environment from risks and threats. Therefore, this study aimed to reveal the effectiveness of using cartoons in developing awareness of protecting the environment from pollution among students with learning disabilities. The study adopted the true experimental method by taking a simple random sample consisting of 33 students with learning disabilities in the elementary stage in the age group (9-12) years in Najran region in the Kingdom of Saudi Arabia. The researchers prepared an attitude test, consisting of ten multiple-choice questions to measure the study sample's awareness of protecting the environment from pollution. The test was applied before and after the treatment on the control and experimental groups. Also, it was applied as a delayed test on the experimental group only. The results showed statistically significant differences in the post-test of awareness of environmental protection from pollution for the experimental group who studied using cartoons. In addition, there were no statistically significant differences between the post and delayed test of the scores of the experimental group on the environmental protection awareness test from pollution. The study recommended urging teachers of learning disabilities to use cartoons to deepen environmental knowledge among students with learning disabilities. Also, students with learning disabilities should be motivated to contribute and participate individually and collectively in protecting the environment, preserving its resources, and reducing potential environmental risks from environmentally unsound behaviors. Finally, the study suggests conducting more future studies examining the effectiveness of cartoons in developing different environmental education concepts.

The study aimed to reveal the degree of using blended learning among teachers of students with learning disabilities in the Kingdom of Saudi Arabia. It also showed statistical differences according to the variables of gender, academic qualification, and years of experience. To achieve the objectives of the study, the descriptive survey design was used. The sample of the study consisted of (110) male and female teachers of students with learning disabilities, of whom (53) male and (57) female teachers were chosen by the stratified random method from the educational regions in the south of the Kingdom of Saudi Arabia in the second semester of the academic year 2022/2023. A questionnaire consisting of (22) items was used, distributed in three domains: planning, implementation, and evaluation, after verifying the indications of its validity and reliability. The results showed that the degree of using blended learning among teachers of students with learning disabilities in all domains and the total score was moderate. The results also showed that there are statistically significant differences in the answers of the study sample about the degree of using blended education among teachers of students with learning disabilities due to the variables of academic qualification in favor of postgraduate studies and years of experience in favor of more than ten years. However, there was no statistically significant difference due to the gender variable. The study recommended that the Ministry of Education in the Kingdom of Saudi Arabia should provide training requirements for teachers with learning disabilities on blended education and include them in their teaching practices (planning, implementation, and evaluation).

Background: Titanium dioxide (TiO2NP) and silver nanoparticles (AgNPs) have been recognized for their ability to enhance the structural integrity of dental materials. This study aimed to compare the influence of these nanoparticles on the structural resilience of treated root canals. Materials and Methods: The crowns of 75 undamaged central incisors were sectioned below the cemento-enamel junction to achieve a consistent root length of 16 mm. The root canals were prepared using K3 files up to size 40 with a 6 % taper. The specimens were then divided into five groups (n = 15), each subjected to a final irrigation protocol with one of the following solutions: normal saline, 2 % chlorhexidine (CHX), 17 % EDTA combined with 2.5 % sodium hypochlorite (NaOCl), 17 % EDTA with 0.1 % silver nanoparticles (AgNPs), and 17 % EDTA with 0.1 % titanium dioxide nanoparticles (TNPs). After obturation with gutta-percha and sealer, fracture resistance (FR) was evaluated. The data were analyzed using one-way ANOVA and Tamhane’s post hoc test (p 0.05). There was also no significant difference in FR between the CHX and saline groups (p > 0.05). In contrast, irrigation with silver nanoparticles (AgNPs) and titanium dioxide nanoparticles (TNPs) resulted in significantly higher fracture resistance compared to the other solutions tested (p

Abstract This research investigates the dynamics of nonlinear coupled hybrid systems using a modified Mittag–Leffler fractional derivative. The primary objective is to establish criteria for the existence and uniqueness of solutions through the implementation of Dhage’s hybrid fixed-point theorem. The study further analyzes the stability of the proposed model. To demonstrate the practical application of this framework, we utilize a modified Mittag–Leffler operator to model the transmission of the Ebola virus, known for its complex and diverse dynamics. The analysis is conducted using a combination of theoretical and numerical methods, including transforming the system of equations into an equivalent integral form, applying the fixed-point theorem, and developing a numerical scheme based on Lagrange’s interpolation for simulating the Ebola virus model. This study aims to enhance our understanding of Ebola virus dynamics and provide valuable insights for developing effective control strategies.