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Artificial Intelligence (AI), particularly AI-Generated Imagery, has the potential to impact medical and patient education. This research explores the use of AI-generated imagery, from text-to-images, in medical education, focusing on congenital heart diseases (CHD). Utilizing ChatGPT's DALL·E 3, the research aims to assess the accuracy and educational value of AI-created images for 20 common CHDs. In this study, we utilized DALL·E 3 to generate a comprehensive set of 110 images, comprising ten images depicting the normal human heart and five images for each of the 20 common CHDs. The generated images were evaluated by a diverse group of 33 healthcare professionals. This cohort included cardiology experts, pediatricians, non-pediatric faculty members, trainees (medical students, interns, pediatric residents), and pediatric nurses. Utilizing a structured framework, these professionals assessed each image for anatomical accuracy, the usefulness of in-picture text, its appeal to medical professionals, and the image's potential applicability in medical presentations. Each item was assessed on a Likert scale of three. The assessments produced a total of 3630 images' assessments. Most AI-generated cardiac images were rated poorly as follows: 80.8% of images were rated as anatomically incorrect or fabricated, 85.2% rated to have incorrect text labels, 78.1% rated as not usable for medical education. The nurses and medical interns were found to have a more positive perception about the AI-generated cardiac images compared to the faculty members, pediatricians, and cardiology experts. Complex congenital anomalies were found to be significantly more predicted to anatomical fabrication compared to simple cardiac anomalies. There were significant challenges identified in image generation. Based on our findings, we recommend a vigilant approach towards the use of AI-generated imagery in medical education at present, underscoring the imperative for thorough validation and the importance of collaboration across disciplines. While we advise against its immediate integration until further validations are conducted, the study advocates for future AI-models to be fine-tuned with accurate medical data, enhancing their reliability and educational utility. [ABSTRACT FROM AUTHOR]

Background: The foremost cause of children's (1–19 year) death is inadvertent injuries. While most of these accidental harms occur at home and school, rapid and suitable parental and teacher intervention is required to increase the chances of a child's survival. Therefore, both parents and teachers of the children in kindergarten and elementary school must be knowledgeable in first aid practice and basic life support (BLS) training. Objectives: In the current study, our ambition is to evaluate the orientation level, knowledge, and attitudes around first aid and BLS training of kindergarten and elementary school teachers and parents in the city of Taif, Makkah region. Methods: A cross-sectional study in Taif, Saudi Arabia, targeted kindergarten and elementary school teachers and parents of students enrolled at these levels. There were 648 participants included in this study. The researchers assessed teachers' and parents' knowledge and attitudes around first aid and BLS using a validated, self-administered online questionnaire. Results: The study included 648 participants, including 248 (38.3%) teachers and 400 (61.7%) parents. The socio-demographic analysis showed that 412 (63.6%) are females and 233 (36.5%) are between the ages of 36 and 45 years. Approximately 142 (21.9%) participants reported previous training in the cardiopulmonary resuscitation (CPR) program, though more than half of them (53.5%) had outdated certificates (more than 2 years). The mean total knowledge for our study was 4.6 ± 1.4, with 22.4% of the participants being educated about first aid support and expressing a fair level of CPR foundations. Only a small percentage (2.3%) of the participants exposed a good and adequate theoretical level of knowledge around CPR skills and performance, while most of the contributors unveiled a poor level of knowledge (over 75%). There were no statistically significant differences between parents and teachers (p > 0.05). Finally, numerous participants (85%) appreciated training in the CPR program, and the most common motive was a "wish to avoid unnecessary death". Conclusions: We concluded that a sizable portion of the contributors expressed a lack of proficiency in the fundamental CPR training knowledge and skills, pointing to an alarming public concern. Promisingly, a sizable percentage of participants expressed motivated attitudes toward CPR training. Therefore, additional study and data are required to effectively combat injury, with an emphasis on investigating causes and risk factors, burden and socioeconomic health determinants, community awareness level and desire to contribute, and accessibility for disseminating specific intervention strategies. [ABSTRACT FROM AUTHOR]

Objectives To analyze the spread rate and the cumulative risk of COVID-19 infection among healthcare workers (HCWs) over the first year of the pandemic. Method An online, cross-sectional study involved HCWs who were in-service during the first year of COVID-19 crisis, including all healthcare institutions of Jeddah. History and date of COVID-19 infection were collected to estimate the COVID-19-free time, by reference to 03 March 2020, when the first case in Saudi Arabia was identified. Kaplan-Meier survival and Cox regression methods were used to analyze the cumulative risk of COVID-19 infection and the associated factors. Results There were three peaks of COVID-19 incidence among HCWs; the highest (7.2%) was in September 2020. The cumulative hazard reached 0.10 by the first trimester, then escalated exponentially during the 3rd trimester to reach a plateau at 0.35. The hazard ratio was independently associated with the HCW’s nationality, department affiliation, and receipt of influenza vaccine, as well as the facility type and bed capacity. Receipt of the BCG vaccine in the last year was associated with 40% reduction of the cumulative hazard. Conclusion The identified risk factors and high-exposure clusters constitute a weak link in the national management strategy of COVID-19 crisis and highlight the urgent need to reinforce the in-hospital protective measures. Findings from the present study have strong implication for the viability and resilience of the healthcare system during major health crises. [ABSTRACT FROM AUTHOR]

Objectives. The level of evidence (LOE) of Saudi dental research from 2000 to 2020 was evaluated, and factors associated with the LOE were determined. Methods. This study was a systematic review. PubMed, Web of Science, and Medline databases were utilized to retrieve available dental articles published in English between January 2000 and May 2020. The inclusion criteria consisted of clinical studies conducted in Saudi Arabia with at least one Saudi dental affiliation. The retrieved eligible articles were evaluated independently by two reviewers using a modified Oxford LOE scale. The LOE of the studies was compared between the last two decades. Results. Of the 7237 articles identified, 1557 articles met the inclusion criteria. Approximately 78% of the published articles reported Level IV evidence. A higher trend toward Level I, II, and III publications has occurred in recent years (i.e., 2010–2020). However, no statistically significant difference existed in LOE proportions between the two decades. The presence of international collaboration and high journals' impact factor was significantly associated with a higher LOE. Conclusion. Most published dental research studies were low LOE studies (i.e., Level IV). National and international collaboration is highly encouraged as this is a factor, according to our findings, that would be a positive addition toward publishing dental research of a higher LOE in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background: Primary intestinal lymphangiectasia is an exceedingly rare disorder. Epidemiology is unknown. It usually presents with lower extremity swelling, diarrhea, ascites, and protein-losing enteropathy. Since the pathogenesis of edema is usually due to hypoalbuminemia; both extremities are typically involved. The edema can rarely be due to abnormal lymphatic circulation, causing lymphedema, which usually involves both extremities as well. Diagnosis is made by the constellation of clinical, biochemical, endoscopic, and histological findings. Treatment involves dietary modification, to reduce lymphatic dilation in response to dietary fat. Other pharmacologic (e.g., octreotide) and replacement measures may be indicated as well. The most serious long-term complication is intestinal lymphoma. Herein is a case of Primary intestinal lymphangiectasia presenting with unilateral lower limb swelling.Case Presentation: A 4-year-old boy presents with left foot swelling since the age of 4 months, in addition to intermittent diarrhea, and abdominal swelling. The foot swelling had been evaluated by different health care professionals in the past, and was mislabeled as either cellulitis, or congenital hemihyperplasia. Physical examination revealed mild ascites, and a non-pitting foot edema with a positive Stemmer's sign (lymphedema). Blood work revealed hypoalbuminemia (albumin 2 g/dl), and hypogammaglobulinemia. Endoscopy showed dilated lacteals throughout the duodenum. Histopathologic examination revealed massively dilated lamina propria lymphatics in the duodenal biopsies. The patient was diagnosed with primary intestinal lymphangiectasia. He was treated with high-protein and low-fat diet, and supplemental formula high in medium chain triglycerides. On follow-up, the patient's diarrhea completely resolved, and his ascites and edema improved significantly.Conclusions: The presence of unilateral lower limb edema should not preclude the diagnosis of systemic disorders, and a high index of suspicion is required in atypical presentations. A good knowledge about Primary intestinal lymphangiectasia manifestations, and physical examination skills to differentiate edema or lymphedema from tissue overgrowth can significantly aid in the diagnosis. [ABSTRACT FROM AUTHOR]

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Background: Antimicrobial resistance (AMR) has reached alarming levels and is considered to be a worldwide public health problem. One of the most significant factors contributing to the spread of AMR is the lack of proper knowledge about the use of antibiotics, which are being used more frequently in dentistry. Recent studies have found that gamification shows promising results for helping the average person improve their knowledge about health and may also be used to boost knowledge about AMR among the public. This study aimed to assess the effects of gamification on AMR awareness, using a board game to promote knowledge about AMR among the public in Saudi Arabia.Methods: Using a single-blinded parallel group randomized controlled trial design, 94 volunteers were recruited and randomized into two groups. The study group received information about AMR by playing a board game, while the control group received the same information given in a conventional lecture. The participants were evaluated three times: (T1) before the intervention, (T2) immediately after the intervention, and (T3) one month after the intervention for follow-up to evaluate their retention of the information.Results: Results showed that there were significant improvements (p <  0.05) in knowledge scores for T2 and T3 in comparison to the T1 baseline scores in both groups. However, the knowledge scores also relapsed significantly from T2 to T3 in both groups. Nevertheless, the difference in knowledge score T1 to T3 was significantly higher in the study group in comparison to the control group, and the participants had higher mean scores to use the game as health promotion method.Conclusions: Gamification using a board game can significantly improve AMR knowledge, with better retention than conventional lecture. It is a promising method for boosting public knowledge about AMR and its relationship to dentistry.Trial Registration: ISRCTN registry: ISRCTN15884410 (retrospectively registered 26-October-2019). [ABSTRACT FROM AUTHOR]

Hyaena hyaena is a carnivorous mammal that inhabits a broad variety of habitat types and ecological niches, H. hyaena spread in the Arabian Peninsula excluding Rub Al Khali and the desert of Nafud. In Saudi Arabia, it can be found commonly in the western mountains and the open land near agricultural areas such as valleys and lava fields (Harat). However, the H. hyaena is considered to be globally "Near Threatened" (NC) according to (IUCN) Red List as a consequence of a drop in carrion as a result of a reduction in the population of big predators and their prey, eradication practices, and fragmentation and loss of their habitat. The current study seeks to evaluate the distribution of H. hyaena in Saudi Arabia in relation to a number of environmental parameters, as well as assess the possible appropriateness of different habitats for it under climate change scenarios, and provide significant insights for future conservation strategies. The species distribution models (SDMs) tools were employed to map and monitor the distribution of H. hyaena , and then provide a prediction of species distribution patterns. Multicollinearity analysis of the total 19 bioclimatic variables and topographic roughness index resulted in seven uncorrelated variables with VIF < 5, which had been used in the ensemble modeling. The result of our study showed that the decrease in seasonal precipitation will lead to a decrease in the probability of the presence of H. hyaena in Saudi Arabia and The probability of finding H. hyaena in Saudi Arabia decreases as the driest quarter and wettest quarter mean temperature decreases. [ABSTRACT FROM AUTHOR]

A new peroxy fatty acid, tagetnoic acid (5) [4-((3S,6S)-6-((3E,8E)- octadeca-3,8-dien-1-yl)-3,6-dihydro-1,2-dioxin-3-yl)butanoic acid] and four known metabolites: ecliptal (5-formyl-a-terthiophene) (1), 5-(4-hydroxybut-1-ynyl)-2,20-bithiophene (2), 22,23-dihydrospinasterone (3), and stigmasterol (4) were separated from the n-hexane fraction of the aerial parts of Tagetes minuta L. (Asteraceae). Their chemical structures were verified using IR, UV, 2D and 1D NMR, and HRMS. Compounds 3-5 displayed potent lipoxygenase inhibitory potential with IC50s 2.26, 1.83, and 1.17 lM, respectively compared to indomethacin (IC50 0.89 lM). Moreover, molecular docking study revealed that the potent activity of 5 is due to H-bonding and hydrophobic interaction. The results of this study suggested that Tagetes minuta dietary consumption would be useful for the individuals at risk of acute and chronic inflammatory disorders. [ABSTRACT FROM AUTHOR]

Background: Natural products display a remarkable role not only in the synthesis, design, and discovery of new drugs but also as the most prominent source of innovative drugs and bioactive substances. Genus Pulicaria (Asteraceae) includes about 100 species that are widely distributed in Europe, Asia, and Africa. Objective: In this work, the chemical investigation of Pulicaria undulata aerial parts was performed. In addition, the cytotoxic activity of the isolated metabolites was estimated toward various cell lines. Materials and Methods: Plant extract was subjected to fractionation and different column chromatography to isolate the biometabolites. Their structures were verified using nuclear magnetic resonance, infrared, ultraviolet, and high-resolution mass spectrometry, as well as compared with the literature. The cytotoxic effect was evaluated in vitro toward various cell lines: HCT-116 (colorectal adenocarcinoma), MCF-7 (human breast adenocarcinoma), and A549 (lung carcinoma). Results: A new triterpene fatty acid ester, undulaterpene A (1) (3β,16β-dihydroxylup-20 (29)-ene 3-decanoate) and four known metabolites: 3-O-acetyl-pseudotaraxasterol (2), pseudotaraxasterol (3), stigmasterol (4), and tomentosin (5) were separated. Compound 1 displayed cytotoxic potential toward hormone-dependent breast carcinoma cell line (MCF7), colon carcinoma cell line (HCT116), and lung carcinoma cell line (A549) cell lines with half maximal inhibitory concentrations (IC50s) 8.2, 6.9, and 12.4 μM, respectively in comparison to doxorubicin (IC50s 0.14, 0.39, and 1.15 μM, respectively). However, 2, 3, and 4 displayed activity toward HCT-116 with IC50s 13.2, 23.1, and 16.4 μM, respectively. Conclusion: This work led to the identification of a new triterpene fatty acid ester (1) and four known metabolites (2–5) from P. undulata growing in Saudi Arabia. The new compound showed moderate cytotoxic potential against hormone-dependent breast carcinoma cell line (MCF7), colon carcinoma cell line (HCT116), and lung carcinoma cell line (A549) cancer cell lines. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) is a serious cardiovascular disorder affecting middle-aged individuals. It is a major cause of death among adults over the age of 35 years. In Saudi Arabia, CAD is associated with higher mortality rate, and Saudi patients are reported to have significantly higher prevalence of risk factors for CAD than the Western population. Furthermore, as, to date, there is no definite cure for CAD, prevention of the disease and tight control of the known risk factors are the cornerstones for reducing CAD-associated mortality. Thus, the present work aimed to assess the population awareness of CAD risk factors in Saudi Arabia. Methods: A cross-sectional study was conducted in Jeddah during the period January 2017 to December 2017 by using an online survey questionnaire to assess participants' awareness of 14 risk factors for CAD, namely: smoking, lack of physical activity, fast food and soft drink intake, television and computer use; history of diabetes mellitus, myocardial infarction and stroke; as well as a family history of diabetes mellitus, diabetes, hypertension, hyperlipidemia, CAD and myocardial infarction. Results: Of 468 respondents, 41% were males. The mean age was 31.9±12.4. Approximately 86% were Saudi, and ~60% had a university education. The mean overall awareness score was 4.31±1.36 (1.00–8.00). Fast food, soft drinks, and family history of diabetes were the most commonly identified risk factors, reported by 74.8%, 64.3%, and 47.2% of participants, respectively. There was a strong correlation between overall awareness score and awareness of each risk factor individually (P<0.003). Conclusion: There is an evident limited knowledge among the population in Jeddah, Saudi Arabia regarding the risk factors for CAD, and it is recommended that the healthcare sector in the country focus on public health education programs about the disease. [ABSTRACT FROM AUTHOR]

Saudi society is one of many where supernatural explanations for neurological and psychiatric disorders are prevalent among lay persons. The frequency of such beliefs among health care professionals in this country, however, is unknown. The frequency of supernatural explanations for neurological and psychiatric disorders was assessed in 126 health care professionals at an academic medical center in Jeddah. A high frequency of belief in supernatural factors as a cause for neurological and psychiatric illness, including the evil eye, divine testing and punishment, and sorcery, was found. Younger age and more junior level of training were associated with a higher likelihood of belief in supernatural causation. A surprisingly high prevalence of supernatural explanations was found among these health care professionals, 80% of whom were attending physicians or physicians in training. Future studies should focus on the potential impact of these beliefs on clinical practice. [ABSTRACT FROM AUTHOR]

Summary Objectives To determine the prevalence and the sociodemographic characteristics and sexual behavior risk factors for human papillomavirus (HPV) infection in a hospital-based cohort of women in Saudi Arabia. Methods Cervical specimens and questionnaire data were collected from women attending clinics in Riyadh, Saudi Arabia. Cervical specimens were examined for abnormal cytology using a standard Pap test and for the presence of HPV-DNA using PCR and reverse line blot hybridization tests. Results Approximately 73% of the 400 women tested were Saudi nationals. Nearly 50% were under 40 years old (range 22–80 years, mean ± standard deviation 41.20 ± 10.43 years). Approximately 17% of the women were HPV-positive. The most commonly detected HPV types were HPV-18 (34%) and HPV-16 (19%), with multiple infections detected in 10% of positive specimens. Multivariate analyses revealed that smoking and multiple partners were significant risk factors for HPV infection ( p < 0.01). Conclusions Because of societal challenges and an unsubstantiated assumption of low HPV prevalence, few studies have examined sociodemographic characteristics or sexual behaviors associated with HPV in Saudi women. However, a high prevalence of HPV infection was found, with smoking and multiple partners as significant risk factors, in this hospital-based cohort of predominantly Saudi women. [ABSTRACT FROM AUTHOR]

Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease that presents with variable local manifestations. We describe here the different management protocols based on the clinical presentation of these patients. A retrospective review of 20 histopathologic confirmed cases of IGM seen over a period of 10 years was performed. The median age was 34 years (age range: 21–45 years). All were married, parous with history of breast feeding. Ill-defined mass mimicking carcinoma was the commonest presentation (70%); however, with the presence of signs of inflammation like pain (55%), redness (40%), and peau d’orange (40%), an inflammatory process appeared more likely. Axillary lymph node enlargement was infrequently seen (40%). Radiologic findings (mammography and ultrasound) were nonspecific. Histopathology showed the characteristic lobular distribution of granulomatous inflammation in all cases. Surgically, 7 patients had abscess drainage with open biopsy, and 7 patients had lumpectomy. Six patients with diffuse breast involvement were diagnosed by core needle biopsy only. Microbial cultures showed no growth. Antibiotics were given empirically when signs of inflammation where present. Two patients needed further abscess drainage followed by persistent sinus excision 3–6 weeks later. The median follow-up was 24 months (range: 15–42 months). Seventeen patients (85%) were recurrence-free, and 3 patients (15%) were lost to follow-up. Management of IGM cases needs to be tailored according to the clinical presentation. Precise radiologic and pathologic data interpretation by a multidisciplinary breast team will facilitate diagnosis and minimize unnecessary intervention. [ABSTRACT FROM AUTHOR]

Background: Type II diabetes is a prominent risk factor for future cardiac events. Its impact on demographic data, mode of presentation and hospital outcome among a group of Saudi patients with ACS was prospectively studied. Methods: We studied 142 consecutive ASC pts. (91 diabetic) admitted to the CCU at NWAFH. Including UA, NSTEMI and STEMI. Results: Diabetics were older (61 vs 51y) [p <0.001], with higher BMI (30 vs 28) [p <0.05], hypertension (71% vs 31%) [p <0.001], hyperlipedemia (54% vs 28%) [p <0.001] and history of IHD (58% vs 39%) [p <0.05]. There was no significant difference in mode of presentation between diabetics and non-diabetics, NSTEMI/UA (62% vs 43%) and STEMI (36% vs 47%) [PNS for both] or KILLIP class at admission. EF by 2D-echo was similar in both groups (37±12% vs 40±13%) [PNS]. Pre-admission medications were more frequently prescribed to the diabetics, asprin (75% vs 57%), clopidogrel (46% vs 24%) [p <0.05] for both. Beta-blockers (56% vs 28%) [p =0.001] and ACEi/ARBs (73% vs 49%) [p <0.001]. Coronary angiography was offered equally to both groups (64% vs 63%), while there was trend for more prevalence of multi-vessel disease (MVD) in diabetics (29% vs 20%) [PNS]. As well as trend for more hospital mortality rate in diabetics (6.6% vs 2%) [PNS]. Conclusions: Compared to non-diabetics ACS at NWAFH, diabetics are older, with more of hypertension, BMI, hyperlipedemia and IHD history. They were more frequently prescribed pre-admission medications. No impact of diabetes on mode of presentation (STEMI vs NSTEMI/UA) was found. Invasive approach is equally offered to both groups, with a trend for more prevalence of MVD and hospital mortality in the diabetic patients. [ABSTRACT FROM AUTHOR]

Bifacial solar cells are receiving increased attention in the PV market due to their higher energy yield compared to conventional monofacial modules thanks to additional light conversion through their back surface. This additional rear side energy gain creates a potential for significant reduction of the overall levelized cost of energy (LCOE). Despite this fact, wide deployment of bifacial PV modules is very limited because of the high unpredictability of their power output due to various factors such as ground reflectance, module elevation angle, orientation and tilt angle. Due to this complexity, modelling of bifacial modules and systems is currently not developed at the same level of maturity as monofacial ones, where established commercial tools have been developed for PV system designers. In this regard, a customized 2D device model has been developed to simulate bifacial PV structures based on the numerical solution of the transport equations by the finite element method. The model was used to simulate actual PV performance and energy yield based on measured outdoor environmental parameters including solar radiation spectrum and temperature. Bifacial device output was also compared with a monofacial one based on the industrial standard Al-BSF structure. Simulated results were also compared and validated with outdoor experimental data based on IV measurements of monofacial and bifacial modules installed at various tilt angles at a location near the Western coast of Saudi Arabia. Image 1 • A new customized 2D device simulator is developed. • Simulations of monofacial and bifacial PV structures are presented. • Climate characteristics of Middle East were taken into account in simulations. • Frequent hazy days in the Middle East favour bifacial devices over monofacial ones. • Bifacial device shows a gain of 10% and 15% when compared to the monofacial one. [ABSTRACT FROM AUTHOR]