Search Results (208)

This study presents the design, fabrication, and performance assessment of a novel, small-scale (30–70 W), hybrid ocean energy system that captures energy from wave-induced heave motion using a point-absorber buoy and from ocean currents via a vertical axis water turbine (VAWT). Key innovations include a custom designed and built dual-rotor generator that accepts independent mechanical input from both subsystems without requiring complex mechanical coupling and a bi-directional mechanical motion rectifier with an overdrive. Numerical simulations using ANSYS AQWA (2024R2) and QBLADE(2.0.4) guided the design optimization of the buoy and turbine, respectively. Wave resource assessment for the Khobar coastline, Saudi Arabia, was conducted using both historical data and field measurements. The prototype was designed and built using readily available 3D-printed components, ensuring cost-effective construction. This mechanically simple system was tested in both laboratory and outdoor conditions. Results showed reliable operation and stable power generation under simultaneous wave and current input. The performance is comparable to that of existing hybrid ocean wave–current energy converters that employ more complex flywheel or dual degree-of-freedom systems. This work provides a validated pathway for low-cost, compact, and modular hybrid ocean energy systems suited for remote coastal applications or distributed marine sensing platforms. Full article

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems. Full article

Background/Objectives: Apixaban is favored over warfarin for atrial fibrillation (Afib) and venous thromboembolism (VTE) due to its effectiveness, safety, and lack of routine monitoring. However, managing anticoagulation in hospitalized patients with acute kidney injury (AKI) is challenging due to altered pharmacokinetics and limited safety data. This study assesses the safety and efficacy of apixaban versus warfarin in these patients. Methods: This retrospective chart review at King Abdulaziz Medical City in Riyadh included adult patients (≥18 years) with AKI, as defined by the Kidney Disease Improving Global Outcome (KDIGO) guideline. Primary outcomes were rates of major and minor bleeding within 30 days, as defined by the International Society on Thrombosis and Haemostasis (ISTH), and thrombotic events. Secondary outcomes included 30-day rates of all-cause mortality and hospital readmissions. Results: Among 513 patients, 294 received apixaban and 219 received warfarin. Major bleeding within 30 days was significantly lower in the apixaban group (3.4%) compared to warfarin (7.3%) (p = 0.0461). Minor bleeding rates were similar (6.5% apixaban vs. 5.5% warfarin; p = 0.616). Thrombotic events occurred in 6.8% of patients, with no significant difference between apixaban (6.5%) and warfarin (7.3%) (p = 0.739). Mortality rates were 8.0%, with no significant difference (8.8% apixaban vs. 6.8% warfarin; p = 0.3846). Readmission rates were comparable (38.8% for apixaban vs. 39.7% for warfarin; p = 0.9499). Conclusions: In hospitalized AKI patients, apixaban was associated with a lower major bleeding risk compared to warfarin, with similar rates of thrombotic events, mortality, and readmissions, suggesting apixaban may be a safer option, warranting further research. Full article

Introduction: Lung cancer (LC) is the leading cause of cancer mortality and is responsible for 1.8 million deaths annually. The early identification of risk factors, particularly smoking, is essential in improving outcomes. Public health campaigns play a crucial role in raising awareness, but misinformation and resource limitations hinder their effectiveness. This study evaluates the impact of a public awareness campaign on Saudi citizens’ understanding of lung cancer (LC) risks and screening. Methods: An interventional study was conducted in Riyadh, Saudi Arabia, using pre- and post-campaign self-administered surveys. A total of 1,426 participants aged 18 or older were surveyed either before or after the campaign. A matching approach was used to control for confounding variables. Each participant may receive a maximum total score of 14 for their knowledge of lung cancer and a maximum total score of 10 for their awareness of lung cancer screening. Results: A total of 713 participants were surveyed pre-campaign, and 859 post-campaign). After matching, 308 participants remained for the analysis, with no significant demographic differences between those who were surveyed before and after the campaign. Post-campaign, awareness was significantly improved, which is reflected in an increase in accurate responses to key statements. The median knowledge scores increased from 11.0 to 23.0, indicating a substantial increase in understanding. Conclusions: The campaign effectively enhanced the awareness of LC risk factors and screening. However, new misconceptions regarding universal screening emerged, emphasizing the need for clear messaging. Future initiatives should address socioeconomic and gender disparities, promote collaborative decision-making, and implement long-term educational strategies. These findings align with previous research and highlight areas for improvement in public health outreach. Full article

In a smart microgrid (SMG) system that deals with unpredictable loads and incorporates fluctuating solar and wind energy, it is crucial to have an efficient method for controlling frequency in order to balance the power between generation and load. In the last decade, cyberattacks have become a growing menace, and SMG systems are commonly targeted by such attacks. This study proposes a framework for the frequency management of an SMG system using an innovative combination of a smart controller (i.e., the Fuzzy Logic Controller (FLC)) with three conventional cascaded controllers, including Fractional-Order PI (FOPI), Tilt Integral Fractional Derivative (TID^μ), and Proportional Integral Derivative Acceleration (PIDA). The recently released Eel and Grouper Optimization (EGO) algorithm is used to fine-tune the parameters of the proposed controller. This algorithm was inspired by how eels and groupers work together and find food in marine ecosystems. The Integral Time Squared Error (ITSE) of the frequency fluctuation (ΔF) around the nominal value is used as an objective function for the optimization process. A diesel engine generator (DEG), renewable sources such as wind turbine generators (WTGs), solar photovoltaics (PVs), and storage components such as flywheel energy storage systems (FESSs) and battery energy storage systems (BESSs) are all included in the SMG system. Additionally, electric vehicles (EVs) are also installed. In the beginning, the supremacy of the adopted EGO over the Gradient-Based Optimizer (GBO) and the Smell Agent Optimizer (SAO) can be witnessed by taking into consideration the optimization process of the recommended regulator’s parameters, in addition to the optimum design of the membership functions of the fuzzy logic controller by each of these distinct algorithms. The subsequent phase showcases the superiority of the proposed EGO-based FFOPI-TID^μ-PIDA structure compared to EGO-based conventional structures like PID and EGO-based intelligent structures such as Fuzzy PID (FPID) and Fuzzy PD-(1 + PI) (FPD-(1 + PI)); this is across diverse symmetry operating conditions and in the presence of various cyberattacks that result in a denial of service (DoS) and signal transmission delays. Based on the simulation results from the MATLAB/Simulink R2024b environment, the presented control methodology improves the dynamics of the SMG system by about 99.6% when compared to the other three control methodologies. The fitness function dropped to 0.00069 for the FFOPI-TID^μ-PIDA controller, which is about 200 times lower than the other controllers that were compared. Full article

Background: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic conditions influenced by various factors, including diet. This study examined the association between fast food consumption and IBD risk through a case-control study and a meta-analysis of epidemiological evidence. Methods: We analyzed data from a hospital-based case-control study conducted in Riyadh. The study included 158 UC patients, 244 CD patients, and 395 controls without IBD. Fast food consumption was assessed using a self-administered questionnaire distributed before diagnoses were made. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs) of UC and CD for individuals who reported daily fast food consumption. Then, we merged our results with those from other studies investigating the same association into a meta-analysis. Results: In the case-control study, daily consumption of fast food was strongly associated with UC and CD among Saudi people: age- and sex-adjusted ORs (95% CIs) = 6.29 (3.89, 10.16) and 5.92 (3.98, 8.80), respectively. The associations remained robust after further adjustments: ORs (95% CIs) = 6.61 (3.93, 11.12) and 5.90 (3.89, 8.94), respectively. Similarly, the meta-analysis revealed higher odds of fast food intake associated with UC and CD, with pooled odds ratios (95% CIs) of 2.41 (1.07, 5.45) and 2.65 (1.23, 5.70), respectively. Conclusions: Our findings highlight the potential role of fast food consumption in the development of IBD. From a preventive medicine perspective, fast food consumption should be discouraged to reduce the risk of IBD. Full article

Background: Aging is a complex biological process characterized by the accumulation of molecular and cellular damage over time, often driven by oxidative stress. This oxidative stress is particularly detrimental to the testes, where it causes degeneration, reduced testosterone levels, and compromised fertility. D-galactose (D-gal) is commonly used to model aging as it induces oxidative stress, mimicking age-related cellular and molecular damage. Testicular aging is of significant concern due to its implications for reproductive health and hormonal balance. This research examines the protection by thymoquinone (TQ) or thymoquinone-loaded chitosan nanoparticles (NCPs) against D-galactose (D-gal)-induced aging in rat testes, focusing on biochemical, histological, and molecular changes. Aging, which is driven largely by oxidative stress, leads to significant testicular degeneration, reducing fertility. D-gal is widely used to model aging due to its ability to induce oxidative stress and mimic age-related damage. TQ, a bioactive ingredient of Nigella sativa, has earned a reputation for its anti-inflammatory, anti-apoptotic, and antioxidant characteristics, but its therapeutic application is limited by its poor bioavailability. Methods: Thymoquinone was loaded into chitosan nanoparticles (NCPs) to enhance its efficacy, and this was hypothesized to improve its stability and bioavailability. Four groups of male Wistar rats participated in the study: one for the control, one for D-gal, one for D-gal + TQ, and the last one for D-gal + NCP. Results: The results exhibited that D-gal substantially increased oxidative injury, reduced testosterone levels, and caused testicular damage. Treatment with TQ and NCPs significantly reduced oxidative stress, improved antioxidant enzyme levels, and restored testosterone levels, with NCPs showing a stronger protective effect than TQ alone. A histological analysis confirmed that NCPs better preserved testicular structure and function. Additionally, the NCP treatment upregulated the expression of key genes of oxidative stress resistance, mitochondrial function, and reproductive health, including SIRT1, FOXO3a, and TERT. Conclusions: The findings suggest that NCPs offer enhanced protection against aging-related testicular damage compared with TQ alone, which is likely due to the improved bioavailability and stability provided by the nanoparticle delivery system. This research emphasizes the potential of NCPs as a more effective therapeutic strategy for mitigating oxidative stress and age-related reproductive dysfunction. Future research should further explore the mechanisms underlying these protective effects. Full article

Background/Objectives: Acinetobacter baumannii is a highly multidrug-resistant pathogen resistant to almost all classes of antibiotics; new therapeutic strategies against this infectious agent are urgently needed. Shikimate kinase is an enzyme belonging to the shikimate pathway and has become a potential target for drug development. This work describes the search for Food and Drug Administration (FDA)-approved drugs and natural compounds, including gallic acid, that could be repurposed as selective shikimate kinase inhibitors by integrated computational and experimental approaches. Methods: Approaches to drug design using structure-based and ligand-based methodology, in-silico screening, molecular docking, and molecular dynamics for the study of both binding affinity and stability. Experimental Validation Determination of minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) on Acinetobacter baumannii and Enterococcus faecalis. Results/Conclusions: Among them, gallic acid, obtained from plants, proved to be the most promising compound that showed sufficient binding with shikimate kinase through computational studies. Gallic acid showed very good activity against Acinetobacter baumannii and Enterococcus faecalis in the MIC and MBC assay, respectively. Gallic acid exhibited better activity against Acinetobacter baumannii due to the overexpression of shikimate kinase. Gallic acid has emerged as a potential therapeutic candidate drug against A. baumannii infection and, therefore, as a strategy against the appearance of multidrug-resistant microorganisms. This study not only identifies a novel repurposing opportunity for gallic acid but also provides a comprehensive computational and experimental framework for accelerating antimicrobial drug discovery against multidrug-resistant pathogens. Full article

Methanol is a widely used industrial and household alcohol that poses significant health risks upon exposure. Despite its extensive use, methanol poisoning remains a critical public health concern globally, often resulting from accidental or intentional ingestion and outbreaks linked to contaminated beverages. Methanol toxicity stems from its metabolic conversion to formaldehyde and formic acid, leading to severe metabolic acidosis and multiorgan damage, including profound CNS effects and visual impairments. Epidemiological data underscore the widespread impact of methanol poisoning, with alarming case fatality rates reported in various countries. Comprehensive prevention and effective management strategies are urgently needed to address the significant morbidity and mortality associated with methanol poisoning. The clinical manifestations of methanol toxicity vary between adult and pediatric populations and between acute and chronic exposure. Adults typically present with gastrointestinal and neurological symptoms, whereas pediatric patients often exhibit more severe outcomes due to differences in metabolism and body weight. The diagnosis of methanol poisoning involves a combination of clinical evaluation, laboratory testing, and advanced diagnostic techniques. The identification of metabolic acidosis, elevated anion and osmolal gaps, and confirmation through methanol and formate levels are critical for accurate diagnosis. Timely intervention is crucial, and the management of methanol poisoning includes securing the airway, breathing, and circulation; addressing metabolic acidosis with sodium bicarbonate; administering antidotes such as fomepizole or ethanol; and administering hemodialysis, which plays a pivotal role in eliminating methanol and its toxic metabolites, especially in severe cases. The complexity of methanol poisoning necessitates a comprehensive approach encompassing early recognition, prompt intervention, and coordinated care among healthcare providers. Increased awareness, effective prevention strategies, and timely treatment protocols are essential to mitigate severe health consequences and improve patient survival and recovery. Full article

Background and Objective: The aim of this study was to evaluate cardiorespiratory fitness (CRF) measures, maximal oxygen consumption (VO₂ max), and minute ventilation/carbon dioxide production (V_E/VCO₂ slope and others) among the T2DM population based on glycated haemoglobin (HBA1c). Material and Methods: The present study comprised a cross-sectional design, with two groups, based on HbA1c values (≤7 and ≥7.1). Laboratory samples were taken to evaluate glycated haemoglobin and fasting blood glucose (FBS). Cardiopulmonary exercise testing was performed to calculate various fitness-related parameters. Data analysis: An independent t-test was used to analyse the outcomes in the two groups. p < 0.05 was considered significant. Linear regression was used to examine the influence of predictor variables on dependent variables. Results: A total of 70 patients agreed to participate in the study, with 19 females and 51 males. The mean (standard deviation) BMI (body mass index) of all participants was 29.7(5.2), the mean (SD) weight was 84.4 (18.9) kg, and the mean height was 167.4 (23) cm. The average age of the individuals was 52 ± 8 years. The independent t-test revealed a significant difference between the two groups in terms of CRF measures. Conclusions: The current research identified the presence of poor glycaemic control and cardiorespiratory fitness measures among the Brazilian population with T2DM. HBA1c, duration of diabetes, age, and BMI can be employed to predict the ventilatory threshold (VT) and VO₂ max. Full article

Background and Objectives: Asthma is associated with several comorbidities, one of which is obesity. The worldwide increase in obesity has been accompanied by a parallel rise in asthma prevalence, with obesity recognized as a significant risk factor for both the development and severity of asthma. Obesity is often linked to various comorbidities, which can complicate asthma management and lead to poorer clinical outcomes. This study aims to investigate the prevalence of obesity and its comorbidities in adults with asthma in a single center in Saudi Arabia, providing an overview of the associated health implications. Materials and Methods: This single-center, retrospective study aimed to assess the prevalence of obesity and other comorbidities in asthma patients. Data were collected from King Khalid University Hospital in Saudi Arabia between July 2023 and December 2023. Results: This study revealed that 72.1% of asthma patients were either obese or overweight. Female patients had significantly higher BMI values compared to males. Our study revealed that 38.21% of female asthma patients (mean age = 57 ± 13.85 years) had comorbidities compared to 24.14% of male asthma patients (mean age = 59 ± 14.02 years). Furthermore, the proportion of obese asthmatic patients with comorbidities was significantly greater than those without comorbidities. Conclusions: This study investigates obesity prevalence and associated comorbidities in adult asthmatics in a single center in Saudi Arabia. The findings reveal a 72.1% rate of obesity and overweight among asthmatic patients, with higher BMI and comorbidity prevalence in females. These results underscore the need for targeted interventions addressing obesity and comorbidities, especially in female asthmatics. Full article

Background: Hyperuricemia has been linked to various adverse clinical outcomes. Data on the clinical outcomes and the relationship between hyperuricemia and sepsis remain limited. The aim of this study was to evaluate the impact of hyperuricemia on clinical outcomes in sepsis patients and to identify whether it can predict the mortality in this patient population. Methods: This was a retrospective cohort study of adult patients with sepsis admitted to the intensive care unit (ICU) from 1 January 2021 to 31 December 2023. The patients were divided into hyperuricemia and non-hyperuricemia groups. Hyperuricemia was defined as a serum uric acid level > 416.4 µmol/L (7.0 mg/dL) in males or >357.0 µmol/L (6.0 mg/dL) in females based on the first serum uric acid reading within 24 h of ICU admission. The primary outcome of this study was ICU mortality. Secondary outcomes included in-hospital mortality, progression to septic shock, and ICU and hospital lengths of stay (LOSs). Results: A total of 599 patients were included in the study. Among these, 303 were in hyperuricemia group, while 296 were in the non-hyperuricemia group. The incidence of ICU and in-hospital mortality was higher in the hyperuricemia group compared to the non-hyperuricemia group (26.7% vs. 18.9% (p < 0.001) and 34.7% vs. 19.3% (p < 0.001), respectively). After adjusting for cofounders, hyperuricemia was not a predictor of ICU mortality (OR 1.52, 95% CI 0.95–2.43, p = 0.083). Most secondary outcomes were similar between the groups. However, the hyperuricemia group had a higher incidence of progression to septic shock (67.3% vs. 50.7%, p < 0.001), and hospital LOS was significantly longer in the hyperuricemia group (384 vs. 264 h, p = 0.004). Conclusions: Our findings demonstrated that hyperuricemia in sepsis patients was associated with worse clinical outcomes such as higher ICU and hospital mortality. Moreover, there was a higher incidence of septic shock progression and longer hospital LOS. The other outcomes were not statistically significantly different. Further prospective research is warranted to confirm these findings. Full article

Aim: To assess the feasibility of video game-based trunk exercises using the Valedo^® system in a chronic stroke population. Method: Ten chronic stroke survivors (eight males and two females, mean age 63 ± 15 years) were asked to complete 18 intervention sessions, each lasting 45 min., over 6–8 weeks. Feasibility was evaluated quantitatively using the Psychosocial Impact of Assistive Devices Scale (PIADS) as well as through recruitment, retention, adherence, and safety measures. Qualitative data on feasibility were collected through post-intervention semi-structured interviews. Descriptive analysis was used to summarize participant characteristics, recruitment, retention, and adherence. Qualitative data were analyzed using thematic analysis of the interviews. Results: Twelve stroke survivors were recruited from Southampton (United Kingdom) and Riyadh (Kingdom of Saudi Arabia), with two participants dropping out after the baseline assessment session. The remaining ten participants completed the study with a mean adherence of 96.11% to the planned sessions. No serious adverse effects were reported, however, four participants did experience trunk muscle tightness and fatigue. Post-intervention interviews revealed that participants encountered some physical and cognitive challenges while playing the Valedo video games. However, they felt that the implementation of trunk exercises using video games was safe, as the exercises were performed in a secure environment and in safe positions. Conclusions: The findings suggest that the Valedo system is feasible for delivering trunk exercises to chronic stroke survivors. Several factors should be considered when implementing this type of intervention in the future. Full article

Inborn errors of metabolism (IEM) and endocrine disorders are common genetic conditions in the Saudi population with the incidence rate often underestimated. Newborn screening (NBS) using various disease panels provides the first line in the early detection and intervention among infants with a high risk of IEM. Here we aim to assess the incidence of screening disorders and provide an overview of the NBS program at the Ministry of Health Tertiary Care King Fahad Medical City. Dried blood spots (DBS) from 40,965 newborn infants collected on the second day after birth were analyzed for 20 disorders. The total number of positive screen (“repeat”) samples over 10 years was about 1% (n = 382/40,965). The true positive result rate was 15.3% (n = 46/301) with the recall rates of individual disorders ranging from 0.26% (95% CI, 0.17–0.69) to 2.6% (95% CI, 2.19–3.05). The false positive result rate was 84.7% (n = 255/301) with biotinidase activity found to be the most common cause of the second sample repeat. The overall incidence of the screened diseases was 1:891 (95% CI, 11.61–12.47). CH and CAH are the most prevalent among endocrine disorders with an incidence of 1:4097 (95% CI, 2.19–3.05), and PA and ASA among the IEM with an incidence of 1:10,241 (95% CI, 0.09–0.95). In summary, we provide updated data and our experience on the incidence of various IEM and endocrine disorders among the Saudi population, highlight the role of false positive results of biotinidase activity that can increase the recall rate and lead to overestimation of the incidence data, and recommend multicenter studies to achieve a successful national NBS program. Full article