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Abstract Non-communicable diseases (NCDs), a significant cause of global mortality, necessitate targeted policy measures to reduce exposure to risk factors, particularly nutrition-related ones. Front-of-pack food labeling aims to shape consumer behavior and decrease exposure to nutritional risk factors. There are various forms of this policy, including traffic light (TL), nutrient profile model (NPM), and reference value (RV) labels. Mathematical models incorporating experimental and dose–response data support determining the most effective form. When selecting a modeling method, it is essential to consider the uncertainty involved in estimating risk factors. This study aims to create a computational model to predict the health and economic impacts of different policy options using an improved version of the Scarborough algorithm, incorporating a validation process to address potential uncertainties. The model shows that NPM was the most effective, reducing the estimated annual mortality rate from 514,247 cases to 447,394 cases (13% reduction). The following labels were TL (11% reduction) and RV (6% reduction). Economically, the RV label affects consumer spending the least, predicting an 8% increase in monthly spending per individual from the baseline. When assessed from both health and economic perspectives, the RV label has emerged as the most advantageous front-of-pack food labeling policy. The proposed model can aid policymakers in evaluating policy alternatives and thus selecting the most advantageous policies based on health and economic outcomes while ensuring the model's accuracy and applicability for the community.

IntroductionAn atlas is a trustworthy resource created from precise data collection that serves as a guide for communities. A food atlas is a useful tool for analyzing dietary data. There is a growing need for a food atlas that is part of the nation’s strategy to help the health sector with specific nutritional or dietary assessments of individual consumption and overall wellbeing. Although researchers previously attempted to create a food atlas on a national level, the process of data collection was not well defined.MethodsThis study provides an overview of global food atlases that can be used to develop a procedure manual to guide experts in creating a dependable food atlas.ResultsTo date, 27 countries have developed food atlases for various reasons. After examining these countries’ experiences, six important steps in the procedure manual that should be considered when developing a food atlas were identified: choosing the most consumed food, using traditional cooking utensils, determining portion sizes, capturing photographs of the food, validating the food atlas, and publishing the food atlas.DiscussionThis procedure manual can be used as a guide until a validation study is conducted.

BackgroundSaudi and Turkish coffee consumption in Saudi Arabia is increasing considerably, and the nationwide consumption patterns need elucidation to determine the contributions of Saudi and Turkish coffee toward nutrition and health.AimTo describe the frequency and quantity of Saudi and Turkish coffee consumption and assess their association with sociodemographic factors.MethodsThis cross-sectional study included 1,030 participants (Saudi Arabia) recruited via an online questionnaire study that collected information on general characteristics and coffee consumption. The caffeine content in Saudi and Turkish coffees was quantified using a standard laboratory technique. The total caffeine intake and exposure were calculated. Associations between the different parameters were assessed.ResultsSignificant differences were observed in several demographic and sociodemographic factors according to the frequency of coffee intake. Specifically, individuals who consumed Saudi coffee almost every day (approximately 40% of respondents) were more likely to differ in age, body mass index, marital status, work status, monthly income, and region compared to those who consumed it less frequently. Additionally, one-third of the respondents consumed Turkish coffee, and the frequency of its consumption showed significant differences according to age, nationality, marital status, educational level, and region. Notably, the highest caffeine exposures were 0.95 mg/kg/d for Saudi coffee, 1.31 mg/kg/d for Turkish coffee, and 2.07 mg/kg/d for both coffees combined. The mean contribution to the 400 mg daily caffeine intake limit was significantly higher for Saudi coffee compared to Turkish coffee (p

Introduction The objectives of this study were to determine the prevalence of unplanned readmissions in the pediatric population within 30 days of discharge, identify the possible reasons behind them, and develop a predictive model for unplanned admissions. Methods A retrospective chart review study of 25,211 patients was conducted to identify the prevalence of readmissions occurring within 30 days of discharge from the King Abdullah Specialized Children’s Hospital (KASCH) in Riyadh, Saudi Arabia, between Jan 1, 2019, and Dec 31, 2021. The data were collected using the BestCare electronic health records system and analyzed using Jamovi statistical software version 1.6. Results Among the 25,211 patients admitted to the hospital during the study period, the prevalence of unplanned readmission within 30 days was 1291 (5.12%). Of the 1291 patients, 1.91% had subsequent unplanned readmissions. In 57.8% of the cases, the cause of the first unplanned readmission was related to the cause of the first admission, and in 90.64% of the cases, the cause of the subsequent unplanned readmission was related to the cause of the first unplanned readmission. The most common reason for the first unplanned readmission was postoperative complications (18.75%), whereas pneumonia (10.81%) was the most common reason for subsequent unplanned readmissions. Most patients with subsequent unplanned readmissions were also found to have either isolated central nervous system pathology or chronic complex medical conditions. Conclusion Internationally, the rate of unplanned readmissions in pediatric patients has been estimated to be 6.5% within 30 days, which is comparable to the results of our study (5.12%). Most of the causes of first and subsequent unplanned readmission were found to be related to primary admission. The diagnosis/causes of readmission vary depending on the patient’s age. A predictive model for pediatric readmission should be established so that preventive measures can be implemented.

Here, we, for the first time, compared the cardioprotective effects of third-generation vasodilating beta-blocker nebivolol (Neb) and conventional beta-blocker metoprolol (Met) on LPS-induced injury in H9c2 cardiomyoblasts. Our findings denoted that Neb and Met pretreatment diminish LPS-mediated cytotoxicity and oxidative stress. Concomitantly, LPS-triggered inflammatory cytokines activation was significantly suppressed by Neb but not by Met. Pretreatment with either Neb or Met alleviated LPS-mediated mitochondrial impairment by enhancing the expression of genes related to its biogenesis such as PGC-1α, NRF1, and TFAM. On the contrary, Neb but not Met-upregulated mitochondrial fusion-related genes such as OPA, and MFN2. In summary, our findings suggest that Neb and Met treatment significantly ameliorated the LPS-induced cytotoxicity and oxidative stress. Additionally, these findings suggest that Neb but not Met significantly down-regulates LPS-induced proinflammatory factors, probably by enhancing mitochondrial biogenesis and fusion.

Abstract Objective The current analysis assessed the economic and clinical burden of treatment‐Resistant Depression (TRD) imposed on the Kingdom of Saudi Arabia (KSA), Kuwait and United Arab Emirates (UAE) from the societal perspective. Methods A Microsoft Excel® based Markov model was developed to estimate the overall burden of disease imposed by TRD across KSA, Kuwait and UAE. Data for the models' adaptation were retrieved from literature and validated by country‐specific key opinion leaders. The cycle length and time horizon used in the model were 4 weeks and 1 year, respectively. Results The study results estimated that at the end of 1‐year time horizon, overall burden imposed by TRD was 3994, 982 and 670 million USD in KSA, Kuwait, and UAE, respectively. This can be attributed to the high cost incurred due to non‐responsive health state (ranging from 44% to 47%). The productivity loss was either the greatest or second greatest component of TRD's burden in the countries of interest (ranging from 32% to 43%). Conclusions TRD represents a large clinical and economic burden on both individual patients and society. Hence, noval and innovative treatments are especially required for the management of TRD patients.

Abstract Background The coronavirus disease 2019 pandemic has shown a significant impact on the psychological well-being of health care workers. The aim of the study was to evaluate the impact of the COVID-19 pandemic on the psychological health of health care workers in the Kingdom of Saudi Arabia. During the months of November and December, 283 health care workers completed a survey containing measures of depression, anxiety and stress (using Depression Anxiety and Stress-21 scale [DASS-21]) and questions regarding potential predictors such as the role of COVID-19 perception, availability of mental health support and work-related factors. Pearson X 2 test revealed factors associated with the presence of significant psychiatric symptoms. Result Among the participants, 17.3% screened positive for depression, 26.2% for anxiety and 17.3% for stress. Nurses reported significantly more depression, anxiety and stress than doctors. Those who received mental health support reported significantly lesser depression, anxiety and stress. Those who felt that quality of life was heavily impacted due to COVID-19 reported significantly high depression, anxiety and stress. Conclusions Poor psychological well-being was prevalent in health care workers; however, mental health measures have been shown to significantly reduce the mental health burden in health care workers.

Background: Preemptive analgesics are commonly used to increase analgesic efficacy and patient satisfaction. The aim of this study was to evaluate the preemptive analgesic effect of intramuscular diclofenac on minimal effective dose spinal anesthesia for perianal surgeries. Materials and Methods: Fifty patients ASA I&II were divided randomly into two groups, control group (GC N = 25) and Diclofenac group (GD N = 25), both groups received saddle block with 5% hyperbaric bupivacaine 0.5 mL (2.5 mg). Thirty minutes before the saddle block, patients in GD received 75 mg (3 mL) diclofenac intramuscularly, whereas patients in GC received 3 mL saline intramuscularly. The differences in the time for the first analgesic request, postoperative analgesic consumption as well as, visual analog scale, were our primary outcomes. Results: Fifty patients (25 in each group) undergoing perianal surgery completed the study successfully. The time to the first request of analgesia was significantly longer in GD 511.8 (108.07) min. compared to the GC 179.56 (49.24) min with P = 0.00001, as well as the total consumption of rescue analgesic (tramadol hydrochloride) was significantly less in GD 66 (23.8) mg compared to 104 (28.5) mg in the GC with P = 0.00001. Conclusion: Preemptive intramuscular diclofenac sodium with minimal dose bupivacaine saddle block significantly minimized the postoperative analgesic consumption and delayed the first analgesia request after perianal surgery.

الملخص: يهدف هذا التقرير إلى تنبيه الأطباء حول النزيف المتأخر داخل المخ باعتباره مظهر نادر لمرض المكورات العقدية من المجموعة ب لدى حديثي الولادة، وتسليط الضوء على الحاجة إلى إرشادات علاجية فاعلة. نقدم هنا حالة مرض نزيف متأخر داخل المخ ناتج عن مرض المكورات العقدية من المجموعة ب لدى طفلة حديثة ولادة تبلغ من العمر ١٧ يوما، وكانت الحالة معقدة مع نزيف ثنائي تحت العنكبوتية أكده التصوير بالرنين المغناطيسي، من خلال مراجعة الملف الطبي. تأخرت الأعراض لهذه المريضة مع أعراض الحمى والخمول والتشنجات والتأكيد الميكروبيولوجي للمكورات العقدية في مزرعة الدم، إضافة إلى وجود نزيف ثنائي تحت العنكبوتية ونقص التروية الدماغي المنتشر الذي أكده التصوير بالرنين المغناطيسي للدماغ، يشير إلى حدوث مضاعفات شديدة، مع عدد قليل جدا من الحالات المبلغ عنها من نزيف داخل المخ. وقد أظهرت المتابعة على المدى القصير تأخرا ملحوظا في النمو.يعد الفحص المبكر لعدوى المكورات العقدية من المجموعة ب بين النساء الحوامل أمرا مهما لمنع الحالات الشديدة من مرض النزيف المتأخر داخل المخ الناتج عن مرض المكورات العقدية من المجموعة ب. وهناك حاجة إلى مزيد من الأدلة لدعم الصلة الوثيقة بين مرض النزيف المتأخر داخل المخ الناتج عن مرض المكورات العقدية من المجموعة ب والنزيف داخل المخ. Abstract: This report aims to alert clinicians to the possibility of intracerebral haemorrhage as a rare manifestation of late-onset neonatal group B streptococcal (LOGBS) disease. This case also highlights the need for effective treatment guidelines for LOGBS disease. We report a case of LOGBS disease in a 17-day-old full-term female neonate, complicated by bilateral subarachnoid haemorrhage confirmed on magnetic resonance imaging (MRI). The patient presented with fever, lethargy, and convulsions. Microbiological examination confirmed the presence of Streptococcus agalactiae in the blood culture. Brain MRI showed bilateral subarachnoid haemorrhage and diffuse cerebral ischaemia, suggesting a severe complication of LOGBS disease. Short-term follow-up of the patient showed marked developmental delay. Early screening for group B streptococcus infection in pregnant women is essential to prevent severe cases of LOGBS disease. Very few cases of intracerebral haemorrhage in LOGBS disease have been reported. Further evidence is required to support a pertinent link between LOGBS disease and intracerebral haemorrhage.

BackgroundThe COVID-19 pandemic along with its confinement period boosted lifestyle modifications and impacted women and men differently which exacerbated existing gender inequalities. The main objective of this paper is to assess the gender-based differentials in food consumption patterns, dietary diversity and the determinants favoring weight change before and amid the COVID-19 pandemic among Arab men and women from 10 Arab countries.MethodsA cross-sectional study was conducted based on a convenience sample of 12,447 households' family members (mean age: 33.2 ± 12.9; 50.1% females) and information from participants aged 18 years and above was collected about periods before and during the pandemic.ResultsFindings showed that, during the COVID-19 period, the dietary diversity, declined by 1.9% among females compared to males (0.4%) (p < 0.001) and by 1.5% among overweight participants (p < 0.001) compared to their counterparts.ConclusionsTo conclude, gender-sensitive strategies and policies to address weight gain and dietary diversity during emergent shocks and pandemics are urgently needed in the region.

The clinical severity of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may rise because of acquiring a co-infection during the hospital stay of the patients. The rate of hospital co-infection alongside COVID-19 infection remains low. However, the mortality rates and intensive care unit (ICU) admission remains ambiguous. The present study investigates the implications of COVID-19 hospitalised infected patients with co-infection and the clinical outcomes. In this study, 142 patients were included. The eligible patients who tested positive for COVID-19 infection were hospitalised for more than two days. Each patient’s characteristics and laboratory results were collected, such as who was admitted to the intensive care unit and who was discharged or expired. The results revealed that out of the 142 hospitalised patients, 25 (17.6%) were co-infection positive, and 12 identified types of co-infection: two Gram-positive bacterial infections, one fungal infection and nine Gram-negative bacterial infections. In addition, 33 (23.2%) were ICU admitted, 21 were co-infection negative and 12 were co-infection positive. Among the 12 ICU admitted with co-infection, 33.4% were discharged. The death rate and ICU admission had a p-value < 0.05, indicating statistical significance for co-infected patients compared to non-co-infected patients. It was concluded that co-infection remains very low within hospitalised COVID-19-infected patients but can have severe outcomes with increased ICU admission and increased mortality rates. Thus, implementing infection preventive measures to minimize the spread of hospital-acquired infections among COVID-19 hospitalised patients.

BACKGROUND: Annual influenza vaccine is recommended among health professionals especially, health science undergraduates; although, studies suggest that there is a low level of vaccine coverage among health care undergraduates. Thus, the study aimed to investigate students' knowledge, attitudes, and practices regarding the seasonal influenza vaccine at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah, Saudi Arabia. METHODS: A cross-sectional, unicentral study was carried out during the period of April to November 2021. A total of 341 validated questionnaires that included four sections were distributed in all four different colleges of KSAU-HS. Data management and analyses were carried out using Statistical Software for Social Sciences (SPSS) version 25. RESULTS: Out of 341 respondents, 336 participants completed the full survey (98.53% completion rate). The majority of participants were males (67.6% and the most participants were from the college of medicine (60.4%). The mean knowledge score of students was found to be (11.3 ± 2.0) out of 14 points. The most common barrier to vaccination among healthcare students was not having enough time to take the vaccine (23.8%), while the second one was the COVID-19 pandemic (22.32%). The vaccination rate in 2020 was 103 (30.7%), while 235 (80.4%) students stated that they have received the vaccine previously. School/work requirements and the student's awareness of the vaccine's importance were the most common reasons for taking the influenza vaccine. CONCLUSION: Even though students showed a high level of knowledge and a positive attitude towards the influenza vaccine, they generally had a low level of vaccine uptake. To enhance immunization rates, we encourage vaccine campaigns in all healthcare colleges. Further studies are needed to identify influences on students' attitudes and practices regarding influenza vaccination.

The electrochemical energy storage that based on earth-abundant materials is essential because of the future demands. Because of carbon-based architecture supercapacitors, rapid charging/discharging, and long life cycle, they considered attractive compared to chemical to batteries. Therefore, copper oxide (CuO) as positive electrode and reduced grapheme oxide (rGO) as negative electrode materials were used for a high-performance supercapacitor in a low cost, simple, and ecofriendly method. During the present work, synthesized reduced graphene oxide/copper oxide (rGO/CuO) nanocomposite using a simple chemical method is carried and investigated. The crystallinity index (Ic) of CuO, 1.0 M rGO/CuO and rGO was 90.61%, 88.42%, and 86.25%, respectively, at 500 °C and one h, while it was 76.30%, 73.51%, and 67.77respectively, at 500 °C and 30 h. As the test temperature increases, Ic% of both rGO and 1.0 M rGO/CuO increases, and that of CuO decreases. As the test period increases, Ic% for rGO, CuO, and 1.0 M rGO/CuO decreases. As the molarity concentration increased, the crystallinity index of rGO/CuO composites increased. The specimens characteristics are carried and investigated using; EDX, SEM, GC/MS, and XRD analysis. The appearance of the peaks at 2θ = 22.20° and 43.58° were related to GO, and peaks at 22°, 20°, 43.58°, 50.70°, and 74.37° indicated the synthesis of the nanocomposite.

Background: The predominance of specific bacteria such as adherent-invasive Escherichia coli (AIEC) within the Crohn's disease (CD) intestine remains poorly understood with little evidence uncovered to support a selective pressure underlying their presence. Intestinal ethanolamine is however readily accessible during periods of intestinal inflammation, and enables pathogens to outcompete the host microbiota under such circumstances. Methods: Quantitative RT-PCR (qRT-PCR) to determine expression of genes central to ethanolamine metabolism; transmission electron microscopy to detect presence of bacterial microcompartments (MCPs); in vitro infections of both murine and human macrophage cell lines examining intracellular replication of the AIEC-type strain LF82 and clinical E. coli isolates in the presence of ethanolamine; determination of E. coli ethanolamine utilization (eut) operon transcription in faecal samples from healthy patients, patients with active CD and the same patients in remission following treatment. Results: Growth on the intestinal short chain fatty acid propionic acid (PA) stimulates significantly increased transcription of the eut operon (fold change relative to glucose: >16.9; p-value 4.72; P 15.64; P

In this study, we synthesized a reduced form of graphene oxide/copper oxide (rGO/CuO) nanocompounds produced at rGO wt. of 0.125%, 0.25%, 0.5% and 1%. The crystallinity indexes for rGO and rGO/CuO increased, and that for CuO decreased as the test temperatures increases, while the crystallinity indexes of rGO, CuO and rGO/CuO decreases with test periods increment. Measurement by dynamic light scattering reported average crystallite sizes of 0.7, 8.8, 25.4, 38.5 nm for 0.125 wt.% rGO/CuO, 0.25 wt.% rGO/CuO, 0.50 wt.% rGO/CuO and 1.0 wt.% rGO/CuO respectively. The electrochemical properties of the nanocomposites were checked. The rGO/CuO XRD peaks were 18.114320 Å, 225.1856 Å, 321.41740 Å, and 365.98290 Å, with 11.051640%, 0.461075%, 0.280083%, and 0.174259% for 2ϴ of 22.2031°, 43.5865°, 50.7050°, and 74.3729°, respectively. FTIR spectroscopy identified the existence of vibrational frequencies with pseudo-capacitance at 458 cm−1 which confirmed the presence of rGO-CuO nanoparticles. The voltammetry of rGO-CuO indicated the increment of electrochemical activity, large capacitance, and conduction in the reduced rGO/CuO composite. For rGO wt. of 0.125%, 0.25%, 0.5%, and 1.0%, the rGO/CuO composite specific capacitance was 561 F/g, 582 F/g, 597 F/g, and 611 F/g, respectively, which indicated good electrochemical performance.

Abstract Background The higher prevalence of smoking among psychiatric patients is well established. However, gender-specific associations have rarely been the focus of studies among patients with various psychiatric disorders. The aim of this study was to estimate the gender-specific prevalence of current smoking by psychiatric patients and its association with various psychiatric disorders and the use of psychotropic medications. Methods A cross-sectional observational study was performed between July 2012 and June 2014. Patients were recruited from six hospitals located in the five regions of Saudi Arabia. Results Of the 1193 patients, 402 (33.7%) were current smokers. The incidence of current smoking was much higher among males than females (58.3% versus 6.7%, p

Abstract Background Mental disorders are considered important public health problems not only to people with mental illness but also their caregivers. As is the case in many countries, the deinstitutionalization of mental health services in Saudi Arabia, has meant that informal caregivers are shouldering responsibilities for which they are not usually prepared; therefore, the current study was aimed at assessment of the burden on caregivers of people with mental illness. Methods Through a cross-sectional design, a sample of the caregivers of people with mental illness (n = 377) was selected randomly from a psychiatric hospital in Jeddah. An Arabic version of the Involvement Evaluation Questionnaire (IEQ) was used for collection of data. The data were analyzed on the subscale scores and the 27 items in two ways. First, we used the summed scores for the subscales based on the Likert scale (0–4) for univariate and multivariate statistical analyses, as recommended. We also used parametric statistics (t-tests, one-way ANOVA) because the IEQ subscale scores were fairly normally distributed. Results Males constituted more than one-half of the participating caregivers (55%), with a mean age of 36.6, SD = 11.4 years. As reported by the caregivers, most of the patients were males (62.7%) with a mean age of 33.8, SD = 13.7 years and a range of 17–90 years old. The total mean IEQ burden score of the caregivers was 38.4, SD = 17.5. “Tension” was significantly prominent among younger caregivers aged ≤30 years. “Worrying” was significantly higher among caregivers living with their spouse and children and those living in families with relatively fewer members (

Aims: We aimed to evaluate congestive heart failure (CHF) multidisciplinary disease management program (DMProg) impact on mortality, readmission rates, length of stay (LOS), and gender health characteristics. Methods and results: This was a quasi-observational, pre- and post-trial with a parallel nonequivalent group. We enrolled 174 inpatients having CHF with reduced ejection fraction and New York Heart Association (NYHA) Class II–IV, and a total of 197 hospital admissions. A comparative follow-up was performed from 15 December 2014 to 15 December 2015. Among 197 consecutive hospital admissions, 76 (39%) were included in the preintervention or usual care group and 121 (61%) were assigned to the postintervention group. After 1 year, in comparison with the preintervention group, the postintervention group had shorter average LOS in days (7.6 days vs. 11.1 days, p

Introduction. Complex partial seizures are focal (CPS) (i.e., start in one area of the brain) and associated with impairment in consciousness. Most of them arise in the temporal region and are characterized by aura, impaired consciousness, and automatisms. CPS that arise in temporal region are most often misdiagnosed as primary psychiatric illness. Case Report. A 25-year-old male presented with fluctuations in consciousness, aggressive behaviour, hallucination, and delusions of grandeur lasting a few hours. He was diagnosed with acute and transient psychotic disorder according to ICD10 criteria and was treated with intramuscular haloperidol 10mg BID followed by oral olanzapine 10mg. Computed tomography of brain and electroencephalogram were normal. After 15 days he presented again to the outpatient department with complaints of aggressive behaviour and sensory misinterpretations. Video electroencephalogram was recommended, which was not done due to financial constraints. The diagnosis was reconsidered and he was started on oral carbamazepine due to high clinical suspicion, of complex partial seizures, in spite of lack of EEG evidence. He responded well to antiepileptic and symptom remission has maintained well. Conclusion. Patients presenting with psychosis need careful diagnostic evaluation for other possibilities.