Search Results (329)

Synthetic dyes, such as methylene blue (MB), constitute a major category of environmental pollutants due to their toxicity, persistence, and resistance to standard treatment methods. In this study, Bacillus cereus BC WW Saida was isolated from the heavily polluted Saida dumpsite in Lebanon and evaluated for its MB degradation efficiency. The isolate was identified through whole-genome sequencing, which revealed the presence of key enzymatic systems involved in azo dye degradation. Under optimized conditions, the strain achieved 82% decolorization, as determined by optical density measurements using a microplate reader. The process was further examined using High-Performance Liquid Chromatography (HPLC), which revealed a significant reduction in the original dye peak and the emergence of new intermediate products. These findings suggest the strong biodegradation capability of B. cereus BC WW Saida isolated from contaminated environments and highlight its potential application in the eco-friendly treatment of azo dye-contaminated wastewater. Full article

Background: Antimicrobial resistance continues to threaten effective infection management worldwide and is driven largely by inappropriate prescribing practices. In Saudi Arabia, the cities of Makkah and Al-Madinah experience intense seasonal healthcare demand due to the annual pilgrimage, creating additional challenges for rational antibiotic use. This study aimed to evaluate physicians’ knowledge, attitudes, and prescribing behaviors related to antibiotics in these high-demand settings. Methods: A cross-sectional analytic study was conducted between June and August 2024 among physicians practicing in Makkah and Al-Madinah, including those participating in Hajj services. A previously validated, structured electronic questionnaire assessed knowledge of common pathogens, perceptions of antimicrobial resistance, prescribing influences, and counseling practices. The survey was distributed electronically to eligible physicians. Descriptive statistics were generated, and associations were examined using appropriate inferential tests with a 95% confidence level. Results: A total of 487 physicians participated. Most respondents (74%) correctly identified major bacterial causes of upper respiratory tract infections, and 90% acknowledged the association between prior antibiotic exposure and resistance. Nonetheless, misconceptions persisted regarding the benefit of antibiotics in viral conditions. Workload and patient expectations influenced prescribing behavior; 77% reported a greater likelihood of prescribing antibiotics during periods of high clinical pressure. While adherence to guideline-based practice was generally reported, variability existed in counseling practices and perceptions of stewardship policies. Conclusions: Although baseline knowledge was satisfactory, contextual and behavioral factors continue to influence prescribing decisions and may contribute to unnecessary antibiotic exposure, highlighting the need for strengthened antimicrobial stewardship strategies in high-demand healthcare environments. Full article

Surgical navigation and augmented reality (AR) are widely used in neurosurgery, spinal surgery, and orthopedics. However, their use in minimally invasive abdominal and thoracic soft-tissue surgery is limited, as tracking deformable, mobile organs is challenging. Recent advances in AR may address these challenges to improve intraoperative navigation. This systematic review, registered in PROSPERO (2024) and based on PRISMA guidelines, analyzes literature from 2014 to 2024 about AR in minimally invasive abdominal and thoracic soft-tissue surgery. It identifies target organs, describes AR hardware and software, and evaluates accuracy levels, usability outcomes, clinical benefits, technical limitations, and research needs. Searches of PubMed, Web of Science, and Embase for English-language studies found 1297 records, of which only 28 (2%) met the inclusion criteria. Nearly half (n =12; 42%) focused on liver surgery; none on gynecologic surgery. The AR devices varied in tracking methods, image processing, visualization, and display. Overall, AR improved anatomical guidance and procedural planning, especially in complex surgeries. Integration with robotic systems may further boost visualization, precision, and workflow, though challenges remain in standardization, large-cohort validation, and workflow integration. Full article

Background/Objectives: HPV vaccination is highly effective in preventing HPV-related cancers when administered before viral exposure. However, vaccination practices for patients already diagnosed with gynaecological cancers remain poorly characterized. Understanding clinicians’ perspectives and barriers is essential for optimizing preventive strategies in oncologic care. Methods: We conducted an international, web-based survey among members of the European Society of Gynaecological Oncology (ESGO) and the European Network of Young Gynaecological Oncologists (ENYGO). The questionnaire explored clinicians’ attitudes, practices, and perceived obstacles regarding HPV vaccination in patients with gynaecological cancer or pre-invasive disease across multiple clinical scenarios and age groups. Results: A total of 149 respondents from 33 countries completed the survey. Most clinicians supported HPV vaccination for patients treated for cervical precancer (78–82% for patients under 45 years), and even for invasive cervical cancer (57–62%). Recommendations varied by patients’ age, cancer type, and treatment status. For endometrial and ovarian cancer, endorsement ranged from 16% to 53%, depending on patient age. Timing of vaccination was a point of divergence: some clinicians favoured vaccination immediately after treatment for CIN2+, while others recommended delaying vaccination depending on HPV test results. Reported barriers discouraging HPV vaccination recommendations included misinformation (69.8%), lack of patient education materials (52.3%), and time constraints (48.3%), alongside economic factors and uncertainty about efficacy in oncologic settings. Conclusions: The survey shows that HPV vaccination is often recommended beyond evidence-supported indications. Randomized trials have not demonstrated a reduction in CIN2+ recurrence with adjuvant vaccination, and no evidence supports vaccination in women with invasive gynaecological cancers. These findings reveal a gap between clinical practice and available evidence, highlighting the need for clearer, evidence-based guidance. Full article

Background/Objectives: Hajj is a major annual mass gathering. It requires prolonged walking under conditions of fatigue, heat stress, and crowd density, which increases mobility difficulties and fall risk, particularly among older adults and individuals with chronic diseases. Therefore, rapid operational mobility screening is required to identify risk and plan mobility. To support an operational mobility-classification workflow in a pre-Hajj setting, this study evaluated whether Timed Up and Go (TUG)-based stratification, combined with spatiotemporal gait and plantar pressure measurements, differentiates fall-risk categories. Methods: We conducted a cross-sectional study at a seasonal medical center near Al-Haram in Madinah Al-Munawwarah (21 May–3 June 2025) within the “I Lean On It” screening initiative. Participants completed the TUG and dynamic baropodometric gait assessments. We stratified the risk of falling as low (≤10 s), moderate (10.1–13.5 s), and high (>13.5 s) according to the TUG performance. We performed between-group comparisons using the Kruskal–Wallis test and evaluated the associations using Spearman’s correlation analysis. Results: Participants were classified as having low (n = 103), moderate (n = 24), or high (n = 29) fall risk. TUG performance significantly increased across the fall-risk groups. Significant between-group differences were observed in cadence, half-step length, walking speed, test duration, and functional mobility, whereas plantar pressure magnitude and gait symmetry did not differ significantly. Spearman correlation analysis showed significant negative correlations between TUG time and sex (rs = −0.357), half-step length (rs = −0.617), walking speed (rs = −0.577), and cadence (rs = −0.420). Significant positive correlations were observed with weight-bearing time (right: rs = 0.584; left: rs = 0.461), test duration (rs = 0.376), and number of steps acquired (rs = 0.356) (all p ≤ 0.003). Overall, TUG performance was primarily associated with dynamic gait and functional mobility. Conclusions: Integrated functional mobility and spatiotemporal gait screening significantly differentiate fall risk and provide clinically actionable mobility-support guidance in a mass-gathering pre-Hajj clinical workflow. Full article

Background: Goldenhar syndrome (oculo–auriculo–vertebral spectrum, OAVS) is a rare congenital disorder characterized by craniofacial malformations, systemic anomalies, and significant phenotypic variability. Although it is the second most common craniofacial malformation after a cleft palate, the genetic etiology of Goldenhar syndrome remains largely unexplored. This study aimed to identify genetic variants contributing to Goldenhar syndrome in a Lebanese family with three affected individuals, using whole-exome sequencing and complementary genomic approaches. Methods: Whole-exome sequencing was performed on the nuclear family to identify variants associated with the syndrome. Complementary DNA methylation and gene ontology analyses were conducted to explore epigenetic modifications. Results: A missense shared variant in the MID1 between the affected individuals [NP_000372.1): p. Ile593Phe] gene was observed in the family, while current ACMG evidence was insufficient to establish causality. Additional variants were identified, including a de novo mutation in FBXW11 and a rare frameshift alteration in NDUFAF8, with limited segregation, implicating these genes in associated phenotypes such as craniofacial anomalies and cardiac defects. DNA methylation analysis revealed hypomethylation at CpG sites within the ZC3H3 gene, suggesting an epigenetic contribution to disease variability. Conclusions: Our findings underscore the genetic and epigenetic complexity of Goldenhar syndrome, providing new insights into its molecular etiology and highlighting the challenges of variant interpretation in familial cases of rare congenital disorders. Full article

Missing values may arise in climate data collection due to sensor malfunction, transmission errors, device calibration and operational issues. This problem can be more catastrophic in the case of multi-dimensional and high-frequency climate data sets, where some or all climate readings could be missing at multiple timestamps. These missing data in high-frequency climate modeling could lead to inaccurate prediction models, which in turn affect overall assessments, planning, and climate-related measures and policy. In this paper, we evaluate the performance of three imputation techniques based on the mean, k-nearest neighbor, time-based interpolation and a new temporal cross-year climate imputation approach using a random forest, long short-term memory (LSTM) model and contextual embedding-based Transformer regression methods. We discussed our findings on four years of multi-output, high-frequency and multi-dimensional climate data collected in Kuwait. Using a leave-one-year-out cross-validation approach, our results show that all imputation methods perform better than no imputation, with LSTM and time-based interpolation emerging as the best combination. Imputing climate data based on previous years’ timestamps did not yield good results, highlighting the variability of climate data across years. Full article

This study provides a comprehensive evaluation of waste-to-energy (WtE) technologies in Saudi Arabia, focusing on municipal solid waste (MSW) across various cities, in alignment with Saudi Vision 2030. Saudi Arabia generates approximately 16 million tons of MSW annually, primarily composed of organic matter (37–57%), followed by paper (11–28%) and plastics (5–36%). According to Vision 2030 projections, MSW generation is expected to increase to approximately 30 million tons per year by 2033, driven by population growth, urbanization, and increased tourism activities. Waste quantities notably increase during the Hajj and Ramadan seasons. The study assesses three main WTE technologies: biochemical, chemical, and thermochemical processes. Anaerobic digestion (AD) effectively converts organic waste into biogas with a methane content of 60% to 80%, potentially yielding up to 2.99 TWh annually. Transesterification efficiently targets fats in waste, generating around 244.2 GWh per year. Thermochemical processes, including incineration, gasification, and pyrolysis, are suitable for high-calorific waste. Incineration can significantly reduce waste volume and generate up to 2073 MW while lowering GHG emissions. Economic assessments reveal that biochemical methods are the most cost-effective for managing organic waste, while thermochemical methods, despite higher capital costs, achieve significant energy recovery. Integrating WTE technologies with recycling is crucial for enhancing environmental sustainability and supporting Saudi Arabia’s Vision 2030 objectives. Full article

Background/Objectives: Human papillomavirus (HPV) is the most common sexually transmitted virus worldwide and is frequently detected in women of reproductive age. In this population, HPV-related diseases and their management may affect reproductive health and pregnancy outcomes. This narrative review summarizes the current evidence on HPV infection and HPV-related diseases in relation to fertility, pregnancy, and neonatal outcomes, and discusses preventive strategies, with a particular focus on HPV vaccination. Methods: An international, multidisciplinary team of clinicians from the European Society of Gynaecological Oncology (ESGO) Prevention Committee reviewed the literature on HPV, HPV-related diseases, HPV vaccination, and reproductive outcomes, without time restrictions, prioritizing studies judged to meaningfully reflect the available evidence. Results: The most consistent evidence linking HPV-related conditions to adverse pregnancy outcomes relates to the treatment of cervical precancer, particularly excisional procedures, which are associated with an increased risk of preterm birth and mid-trimester pregnancy loss. In contrast, evidence that maternal HPV detection alone causes adverse pregnancy or neonatal outcomes remains limited and inconsistent. Data on HPV infection and subfertility are scarce and heterogeneous. Management of HPV-related lesions during pregnancy remains challenging and requires careful balancing of maternal safety with avoidance of unnecessary interventions. HPV DNA has been detected in neonatal samples, but convincing evidence for clinically relevant vertical transmission is lacking. Available data indicate that inadvertent HPV vaccination shortly before or during pregnancy is not associated with adverse pregnancy outcomes. Conclusions: Current evidence suggests that reproductive risks are more strongly associated with the treatment of HPV-related diseases than with HPV infection itself. Preventive strategies—especially HPV vaccination—remain central to reducing HPV-related disease burden. Although HPV vaccines are not routinely recommended during pregnancy, evidence supports the safety of inadvertent exposure around conception or during gestation, while potential long-term benefits of vaccination regarding reproductive health require further study. Full article

Growing interest in reducing the environmental impacts of pavement preservation materials has increased the need for evaluations of emulsified asphalt. This study applies a cradle-to-gate Life Cycle Assessment (LCA) to quantify and compare the environmental profiles of four widely used cationic emulsions in the United States: CSS 1, CSS 1H, CRS 2, and CRS 2P. The assessment incorporates primary data collected from 17 manufacturing plants across different regions, supported by information from suppliers and secondary datasets from the 2023 GaBi database. Impact calculations were performed using GaBi software, and sensitivity analyses were conducted to determine which formulation components most influence the results. Environmental impact categories in the study include global warming potential (GWP), particulate matter (PM_2.5), photochemical ozone creation potential (POCP), and renewable and nonrenewable primary energy demand. The findings show that rapid-setting emulsions (CRS 2 and CRS 2P) generally exhibit lower environmental burdens than slow-setting emulsions (CSS 1 and CSS 1H). Differences in asphalt binder content, emulsifier dosage, and latex additions were identified as major contributors to environmental performance. By identifying key drivers of environmental impact, this study supports more sustainable material choices in pavement preservation. The results provide updated industry-specific LCA benchmarks for emulsified asphalt and highlight opportunities for environmental improvement through targeted adjustments to product formulations. Full article

Background/Objectives: Performing Hajj, the annual Islamic pilgrimage to Mecca and one of the world’s largest mass gatherings, involves considerable physical exertion in high temperatures and presents unique challenges for people with type 1 diabetes (PWT1D). We examined the feasibility, safety, and user experience of automated insulin delivery (AID) systems during Hajj. Methods: This mixed-methods study evaluated six PWT1D who used an AID pump (2 MiniMed 780G, 2 Medtrum, 1 OmniPod 5, and 1 Open-source AID) while performing Hajj in 2024–2025. Pump and CGM-derived metrics were compared across pre-Hajj, during Hajj, and post-Hajj periods. A structured survey captured participants’ experiences, challenges, and recommendations for AID use during Hajj. Results: The average percent time in range (TIR) remained stable from pre- to during Hajj (54.98 to 54.18, p > 0.05) and significantly increased post-Hajj (62.62, p < 0.05). The percent time above range (TAR > 180) and Glycemia Risk Index significantly decreased from pre- to post-Hajj (28.34 to 26.28 and 50.3 to 19.3, respectively, both p < 0.05). The percent time below range (TBR) remained low (<1%) across the three periods with no incidence of acute diabetes-related complications. Participants emphasized increased confidence and peace of mind with AID use and reported challenges related to heat exposure, prolonged walking, and lack of awareness regarding diabetes technology among HCPs. Conclusions: The use of AID during Hajj appeared to be safe and effective for PWT1D in our study, maintaining stable glycemic control under physically demanding conditions. As the first study to evaluate AID use during Hajj, our findings call for larger studies to explore the integration of diabetes technology into Hajj care protocols and highlight the need for structured pre-Hajj education for PWT1D and HCPs. Full article

This article examines the relationship between jihād and the protection of non-Muslim places of worship in early Islam. Drawing primarily on Qurʾānic verses 22:39–41 and the Covenants of the Prophet, it employs a synchronically comparative framework that analyzes a broad corpus of textual sources, seeking to reconstruct how the early Muslim worldview understood the justification for jihād. It also examines the norms governing conduct after conflict, particularly in relation to treaty-making. The article attempts to make sense of Q22:39–41 within the broader landscape of late antiquity, which was marked by religious persecution and the destruction of sanctuaries under Byzantine and Sasanian rule. The study highlights how clear rules of engagement were articulated in early Islam, including limits on violence and the consequences of treaty violation. It argues that the motivations behind the early conquests cannot be reduced to material interests but rather were guided by a theological and ideological vision linking conquest with the establishment of a just peace, one grounded in the protection of communities, faith, and places of worship through a covenantal paradigm. Full article

Background/Objectives: Recent preclinical studies suggest that acute exercise induces immune modulation, enhances tumor blood perfusion, and is associated with reduced tumor growth. Adding exercise to immunochemotherapy treatment (ICT) has been proposed as a strategy to increase treatment effectiveness. The ERICA trial (NCT04676009) aimed to assess the feasibility of acute aerobic exercise performed immediately before the administration of ICT in patients with metastatic non-small cell lung cancer (mNSCLC) and to explore hypothesis-generating outcomes related to physical fitness and patient-reported outcomes. Methods: Newly diagnosed mNSCLC patients were randomly assigned (2:1) to the exercise or control group. The exercise intervention included supervised acute exercise before each of four ICT cycles plus a 3-month home-based walking program with an activity tracker and step goals. The feasibility of the exercise protocol was assessed through adherence, acceptability, tolerability, and safety. Clinical, physical, and patient-reported outcomes were assessed at baseline and after 3 months. Results: Twenty-six patients (mean age 60.6 years; SD 10.65) participated, with an 87.5% acceptance rate. In the exercise group (n = 17), 80.9% of participants completed the acute exercise sessions, with a median interval of 38 min [IQR, 20–60] between exercise and ICT. No exercise-related adverse effects were reported. After 3 months, 60% of participants in the exercise group were classified as active and maintained their step goals. Self-reported measures suggest that maintaining physical fitness is favorable for reducing fatigue and insomnia, and therefore improving quality of life. Conclusions: Acute exercise performed immediately before each ICT administration in patients with mNSCLC appears feasible and safe. Full article

Artificial intelligence (AI) is increasingly transforming higher education, evolving from simple personalization tools into a wide range of applications that support teaching, learning, and assessment. This study examines how university instructors in Lebanon perceive and adopt AI in their academic practices, drawing on evidence from two private institutions: Notre Dame University–Louaize (NDU) and the Holy Spirit University of Kaslik (USEK). The study also proposes practical directions for effective institutional implementation. Using a cross-sectional design and convenience sampling, data were collected from 133 faculty members. Although 73.7% of participants reported moderate to high familiarity with AI, their actual classroom use of such tools remained limited. Adoption was primarily centered on chatbots (69.2%) and translation tools (54.9%), while more advanced technologies, such as adaptive learning systems and AI-based tutoring platforms, were seldom utilized (under 7%). Additionally, participants identified efficiency (69.2%), increased student engagement (44.4%), and personalized learning opportunities (42.9%) as the main benefits of AI integration. In contrast, they reported insufficient training (46.6%), restricted access to resources (45.9%), and concerns about the accuracy of AI-generated outputs (29.3%) as major barriers. Moreover, statistical analysis indicated a strong positive relationship between familiarity with AI and frequency of adoption, with no significant differences across gender, age, or academic qualifications. Overall, the results suggest that faculty members in Lebanese higher education currently view AI primarily as a helpful tool for improving efficiency rather than as a transformative pedagogical innovation. To advance integration, higher education institutions should prioritize targeted professional development, ensure equitable access to AI tools, and establish transparent ethical and governance frameworks. Full article

Simulating what-if scenarios in 3D environments has become popular due to its potential to improve planning and operations for large-scale, complex events, such as the annual Hajj. Despite the extensive availability of spatial data through Geographic Information Systems (GIS)—information systems specialized in collecting, organizing, and analyzing geospatial information—these resources remain underutilized for such use cases. Three-dimensional modelers create simulations for these use cases and build them from scratch despite the availability of GIS data, which can be tedious and error-prone. We raise the question of whether it is reasonable to use machine learning (ML) algorithms to learn coordinate conversion systems, laying the foundations for accelerating the construction of 3D environments and achieving more accurate results. In this paper, we introduce a simple yet novel framework that facilitates learning coordinate conversion systems. Using our framework, we evaluate 35 ML models and provide a detailed analysis of their prediction performance, overfitting characteristics, and trade-offs in terms of time and model size. Notably, 14 of the ML models demonstrate near-perfect learning (i.e., R-squared very close to 1.0). Furthermore, we use grid search to find better parameter settings for underperforming models. Our results demonstrate that ML can help 3D modelers automate manual tasks and improve the efficiency of 3D modeling from GIS data. Full article