Search Results (184)

In arid and semi-arid climates, where water scarcity is a persistent challenge, accurately estimating reference evapotranspiration (ET) becomes essential for sustainable water management and agricultural planning. The objectives of this study are to compare hourly ET among P–M ASCE, P–M FAO, and P–M KSA mathematical models. In addition to the accuracy assessment of daily ET derived from hourly timestep calculations for the P–M ASCE, P–M FAO, and P–M KSA. To achieve these goals, a total of 525,600-min data points from the Riyadh region, KSA, were used to compute the reference ET at multiple temporal resolutions: hourly, daily, hourly averaged over 24 h, and daily as the sum of 24 h values, across all selected Penman–Monteith (P–M) models. For hourly investigation, the comparison between reference ET computed as average hourly values and as daily/24 h values revealed statistically and practically significant differences. The Wilcoxon test confirmed a statistically significant difference (p < 0.0001) with R² of 94.75% for ASCE, 94.87% for KSA at h_plt = 50 cm, 92.41% for FAO, and 92.44% for KSA at h_plt = 12 cm. For daily investigation, comparing the sum of 24 h ET computations to daily ET measurements revealed an underestimation of daily ET values. The Wilcoxon test confirmed a statistically significant difference (p < 0.0001), with R² exceeding 90% for all studied reference ET models. This comprehensive approach enabled a rigorous evaluation of reference ET dynamics under hyper-arid climatic conditions, which are characteristic of central Saudi Arabia. The findings contribute to the growing body of literature emphasizing the importance of high-frequency meteorological data for improving ET estimation accuracy in arid and semi-arid regions. Full article

Gastric cancer traditionally affects older adults, and its precursor lesions and risk factors are well-documented in this population. Helicobacter pylori (H. pylori) infection remains highly prevalent in Saudi Arabia and contributes to gastric pathology. However, early-onset gastric cancer (EOGC), diagnosed in individuals aged ≤ 45 years, presents unique challenges and remains poorly understood in young populations. Therefore, we conducted an observational cohort study using a prospective longitudinal design (2021–2024) involving 1823 Saudi nationals aged 18–45 years who underwent zoom high-definition chromoendoscopy to evaluate the prevalence of premalignant gastric lesions (PGLs) and EOGC. We found a high H. pylori prevalence (78.0%) with PGLs in 1.9% of participants and EOGC-adenocarcinoma in 0.7% of patients. All EOGC cases arose from dysplasia, with most PGLs being classified as OLGA/OLGIM stage II/III. Multiple risk factorswere significantly associated with PGLs and EOGC, including H. pylori infection (p = 0.022), increasing age (p < 0.001), a family history of gastric cancer (p < 0.001), poor dietary habits (p < 0.001), obesity (p < 0.001), and smoking (p < 0.001). Additional EOGC risk factors include dage of 36–45 years (p = 0.018), EBV infection (p = 0.016), and diabetes mellitus (p = 0.001). These findings demonstrate the notable presence of PGLs and EOGC in young Saudi adults and emphasize the importance of early detection and risk factor management in this vulnerable population. Full article

Background and Objectives: Hospital mortality rates have repeatedly been used as important indicators of the quality of care provided and as a good monitoring and evaluation tool. Studies on hospital mortality in Saudi Arabia are scant, with most of the available literature focusing on the COVID-19 era. In this study, the patterns and trends in inpatient mortality at King Fahad Central Hospital in southwest Saudi Arabia from 2018 to 2022 were analyzed. Mortality characteristics, including age-specific mortality rates and associated factors, were also investigated. Materials and Methods: This was a retrospective study analyzing hospital mortality data in King Fahad Central Hospital (KFCH) from 2018 to 2022 using the largest hospital discharge database in the Jazan region. The mortality rates were calculated, and 95% confidence intervals (CIs) were reported. The analysis also documented some associations using logistic regression models. Results: Of the 62,534 patients admitted, 36,971 (59.1%) were females, and 25,543 (40.9%) were males. The mean age (standard deviation) was 24.6 (22.8) years. The overall hospital mortality was 4.8% [95% CI: 4.6–5.0] and was significantly higher among males [7.0%, 95% CI: 6.7–7.3] than females [3.2% 95% CI: 3.1–3.4] (p < 0.05). Mortality was significantly higher in the population aged 60 years and above [17.25%, 95% CI: 16.3–18.2] (p < 0.001). During the five-year period analyzed, mortality was low in 2018 (3.3%), with remarkably high rates during the COVID-19 period of 2020 and 2021 (5.6% and 6.0%, respectively). The disease groups with the highest prevalence of mortality include certain conditions originating in the perinatal period. In the logistic regression model, the male sex [odds ratio OR = 2.3, 95% CI = 2.01–2.43) was associated with an increased mortality risk. Compared to intensive care beds, general bed departments are associated with a 98% lower risk of mortality [OR = 0.015, 95% CI = 0.014–0.017]. Conclusions: This analysis of hospital data statistics revealed a relatively low hospital mortality rate in Jazan. However, the high mortality rates among male patients require further analysis and investigation. Customized interventions targeting high-mortality diseases are recommended. Full article

The integration of traditional geomorphological approaches with advanced artificial intelligence techniques represents a promising frontier in flood risk assessment for arid regions. This study presents a comprehensive analysis of the Wadi Ranuna basin in Medina, Saudi Arabia, combining detailed morphometric parameters with advanced Geospatial Artificial Intelligence (GeoAI) algorithms to enhance flood susceptibility modeling. Using digital elevation models (DEMs) and geographic information systems (GISs), we extracted 23 morphometric parameters across 67 sub-basins and applied XGBoost, Random Forest, and Gradient Boosting (GB) models to predict both continuous flood susceptibility indices and binary flood occurrences. The machine learning models utilize morphometric parameters as input features to capture complex non-linear interactions, including threshold-dependent relationships where the stream frequency impact intensifies above 3.0 streams/km², and the compound effects between the drainage density and relief ratio. The analysis revealed that the basin covers an area of 188.18 km² with a perimeter of 101.71 km and contains 610 streams across six orders. The basin exhibits an elongated shape with a form factor of 0.17 and circularity ratio of 0.23, indicating natural flood-moderating characteristics. GB emerged as the best-performing model, achieving an RMSE of 6.50 and an R² value of 0.9212. Model validation through multi-source approaches, including field verification at 35 locations, achieved 78% spatial correspondence with documented flood events and 94% accuracy for very high susceptibility areas. SHAP analysis identified the stream frequency, overland flow length, and drainage texture as the most influential predictors of flood susceptibility. K-Means clustering uncovered three morphometrically distinct zones, with Cluster 1 exhibiting the highest flood risk potential. Spatial analysis revealed 67% of existing infrastructure was located within high-risk zones, with 23 km of major roads and eight critical facilities positioned in flood-prone areas. The spatial distribution of GBM-predicted flood susceptibility identified high-risk zones predominantly in the central and southern parts of the basin, covering 12.3% (23.1 km²) of the total area. This integrated approach provides quantitative evidence for informed watershed management decisions and demonstrates the effectiveness of combining traditional morphometric analysis with advanced machine learning techniques for enhanced flood risk assessment in arid regions. Full article

The study examined the relations and Granger causality among environmental pollution, air quality, life expectancy, religious tourism, petroleum consumption and economic growth in three countries, Italy, Saudi Arabia and Türkiye, three countries with a prominent role of religious tourism, given the high shares of religious tourism revenues in their economies and due to pilgrimage-type religious tourism activities in total tourism activities. The study employed a yearly sample of 1975–2019 and novel Fourier-augmented vector autoregressive and Fourier Granger causality tests, under the structural breaks in the data. The findings indicate negative effects on environmental pollution and air quality from tourism in addition to such effects on life expectancy in all countries analyzed, and in this relation, fossil fuel consumption in these nations and its acceleration with tourism play crucial roles. These effects are amplified by economic growth coupled with tourism revenues that go in hand with high fossil fuel consumption, which further worsen the impacts on the environment. In the causality testing stage, the results determined unidirectional causality from tourism, fossil fuel energy consumption, and economic growth to both carbon dioxide emissions and to particulate matter 2.5. These effects are also reinforced by feedback effects between air pollution and life expectancy, which enhance the effects on both environment and air quality. These findings are used to suggest important policy recommendations, among which, the reduction in high dependency on fossil fuel in the energy mix is most central. Equally, policies are suggested to encourage sustainable tourism to reverse the adverse effects on health, environmental degradation and worsened air quality in these nations. Full article

This study investigates the role of urban centrality in shaping urban form and function, with a specific focus on the city of Hail, Saudi Arabia as a representative case. Urban centrality—defined as the spatial and functional concentration of economic, social, and cultural activities—plays a critical role in determining the vibrancy, resilience, and adaptability of cities. Through a mixed-methods approach combining spatial analysis, field observations, and stakeholder insights, this research explores the dynamics of Hail’s central areas, examining how they navigate the tension between preserving historical identity and accommodating contemporary urban growth. The findings reveal that successful urban centrality requires a balanced integration of heritage conservation, economic diversification, and spatial accessibility, supported by inclusive governance and strategic infrastructure investments. The study highlights both the challenges and opportunities associated with the evolution of central urban spaces, particularly in medium-sized cities experiencing rapid socio-economic and spatial transformations, defined in this study as urban regions undergoing annual population growth rates exceeding 3% and substantial changes in land-use, infrastructure development, and governance structures within a decade. By providing actionable insights into the interplay between permanence and change, this research contributes to the broader discourse on urban resilience and sustainable development, offering practical guidance for planners and policymakers aiming to cultivate adaptive and inclusive urban environments capable of responding to future challenges. Full article

This study explores the adoption of green bonds within Saudi Arabia’s municipal sector, situated at the intersection of centralized governance, fossil fuel dependency, and ongoing sustainability reforms under Vision 2030. Employing a mixed-methods approach, this research integrates quantitative and qualitative insights from expert survey data to uncover key institutional, market, and stakeholder dimensions influencing green bond uptake. The findings reveal an emerging framework shaped by regulatory capacity, global integration, and risk perceptions. Rather than focusing solely on statistical outputs, this study highlights how governance structures, economic diversification efforts, and stakeholder alignment collectively shape the trajectory of green finance adoption. Practical implications include the need for harmonized regulatory frameworks, enhanced transparency through ESG standards, and stronger public–private collaboration. While focused on Saudi Arabia, this study offers broader lessons for green bond integration in similarly structured, resource-dependent economies. Full article

Over the past four decades, Wadi Fatimah in western Saudi Arabia has undergone significant environmental changes that have contributed to desertification. High-resolution spatial and temporal analyses are essential for monitoring the extent of desertification and understanding its driving factors. This study aimed to assess the spatial distribution of desertification in Wadi Fatimah using satellite and climate data. Landsat imagery from 1984 to 2022 was employed to derive land surface temperature (LST) and assess vegetation trends using the Normalized Difference Vegetation Index (NDVI). Climate variables, including precipitation and evapotranspiration (ET), were sourced from the gridded TerraClimate dataset (1980–2022). LST estimates were validated using MOD11A2 products (2001–2022), while TerraClimate precipitation data were evaluated against observations from four local rain gauge stations: Wadi Muharam, Al-Seal Al-Kabeer, Makkah, and Baharah Al-Jadeedah. A Desertification Index (DI) was developed based on four variables: NDVI, LST, precipitation, and ET. Five regression models—ridge, lasso, elastic net, polynomial regression (degree 2), and random forest regression—were applied to evaluate the predictive capacity of these variables in explaining desertification dynamics. Among these, Random Forest and Polynomial Regression demonstrated superior predictive performance. The classification accuracy of the desertification map showed high overall accuracy and a strong Kappa coefficient. Results revealed extensive land degradation in the central and lower sub-basins of Wadi Fatimah, driven by both climatic stressors and anthropogenic pressures. LST exhibited a clear upward trend between 1984 and 2022, especially in the lower sub-basin. Precipitation and ET analysis confirmed the region’s arid climate, characterized by limited rainfall and high ET, which exacerbate vegetation stress and soil moisture deficits. Validation of LST with MOD11A2 data showed reasonable agreement, with RMSE values ranging from 2 °C to 6 °C and strong correlation coefficients across most years. Precipitation validation revealed low correlation at Al-Seal Al-Kabeer, moderate at Baharah Al-Jadeedah, and high correlations at Wadi Muharam and Makkah stations. These results highlight the importance of developing robust validation methods for gridded climate datasets, especially in data-sparse regions. Promoting sustainable land management and implementing targeted interventions are vital to mitigating desertification and preserving the environmental integrity of Wadi Fatimah. Full article

This study explores the toothbrushing frequency and its association with sociodemographic factors, health status, and dietary habits in Saudi Arabia. Using data from the 2017 National Demographic and Health Survey by the Ministry of Health, we analyzed responses from 44,779 individuals aged five and older. Statistical analysis using SPSS and multinomial regression revealed that 57.3% of the population brushed their teeth less than once a day. Differences were noted across regions, ages, and genders. Key factors associated with increased brushing frequency included age (45–54 vs. older than 60), nationality (Saudi vs. non-Saudi), region (Western vs. Central), and marital status (married vs. non-married). Conversely, individuals with co-morbidities, disabilities, smokers, and those without prior dental treatment were less likely to maintain recommended oral hygiene practices. Our findings suggest that toothbrushing practices fall short of professional recommendations, highlighting a need for enhanced educational efforts. Oral health care providers in Saudi Arabia are encouraged to implement regular awareness programs to improve brushing habits and overall oral hygiene. Full article

Background/Objectives: Pediatric obstructive sleep apnea (POSA) is a long-term sleep disorder characterized by repeated interruptions in breathing during sleep among children. These interruptions result from blockages in the upper airways, causing decreased oxygen intake and disturbed sleep. Assessing parents’ awareness level and the factors affecting their knowledge is vital for enhancing early diagnosis and management of POSA. Methods: This was a cross-sectional study that utilized data from a sample of 838 parents in the Central Region of the Kingdom of Saudi Arabia. The participants completed self-administered online surveys, which ensured anonymity. Results: Only 320 (38.2%) of the parents demonstrated good knowledge about POSA, while the majority, 518 (61.8%), had poor knowledge. Nearly a third, 261 (31.2%), of the parents indicated that their primary sources of information on POSA were the internet and social media platforms. The prevalence of OSA among children was quite significant, with nearly a quarter, 236 (28.2%), of parents having a child affected by the condition. Commonly recognized symptoms included snoring, reported by 425 (50.7%), and mouth breathing, reported by 156 (18.6%). Frequently cited risk factors included obesity, mentioned by 373 (44.5%), and enlarged tonsils, mentioned by 175 (20.9%). A statistically significant association was found between age, gender, marital status, education level, specialization/work, source of knowledge about POSA, knowing someone with OSA, and having a child with OSA and the level of knowledge about POSA (p < 0.05). The study identified several significant factors predicting poor parental awareness of pediatric obstructive sleep apnea (POSA) including gender [AOR = 1.65; 95% CI = 1.220–2.223; p = 0.001], source of knowledge about pediatric obstructive sleep apnea [AOR = 1.35; 95% CI = 1.167–1.572; p < 0.001], and knowing someone with OSA [AOR = 1.92; 95% CI = 1.301–2.832; p = 0.001]. Conclusions: The study revealed that parents in the Central Region had limited knowledge about POSA. There were notable gaps in recognizing and understanding the symptoms of POSA and its impact on children’s mental health and academic performance. This underscores the importance of introducing targeted educational programs and initiatives for both parents and healthcare providers to enhance children’s mental health and overall well-being. Full article

Background and Objectives: Multiple sclerosis (MS) is a chronic autoimmune condition that impacts the central nervous system and has a rising incidence globally, especially in Saudi Arabia. Materials and Methods: This study examines environmental, lifestyle, and familial risk factors associated with MS in the Aljouf Region by a cross-sectional analysis of 155 clinically diagnosed MS patients. Data were gathered using structured questionnaires and medical record examinations to evaluate sociodemographic characteristics, sun exposure, smoking, obesity, eating habits, and childhood infections. Results: Logistic regression research found insufficient daily sun exposure (<15 min/day), smoking, obesity, and childhood measles infection as significant risk factors, but substantial weekend sun exposure (>4 h/day), exclusive breastfeeding, and regular fish consumption were deemed protective. While familial history of MS was statistically significant (5.5%, p = 0.04), parental consanguinity (38.7%) did not show a significant association with MS risk (p = 0.07). Conclusions: The findings underscore the complex nature of MS and the pressing necessity for preventive efforts, such as advocating for vitamin D supplementation, smoking cessation, obesity prevention, and dietary adjustments. Mitigating these controllable risk factors may alleviate the prevalence of MS in Saudi Arabia. Full article

Background: The dirty utility room (DUR) plays a vital role in maintaining and optimizing the safety of patients and healthcare staff. A substantial gap exists in the literature concerning the current topic in terms of empirical studies and reviews. Therefore, this study aims to shed light on the subject and provide reliable evaluations. Methods: A qualitative case study design (observational) was used. We included the DURs of hospitals in multiple regions of the Kingdom of Saudi Arabia/in wards and units of each hospital. To achieve data saturation, visits across wards and ICUs were conducted until no new information was retrieved. NVivo Software version 14 was used for management and analysis of the data. We used our notes to initiate codes and then created themes involving the six steps of thematic analysis for the observational study. Results: Among several main hospitals in the central, western, eastern, southern, and northern geographical locations in Saudi Arabia that included DURs, a total of 24 DURs were explored to capture all relevant aspects related to the observations. Considering the range of items presented in DURs, the majority of hospitals exhibited a substantial lack of equipment. There were disagreements regarding the definition of DURs and the name of DURs. The observers agreed with the practice of urine disposal, which is performed by hand. The observers from all regions mutually agreed that stool disposal methods for patients involved diapers and the cleaning of patients manually with bed sheets. Several risks of infection control were observed related to DUR design and protocols. Conclusions: This national observational study of DURs in Saudi Arabian hospitals revealed major inadequacies in the design, equipment, and processes that are critical for infection control and healthcare quality, emphasizing the critical necessity for standardized methods and appropriate equipment. Full article

Background/Objectives: Hypoparathyroidism (HPT) is a common complication following thyroid surgery with an incidence reaching up to 29%, potentially resulting in significant long-term morbidity. To improve its early identification and patient outcomes, we investigated the prevalence and predictors of postoperative HPT. Methods: This retrospective, multicenter observational study included patients who underwent thyroid surgery from 2016 to 2022 in four centers located in Saudi Arabia’s Eastern Province. We analyzed demographic data, underlying thyroid or parathyroid conditions, surgical indications, types of procedures, pathology results, and preoperative corrected calcium and vitamin D levels, along with postoperative corrected calcium and parathyroid hormone (PTH) levels. For data analysis, IBM Statistical Package for the Social Sciences (SPSS) Statistics 22 was used, with categorical variables presented as frequencies/percentages and non-normal continuous variables as the median/first quartile (Q1) and third quartile (Q3). Associations were tested with chi-square/Fisher exact tests, medians with Mann–Whitney U-tests, and odds ratios (ORs) with 95% confidence intervals (CIs) via multivariate analysis with statistical significance set at p < 0.05. Results: A total of 679 cases were included. The median age of patients was 43 years (with 48.9% of them aged 41–60 years), and 82% were female. HPT occurred in 228 cases (35.3%), with 115 (81.0%) experiencing transient HPT and 27 (19.0%) permanent HPT. Multivariate analysis identified total thyroidectomy (OR 2.7, p = 0.005), completion thyroidectomy (OR 8.4, p = 0.004), and low immediate postoperative PTH level (OR 3.1, p < 0.001) as independent predictors of HPT. Central lymph node dissection (CLND; OR 4.03, p = 0.004) and low postoperative PTH level (OR 2.56, p = 0.049) were significant predictors of permanent HPT. Conclusions: Key predictors of HPT include surgical extent and low postoperative PTH level, while CLND and low postoperative PTH level are the strongest predictors of permanent HPT. Careful assessment of these risks when determining the extent of surgery and avoiding unnecessary aggressive procedures can help to minimize the occurrence of HPT. Measuring the PTH level immediately after surgery may aid in identifying high-risk patients for early intervention and appropriate follow-up. Full article

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi healthcare providers, with numerous studies outlining the incidence of medication errors and the need for enhanced safety standards. This review will examine the existing level of drug-related safety in Saudi Arabia, categorizing the areas for improvement and highlighting concepts to improve safety practices. The overview discusses the history and evolution of pharmaceutical safety procedures, the present regulatory framework, major stakeholders, and the types and origins of prescription errors. It also examines the role of healthcare personnel and the use of technology and patient education in promoting pharmaceutical safety. The data reveal that the rate of pharmaceutical errors in Saudi hospitals is shockingly high, ranging from 13 to 56 per 100 medication orders, highlighting the urgent need for effective medication safety standards. Despite the formation of the Saudi Food and Drug Authority (SFDA) and the National Pharmacovigilance and Drug Safety Centre, issues such as poor understanding among healthcare providers and the need for more effective reporting methods remain a challenge. The evaluation highlights the deficiencies in ongoing education, such as real-world case scenarios and related trainings, inadequate incorporation of skills in assessment methods, and deficiency in standardized protocols for error reporting. To address these gaps, it is proposed to implement structured competency-based training, simulation exercises must be preferred for periodic skill assessments, and a safe reporting culture should be encouraged for the sake of transparency and learning from errors. We recognize the use of technology, such as electronic health records and computerized physician order input systems, as an important technique for improving medication safety. Future directions include creating national guidelines, establishing a centralized pharmaceutical error reporting system, and fostering a safety culture inside healthcare organizations. By addressing these obstacles and capitalizing on the opportunities indicated, we may improve pharmaceutical safety and, ultimately, patient care and outcomes in Saudi Arabia. Full article

Adopting photovoltaic (PV) systems in government schools across Saudi Arabia presents an opportunity to reduce energy costs and contribute to the country’s RE goals. In this paper, the energy consumption and energy consumption indicators of 3 schools in Qassim region (the central region of the Kingdom of Saudi Arabia) were determined. The integration of PV systems into the buildings of these schools was also studied to achieve zero energy and zero bills along the system’s life cycle. The analysis considered the effects of temperature and other factors on PV system output and a projected 1% annual increase in school load. Energy use intensity ranged from 22 to 48 kWh per square meter, while per capita energy use varied between 337 and 630 kWh. Values for end-use of electricity of 80%, 11%, and 9% were obtained for air conditioning, lighting, and others, respectively. The results note that the zero-energy scenario’s technical, economic, and environmental indicators are appropriate. The indicators in the zero-billing case were similar to the energy-zero scenario except for the payback period, which was longer and, in some cases, not economically feasible. The results show that economic evaluation must be revisited by reviewing the tariff value for selling surplus energy to the distribution network. The study also recommends scaling this model to other educational institutions, contributing to sustainable energy transitions in Saudi Arabia. Full article