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Doaa M Abdel-Salam,1,2 Rehab A Mohamed,3 Hind Y Alyousef,4 Wahaj A Almasoud,4 Mashael B Alanzi,4 Atheer Z Mubarak,4 Doaa M Osman2 1Family and Community Medicine Department, College of Medicine, Jouf University, Aljouf 42421, Saudi Arabia; 2Public Health and Community Medicine Department, Faculty of Medicine, Assiut University, Assiut 71526, Egypt; 3Family Medicine Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; 4College of Medicine, Jouf University, Aljouf 42421, Saudi ArabiaCorrespondence: Doaa M Abdel-SalamPublic Health and Community Medicine Department, Faculty of Medicine, Assiut University, Assiut 71526, EgyptTel +966537242691Fax +966146542256Email doaa.mazen@aun.edu.egPurpose: Mammography screening (MS) is an underutilized screening tool; although it is provided free of charge to the Saudi community. The present study aimed at assessing knowledge and barriers of mammography screening among women attending primary health centers in Aljouf region, Saudi Arabia.Materials and Methods: A cross-sectional study was carried out among 423 women aged 41– 75 years attending ten primary health centers in Aljouf region, Saudi Arabia. Structured interviewing questionnaires were used for data collection. SPSS program, version 24 was used for data analysis.Results: The least reported risk factors of BC in this study were early menarche (14.9%), first pregnancy after the age of 30 years (18%), and late menopause (18.7%). Concerning knowledge of MS, 50.8% of the women correctly identified that mammogram is the ideal method for detecting BC. The most encountered personal barriers towards MS were lack of information about mammogram (69.5%), fear of exposure to radiation (67.4%), fear of discovery of BC (62.9%), being busy all the time (62.2%), and fear of cancer treatment (61.9%). Regarding economic barriers, 40% of the participants reported that taking sick leave from work is difficult while 37.8% revealed that mammogram is costly. Concerning health system barriers, the most common barriers were fear of error in diagnosis (62.6%), long time to take medical appointment (57%), and preferring not to have a mammogram except after a doctor recommendation (52.7%). The present study showed that women’s education and residence significantly predicted their knowledge. Furthermore, women’s education and income significantly predicted their barriers towards MS.Conclusion: Many barriers toward mammography screening were encountered in the present study. Addressing these barriers and raising awareness about MS may be of great value to increase its uptake by Saudi women.Keywords: knowledge, barriers, health services, secondary prevention, Saudi Arabia

Purpose: The analysis of different language domains and exploration of variables that affect the outcomes of cochlear implantation would help to document the efficacy of cochlear implantation and intervention programs. The aim of this work was to examine the language profile of children with Cochlear Implants (CI) and to assess the effect of age at the time of cochlear implantation and the impact of duration of rehabilitation on the development of linguistic abilities for cochlear implanted children., Methods: The study was conducted on 46 Arabic speaking children using unilateral CI who are receiving regular post-cochlear auditory and language rehabilitation in the phoniatrics unit, Kasr Alaini hospital. A Proficient Preschooler Language Evaluation (APPEL TOOL) was applied for the assessment of different language domains., Results: Children who received post implant rehabilitation for ≥ 2 years showed significant improvement in all subtests' scores of APPEL tool than children who received same rehabilitation for ≤ 1 year. There was no significant difference of language scores between children who have received CI before age of 3 years and those who have been implanted after age of 3 years., Conclusion: This study showed that the language profile of CI children was beneficially affected by the longer duration of therapy post implantation., (© 2024. The Author(s).)

Microplastic pollution is a global issue of great public concern. Africa is flagged to host some of the most polluted water bodies globally, but there is no enough information on the extent of microplastic contamination and the potential risks of microplastic pollution in African aquatic ecosystems. This meta-analysis has integrated data from published articles about microplastic pollution in African aquatic ecosystems. The data on the microplastic distribution and morphological characteristics in water, sediments and biota from African rivers, lakes, oceans and seas were extracted from 75 selected studies. Multivariate statistics were used to critically analyze the effects of sampling and detection methods, ecological risks, spatial distribution and similarity of microplastics in relation to the geographical distance between sampling sites. This study found that sampling methods have significant effect on abundance and morphological characteristics of microplastics and that African aquatic ecosystems are highly contaminated with microplastics compared to global data. The most prevalent colors were white, transparent and black, the most prevalent shapes were fibres and fragments, and the most available polymers were polypropylene (PP), polystyrene (PS) and polyethene terephthalate (PET). Microplastic polymers similarity decreased with an increase in geographical distance between sites. Risk levels of microplastics in African aquatic ecosystems were comparatively high, and more than 40 % of water and sediments showed highest level of ecological risk. This review provides recent information on the prevalence, distribution and risks of microplastics in African aquatic ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The genotyping of long non-coding RNA (lncRNA)-related single-nucleotide polymorphisms (SNPs) could be associated with cancer risk and/or progression. This study aimed to analyze the angiogenesis-related lncRNAs MALAT1 (rs3200401) and MIAT (rs1061540) variants in patients with ovarian cancer (OC) using "Real-Time allelic discrimination polymerase chain reaction" in 182 formalin-fixed paraffin-embedded (FFPE) samples of benign, borderline, and primary malignant ovarian tissues. Differences in the genotype frequencies between low-grade ovarian epithelial tumors (benign/borderline) and malignant tumors and between high-grade malignant epithelial tumors and malignant epithelial tumors other than high-grade serous carcinomas were compared. Odds ratios (ORs)/95% confidence intervals were calculated as measures of the association strength. Additionally, associations of the genotypes with the available pathological data were analyzed. The heterozygosity of MALAT1 rs3200401 was the most common genotype (47.8%), followed by C/C (36.3%). Comparing the study groups, no significant differences were observed regarding this variant. In contrast, the malignant epithelial tumors had a higher frequency of the MIAT rs1061540 C/C genotype compared to the low-grade epithelial tumor cohorts (56.7% vs. 37.6, p = 0.031). The same genotype was significantly higher in high-grade serous carcinoma than its counterparts (69.4% vs. 43.8%, p = 0.038). Multivariate Cox regression analysis showed that the age at diagnosis was significantly associated with the risk of OC development. In contrast, the MIAT T/T genotype was associated with a low risk of malignant epithelial tumors under the homozygote comparison model (OR = 0.37 (0.16-0.83), p = 0.017). Also, MIAT T allele carriers were less likely to develop high-grade serous carcinoma under heterozygote (CT vs. CC; OR = 0.33 (0.12-0.88), p = 0.027) and homozygote (TT vs. CC; OR = 0.26 (0.07-0.90), p = 0.034) comparison models. In conclusion, our data provide novel evidence for a potential association between the lncRNA MIAT rs1061540 and the malignant condition of ovarian cancer, suggesting the involvement of such lncRNAs in OC development.

Plastics have been recognized as an emerging pollutant and have raised global concerns due to their widespread distribution in the environment and potential harm to living systems. However, research on the threat of micro/nanoplastics (MPs/NPs) to the unique group of aquatic plants is far behind, necessitating a comprehensive review to summarize current research progress and identify future research needs. This review explores the sources and distribution patterns of MPs/NPs in aquatic environments, highlighting their uptake by aquatic plants through roots and leaves, and subsequent translocation via the vascular system facilitated by the transpiration stream. Exposure to MPs/NPs elicits diverse effects on the growth, physiology, and ecological interactions of aquatic plants, with variations influenced by plastic properties, plant species, and experimental conditions. Furthermore, the presence of MPs/NPs can impact the toxicity and bioavailability of other associated toxicants to aquatic plants. This review shows critical knowledge gaps and emphasizes the need for future research to bridge the current understanding of the limitations and challenges posed by MPs/NPs in aquatic ecosystems., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Depression affects about 3.8% of the world's population. Although marriage may contribute to subjective well-being, some marital variables could increase women's risk for depression. This study aimed to determine the prevalence of depressive symptoms and their correlates among married females attending primary healthcare facilities., Methods: A cross-sectional study was conducted on a purposive sample of 371 married women at the primary healthcare centers, Assiut Governorate, Upper Egypt. In this study, an interviewer-administered questionnaire was used for data collection. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and marital satisfaction using the ENRICH Marital Satisfaction Scale (EMS). Standardized measurements of weight and height were performed., Results: According to the PHQ-9 diagnostic criteria, the prevalence of depressive symptoms among the studied married females was 30.2%. The significant predictors of depressive symptoms were advanced husbands' ages, living with an extended family, exposure to spousal verbal violence, high body weight, and low marital satisfaction levels., Conclusions: Approximately one-third of married Egyptian women experienced depressive symptoms. In addition to high body weight, some social and marital factors contributed to the increase in women's vulnerability to depressive symptoms. Egyptian primary healthcare physicians should be trained to identify females with depressive symptoms and refer them to specialists if need be. To combat depression in women, it may be helpful to construct qualified marital counseling centers. This may improve marital satisfaction, decrease the negative consequences of spousal violence, and ensure the value of independence for new families., (© 2022. The Author(s).)

Backgrounds: Healthcare providers (HCPs) in COVID-19 epidemic face stressful workload of disease management, shortage of protective equipment and high risk of infection and mortality. These stressors affect greatly their mental health. The aim is to identify working conditions among Egyptian HCPs during COVID-19 epidemic as well as stigma and worry perceptions from contracting COVID-19 infection and their predictors., Methods: A cross-sectional study was conducted among 565 HCPs. Data was collected through Google online self-administered questionnaire comprised seven parts: demographics characteristics, knowledge and attitude of COVID-19, working condition, worry of contracting COVID-19 at work, discrimination intention at work for COVID-19 patients, stigma assessment using impact stigma, and internalized shame scales., Results: The vast majority of HCPs (94.7%) were worried from contracting COVID-19 at work. Risk factors for perceiving severe worry from contracting COVID-19 were expecting infection as a severe illness, believing that infection will not be successfully controlled, improbability to continue working during the pandemic even if in a well/fit health, high discrimination intention and impact stigma scales. Significantly high impact stigma scores were detected among those aged < 30 years, females, workers primarily in sites susceptible for contracting COVID-19 infection, those had severe worry from contracting infection at work, and high internalized shame scale. The risk factors for perceiving higher internalized shame scores were not having a previous experience in working during a pandemic, high discrimination intention towards COVID-19 patients and high impact stigma scale., Conclusions: Considerable levels of worry and stigma were detected among Egyptian HCPs during COVID-19 outbreak. The psychological aspect of health care providers should not be overlooked during epidemic; appropriate institutional mental health support should be provided especially for young HCPs, those without previous work experience in epidemic and those who work in high-risk units. Raising the community awareness about contribution of HCPs in fighting the epidemic might decrease stigmatization action toward HCPs., (© 2021. The Author(s).)

Many dairy products are discarded and useless after end of shelf-life, which causes economic and environmental challenges. The objective of this study was to study the compositional characteristics of some dairy products before and after shelf-life, and develop a process to utilize those dairy products after end of shelf-life in non dairy applications (cosmetic cream and soap). Several dairy products, such as sterilized milk, yogurt, soft cheese, hard cheese, cream, and butter were collected from markets in Egypt before shelf-life and after three months of shelf-life. Electrophoresis analysis was conducted to estimate the changes in the protein fractions of protein products (sterilized milk, yogurt, and cheese) before and after expiration. Also, gas chromatography (GS) was performed to compare the fatty acids of fat products (cream and butter) before and after end of shelf-life. Sterilized milk, yogurt, soft, and hard cheese were turned into powder (Expired dairy products powder; EDPP) to be used as a raw material in manufacturing of cosmetic creams. The fat was separated from cream, butter, and hard cheese (Expired dairy products fat; EDPF) to be utilized in making soap. The formulated cosmetic creams were examined in vitro. Functional properties of cream were determined, such as appearance, spreadability, irritancy, and pH. Additionally, the soap quality was tested after manufacture. We found that dairy products, such as milk, yogurt, and cheese after shelf-life can be utilized as raw materials for the production of cosmetic creams, as well as production of soap from butter and cream. The produced products were similar to those in commercial markets. This study is an endeavor to conquer the dairy industry challenges, which are considered a huge loss from the economic and environmental aspects., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors. Published by Elsevier B.V.)

Background and Objectives: Intimate partner violence (IPV) is a serious and widespread problem worldwide. IPV can seriously influence the physical, mental, sexual, and reproductive health of women as well as the welfare of their children. In the Middle East, IPV is pervasive and widely acceptable. The present study was done to determine the prevalence and correlates of IPV among women attending different primary health centers in the Aljouf region, Saudi Arabia., Methods: A cross-sectional study was conducted among 403 Saudi women attending different primary health centers in the Aljouf region, Saudi Arabia. A structured anonymous questionnaire was distributed to the targeted population during a face-to-face interview. Data analysis was done using the SPSS program, version 24., Results: The present study showed that 30.3% of the participants had been exposed to IPV over the last year. Concerning the types of violence, the present study revealed that emotional violence is the highest followed by physical and then sexual violence representing 92.6%, 67.2%, and 44.3%, respectively. The significant predictors of IPV were women with one to three children (OR = 7.322, p -value = 0.006), women with four children or more (OR = 13.463, p -value = 0.006), and women married to husbands with aggressive behavior (OR = 98.703, p -value < 0.001). Not taking the approval on marriage was significantly associated with more exposure to violence (OR = 3.190, p -value = 0.042). In addition, husband smoking status was a significant predictor for IPV (OR = 2.774, p -value = 0.012). However, women married to alcoholic drinkers had a significantly lower risk for exposure to IPV (OR = 0.108, p -value = 0.040). On the other hand, women's age, marital status, women's educational level, monthly income in RS, perception of income sufficiency, marriage duration, the age difference between women and their husband, and drug abuse status of the husband were not significant predictors of IPV ( p -value ≥ 0.05). Sociocultural effects were the most frequent reason for IPV as reported by the participants (57.4%). The most common consequences of IPV were psychological problems (75.4%) and injuries (42.6%). Women's reactions to IPV were leaving home (32.8%) or no reaction (36.8%) to retain their marriage., Conclusions: IPV remains an important public health problem among married women in this study area. Urgent interventions including educational and screening programs for Saudi women are required to mitigate the problem.

The objectives of this study were to produce probiotic yogurt (5.0-7.0 log cfu/g) fortified with nanopowdered eggshell (NPES) at a rate of 0.02, 0.04, and 0.06 mg/ml, as well as, examine the effect of NPES on the physicochemical, microbial, sensory properties, and shelf-life of probiotic yogurt. The NPES was prepared by milling preboiled dried eggshell using a mortar grinder. The size of the milled powder was measured to assure that the diameter of the powder is 27 ± 1.7 nm. Yogurt was manufactured by dividing the pasteurized milk into four aliquots portions. The first portion was utilized as control (T1), while the other three portions were supplemented with 0.02 (T2), 0.04 (T3), and 0.06 (T4) mg/ml NPES. All treatments were inoculated with 5.11 log cfu of Lactobacillus delbruckii ssp. bulgaricus (Lb) and Streptococcus thermophilus (St) combined and 5 log cfu of Bifidobacterium bifidum (Bb) per kg of milk at 40°C until the pH of 4.6 was reached. The acidity, sensory properties, Bb count, total bacterial count (TBC), yeast, and mold counts were examined. The results showed that the acidity was increasing during storage, however, increasing NPES resulted in low acid development ( p  < .05). The shelf-life of control was ended after 8 d of storage at 4°C because molds were grown on the surface of the sample. The TBC significantly decreased ( p  < .05) as the concentration of NPES increased. Bb count in probiotic yogurt was also decreasing during storage. Yeast and molds were detected in control after 8 d; however, NPES did not result in molds even after 16 d of storage but yeast was exhibited. The NPES improved the sensory evaluation of probiotic yogurt slightly and increased the shelf-life of probiotic yogurt as compared to control., (© 2021 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

The objective of this work was to study the effect of different concentrations of inulin (0.2, 0.4, and 0.6%) on the viability of probiotic bacteria ( Bifidobacterium bifidum ) and sensory characteristics of probiotic yogurt. The yogurt was manufactured with Lactobacillus delbruckii ssp. bulgaricus (Lb), Streptococcus thermophilus (St), and Bifidobacterium bifidum (Bb). Raw milk was received, heated to 90°C, and divided into 4 aliquots portions. All portions were inoculated with 5.11 log cfu of Lb and St combined and 5 log cfu of Bb per kg of milk. The first portion was utilized as control (T1) while 0.2, 0.4, and 0.6% of inulin were added to the second (T2), third (T3), and fourth (T4) portions, respectively. All treatments were incubated at 40°C until a pH of 4.6 was reached. Subsequently, the yogurt was cooled and stored at 4°C for 16 days. Titratable acidity, total bacterial count (TBC), Bb count, yeast count, mold count, and sensory evaluation were determined during the storage. The results showed that the addition of inulin and the storage period have significant effects ( p  < .05) on the titratable acidity of the yogurt. The storage of control was ended after 8 days at 4°C due to the growth of molds on the surface of the samples. The TBC decreased ( p  < .05) over time in control from 8.28 to 7.97 log cfu/g. It was also decreased ( p  < .05) with increasing the concentration of inulin. However, the addition of inulin increased ( p  < .05) the viability of Bb during the storage, as well as, acted as an antimicrobial against molds in T2, T3, and T4. Additionally, there were no significant differences ( p  > .05) in the sensory evaluation of all treatments. We conclude that inulin can be utilized in the manufacturing of probiotic yogurt as a prebiotic, which, inturn, enhances the growth of Bb and increase the shelf-life., (© 2021 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Most of the children having Specific Language Impairment (SLI) exhibit pragmatic difficulties that are often overlooked while their communication skills are being evaluated. Identifying pragmatic needs in such children can be lengthy and indeterminate as many of such children don't quite "fit" into a definite diagnostic category. This study aimed at identifying and clarifying the nature of pragmatic difficulties in a group of children with Specific Language Impairment by comparing their pragmatic skills with those of a group of normally developing children using a simple Pragmatic Screening protocol hoping that this would aid in reaching a better understanding of the nature of pragmatic difficulties in such children. The present study examined the pragmatic profiles of 60 age and gender matched native Cairo-Egyptian Arabic speaking children (with age range 4-6 years old). The children were divided into two groups; Group A and Group B. Group A included 30 children with normal language development whereas Group B included 30 children who had been previously diagnosed as having Specific Language Impairment. For each subject, history taking followed by audiological and psychometric evaluation to rule out the existence of any hearing difficulties or mental deficiency was performed. Afterwards, each child under study was subjected to the Arabic Pragmatic Screening tool [1]. For each child, the screening was scored by three readers; average scores were obtained and statistically analyzed. All the values obtained by the control group were found to be significantly higher than those obtained by the SLI group except for some non-verbal paralinguistic skills where non-significant differences were found between the two groups. Through the ROC curve, cut off level for Total Pragmatic Score (TPS) was found to be less than or equal to 78.16, i.e. 4-6 year old children with a TPS equal to or less than 78.16 were considered to have pragmatic difficulties. Thorough screening of pragmatic skills while evaluating the communication skills of children with specific Language Impairment should be seriously considered., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Childhood apraxia of speech is a neurological childhood speech-sound disorder in which the precision and consistency of movements underlying speech are impaired in the absence of neuromuscular deficits. Children with childhood apraxia of speech and those with multiple phonological disorder share some common phonological errors that can be misleading in diagnosis. This study posed a question about a possible significant difference in language, speech and non-speech oral performances between children with childhood apraxia of speech, multiple phonological disorder and normal children that can be used for a differential diagnostic purpose. 30 pre-school children between the ages of 4 and 6 years served as participants. Each of these children represented one of 3 possible subject-groups: Group 1: multiple phonological disorder; Group 2: suspected cases of childhood apraxia of speech; Group 3: control group with no communication disorder. Assessment procedures included: parent interviews; testing of non-speech oral motor skills and testing of speech skills. Data showed that children with suspected childhood apraxia of speech showed significantly lower language score only in their expressive abilities. Non-speech tasks did not identify significant differences between childhood apraxia of speech and multiple phonological disorder groups except for those which required two sequential motor performances. In speech tasks, both consonant and vowel accuracy were significantly lower and inconsistent in childhood apraxia of speech group than in the multiple phonological disorder group. Syllable number, shape and sequence accuracy differed significantly in the childhood apraxia of speech group than the other two groups. In addition, children with childhood apraxia of speech showed greater difficulty in processing prosodic features indicating a clear need to address these variables for differential diagnosis and treatment of children with childhood apraxia of speech., (Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.)