Search

ABSTRACT: Objective: This study aimed to determine the impact of a transformational leadership style on the quality of nursing care in the second health cluster of Riyadh, Saudi Arabia. Methods: A quantitative cross-sectional research design was used in this investigation. Convenience sampling was used to choose 350 nurses as participants for the investigation. The nurses' perceptions of transformational leadership and the quality of nursing care were evaluated using the Global Transformational Leadership Scale and the Quality Nursing Care Scale. A 52-item online survey that participants self-administered through Google Forms was used to collect data. Results: The nurses perceived leadership positively and endorsed transformational qualities, with a mean value of 3.87 and a total score of 27.15. The Quality of Nursing Care Scale, which had a total score of 146.5 and a mean of 4.07, indicates nurses' approval of the present quality of care and a holistic approach to patient well-being. Conclusion: A strong positive link was found between quality of nursing care and transformative leadership. [ABSTRACT FROM AUTHOR]

Trauma is a major cause of death and disability among young adults in Saudi Arabia, with a road traffic fatality rate three times higher than other high-income countries. The vast expanse of the Riyadh region comprises 21 governorates over 156,078 square miles, most of which is rural. Although delays in access to trauma care pose a significant mortality and economic burden, regions at highest risk of delays have not been previously studied. This paper aims to identify the trauma center distribution, trauma burden, and areas with delayed access to trauma care in the rural governorates of the Riyadh region. We conducted a retrospective review of 24,268 reports from 17 rural governorates in the Riyadh region from the official data registry of the Red Crescent of Saudi Arabia from January 2021 to March 2023. Higher severity cases were classified under the red criteria (for age 15-64 ys: systolic blood pressure (SBP) < 90 mmHg or heart rate > SBP); for age ≥65 ys: SBP <110 mmHg or heart rate > SBP) based on established trauma activation criteria. We geospatially mapped all level 1-3 trauma centers in the rural governorates of the Riyadh region with an overlay of trauma burden, and identified red criteria cases and those that had delayed access to trauma centers in each of the governorates. Data were mapped using Quantum Geographic Information System, and analysis was performed using R statistics. Rural Riyadh lacks level 1 trauma centers, with level 3 facilities primarily delivering trauma care. Among the reported trauma cases, majority were classified under the red criteria (67.7%, n = 16,433). Al-Kharj emerged as a hotspot for trauma cases, reporting the highest number of cases (21.4%, n = 5202) and red criteria cases (21.4%, n = 3512), followed by Al-Quwayiyah (14.4%, n = 3490) and Al-Majma'ah (9.8%, n = 2369). Blunt trauma predominated (79.4%, n = 19,280), with a substantial portion meeting the red criteria (62.4%, n = 12,032), while penetrating injuries were less common (14.5%, n = 3524). Of the red criteria cases, 38.2% (n = 6048) were delayed, most notably in Al-Kharj (21.8%, n = 1320). In conclusion, our study reveals significant gaps in trauma care access and burden across rural governorates in the Riyadh region. The absence of level 1 trauma centers, coupled with high proportions of red criteria cases and delays in accessing care, underscores the need for targeted interventions and resource optimization. Addressing these challenges requires standardized trauma systems, improved transfer protocols, and a national trauma registry for comprehensive monitoring of patient outcomes. [ABSTRACT FROM AUTHOR]

Influenza A virus (IAV) is the principal cause of seasonal flu and is often reported among pilgrims in Saudi Arabia (SA) due to their mass gatherings. The epidemiological, phylogenetic, and molecular details of A/H1N1pdm2009 in 200 clinical samples collected from hospitalized children in Riyadh during two epidemic seasons (2020/21 and 2021/22) are reported in this study. A total of 21 (10.50%) samples were positive for IAV, as determined using PCR. Fifteen isolates (71.42%) were identified as H1N1pdm2009: eight (53.33%) samples were from males, seven (46.67%) from females. The prevalence of H1N1pdm2009 isolates was significantly (p < 0.05) higher among the age group 15-64 years than the other age groups. A comparison of hemagglutinin (HA) and neuraminidase (NA) amino acid sequences between SA H1N1pdm and certain vaccine strains revealed 19 mutations relative to reference strain A/ California/07/2009. Among them, eight (0.47%) were in HA, and eight (0.56%) were in NA sequences that differed from vaccine strains. All isolates of the 2020-2022 seasons exhibited N- and O-glycosylation sites comparable to vaccine strains. Phylogenetically their HA and NA genes are divided into different clades. Most of the studied isolates (five) belonged to clade 5a.1 of HA. These data identify the genetic makeup of circulating influenza virus subtypes. [ABSTRACT FROM AUTHOR]

This paper investigates the potential for creating walkable communities in Riyadh using a qualitative research methodology. This approach encompassed: (1) systematic selection of international case studies renowned for their walkability strategies, (2) critical comparative analysis of these case studies, and (3) extraction of a Walkability model to derive strategic guidelines and recommendations tailored to Riyadh's context. Through literature review, four international case studies emblematic of effective walkability practices were examined. Key themes and strategies that emerged from these analyses included integrated public transit, compact urban design, pedestrian infrastructure, community engagement, cultural considerations, and context-sensitive innovation. Based on these themes we threaded a comprehensive model for sustainable walkability in Riyadh. To assess such model, we extracted conceptual framework and suggested future hypotheses for future studies. By synthesising these findings, the research proposed a walkability model to advance Riyadh's transformation into a walkable city. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Special Education & Rehabilitation (2314-8608) is the property of Association of Arab Universities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: The current study was conducted to assess the common lifestyle risk factors affecting the quality of life (QoL) among patients with chronic diseases. METHODS: This cross-sectional study was conducted using a valid structured questionnaire among 734 patients with chronic diseases. Patients were randomly selected from five primary health care centers in Riyadh of Saudi Arabia during January to February 2024. The study survey included a checklist of socio-demographic and lifestyle variables; the Arabic short version of the World Health Organization QoL questionnaire was used. The SPSS (version 24) was used for data analysis. RESULTS: A total of 734 patients (14.7% males and 85.3% females) were included. The mean age of the patients was 48.54±19 years. The total QoL and its four domains mean scores were relatively high, with no statistically significant differences were found between males and females. Statistically significant reductions in the positive (good) QoL were found in patients with obesity; patients who using butter and animal fat in cooking; and patients who eating meals out > 3 times per week (OR 0.64 CI 95% (0.325-0.891)), (OR 0.21 CI 95% (0.031-0.754)), and (OR 0.42 CI 95% (0.112-0.851)) respectively. CONCLUSION: The current study shows high level (69.3%) of good QoL among patients with chronic diseases at the primary healthcare centers in Riyadh of Saudi Arabia. Furthermore, obesity, poor cooking practices, and eating meals outside-home are the main unhealthy lifestyle factors that impaired the level of the QoL among the studied population. [ABSTRACT FROM AUTHOR]

Motivation plays a crucial role in adult learners' decisions to enroll in educational programs. This study aimed to evaluate the motivations for adult learners who enrolled at adult high schools in Riyadh as well as the potential gender and age differences for their motivations. The Education Participation Scale (EPS) A-Form was administered to adult learners, and 221 valid responses were analyzed using Wilcoxon signed-rank, Mann–Whitney U, and Kruskal–Wallis H tests. The results indicated that professional advancement, cognitive interest, and educational preparation were the primary motivations, while social contact was the least influential motivator. Furthermore, female respondents reported higher levels of motivation for educational preparation than male respondents, but no significant differences were observed for motivational orientations across age groups. To enhance participation in adult high-school programs, the General Department of Continuing Education should tailor its enrollment strategies that they appeal to the three main motivations for various groups. [ABSTRACT FROM AUTHOR]

Riyadh has recently witnessed rapid growth in the use of short-term rentals. Their impact on the city's housing market and long-term rentals has been critical. The emergence of recreational festivals such as the Riyadh and Diriyah Seasons, with their accompanying events, as well as the widespread use of daily rental platforms such as Airbnb, have created a new market for short-term rentals that has changed the city's rental landscape. This study compared data on the number of units geared toward daily rent and their average daily rates (ADRs), obtained from the Airbnb platform, with data on long-term rental units and their revenue, extracted from the Ejar platform. The data cover the five sectors of Riyadh city. Sample neighborhoods were selected from each sector. The results show that after a period of stagnation due to the precautionary measures taken during the COVID-19 pandemic, the short-term rental market saw a significant recovery once these measures were lifted. The emergence of the short-term rental market has negatively affected the long-term rental market by drying up its stock and raising rent prices, thus leading to tourism-induced displacement of low-income residents and further exacerbating the housing problem in the city. Therefore, there is an urgent need to regulate this new rental market to maintain a balance between short- and long-term markets in Riyadh. [ABSTRACT FROM AUTHOR]

This study examines residents' perceptions of tourism development in Riyadh city, Saudi Arabia, focusing on its benefits and costs, guided by social exchange theory. The objective is to explore how the perceived impacts of tourism development, along with external factors such as community attachment, residents' knowledge of tourism development, and community involvement, affect locals' satisfaction with tourism and their intention to support tourism development. A survey of 427 locals, analyzed using structural equation modeling (SEM), reveals a positive correlation between community attachment and the perceived benefits from tourism. Residents' knowledge about tourism is linked to perceived benefits, but not to perceived costs, and community involvement does not significantly impact perceptions. Perceived benefits positively influence support for tourism, while perceived costs have a negative effect. Residents' satisfaction with tourism, shaped by their perceptions of the benefits and costs, influences their future support for tourism initiatives. The theoretical implications highlight social exchange theory's role in understanding community perceptions, while the practical implications emphasize inclusive and transparent tourism planning to gain local support. These results underscore the importance of considering locals' perceptions and satisfaction in both current and future tourism planning and development strategies. [ABSTRACT FROM AUTHOR]

Administrative and leadership requirements are crucial to the application of evidence-based practices (EBPs) in special education. Therefore, the current study aimed to assess the availability of administrative and leadership requirements for applying EBPs in special education programs from the teachers' perspective, as well as determine the differences in their availability depending on the variables of disability category (intellectual disability (ID), autism spectrum disorder (ASD), and learning disabilities (LDs)) and school stage (e.g., primary or middle school). The sample included 243 special education teachers working in the city of Riyadh, Kingdom of Saudi Arabia. A questionnaire on the administrative and leadership requirements for implementing EBPs in special education programs (prepared by the researchers) was used to collect data. The results revealed the availability (which ranged from moderate to high) of administrative and leadership requirements for implementing EBPs. Moreover, there were differences in the availability of administrative and leadership requirements according to students' disability category; these differences were in favor of the learning disability group. However, there were no differences according to the academic stage. We recommend conducting further research on administrative and leadership requirements using different methods. [ABSTRACT FROM AUTHOR]

The traditional methods of educating the population to empower them and improve their daily lifestyle as well as their general health and their health literacy, has changed over the years. The current generation is technologically oriented; therefore use of technology to gain their interest is paramount in health education. The aim of this study is to assess the effectiveness of using a virtual reality tool compared to a traditional method of dental education among school children aged 10-18 years old in Riyadh, Saudi Arabia. A longitudinal phase of assessment for student's daily dental hygiene was assessed using a mixed method. There was a statistically significant improvement in plaque index score (p=.000), plaque percentage (p=.000), and brushing score (p=.000), when comparing education using Virtual Reality vs traditional method. Conclusion: Use of virtual reality education is more effective in improving the oral health status of children compared to the traditional educational method. [ABSTRACT FROM AUTHOR]

In education, the integration of artificial intelligence (AI) has presented opportunities to transform the dynamics of online learning. This study investigated the impact of an AI-powered application, namely ChatGPT, on the autonomy of Saudi Arabian primary students participating in online classes. It also explored how the implementation of Chat GPT influenced Saudi Arabian primary students’ autonomy. In this mixed-methods study, a quasi-experimental design assessed the impact of ChatGPT on learner autonomy among 250 Saudi Arabian primary students from six primary schools in Riyadh, Saudi Arabia. The quantitative analysis employed descriptive statistics and t-tests, while the qualitative data underwent interpretative phenomenological analysis. To ensure coding reliability, 20% of the codes were independently reviewed by an external coder, with a 94% inter-coder agreement coefficient reached through consensus. Findings revealed that ChatGPT significantly affected the participants’ perceptions of autonomy and its different dimensions. Qualitative data showed that AI-powered applications contributed to the students’ autonomy in 10 different ways. Participants also mentioned that AI-powered apps might have some negative consequences. This study has theoretical implications for redefining learner autonomy in the digital age and calls for the exploration of many facets of autonomy. Practical applications from this study include strategic integration of AI into online education, data security, and the need for orientation programs. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of electronic cigarette (e-cigarette) usage among young adults in Riyadh, Saudi Arabia; their perceptions of its harm and legal age, and the reasons and factors influencing their use. Methods: This cross-sectional study was carried out within the general community of Riyadh, Saudi Arabia, between December 2023 and April 2024. Participants aged 18-25 years were included. A selfadministered online questionnaire was used to gather demographic data, perceptions, and attitudes toward e-cigarettes and reasons for their use. Results: The majority of the 476 participants were female (n=378, 79.4%) and Saudi nationals (n=451, 94.7%). Current e-cigarette usage was 10.5% (n=50), being more prevalent among males (n=46, 46.9%) and non-Saudis (n=12, 48%). Respondents living alone (n=11, 34.4%) or with friends (n=4, 80%), those who perceived e-cigarettes as safer than cigarettes (n=38, 42.2%), or were unsure of age restrictions demonstrated high usage. Key motivators included flavors available, stress relief, and curiosity. Conclusion: Eelectronic cigarette use among Riyadh's youth was remarkable, especially among males. Reducing the e-cigarette usage prevalence in Saudi Arabia should be prioritized. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The purpose of the present observational study was to assess the prevalence of radiographic alveolar bone loss (ABL) as a function of age at the Periodontics Clinics at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. Materials and Methods: Medical and dental healthcare records of individuals visiting the Periodontics Clinics at College of Dentistry, King Saud University, Riyadh Saudi Arabia were assessed. The following information was retrieved: age, gender, educational status, and systemic diseases (diabetes mellitus [DM], hypertension, osteoporosis and obesity). Digital full-mouth radiographs were retrieved from patients' dental records, and marginal bone loss (MBL) was assessed on the mesial and distal surfaces of all teeth. Logistic regression analyses (LRA) were done to assess the correlation between ABL and gender, age, educational status and duration since diagnosis of the aforementioned systemic conditions. p < 0.05 was considered statistically significant. Results: In total, medical and periodontal healthcare records of 495 individuals were retrieved and assessed. All individuals were citizens of the KSA. Among these, 107 were healthy controls and 98, 95, 96 and 99 individuals had a medical diagnosis of type-2 DM, hypertension, obesity and osteoporosis, respectively. There was no statistically significant difference in the mean age and gender of all medically compromised participants. The prevalence of mild, moderate, and severe periodontitis in the total patient population was 51.4%, 37.5% and 36.5%, respectively. Among all healthy controls, the prevalence of mild, moderate, and severe periodontitis was 16.3%, 25.5% and 33.4%, respectively. There was no difference in the prevalence of mild, moderate, and severe periodontitis in relation to advancing age in the entire patient population. Conclusion: Advancing age did not seem to affect ABL in the present patient population. Patient education, oral hygiene maintenance and SES seem to be more predictable indicators of ABL than increasing age. [ABSTRACT FROM AUTHOR]

Background: Pedestrian traffic injuries are a rising public health concern worldwide. In rapidly urbanizing countries like Saudi Arabia, these injuries account for a considerable proportion of trauma cases and represent a challenge for healthcare systems. The study aims to analyze the key characteristics, seasonality, and outcomes of pedestrian traffic injuries in Riyadh, Saudi Arabia. Methods: This study was a retrospective cohort analysis of all pedestrian traffic injuries presented to King Saud Medical City, Riyadh, and included in the Saudi Trauma Registry (STAR) database between August 1, 2017, and December 31, 2022. The analysis of metric and nominal variables was reported as mean (standard deviation, SD) or median (interquartile range, IQR) and frequencies (%), respectively. A logistic regression analysis was performed to examine the influence of patients' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation and in-hospital mortality. Results: During the study period, 1062 pedestrian-injured patients were included in the analysis, mostly males (89.45%) with a mean (SD) age of 33.44 (17.92) years. One-third (35.88%) of the patients were Saudi nationals. Two-thirds (67.04%) of the injuries occurred from 6 p.m. until 6 a.m. Compared to other years, a smaller % of injury events (13.28%) were noticed during the COVID-19 pandemic (2020). Half (50.19%) of the patients were transported to the emergency department by the Red Crescent ambulance, and 19.68% required intubation and mechanical ventilation. Most of the patients (87.85%) were discharged home after completion of treatment, and our cohort had a 4.89% overall mortality. The logistic regression analysis showed the influence of patients' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation (Chi2 = 161.95, p < 0.001) and in-hospital mortality (Chi2 = 63.78, p < 0.001) as a whole significant. Conclusion: This study details the demographic, temporal, and clinical trends of pedestrian traffic injuries at a major Saudi trauma center. Identifying high-risk individuals and injury timing is crucial for resource allocation, targeting road safety interventions like public awareness campaigns and regulatory reforms, and improving prehospital care and patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Retinoblastoma (RB) is an intraocular malignant tumor detected in early childhood with variable global impact. Histopathological classification of the tumor in enucleated globes with RB is the key for the decision of adjuvant chemotherapy use. We aim to validate the use of adjuvant chemotherapy in cases with combined pre-laminar/intralaminar optic nerve (ON) invasion and focal choroidal invasion according to the American Joint Committee on Cancer (AJCC) 8th classification. Methods: This is a retrospective study conducted at King Abdulaziz University Hospital (KAUH) and King Khalid Eye Specialist Hospital (KKESH) in Riyadh, Saudi Arabia of all RB cases who underwent enucleation over 22 years (2000 to 2021). The histopathological findings were reviewed to identify the enucleated globes classified as pT2a tumors, as an inclusion criterion. Basic demographic and clinical data were collected via chart review Simple descriptive and basic statistical analysis of the data was used where applicable. Results: Thirty-one patients who had an enucleated globe with RB that fit into the above classification were included. Sixteen were males and 15 were females. The median age was 14 months (IQR = 14 months). Most of the patients (93.5%) had no family history of RB. The commonest presentation was leukocoria in 87.1% followed by squint in 32.3%. Fourteen patients (45.2%) were treated by enucleation alone while 17 patients (54.8%) received adjuvant chemotherapy. Out of these, 7 patients had unilateral RB and the remaining 10 patients had bilateral RB. None of our patients developed recurrence or metastatic disease irrespective of the indication for adjuvant chemotherapy use after a maximum period of follow up reaching 17.84 years and a median of 10.6 years (IQR = 5.92). Conclusions: In patients with 8th AJCC histopathological classification of pT2a, chemotherapy following enucleation might not be justified. The outcome in our untreated group of patients did not differ from the treated group with the absence of metastasis after a relatively long period of follow up with a median exceeding 10 years in both groups. Therefore, the risk and benefit of post enucleation adjuvant chemotherapy in the treatment of unilateral RB should be carefully decided and discussed with the primary caregivers taking into consideration the most recent evidence and recommendations in the literature. [ABSTRACT FROM AUTHOR]

Objectives: To study the effect of agitation and temperature on biofilm formation (cell aggregates embedded within a self-produced matrix) by pathogenic bacteria isolated from Raw cow milk (RCM). Methods: A 40 RCM samples were gathered from eight dairy farms in Riyadh, Saudi Arabia. After bacterial culturing and isolation, gram staining was performed, and all pathogenic, identified using standard criteria established by Food Standards Australia New Zealand (FSANZ), and non-pathogenic bacteria were identified using VITEK-2 and biochemical assays. To evaluate the effects of temperature and agitation on biofilm formation, isolated pathogenic bacteria were incubated for 24 h under the following conditions: 4 °C with no agitation (0 rpm), 15 °C with no agitation, 30 °C with no agitation, 30 °C with 60 rpm agitation, and 30 °C with 120 rpm agitation. Then, biofilms were measured using a crystal violet assay. Results: Of the eight farm sites, three exhibited non-pathogenic bacterial contamination in their raw milk samples. Of the total of 40 raw milk samples, 15/40 (37.5%; from five farms) were contaminated with pathogenic bacteria. Overall, 346 bacteria were isolated from the 40 samples, with 329/346 (95.1%) considered as non-pathogenic and 17/346 (4.9%) as pathogenic. Most of the isolated pathogenic bacteria exhibited a significant (p < 0.01) increase in biofilm formation when grown at 30 °C compared to 4 °C and when grown with 120 rpm agitation compared to 0 rpm. Conclusion: Herein, we highlight the practices of consumers in terms of transporting and storing (temperature and agitation) can significantly impact on the growth of pathogens and biofilm formation in RCM. [ABSTRACT FROM AUTHOR]

Creating a supporting learning environment for students with learning disabilities has been the concern of most teachers. However, digital applications provide numerous pedagogical affordances for teaching students with learning disabilities. This quantitative study examined teachers’ perspectives on the pedagogical affordances of digital applications and challenges when teaching students with learning disabilities in primary schools in Riyadh, Saudi Arabia. Data were collected from 280 teachers of students with learning disabilities through a questionnaire using a random strategy. The results showed that despite teachers’ awareness of the pedagogical affordances of digital applications in developing the academic skills of students with learning disabilities, the use of digital applications was intermediate. Teachers identified a lack of digital tools, time pressure and teachers’ workload as hindering the use of digital applications in their teaching. Findings also reveal statistically significant differences in perceptions for males and females, holding a master’s degree or above qualification, experience category (1–5 years), and training category (1–5 training sessions). These findings highlight the need for ongoing professional development and support that focuses more on real-classroom practices and resources, and how teachers can use digital tools to meet the various learning needs of students with learning disabilities. [ABSTRACT FROM AUTHOR]

We show that the Landsat and Sentinel-2 satellites can detect NO2 plumes from large point sources at 10 to 60 m pixel resolution in their blue and ultrablue bands. We use the resulting NO2 plume imagery to quantify nitrogen oxides (NOx) emission rates for several power plants in Saudi Arabia and the United States, including a 13-y analysis of 132 Landsat plumes from Riyadh power plant 9 from 2009 through 2021. NO2 in the plumes initially increases with distance from the source, likely reflecting recovery from ozone titration. The fine pixel resolutions of Landsat and Sentinel-2 enable separation of individual point sources and stacks, including in urban background, and the long records enable examination of multidecadal emission trends. Our inferred NOx emission rates are consistent with previous estimates to within a precision of about 30%. Sources down to ~500 kg h-1 can be detected over bright, quasi-homogeneous surfaces. The 2009 to 2021 data for Riyadh power plant 9 show a strong summer peak in emissions, consistent with increased power demand for air conditioning, and a marginal slow decrease following the introduction of Saudi Arabia's Ambient Air Standard 2012. [ABSTRACT FROM AUTHOR]

This research paper presents a comprehensive analysis to develop an energy-efficient and net-zero-energy (NZE) model for a proposed hypothetical mosque model located in Riyadh, Saudi Arabia. The study employs a sequential optimization analysis using BEopt software (Building Energy Optimization Tool) to explore various energy conservation measures (ECMs) from three main categories: HVAC, lighting, and building envelope. The ECMs are evaluated based on energy savings and life-cycle cost, with the most cost-effective options selected for the proposed energy-efficient design package. Furthermore, a passive downdraught evaporative cooling (PDEC) system is introduced as a passive cooling strategy to further reduce the cooling energy consumption. Computational fluid dynamics (CFD) analysis is utilized to optimize the airflow around the building and PDEC tower, determining the optimal PDEC dimensions for enhanced ventilation performance. The PDEC system is found to contribute 12% to cooling energy savings, which further enhances the energy efficiency of the proposed mosque. A rooftop solar PV system is incorporated into the optimal energy-efficient design to achieve a NZE mosque. The results demonstrate that the NZE model achieves 80% energy savings, with the remaining 20% offset by the solar PV system. Moreover, life-cycle cost analysis reveals that the NZE model offers the lowest cost, making it the most cost-effective design option. This research provides valuable insights into designing sustainable mosques in hot and dry climates, such as Riyadh, offering a comprehensive solution to significantly reduce energy end-use and promote sustainable building practices. [ABSTRACT FROM AUTHOR]

Background: Reducing antimicrobial resistance (AMR) is a priority for public health. Inappropriate patient demand is an important driver of unnecessary antibiotic use. To develop an effective intervention to reduce inappropriate demand for antibiotics in upper respiratory tract infections (URTIs), it is important to identify patient perceptions that influence demand for, and appropriate use of antibiotics. Aim: To identify and describe the beliefs about antibiotics necessity and concerns that patients with URTIs have, in Riyadh, Saudi Arabia. Method: An exploratory qualitative approach was used. One-to-one, face-toface or telephone semi-structured interviews were conducted with participants recruited using purposive sampling (based on age and gender) from primary healthcare centre in Riyadh, Saudi Arabia were conducted. Only adult patients who currently experience URTIs symptoms and agreed to participate were recruited. Recruitment for interviews continued until data saturation point was reached. The interview guide explored patients' necessity beliefs and concerns about antibiotics, AMR perceptions, and expectations from URTIs consultation. Interview transcripts were coded using QSR NVivo 12 using framework analysis informed by the Necessity-Concerns Framework to identify key motivations driving antibiotic requests and consultations. Results: the study interviewed 32 participants (44% were male, average age was 36.84). Results identified that the patients often relate their personal need for antibiotics when encountering an URTIs symptoms to the type, severity and duration of symptoms. Patients also linked antibiotics with quicker recovery, generally expressing few concerns about antibiotics mainly because of its short duration of use. However, some conveyed their concern about frequent administration of antibiotics and effect on the body's immune system function, which may make them more prone to infections in the future. Participants varied widely in their awareness of AMR; this was associated with many misconceptions, such as confusing AMR with antibiotics efficacy and tolerance. Interestingly, the interplay between necessity beliefs and concerns was observed to influence the decision to start and stop antibiotic, potentially impacting inappropriate antibiotic demand and unnecessary use. Conclusion: This study highlighted important beliefs and misconceptions about antibiotics and AMR in Saudi population which can be targeted in future interventions to reduce inappropriate demand for antibiotics and optimise appropriate usage. [ABSTRACT FROM AUTHOR]

in managing tracheostomy patients at King Abdulaziz Medical City under the Ministry of National Guard Health Affairs. Home healthcare is care provided to patients in the convenience of their homes to ensure highquality care based on healthcare providers' supervision. Methods: This retrospective cohort study utilizing a nonprobability consecutive sampling technique, including all available tracheal patients with no exclusion criteria, was carried out in Riyadh, Saudi Arabia, between January 2019 and June 2022. The collected data included patient demographic variables and respiratory settings (ventilation type, daily ventilation need, tracheostomy Original Article duration, and ventilator settings). The outcomes included mortality rate and therapeutic outcomes of tracheal management. Results: Of the 183 patients in the study, the most common type of respiratory-related infection was pneumonia (53%). Unlike respiratory-related causes, The mortality rate of patients admitted to the intensive care unit that was unrelated to respiratory causes was statistically significant (57%) (p=0.003). The mortality rate of patients who used aerosol tracheal collars (34%) was markedly higher than mechanically ventilated patients (57%) (p=0.004). The mortality rate following discharge from HHC was 40%, and was higher among patients aged >70 years (47%) (p=0.04). Conclusion: Pneumonia was associated with the majority of ventilator-related infections and resulted in hospital readmissions. Ensuring proper practices and caregiver education is crucial to decrease the incidence of ventilator-related infections. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the incidence of post tonsillectomy bleeding and to identify its predisposing factors among the pediatric population. Methods: A retrospective cohort study included 1280 pediatric patients (18 years or younger) who underwent tonsillectomy at King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia between 2019 and 2020. The study sample was divided into 2 groups based on the development of postoperative bleeding and were compared using Chi-square test and independent t-test. Significant variables (p-value ≤0.05) were included in the logistic regression model to determine the predictors of bleeding following tonsillectomy. Original Article Results: The bleeding rate following tonsillectomy was 3.4% in 43 (95% confidence interval [CI] 2.4-4.5) patients. In the multivariable logistic regression model, the significant predictors of post tonsillectomy bleeding were age ≥12 years (odds ratio [OR]: 2.685, p=0.027), decreased postoperative oral intake (OR: 4.244, p=0.042), and single use of postoperative analgesia (OR: 53.124, p<0.001). Out of the 43 patients, 39 (90.7%) patients experienced secondary bleeding, and more than half of the patients who developed bleeding required surgical intervention 27 (62.8%). Conclusion: Tonsillectomy is a safe and common surgical procedure but carries risks for postoperative bleeding. Age ≥12 years, poor postoperative oral intake, and the use of a single postoperative analgesic increase the risk of bleeding. We encourage healthcare providers to ascertain early resumption of oral intake and ensure effective pain management. We recommend a dual alternating analgesic regimen with weight-based dosing for optimal pain control. Furthermore, educating caregivers about the importance of adequate oral intake following tonsillectomy may improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Understanding patient satisfaction is key to advancing pharmacy services and improving health outcomes. There is a lack of a translated and psychometrically validated tool in the Arabic language to measure patient satisfaction with pharmacy services. Objective: To translate the English version of the PSPSQ 2.0 into Arabic language, culturally adapt, and verify its reliability and validity. Setting: A community pharmacy in Riyadh, Saudi Arabia. Method: A cross-sectional study was conducted between April 2021 and June 2022 among patients with diabetes attending a community pharmacy. The International Society for Pharmacoeconomics and Outcomes Research good practice guidelines for linguistic translation and cultural adaptation were used to translate and culturally adapt the English version of PSPSQ 2.0 into Arabic. The Arabic version of PSPSQ 2.0 was subjected to factor analysis using principal component analysis with varimax rotation to evaluate its validity and Cronbach's alpha was used to assess the reliability of PSPSQ 2.0. Results: A total of 129 (68.2% male, and mean age 50 (SD: 11.9) years) patients with diabetes participated in the study. The analysis was undertaken for the items in each of the three domains of PSPSQ 2.0: quality of care, interprofessional relationship and overall care. Exploratory factor analysis revealed validity of 92.7%, 80.5% and 96.2%, respectively. The Arabic version of PSPSQ 2.0 had high internal consistency with Cronbach's alpha scores 0.99, 0.95 and 0.98 for the three measured domains, respectively. The sample adequacy was 0.924. Conclusion: The PSPSQ 2.0 was successfully translated and culturally adapted into the Arabic language and had acceptable validity and reliability to measure patient satisfaction with services provided by pharmacists in community pharmacies. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence on the association between psychological distress, academic stress, and burnout among Saudi nursing students. Clarifying such an association is crucial to understanding the factors associated with psychological distress and developing interventions to prevent it. Aim: To explore the prevalence and association of psychological distress with academic stress and burnout among Saudi nursing students. Methods: A cross-sectional design was used, and 237 students participated from a nursing college in Riyadh, Saudi Arabia. Students' demographics; the Depression, Anxiety, and Stress Scale; the Academic Stress Inventory; and the Maslach Burnout Inventory were used for data collection. Results: Most of the participants reported no-to-mild depression, anxiety, and stress. Stress related to studying in groups, time management, emotional exhaustion, depersonalization, and personal accomplishment were the significant predictors of psychological distress, explaining 52.1% of the variance. Conclusions: This study suggest implementing tailored mental health screenings and support services for nursing students, embedding mental health professionals in the program, and using telehealth or mobile apps for remote monitoring to ensure comprehensive care for nursing students. Future research should consider these predictors while designing strategies to decrease psychological distress among students. [ABSTRACT FROM AUTHOR]

The site characterization process is vital for the engineering structures and earthworks. In the current study, a Multi-Channel Analysis of Surface Waves (MASW) was carried out in western Riyadh City, Saudi Arabia. This aimed to determine subsurface geology, material stiffness, and potential weak zones approximately down to a depth of 30 m, and to propose the suitable seismic site characterization for precise foundation design. A total of 30 MASW lines were executed utilizing the Geode digital seismograph equipped with a 24geophone array of 4.5 Hz. The data acquisition, processing, and inversion were meticulously calibrated to derive shear velocities representing subsurface geological conditions. The Vs30 map, based on estimated values ranging from 443.71 m/s to 639.78 m/s for soil, was prepared for the area. The results of the 1D and 2D Vs profiles tinted small Vs values at shallow depths. The resulting geological model is composed of sand, gravel, moderately weathered limestone, and hard limestone sequence. Analysis of shear wave velocities shows variations, indicating low shear velocity (representing sediments or rocks of low stiffness) juxtaposed with higher velocity layers (indicating rocks of higher stiffness) at depths greater than 10 m. This could imply the presence of a cavity or weak zone. The topmost shear wave velocity zone indicated materials with low Vs values (ranging from 180 m/s to 360 m/s), predominantly associated with stiff materials such as silty sand, gravel, and sandy deposits. The subsequent zone, with 3 to about 10 m depth, was characterized by medium to very dense soil with shear wave velocity values ranging from 360 m/s to 760 m/s, attributed to layers of silty clay and silty sand. At approximately 12 m, a high shear velocity layer (ranging from 760 m/s to 1,500 m/s) was identified, extending to a maximum depth of 22 m, potentially indicative of less weathered or fractured bedrock associated with limestone. While the deepest layer, with very high shear velocity (exceeding 1,500 m/s) beyond 22 m, indicated bedrock associated with hard limestone. The average Shear-wave velocity of soil for the whole study area (Vs30 = 551.2 m/s) suggests that the site can be classified as Class C (Very Dense Soil and Soft Rock) according to the National Earthquake Hazard Reeducation Program NEHRP (National earthquake hazards reduction program, 2001). These results will support, to a great extent, the design of engineering structures in the area of study. [ABSTRACT FROM AUTHOR]

Introduction: Hereditary Vitamin D-dependent rickets type II (HVDDR-type II) is a rare autosomal recessive disorder caused by molecular variation in the gene encoding the vitamin D receptor (VDR). This study aims to evaluate phenotype and genotype characteristics and long-term follow-up of the largest group of patients with (HVDDR-type II) in Saudi Arabia. Methodology: We conducted a retrospective chart review to collect the clinical, biochemical, and genetic data for all HVDDR-type II patients currently receiving treatment at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. Results: A total of 42 patients, 57.1% female, and 42.9% male were included in the study. Seven patients were treated with high doses of oral calcium, while 35 patients were treated with IV calcium infusion. The median age at presentation was 15.5 months. Alopecia was found in 97.6%, 21.4% presented with bowing legs, 14.3% with delayed walking, 9.5% with seizure, and 2.4% presented with respiratory failure, while a family history of the disease was positive in 71.4% of total patients. Molecular genetic testing of the VDR gene in our cohort identified six different gene variants c.885 C>A (p.Tyr295Ter), c.88 C>T (p.Arg30Ter), c.1036G>A (p.Val346Met), c.820C>T (p.Arg274Cys), c.803 T>C (p.Ile268Thr), and c.2T>G (p.Met1?). Conclusion: We are describing the largest cohort of patients with HVDDR-type II, their clinical biochemical findings, and the most prevalent genetic variants in our population. [ABSTRACT FROM AUTHOR]

Praise be to God, who created mankind and the jinn to command them to worship and obey Him, and may blessings and peace be upon the Messenger of God, Muhammad (peace be upon him), whom we were commanded to follow and imitate, and upon his family and all his companions, and after : It is from the mercy of God Almighty that He created them for a purpose and goal, and assigned them to direct them to what is for their benefit, benefit, and salvation in the two worlds. Sharia law, including it, considers the spiritual nourishment that the servants need more than their food, drink, and breath. If food, drink, and breath are cut off, the body dies, while the soul dies with the cessation of faith. With its death, the body dies . These costs come from the Qur’an and the Sunnah, which were the source of the rulings of Sharia with their definite and speculative significance, or by analogy with their texts, which are considered the source of deduction for all new facts and calamities. The knowledge of the accountable person about the purposes of the Sharia, its means, and the completion of its rulings, and his understanding of the Lawgiver’s ruling from its legislation, makes him feel the pleasure of obedience, prompts him to hasten to adhere to it, and urges him to avoid its prohibitions and prohibitions, due to his awareness that the Lawgiver has not commanded a matter except that there is benefit and good in it, and he has not forbidden doing anything except that it contains corruption and evil. Realize it or not. [ABSTRACT FROM AUTHOR]

Over the coming years, the advancement of driverless transport systems for people and goods that are designed to be used on fixed routes will revolutionize the transportation system. Therefore, for a safe transportation system, detecting and recognizing traffic signals based on computer vision has become increasingly important. Deep learning approaches, particularly convolutional neural networks, have shown exceptional performance in various computer vision applications. The goal of this research is to precisely detect and recognize traffic signs that are present on the streets using computer vision and deep learning techniques. Previous work has focused on symbol-based traffic signals, where popular single-task learning models have been trained and tested. Therefore, several comparisons have been conducted to select accurate single-task learning models. For further improvement, these models are employed in a multi-task learning approach. Indeed, multi-task learning algorithms are built by sharing the convolutional layer parameters between the different tasks. Hence, for the multi-task learning approach, different experiments have been carried out using pre-trained architectures like, for instance, InceptionResNetV2 and DenseNet201. A range of traffic signs and traffic lights are employed to validate the designed model. An accuracy of 99.07% is achieved when the entire network has been trained. To further enhance the accuracy of the model for traffic signs obtained from the street, a region of interest module is added to the multi-task learning module to accurately extract the traffic signs available in the image. To check the effectiveness of the adopted methodology, the designed model has been successfully tested in real-time on a few Riyadh highways. [ABSTRACT FROM AUTHOR]

Urbanization is one of the biggest challenges in the world today. Sixty-eight percent of the world's population will reside in cities and urban areas by 2050. Transitioning to a smart city is the key to overcoming the urbanization challenges. This study aimed to develop a smart city rating system that determines the overall smartness score of Riyadh City. A mixed method approach was used: qualitative research involved interviews, whereas quantitative analysis utilized the fuzzy analytic hierarchy process (AHP) and multiple-criteria decision analysis (MCDA) to determine city smartness scores using main pillars and subfactors. The findings showed that Riyadh's smart city development is influenced by several factors. The smart economy carries a weight of 17.8% and a smartness score of 74.15%, while smart people holds a weight of 8.1% and a score of 59.79%. Culture diversity, education, and the Human Development Index emerge as the most dominant subfactors. Smart living carries a weight of 8.2% and a smartness score of 51.86%, with health and security being crucial aspects of human life. Smart governance carries a weight of 17.8% and a smartness score of 81.451%, with smart business services, transparency, open communication, and collaboration being the most important factors. Smart urban services hold a weight of 17.9% and a score of 43%, with transport, logistics, urban planning, infrastructure, smart parking, digital monitoring, and safety being the most dominant subfactors. Smart construction carries a weight of 3.9% and a smartness score of 43.83%, with sustainable houses and smart buildings being the most dominant subfactors. Smart mobility holds a weight of 18% and a smartness score of 52.34%, with congestion, accidents, transport efficiency, and a sustainable transportation system being the most dominant subfactors. Understanding the strengths and weaknesses of Riyadh smart city from the current research will help developers improve and maintain areas aligned with Saudi Vision 2030 while also providing a foundation for future research on similar cities or varying factors. [ABSTRACT FROM AUTHOR]

The present study aims to investigate the levels of some heavy metals: Arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg) in infused tea consumed in Riyadh, Saudi Arabia, and their potential health risk. Inductively coupled plasma mass spectrometry (ICP-MS) was used to assay the concentration of heavy metals in tea samples, after microwave acid digestion. This study was carried out on 25 brands of tea purchased from Riyadh city supermarkets. The validation of the proposed method was developed by measuring different parameters e.g. accuracy, precision, linearity, the lower limit of quantification (LLOQ), the lower limit of detection (LLOD). The method was examined for the determination of As, Cd, Pb and Hg in spiking samples with good accuracy and precision. The average daily intake (ADI), the hazard quotient (HQ), the total hazard quotations (THQs), and hazard index (HI) of the investigated metals were used for the assessment of health risks associated with the intake of metals. The mean concentration of heavy metals in infused tea were found in the range of 0.008–0.445, 0.0097–0.044, 0.012–2.379 and 0.0053–0.044 mg/kg for As, Cd, Pb and Hg, respectively. The results revealed that the concentration of As, Cd and Hg metals in all samples of infused tea was considered in the standard range, whereas the concentration of Pb exceeded the maximum concentration limit presented by World Health Organization (WHO). Therefore, the continuous monitoring of the concentration of heavy metals in tea is essential on a regular basis. [ABSTRACT FROM AUTHOR]

Rhanterium epapposum Oliv. (Family: Asteraceae) is a common plant in Saudi Arabia, possessing a variety of traditional uses. The current targets were studying the comparative chemical profile and antioxidant of the essential oil (EO) of R. epapposum collected from a sandy habitat at Qareenah, Riyadh, Saudi Arabia. The EO profiling was constructed via gas chromatography-mass spectrometry (GC-MS) and GC-flame ionization detection (GC-FID). Forty-eight compounds were found, including monoterpenes (hydrocarbons 3.25% and oxygenated 48.64%), sesquiterpenes (hydrocarbons 12.64 % and oxygenated 32.38%), which are the backbone of the oil along with a minor of other non-terpenoid compounds (1.31%). Linalool (18.02%), α-eudesmol (11.98%), trans-sesquisabinene hydrate (11.63%), aromadendrene oxide-(1) (7.68%), nerol (6.88%), and α-terpineol (5.01%) were identified as the dominant components. The EO was evaluated for its antioxidant activity using in vitro DPPH, ABTS, and FRAP methods. The results demonstrated that R. epapposum EO possesses a dosage-dependent ability for antioxidant scavenging activity as per all three techniques. This EO exhibited IC50 values of 517.59, 350.24, and 713.72 μg/mL for the DPPH, ABTS, and FRAP, respectively, through the comparison with the ascorbic acid with respective values of 36.10, 26.12, and 44.58 μg/mL. The main compounds were subjected to docking analysis on cytochrome P450 1A1 and xanthine oxidase. All evaluated compounds exhibited good binding affinities especially α-eudesmol and linalool for both enzymes, respectively. The current research confirmed the potent free radical scavenging properties of R. epapposum EO. More research on the antioxidant content of this oil and/or its primary constituents in pure form on the two enzymes, cytochrome P450 1A1 and xanthine oxidase, is proposed to develop a better understanding of the oxidative action routes in vivo and in vitro. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged as a global pandemic in late 2019, quickly affecting millions worldwide. It presents with a range of symptoms, from mild respiratory issues to severe cases requiring hospitalisation. The disease's long-term effects, especially cognitive impairments post-recovery, remain an area of active research and concern. Aim: To assess the prevalence and severity of cognitive impairments, including memory loss, attention deficits, and executive function disorders, in individuals who have recovered from COVID-19 in Riyadh, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted from May to August 2023 in Riyadh, Saudi Arabia, involving 539 participants confirmed to have recovered from COVID-19 via Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) tests. Cognitive impairments, including memory loss, attention deficits, and executive function disorders were assessed. Data were analysed using IBM Statistical Package for Social Sciences (SPSS) version 22.0 Chi-square tests and T-tests were utilised to examine the statistical significance of differences between recovered individuals and controls. Results: The study identified significant memory changes in 211 (39.15%) of post-COVID-19 patients, with specific challenges including difficulty recalling names/faces in 146 (27.09%), reduced attention span in 45 (8.35%), and verbal communication issues in 145 (26.9%) study subjects. Demographically, females (n=134, 24.86%) and individuals aged 21-30 reported higher rates of memory impairments compared to males (n=77, 14.29%) or other age groups, challenging prior assumptions about cognitive recovery and age. Further, patients with brain injuries and mental health conditions experienced exacerbated memory issues, underscoring the need for thorough patient assessments. Despite the considerable impact on daily activities reported by 111 (20.59%) of participants, only 17 (3.15%) sought medical help for these memory concerns. The findings highlight the prevalence of memory impairments among Saudi post-COVID-19 patients and call for increased healthcare interventions to manage these long-term cognitive effects. Conclusion: The study conclusively demonstrated that post-COVID-19 memory impairment was prevalent among recovered patients in Saudi Arabia, with significant variations by age, gender, and medical history. This underscored the critical need for healthcare providers to have enhanced awareness and to have developed targeted support services to effectively address and manage the long-term cognitive consequences of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Carpal Tunnel Syndrome (CTS) presents with symptoms like numbness, tingling, and weakness along the median nerve pathway. Risk factors include prolonged wrist positions, repetitive muscle contractions, and exposure to vibrations. Aim: To determine the prevalence of CTS among healthcare practitioners at vaccine facilities in Saudi Arabia. Materials and Methods: A cross-sectional study on a total of 150 healthcare practitioners (aged 25-30 years) working in vaccination centres in Riyadh, Saudi Arabia were recruited. The study was conducted from November 2021 to March 2022. The authors collected demographic data, Body Mass Index (BMI) and work shift information, and administered two validated questionnaires, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and the Duruoz Hand Index (DHI). CTS symptoms were diagnosed using Phalen's and Arm Raising Test (ART). Results: Of the 150 practitioners (aged 25-45 years), predominantly in the 25-30 age group, n=65 (44.0%) tested positive on the Phalen's test, and n=65 (43.5%) on the ART. Females had higher BCTSQ scores, while DHI scores were similar across genders. Spearman's correlation analysis showed positive correlations between BCTSQ and DHI, and a moderate negative correlation between ART and DHI. Logistic regression analysed factors affecting the likelihood of CTS diagnosed by ART and Phalen's Test. Higher BCTSQ and DHI scores increased the likelihood of CTS (ART: BCTSQ OR=0.843, DHI OR=1.064; Phalen's Test: BCTSQ OR=0.830, DHI OR=1.069). Conclusion: During the Coronavirus Disease-2019 (COVID-19) pandemic, the prevalence of CTS among healthcare practitioners at vaccine centres in Riyadh, Saudi Arabia reached up to 43-44%. The present study highlights that day shift workers face a higher risk of CTS compared to night shift workers, likely due to heavier daytime workloads. This underscores the need for ergonomic interventions and workload management, especially during high-demand periods like the vaccination campaign, to safeguard healthcare workers' health and productivity. [ABSTRACT FROM AUTHOR]

Purpose: To examine the factors that affect graft healing after laryngotracheal reconstruction (LTR). Methods: We conducted a retrospective chart review at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between January-2008 and October-2023. We included all patients who underwent LTR and required anterior and/or posterior graft placement, while those who underwent procedures without graft placement and those with incomplete information were excluded. Results: Forty-nine patients were analyzed. Most patients were pediatric (65.3%), male (65.3%), had no coexisting comorbidities (55.1%), and harbored grade 3–4 stenosis (59.2%). Thirty patients (61.2%) underwent open surgery. Various graft complications occurred including infection (n = 1, 2%), dehiscence (n = 3, 6.1%), scar (n = 6, 12.2%), and granulation (n = 29, 59.2%). Only 15 patients (30.65%) achieved the composite status of "healthy" graft. Among 43 patients who had postoperative cultures, positive results for Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus were observed in 10 and four patients, respectively. Open surgery and double-stage procedure were significantly associated with higher rates of granulation tissue formation. Pediatric-age group had significantly higher rate of complete epithelization compared to adult-age group. A significantly greater proportion of patients who had unhealthy grafts had open surgery. The rate of double-stage LTR was significantly higher in unhealthy grafts compared to healthy grafts. Prolonged stent duration was linked to various graft-related complications. Multivariate logistic regression analyses showed no statistically significant correlations between various factors and postoperative graft-related complications. Conclusion: Open surgery, double-stage procedure, pediatric age group, and stent duration were not significant risk factors associated with postoperative graft-related complications during LTR in multivariate analysis. [ABSTRACT FROM AUTHOR]

BACKGROUND: Colonoscopy is a diagnostic modality and therapeutic procedure widely used for screening and diagnosing and treating colorectal diseases. Colitis is the inflammation of the colon. There are a variety of causes of colitis including infections, ischemia and autoimmune reactions (inflammatory bowel disease, IBD). The study is aimed to determine the clinical, epidemiological, the prevalence of various colonic diseases and characteristics of colitis in patients undergoing colonoscopy in a primary health center in Saudi Arabia. This data may provide a comparison for researchers. METHODS: Data from colonoscopized patients attending a gastroenterology clinic, primary health center in Riyadh, KSA between July 2014 and July 2015 were studied. This including the record of patient characteristics, age at diagnosis, course of the disease, manifestations, colonoscopy and Histopathology reports. RESULTS: Among 100 patients, males comprised 90% and only 10% females. According to the Montréal classification of age, the majority of our patients belonged to the A2 category for age of diagnosis at 17-40 years 63% while 72% of the colitis patients and 50% of IBD patients. 36% belonged to the A3 category > 40 years. Normal colonoscopy was seen in most of our series cases and anorectal diseases (piles and fissures) were in 16%. Biopsies showing colitis in 11% of cases, 7% non-specific and 4% IBD (ulcerative 3% crohns 1%). Colonic mass and cancer in 5%. Diverticula in 4% and polyps in 3%. Mean of age for the colitis patients was 36.1 years and 29 years for IBD. CONCLUSION: The majority of colonoscopised cases were young people and similar to the colitis and IBD cases, with a male preponderance. Colitis represented more than one tenth of cases with Ulcerative colitis more than crohns disease in 3:1 manner. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Are sperm phospholipase C zeta (PLCζ) profiles linked to the quality of embryogenesis and pregnancy? SUMMARY ANSWER Sperm PLCζ levels in both mouse and humans correlate with measures of ideal embryogenesis whereby minimal levels seem to be required to result in successful pregnancy. WHAT IS KNOWN ALREADY While causative factors underlying male infertility are multivariable, cases are increasingly associated with the efficacy of oocyte activation, which in mammals occurs in response to specific profiles of calcium (Ca2+) oscillations driven by sperm-specific PLCζ. Although sperm PLCζ abrogation is extensively linked with human male infertility where oocyte activation is deficient, less is clear as to whether sperm PLCζ levels or localization underlies cases of defective embryogenesis and failed pregnancy following fertility treatment. STUDY DESIGN, SIZE, DURATION A cohort of 54 couples undergoing fertility treatment were recruited at the assisted reproductive technology laboratory at the King Faisal Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia. The recruitment criteria for males was a minimum sperm concentration of 5×106 sperm/ml, while all female patients had to have at least five oocytes. Sperm PLCζ analysis was performed in research laboratories, while semen assessments were performed, and time-lapse morphokinetic data were obtained, in the fertility clinic as part of routine treatment. The CRISPR/Cas9 system was concurrently used to induce indels and single-nucleotide mutations within the Plcζ gene to generate strains of Plcζ mutant mice. Sperm PLCζ was evaluated using immunofluorescence and immunoblotting with an antibody of confirmed consistent specificity against PLCζ. PARTICIPANTS/MATERIALS, SETTING, METHODS We evaluated PLCζ profiles in sperm samples from 54 human couples undergoing fertility treatment in the context of time-lapse morphokinetic analysis of resultant embryos, correlating such profiles to pregnancy status. Concurrently, we generated two strains of mutant Plcζ mice using CRISPR/Cas9, and performed IVF with wild type (WT) oocytes and using WT or mutant Plcζ sperm to generate embryos. We also assessed PLCζ status in WT and mutant mice sperm in the context of time-lapse morphokinetic analysis and breeding outcomes. MAIN RESULTS AND THE ROLE OF CHANCE A significant (P  ≤   0.05) positive relationship was observed between both PLCζ relative fluorescence and relative density with the times taken for both the second cell division (CC2) (r  = 0.26 and r  = 0.43, respectively) and the third cell division (S2) (r  = 0.26). Examination of localization patterns also indicated significant correlations between the presence or absence of sperm PLCζ and CC2 (r  = 0.27 and r  = −0.27, respectively; P  ≤   0.025). Human sperm PLCζ levels were at their highest in the ideal times of CC2 (8–12 h) compared to time ranges outside the ideal timeframe (<8 and >12 h) where levels of human sperm PLCζ were lower. Following assignment of PLCζ level thresholds, quantification revealed a significantly higher (P  ≤   0.05) rate of successful pregnancy in values larger than the assigned cut-off for both relative fluorescence (19% vs 40%, respectively) and relative density (8% vs 54%, respectively). Immunoblotting indicated a single band for PLCζ at 74 kDa in sperm from WT mice, while a single band was also observed in sperm from heterozygous of Plcζ mutant mouse sperm, but at a diminished intensity. Immunofluorescent analysis indicated the previously reported (Kashir et al. , 2021) fluorescence patterns in WT sperm, while sperm from Plcζ mutant mice exhibited a significantly diminished and dispersed pattern at the acrosomal region of the sperm head. Breeding experiments indicated a significantly reduced litter size of mutant Plcζ male mice compared to WT mice, while IVF-generated embryos using sperm from mutant Plcζ mice exhibited high rates of polyspermy, and resulted in significantly reduced numbers of these embryos reaching developmental milestones. LIMITATIONS, REASONS FOR CAUTION The human population examined was relatively small, and should be expanded to examine a larger multi-centre cohort. Infertility conditions are often multivariable, and it was not possible to evaluate all these in human patients. However, our mutant Plcζ mouse experiments do suggest that PLCζ plays a significant role in early embryo development. WIDER IMPLICATIONS OF THE FINDINGS We found that minimal levels of PLCζ within a specific range were required for optimal early embryogenesis, correlating with increased pregnancy. Levels of sperm PLCζ below specific thresholds were associated with ineffective embryogenesis and lower pregnancy rates, despite eliciting successful fertilization in both mice and humans. To our knowledge, this represents the first time that PLCζ levels in sperm have been correlated to prognostic measures of embryogenic efficacy and pregnancy rates in humans. Our data suggest for the first time that the clinical utilization of PLCζ may stand to benefit not just a specific population of male infertility where oocyte activation is completely deficient (wherein PLCζ is completely defective/abrogated), but also perhaps the larger population of couples seeking fertility treatment. STUDY FUNDING/COMPETING INTEREST(S) J.K. is supported by a faculty start up grant awarded by Khalifa University (FSU-2023-015). This study was also supported by a Healthcare Research Fellowship Award (HF-14-16) from Health and Care Research Wales (HCRW) to J.K. alongside a National Science, Technology, and Innovation plan (NSTIP) project grant (15-MED4186-20) awarded by the King Abdulaziz City for Science and Technology (KACST) for J.K. and A.M.A. The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Background: The burden of respiratory syncytial virus (RSV) in high-risk pediatric patients remains unclear. Therefore, this study aims to characterize pediatric RSV cases from January 2019 to December 2022 and assess the impact of the COVID-19 pandemic on RSV burden and RSV-related outcomes. In addition, examining factors influencing RSV-related hospitalization. Methods: This is a retrospective study that included pediatric patients (aged 14 and below) who presented at King Faisal Specialist Hospital and Research Centre (KFSHRC) in Riyadh, Saudi Arabia with RSV infection identified using real-time reverse-transcriptase polymerase chain reaction assays. Statistical analyses were performed using STATA. Results: A total of 885 RSV cases were reported; (56.05%) were males and (43.95%) were females with a median age of 24 months [interquartile range (IQR): 11–60]. 534 (60.34%) required hospitalization. As for RSV seasonality, there was a significant increase in RSV prevalence following the COVID-19 pandemic, escalating from 205 cases in 2019 to 425 cases in 2022. The increase in 2022 was evident in January and persisted from September to December, reaching its peak during the months of October (20.70% − 88 cases) and November (32.00% − 136 cases). About (27.12%) of RSV infected children were medically free patients. Symptomatic patients exhibited various clinical manifestations, with ventilation necessary in (13.11%) of cases. Further analysis revealed significant changes in RSV-related outcomes post-COVID-19, including a decrease in hospitalization rates, an increase in medically free patients, and a lower need for ventilation (p < 0.05). Notably, a significant proportion of RSV admissions occurred within the first 6 months of life, with (77.69%) in the age group of 0 to 5 months. In addition, previous RSV infection, prematurity, low birth weight, renal disease, congenital heart disease, endocrine/metabolic disease, neuro/neuromuscular diseases, and genetic disorders were positively associated with hospitalization (P < 0.05). Interestingly, asthma and bone marrow transplantation were negatively associated with hospitalization (P < 0.05). The mortality rate in this study is (2.37%) (21/885). Conclusion: This study provides a comprehensive understanding of the demographic and clinical factors influencing RSV outcomes, highlighting the impact of the COVID-19 pandemic and shedding light on potential risk factors for RSV-related hospitalization. The highest prevalence of RSV during (September to January), aligning with global patterns and emphasizing the importance of timing in preventive strategies. [ABSTRACT FROM AUTHOR]

Background. Several endodontic difficulty assessment forms are available to help dental students and general dentists estimate the difficulty of the case before initiating the endodontic treatment. Objectives. This study aimed to assess if the American Association of Endodontics (AAE) case difficulty assessment form affects the dental student's perception of the difficulty encountered while performing root canal treatment (RCT). Materials and Methods. This was a cross-sectional online survey. After obtaining IRB approval, an electronic questionnaire was sent to dental students enrolled in the 4th and 5th years at King Saud University (KSU) and King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. The questionnaire was divided into informed consent, demographic data, the use of the AAE case assessment form, RCT steps, diagnosis, local anesthesia administration, tooth isolation, and endodontic procedure. Results. A total of 195 dental students participated in the study. There were 101 (52%) females, and 139 (71%) were from KSAU-HS. A positive association was found between students who used the AAE assessment form and who did not with their ability to reach the correct diagnosis (p = 0.005), tooth isolation (p = 0.03), and endodontic procedure difficulty score (p = 0.018). Conclusion. The use of the AAE form by dental students enabled them to differentiate between complicated and uncomplicated cases, thus lowering the difficulty encountered during RCT. [ABSTRACT FROM AUTHOR]

Background: Determining the prevalence of PTSD and contributing variables among (EMS) specialists was the goal of the current investigation. Furthermore, limited evidence exists regarding the application of PCL-5 for EMT practitioners, and the incidence of PTSD among different age groups and genders in Saudi Arabia. Methods: This cross-sectional descriptive study includes 211 prehospital care providers of the Saudi Red Crescent Authority stations in Riyadh. The randomization was done using Google Forms into subgroups according to participants' gender, years of experience, occupations, and average working hours. The presence and severity of PTSD symptoms were evaluated using the 20-item PTSD Checklist for DSM-5 (PCL-5) self-report questionnaire. Data were analyzed using Pearson Chi-Square, Mann-Whitney and Kruskal-Wallis tests. The reliability statistics were calculated using Cronbach's Alpha for the 20-survey questionnaire. Results: The comparison of PCL-5 total scores indicated more PTSD symptomatology among females (1.61 + 0.799) as compared to male workers (1.13 + 0.642). The total score of PTSD demonstrated no statistically significant (P=0.79) differences between our age group classifications. In terms of the participants' city (Riyadh), the total PTSD score was less than the cutoff point which is 31. PTSD total score may not be affected by working experience as indicated by the non-significant difference in prevalence among EMT practitioners having <5 years, 5-10 years and above 10 years of working experience (P=0.215 with X2 = 3.076). PTSD incidence is affected by the type of occupation as statistically significant differences between groups (P=0.001) were recorded depending on the position and responsibilities of EMS practitioners. PTSD is also affected by average working hours per week, and there were statistically significant differences between groups (P=0.001). Conclusion: The total score of PTSD in the case of emergency service practitioners was found to be 33.7% among all the research participants, which may be regarded as a high prevalence when compared to the general population. Our investigations would contribute to a better understanding of the underlying factors of mental stress in EMS specialists in Saudi Arabia and to the development of adequate mental health practices. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are one of the most common health problems worldwide and mainly affect women. This study aimed to evaluate the prevalence of UTIs in pregnant women and determine the antimicrobial resistance patterns of bacterial pathogens isolated from pregnant and nonpregnant women in Riyadh, Saudi Arabia. Methods: This retrospective cohort study was conducted at an academic medical center in Riyadh, Saudi Arabia, from January to June 2022. The study included all urine cultures performed for adult women during the study period. We excluded urine culture performed for women on antibiotics prescribed for any infection, children, and men. Using the SPSS (version 27) package, descriptive statistics and chi-square tests were used to analyze the data, and p < 0.05 was considered to indicate statistical significance. Results: A total of 2,418 urine cultures performed during the study period were included (985 and 1,433 for pregnant and nonpregnant women, respectively). The overall prevalence of UTIs in pregnant women was 5% (95% CI 3.6–6.4); 10 (1%) women were symptomatic, and 40 (4%) women were asymptomatic. Of the entire cohort, 244 (10.1%) women were diagnosed with UTIs based on bacterial cultures. The predominant bacteria in both pregnant and nonpregnant women were Escherichia coli (134, 54.9%), followed by Klebsiella pneumoniae (48, 19.6%). The antibiotic susceptibility criteria for Escherichia coli and Klebsiella pneumoniae were as follows: nitrofurantoin (94% and 18.8%, respectively), amoxicillin-clavulanic acid (82.8% and 70.8%, respectively), ciprofloxacin (65.7% and 83.3%, respectively), trimethoprim-sulfamethoxazole (65.7% and 79.2%, respectively) and cephalothin (47% and 68.8%, respectively). Conclusion: Compared to the findings of other similar studies, the prevalence of UTIs was lower in pregnant women. This may be because the patient population was composed of healthy and educated women who received prenatal education and underwent prenatal assessment as per institutional guidelines. Nitrofurantoin and amoxicillin-clavulanic acid are recommended for use as an empirical therapy for UTIs in pregnant and nonpregnant women because bacteria have the least amount of resistance to these drugs. [ABSTRACT FROM AUTHOR]