Nanoparticle Augmentation of Adhesive Systems: Impact on Tensile Strength in Fiberglass Post Placement within Root Dentin.

BACKGROUND Modification of the glass fiber post (GFP) with titanium dioxide or silver particles can improve the durability and reliability of dental treatments for ensuring long-term success. This research assessed the tensile bond strength (TBS) of an adhesive system used for cementing GFPs into root dentin following the incorporation of nanoparticles of titanium dioxide (NTiO2) and silver (NAg). MATERIAL AND METHODS Sixty human maxillary canines were prepared to create a 10-mm intra-radicular space for post placement from the cementoenamel junction. The specimens were randomly allocated into 2 groups (a non-thermocycling group and a thermocycling group). Each group was divided into 3 subgroups (10 samples each) according to the adhesive system used (adhesive system devoid of any addition, adhesive system including 1% NAg, and adhesive system infused with 1% NTiO2). TBS tests were conducted and recorded in MPa using a Universal Testing Machine, with an axial load applied at a rate of 0.5 mm/min until failure. The TBS for both groups (non-thermocycling and thermocycling) was measured in megapascals (MPa), and the failure type was recorded. The data were statistically analyzed using one-way analysis of variance (ANOVA) and Tukey's test with P.

Potential of Natural Phenolic Compounds as Antimicrobial Agents against Multidrug-Resistant Staphylococcus aureus in Chicken Meat.

Staphylococcus aureus is one of the most widespread foodborne bacteria that cause high morbidity, mortality, and economic loss, primarily if foodborne diseases are caused by pathogenic and multidrug-resistant (MDR) strains. This study aimed to determine the prevalence of S. aureus in chicken meat in Egyptian markets. Thus, this study might be the first to assess the efficiency of different natural phenolic compounds as novel antibacterial agents against MDR S. aureus pathogens isolated from raw chicken meat in the Egyptian market. The incidence and quantification of pathogenic S. aureus were detected in retail raw chicken meat parts (breast, thigh, fillet, and giblets). In total, 73 out of 80 (91.3%) of the chicken meat parts were contaminated, with S. aureus as the only species isolated. Of the 192 identified S. aureus isolates, 143 were coagulase-positive S. aureus and 117 isolates were MDR (81.8%, 117/143). Twenty-two antibiotic resistance profile patterns were detected. One strain was randomly selected from each pattern to further analyze virulence and resistance genes. Extracted DNA was assessed for the presence of antibiotic-resistance genes, i.e., vancomycin-resistance (vanA), aminoglycosides-resistance (aacA-aphD), apramycin-resistance (apmA), and methicillin-resistance (mecA), penicillin-resistance (blaZ), and virulence genes staphylococcal enterotoxins (sea and seb), Panton-Valentine leucocidin (pvl), clumping factor A (clfA), and toxic shock syndrome toxin (tst). Clustering analyses revealed that six S. aureus strains harbored the most virulence and resistance genes. The activity of hydroquinone was significantly higher than thymol, carvacrol, eugenol, and protocatechuic acid. Therefore, phenolic compounds, particularly hydroquinone, could potentially alternate with conventional antibiotics against the pathogenic MDR S. aureus inhabiting raw chicken meat. Hence, this study indicates that urgent interventions are necessary to improve hygiene for safer meat in Egyptian markets. Moreover, hydroquinone could be a natural phenolic compound for inhibiting foodborne pathogens.

Risk of depression, anxiety, and stress among the Saudi general population during the COVID-19 pandemic.

BACKGROUND: Promoting mental health and wellness is crucial for healthy communities. This study aims to assess the vulnerability of experiencing psychological reactions such as depression, anxiety, and stress within the general population in Saudi Arabia during the COVID-19 pandemic. METHODS: A cross-sectional online survey was completed by 754 participants recruited from thirteen regions of Saudi Arabia. The information on background variables was obtained by using a set of close-ended questions. The DASS-21, a screening tool was used to assess the risk of depression, anxiety, and stress. Pie-chart displayed the levels of risk to experience psychological reactions. The Chi-square test and Adjusted Odd Ratios (AOR) reported the risk factors associated with experiencing psychological reactions in the study population. RESULTS: The vulnerability to mild to extremely severe levels of stress, anxiety and depression were (36.5%), (34.9%), and (43.5%), respectively. Findings demonstrated that females were at higher risk to experience anxiety (AOR = 1.56; 95% CI 1.11-2.18) and stress (AOR = 1.48; 95% CI 1.10-2.10) as compared to males. Unmarried individuals had higher vulnerability for anxiety (AOR = 1.60; 95% CI 1.04-2.44) and depression (AOR = 1.55; 95% CI 1.02-2.37) as compared to married individuals. Those who lost their job during the pandemic had a higher risk to experience anxiety (AOR = 2.02; 95% CI 1.10-3.74) and depression (AOR = 2.01: 95% CI 1.09-3.87) as compared to those who remain employed. Diagnosis with COVID-19 was associated with anxiety (AOR = 2.40; 95% CI 1.27-4.52) and stress (AOR = 2. 0; 95% CI 1.10-3.69). Participants with chronic medical conditions were almost twice at risk to experience stress (AOR = 2.0; 95% CI 1.38-2.87) depression (AOR = 2.14; 95% CI 1.53-2.99) and anxiety (AOR = 2.59; 95% CI 1.78-3.78) as compared to those without such conditions. CONCLUSIONS: Findings imply the allocation of adequate psychological resources to prevent long-term psychological repercussions in at-risk populations such as females, unmarried individuals, those who lost their jobs, diagnosed with COVID-19 and those with chronic medical conditions.

Time-Series Analysis and Healthcare Implications of COVID-19 Pandemic in Saudi Arabia.

The first case of coronavirus disease 2019 (COVID-19) in Saudi Arabia was reported on 2 March 2020. Since then, it has progressed rapidly and the number of cases has grown exponentially, reaching 788,294 cases on 22 June 2022. Accurately analyzing and predicting the spread of new COVID-19 cases is critical to develop a framework for universal pandemic preparedness as well as mitigating the disease's spread. To this end, the main aim of this paper is first to analyze the historical data of the disease gathered from 2 March 2020 to 20 June 2022 and second to use the collected data for forecasting the trajectory of COVID-19 in order to construct robust and accurate models. To the best of our knowledge, this study is the first that analyzes the outbreak of COVID-19 in Saudi Arabia for a long period (more than two years). To achieve this study aim, two techniques from the data analytics field, namely the auto-regressive integrated moving average (ARIMA) statistical technique and Prophet Facebook machine learning technique were investigated for predicting daily new infections, recoveries and deaths. Based on forecasting performance metrics, both models were found to be accurate and robust in forecasting the time series of COVID-19 in Saudi Arabia for the considered period (the coefficient of determination for example was in all cases more than 0.96) with a small superiority of the ARIMA model in terms of the forecasting ability and of Prophet in terms of simplicity and a few hyper-parameters. The findings of this study have yielded a realistic picture of the disease direction and provide useful insights for decision makers so as to be prepared for the future evolution of the pandemic. In addition, the results of this study have shown positive healthcare implications of the Saudi experience in fighting the disease and the relative efficiency of the taken measures.

Using Spiritual Connections to Cope With Stress and Anxiety During the COVID-19 Pandemic.

During the initial phases of the COVID-19 pandemic, stress and anxiety were pervasive among the masses due to high morbidity and mortality. Besides the fear of coronavirus was also particularly driven by social media. Many people started to look for faith and spiritual connections to gain comfort. The role of spiritual ties and religious beliefs in relation to coping with pandemic stress has acquired the attention of researchers in some parts of the world. This cross-sectional survey aimed at assessing the intensity of stress and anxiety symptoms experienced by people and how much they were alleviated by employing spiritual connections. The study sample comprises 795 respondents with 52% males and 48% females living in Saudi Arabia. The brief online study questionnaire collected data about background variables, anxiety and stress scale from DASS-21, and items from the WHOQOL (SRBP) instrument assessed the use of spiritual beliefs to cope. Multiple regression models were tested to determine the role of spiritual connections after adjusting demographic variables. Results illustrated that after adjusting for gender and age, participants' anxiety symptoms decreased by (ß = -0.27; p = 0.000) units with each unit increase in the use of spiritual connections, and participants' stress symptoms reduce by (ß = -0.36; p = 0.000) units with each unit increase in coping with spirituality. Additionally, females' risk to experience anxiety and stress symptoms was more than males [(ß = 0.88; p = 0.01) and (ß = 0.92; p = 0.000)], respectively. An increase in age decreases the likelihood of experiencing anxiety symptoms and stress symptoms by (ß = -0.75; p = 0.02) and (ß = -0.11; p = 0.000) units, respectively. Findings support the protective role of spiritual connections despite small beta coefficients. The social and cultural context in Saudi Arabia favors deep-rooted connections with spirituality and faith. Our findings support the fact that the reliance on spiritual connections helped older people to deal with exaggerated fear during the initial phase of the COVID-19 pandemic and reduces the risk of experiencing anxiety and stress symptoms. Females and younger participants were relatively vulnerable to developing these symptoms. We discussed these findings considering some recent studies that reported similar relationships and made recommendations for future research.

Evolving Risk of Acute Kidney Injury in COVID-19 Hospitalized Patients: A Single Center Retrospective Study.

Background and Objectives: Within a year, COVID-19 has advanced from an outbreak to a pandemic, spreading rapidly and globally with devastating impact. The pathophysiological link between COVID-19 and acute kidney injury (AKI) is currently being debated among scientists. While some studies have concluded that the mechanisms of AKI in COVID-19 patients are complex and not fully understood, others have claimed that AKI is a rare complication of COVID-19-related disorders. Considering this information gap and its possible influence on COVID-19-associated AKI management, our study aimed to explore the prevalence of AKI and to identify possible risk factors associated with AKI development among COVID-19 hospitalized patients. Materials and Methods: A retrospective cohort study included 83 laboratory-confirmed COVID-19 patients hospitalized at the isolation department in a tertiary hospital in Zagazig City, Egypt between June and August 2020. Patients younger than 18 years of age, those diagnosed with end-stage kidney disease, or those on nephrotoxic medications were excluded. All study participants had a complete blood count, liver and renal function tests, hemostasis parameters examined, inflammatory markers, serum electrolytes, routine urinalysis, arterial blood gas, and non-enhanced chest and abdominal computer tomography (CT) scans. Results: Of the 83 patients, AKI developed in 24 (28.9%) of them, of which 70.8% were in stage 1, 8.3% in stage 2, and 20.8% in stage 3. Patients with AKI were older than patients without AKI, with hypertension and diabetes being the most common comorbidities. Risk factors for AKI include increased age, hypertension, diabetes mellitus, and a higher sequential organ failure assessment (SOFA) score. Conclusions: AKI occurs in a considerable percentage of patients with COVID-19, especially in elderly males, those with hypertension, diabetes, and a higher sequential organ failure assessment (SOFA) score. Hence, the presence of AKI should be taken into account as an important index within the risk spectrum of disease severity for COVID-19 patients.

Analysis and modeling of COVID-19 epidemic dynamics in Saudi Arabia using SIR-PSO and machine learning approaches.

INTRODUCTION: COVID-19 has become a global concern because it has extensive damage to health, social and economic systems worldwide. Consequently, there is an urgent need to develop tools to understand, analyze, monitor and control further outbreaks of the disease. METHODOLOGY: The Susceptible Infected Recovered-Particle SwarmOptimization model and the feed-forward artificial neural network model were separately developed to model COVID-19 dynamics based on daily time-series data reported by the Saudi authorities from March 2, 2020 to February 21, 2021. The collected data were divided into training and validation datasets. The effectiveness of the investigated models was evaluated by using various performance metrics. The Susceptible-Infected-Recovered-Particle-Swarm-Optimization model was found to well predict the cumulative infected and recovered cases and to optimally tune the contact rate and the characteristic duration of the illness. The feed-forward artificial neural network model was found to be efficient in modeling daily new and cumulative infections, recoveries and deaths. RESULTS: The forecasts provided by the investigated models had high coefficient of determination values of more than 0.97 and low mean absolute percentage errors (around 7% on average). CONCLUSIONS: Both the Susceptible-Infected-Recovered-Particle-Swarm-Optimization and feed-forward artificial neural network models were efficient in modeling COVID-19 dynamics in Saudi Arabia. The results produced by the models can help the Saudi health authorities to analyze the virus dynamics and prepare efficient measures to control any future occurrence of the epidemic.

Tomatidine and Patchouli Alcohol as Inhibitors of SARS-CoV-2 Enzymes (3CLpro, PLpro and NSP15) by Molecular Docking and Molecular Dynamics Simulations.

Considering the current dramatic and fatal situation due to the high spreading of SARS-CoV-2 infection, there is an urgent unmet medical need to identify novel and effective approaches for prevention and treatment of Coronavirus disease (COVID 19) by re-evaluating and repurposing of known drugs. For this, tomatidine and patchouli alcohol have been selected as potential drugs for combating the virus. The hit compounds were subsequently docked into the active site and molecular docking analyses revealed that both drugs can bind the active site of SARS-CoV-2 3CLpro, PLpro, NSP15, COX-2 and PLA2 targets with a number of important binding interactions. To further validate the interactions of promising compound tomatidine, Molecular dynamics study of 100 ns was carried out towards 3CLpro, NSP15 and COX-2. This indicated that the protein-ligand complex was stable throughout the simulation period, and minimal backbone fluctuations have ensued in the system. Post dynamic MM-GBSA analysis of molecular dynamics data showed promising mean binding free energy 47.4633 ± 9.28, 51.8064 ± 8.91 and 54.8918 ± 7.55 kcal/mol, respectively. Likewise, in silico ADMET studies of the selected ligands showed excellent pharmacokinetic properties with good absorption, bioavailability and devoid of toxicity. Therefore, patchouli alcohol and especially, tomatidine may provide prospect treatment options against SARS-CoV-2 infection by potentially inhibiting virus duplication though more research is guaranteed and secured.

Association between Cholera Outbreak and Traditional Gold Mining in Northern State, Sudan 2017.

INTRODUCTION: Cholera is one of the health problems causing considerable morbidity and mortality. The Northern State of Sudan experienced a recent cholera outbreak, however, there are limited data on the outbreak. METHODS: The objective of this study was to assess the magnitude and risk factors associated with the cholera outbreak in the Northern State of Sudan. A retrospective case series study was conducted in the Northern State of Sudan, which involved tracing cases of cholera outbreak of 2017. Data were collected through reports and interviews. A geographical information system was used to map all cases during the outbreak. Chi-square test and logistic regression were used to identify associated factors. RESULTS: There were 957 cholera cases reported in the state with an attack rate of 14.2/10,000 persons. Dalgo locality had the highest number (415) of cases reported with an attack rate of 167.2/10,000 persons. About 78% of cases were adult males, while 56.2% of cases were immigrants from other states. Immigrants in Halfa and Dalgo localities were four times (odds ratio [OR] = 4.031, 95% confidence interval [CI]: 2.482-6.547) and eight times (OR = 8.318, 95% CI: 5.674-12.193), respectively, at risk of cholera infection compared to immigrants in Dongola locality. The overall case-fatality rate was 1.9%. This was significantly higher in younger (5.8%) and older (22.7%) age groups (P < 0.05). CONCLUSIONS: The study revealed that the cholera outbreak spread highly along with traditional gold mining areas due to poor sanitation. Therefore, improving sanitation services and establishing an effective surveillance system in these areas are essential to prevent future occurrence of outbreaks.

Coping during COVID-19 Pandemic in Saudi Community: Religious Attitudes, Practices and Associated Factors.

The COVID-19 pandemic has affected many societies' life aspects and activities including social and Islamic practices; more attention should be given to investigate the interaction between Islamic worships and the spread of the disease. Here, we performed a cross-sectional study using an online questionnaire to assess the preventive Islamic attitudes and practices during the COVID-19 lockdown period from the Saudi publics' perspectives. Mann-Whitney, Kruskal and logistic regression tests were used to analyze the data. The results revealed that most participants had positive Islamic attitudes and practices. However, elders and males were less obeyed to preventive measures during performing worship (p < 0.05). While younger, females and not married were less obeyed when dealing with COVID-19 related death (p < 0.05). Even though, elders were less likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 0.38; 95% CI: 0.176-0.816) than younger. Furthermore, males, Saudi participants, lower education level, lower Islamic attitudes scores were more likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 1.65; 95% CI: 1.126-2.421; OR = 1.57; 95% CI: 1.067-2.322; OR = 3.09; 95% CI: 1.721-5.563; and OR = 1.89; 95% CI: 1.309-2.753, respectively), than their corresponding targeted counterparts. Thus, despite the high preventative perceptions of Islamic attitudes and practices of the Saudi community, our study highlighted some risk groups with less preventative practices. Thus, targeted health education interventions are highly recommended for these risk groups to enhance the commitment to government instructions.

The Prospect of Lactoferrin Use as Adjunctive Agent in Management of SARS-CoV-2 Patients: A Randomized Pilot Study.

Background and Objectives: Preventive, adjunctive and curative properties of lactoferrin have been evaluated since the first wave of severe acute respiratory syndrome coronavirus (SARS-CoV), a viral respiratory disease, emerged 18 years ago. Despite the discovery of new vaccine candidates, there is currently no widely approved treatment for SARS-CoV-2 (COVID-19). Strict adherence to infection prevention and control procedures, as well as vaccines, can, however, prevent the spread of SARS-CoV-2. This study aimed to evaluate the efficacy of lactoferrin treatment in improving clinical symptoms and laboratory indices among individuals with mild to moderate coronavirus disease-19 (COVID-19). Materials and Method: A randomized, prospective, interventional pilot study conducted between 8 July and 18 September 2020 used a hospital-based sample of 54 laboratory-confirmed participants with mild to moderate symptoms of COVID-19. Randomization into a control and two treatment groups ensured all groups received the approved Egyptian COVID-19 management protocol; only treatment group participants received lactoferrin at different doses for seven days. Clinical symptoms and laboratory indices were assessed on Days 0, 2 and 7 after starting treatments. Mean values with standard deviation and one-way analysis of variance with least significant difference of demographic and laboratory data between control and treatment groups were calculated. Results: Our study showed no statistically significant difference among studied groups regarding recovery of symptoms or laboratory improvement. Conclusions: Further research into therapeutic properties particularly related to dosage, duration and follow-up after treatment with lactoferrin in individuals with COVID-19 is required.

MALDI-TOF MS Based Typing for Rapid Screening of Multiple Antibiotic Resistance E. coli and Virulent Non-O157 Shiga Toxin-Producing E. coli Isolated from the Slaughterhouse Settings and Beef Carcasses.

BACKGROUND: The emergence of multiple antibiotic resistance (MAR) Escherichia coli (E. coli) and virulent non-O157 Shiga toxin-producing Escherichia coli (STEC) poses a growing concern to the meat industry. Non-O157 STEC strains including O26, O45, O103, O111, O121, and O145 have been implicated in the occurrence of bloody diarrhea and hemolytic uremic syndrome in humans. This research assessed prevalence, matrix-assisted laser desorption/ionization-time of flight mass-spectrometry (MALDI-TOF MS) protein mass-spectra profiles, multidrug-resistance traits, polymerase chain reaction detection of virulence, and antibiotic-resistance genes of E. coli isolated from beef carcasses and slaughterhouse environments. METHODS: A total of 180 convenience sponge samples were collected from two different sources-specific parts of beef carcasses and surfaces of the processing environment at the slaughterhouse of Ha'il, Saudi Arabia between September and November 2020. MALDI BioTyper and phylotype-based identification methods accurately identified and classified the samples as belonging to the genus belonging to the Escherichia coli domain of bacteria (NCBI txid: 562). RESULTS: Expected changes were seen in the mass peak spectrum defining nine closely related isolates and four unrelated E. coli isolates. Serological typing of E. coli revealed enterotoxigenic E. coli O166 (19.10%); enteropathogenic E. coli O146 (16.36%) and O44 (18.18%); enterohemorrhagic E. coli O111 (31.18%) and O26 (14.54%). Forty-five percent of examined E. coli were resistant to seven antimicrobials; 75% of 20 selected isolates were resistant to three or more antimicrobials. phoA and blaTEM genes were detected in all selected E. coli isolates. CONCLUSION: This study confirmed the efficiency and validity of Matrix-assisted laser desorption/ionization time of flight mass-spectrometry in screening for multi-drug resistant E. coli isolated from slaughterhouse derived beef carcasses in Ha'il, Saudi Arabia. We contributed by revealing the distinction between related and non-related strains of E.coli in livestock. The findings in this study can inform improved policy development decision making and resource allocation related to livestock processing regarding antimicrobial use in food animals and rapid screening for effective multiple antibiotic resistance E. coli and virulent non-O157 STEC control in the slaughterhouses.

Role of community-based measures in adherence to self-protective behaviors during first wave of COVID-19 pandemic in Saudi Arabia.

Background: The expected second wave of the COVID-19 pandemic has started in various regions of the world. Public health experts warned that it could be as lethal as the first wave if people did not comply with self-protective measures. Currently, there is a gap in the literature on the relationship between peoples' assessment of the effectiveness of community-based measures regarding adherence to self-protective behaviors for COVID-19 prevention and control. This study aimed to assess the role of the perceived effectiveness of community-based measures in adherence to self-protective behaviors during the COVID-19 pandemic. Methods: The cross-sectional online survey conducted from March 24 to June 22, 2020. The study sample Included 400 participants (49% male and 51% female) from the Kingdom of Saudi Arabia (KSA). The outcome measure was compliance to four self-protective behaviors i.e., "social distancing;" "wearing facemask;" "washing hands more frequently;" and "disinfecting surfaces in homes." We computed Chi-square statistics and odds ratios (ORs) using 95% confidence intervals (CIs). Results: The findings demonstrated that participants aged 25-34 years old were 25% less likely to comply with hand hygiene (OR = 0.75; 95% CI: 0.33-0.95) and social distancing (OR = 0.76; 95% CI: 0.34-0.98). Misconceptions related to COVID-19 significantly decreased compliance with self-protective behaviors by up to 27%. Participants who rated government decisions as useful were approximately 1.7 times more likely to comply with self-protective behaviors. Conclusion: Community-based measures should focus on engaging segments of the population That are currently less compliant. Health education policies should also focus on enhancing the perceived sense of control and personal responsibility and reduce anxiety levels. A continuous commitment to the implementation of preventive interventions and the clarification of misconceptions are required to combat the expected second wave.

Assessment of the Quality of Life during COVID-19 Pandemic: A Cross-Sectional Survey from the Kingdom of Saudi Arabia.

The COVID-19 outbreak emerged as an ongoing crisis at the beginning of the year 2020. Its horrific manifestation at the community level significantly affects various dimensions of the quality of life (QoL) of all individuals. The study aimed to examine some of the predictors of the QoL during the first wave of the COVID-19 pandemic in Saudi Arabia. A cross-sectional online survey questionnaire was used to gather data on the participants' sociodemographic backgrounds, physical health status, psychological reactions, and QoL. We adapted 12 items from the World Health Organization Quality of Life Instruments (WHOQOL-BREF) to assess the QoL. The Depression, Anxiety and Stress Scale-21 (DASS-21) was used to assess depression, anxiety, and stress. The median and inter-quartile range were used to describe the QoL scores. A multinomial regression analysis was computed between QoL score quartiles and associated factors, and the statistical significance was set at p < 0.05. The results of the multinomial regression analysis demonstrated that males (OR = 1.96; 95% CI = 1.31-2.94); participants aged 26 to 35 years (OR = 5.1; 95% CI = 1.33-19.37); non-Saudi participants (OR = 1.69; 95% CI = 1.06-2.57); individuals with chronic diseases (OR = 2.15; 95% CI = 1.33-3.48); those who lost their job (OR = 2.18; 95% CI = 1.04-4.57); and those with depression (OR = 5.70; 95% CI = 3.59-9.05), anxiety (OR = 5.47; 95% CI = 3.38-8.84), and stress (OR = 6.55; 95% CI = 4.01-10.70) were more likely to be in the first quartile of the QoL scores. While the full model predicting the total QoL score was statistically significant (R2 = 0.962, F (750, 753) = 16,705.4, p < 0.001), the three QoL dimensions explained 0.643, 0.283, and 0.036 of the variability in environmental, social, and religious/spiritual dimensions, respectively. The COVID-19 pandemic has significantly influenced various aspects of individuals' QoL, as well as their physical and psychological health. Community-based interventions are needed to mitigate the pandemic's negative effects and enhance the health and QoL of the general population.

The Impact of Extended E-Learning on Emotional Well-Being of Students during the COVID-19 Pandemic in Saudi Arabia.

Educational institutions in Saudi Arabia extended e-learning until the third semester of the academic calendar to prevent the spread of COVID-19 infection and to achieve 70% inoculation for the Saudi population. This study assesses the impact of extended e-learning and other associated stressors on the emotional health of university students in Saudi Arabia. An online cross-sectional survey collected data between the months of January-March 2021. The emotional signs of stress were measured by using a subset of items from the COVID-19 Adolescent Symptom and Psychological Experience Questionnaire (CASPE). Data about demographic variables, educational characteristics and academic performance were also collected. A regression analysis was performed to determine predictors of emotional health. A total of 434 university students including females (63%) and males (37%) provided responses. One-third of students (33%) indicated that the COVID-19 pandemic and its resulting changes including online distance studies greatly influenced their daily lives in a negative way. The regression analysis demonstrated that female students and students with average academic performance had increased vulnerability to experience emotional signs of stress (p < 0.05). The factors 'Not going to university' and 'Not having a routine life' were significant predictors of stress responses (p < 0.01) and (p < 0.001) respectively. E-learning during the COVID-19 pandemic made it possible for students to complete their studies as per academic calendar; simultaneously, it increased the vulnerability to experience stress, particularly for female students and students with average academic performance. These findings imply that academic advising and counseling services should be more readily available during digital studies to support at risk students.

Intestinal parasitic infection among foreign housemaids in northwestern Saudi Arabia: A cross-sectional study.

Owing to Saudi Arabia's high-income economy many Saudi families hire foreign housemaids. However, since the housemaids are potential carriers of intestinal parasites, hiring them increases the risk of transmission to the Saudi community. In this context, this study aimed to evaluate the prevalence of intestinal parasitic infections in foreign housemaids in northwestern Saudi Arabia. Using direct wet mount and concentration by flotation, the stool samples of 169 housemaids were examined, and eleven parasite species, six helminths and five protozoans, were detected. The overall prevalence of intestinal parasitic infection was 20.11% (34/169). Twelve cases were infected with one intestinal helminth, 12 were infected with one intestinal protozoan, and 10 had polyparasitism. The most common intestinal parasites were Cryptosporidium spp. (n = 10), hookworms (n = 7), and T. Trichiura (n = 7). The findings highlight that intestinal parasites present an important public health concern for foreign housemaids in Saudi Arabia. More vigilance is thus required, and periodic follow-up should be exercised throughout foreign housemaids' stay in the country.

Generalized Richards model for predicting COVID-19 dynamics in Saudi Arabia based on particle swarm optimization Algorithm.

COVID-19 pandemic is spreading around the world becoming thus a serious concern for health, economic and social systems worldwide. In such situation, predicting as accurately as possible the future dynamics of the virus is a challenging problem for scientists and decision-makers. In this paper, four phenomenological epidemic models as well as Suspected-Infected-Recovered (SIR) model are investigated for predicting the cumulative number of infected cases in Saudi Arabia in addition to the probable end-date of the outbreak. The prediction problem is formulated as an optimization framework and solved using a Particle Swarm Optimization (PSO) algorithm. The Generalized Richards Model (GRM) has been found to be the best one in achieving two objectives: first, fitting the collected data (covering 223 days between March 2nd and October 10, 2020) with the lowest mean absolute percentage error (MAPE = 3.2889%), the highest coefficient of determination (R2 = 0.9953) and the lowest root mean squared error (RMSE = 8827); and second, predicting a probable end date found to be around the end of December 2020 with a projected number of 378,299 at the end of the outbreak. The obtained results may help the decision-makers to take suitable decisions related to the pandemic mitigation and containment and provide clear understanding of the virus dynamics in Saudi Arabia.

Perception of Altered Smile Esthetics by Orthodontists, Dentists, and Laypeople in Riyadh, Saudi Arabia.

BACKGROUND: Mini-esthetics is an important concept in orthodontics concerned with relatedness of dentition to the face. PURPOSE: We compared the perception of altered smile esthetics between orthodontists, dentists, and laypeople in Riyadh, Saudi Arabia. PATIENTS AND METHODS: A total of 216 participants (orthodontists, dentists, and laypeople) were conveniently surveyed. An image representing the ideal smile was altered in terms of buccal corridor, gingival display, and midline diastema. Using Likert scale, participants were asked to rate the attractiveness of the altered images. RESULTS: The three surveyed groups preferred wide rather than narrow buccal corridors. Also, as the amount of gingival display and midline diastema increased, the smile was rated less attractive. Age of participants was significantly associated with more precise recognition of gingival display and midline diastema, P<0.05 and P<0.001, respectively. CONCLUSION: The concept of an ideal smile holds true across the heterogenous groups we studied despite gender and professional background.

Anthelmintic and antimicrobial activity of Indigofera oblongifolia leaf extracts.

Due to the endless emergence of drug resistant pathogens, there is a constant need for new therapeutic agents for clinical use. The identification of active components in natural products and determining the efficacy of these active components has become the current focus of pharmacological research. The present study aimed to evaluate the anthelmintic and antimicrobial activities of Indigofera oblongifolia leaf extract (ILE) against the earthworm Allolobophora caliginosa, the gram-positive bacteria (Bacillus cereus, Streptococcus pneumoniae, and Staphylococcus aureus), the gram-negative bacteria (Klebsiella pneumoniae, Pseudomonas aeruginosa and Escherichia coli) and the yeast Candida albicans. Methanolic extract of I. oblongifolia leaf was obtained and the total phenolics and flavonoids in ILE were determined. The anthelmintic study was carried out to determine the time to paralysis and time to death of worms using three doses (100, 200, and 300 mg/mL) of ILE. Also, Kirby-Bauer disk diffusion susceptibility method was used to determine the antimicrobial activity of ILE. The results showed that ILE induces paralysis and death of A. caliginosa at all concentration tested faster than the reference drug, Albendazole. Additionally, ILE exhibited prominent antimicrobial activity against all gram-positive bacteria tested but almost no significant activity against the gram-negative bacteria, except K. pneumoniae. ILE showed close similarity to the spectrum of chloramphenicol and cefoxitin activities. Furthermore, C. albicans was highly susceptible to the leaf extracts. Our results showed that ILE is an effective anthelmintic and antimicrobial agent.

Patient experiences of engagement with care plans and healthcare professionals' perceptions of that engagement.

BACKGROUND: Although patient engagement is internationally recognized as a core quality indicator of healthcare systems, no report has yet explored patient engagement in Saudi Arabia. Thus, we explored patients' experiences of engagement with healthcare services and assessed physicians' and nurses' perceptions of this engagement. METHODS: We performed a cross-sectional study on patients and their family members admitted to either the rehabilitation or neurology department of King Fahad Medical City, Riyadh, Saudi Arabia. We also studied physicians and nurses involved in direct patient care in these departments. Two self-administered questionnaires were used to collect data on patients' experiences of engagement with healthcare services and physicians' and nurses' perceptions of that engagement. RESULTS: We recruited 36 patients and 46 family members, as well as 64 nurses and 36 physicians. About 73% of patients and family members felt that doctors and nurses engaged them in decision making regarding care plans; 80% felt that they were a partners in the treatment plans. Over one-third of physicians and nurses believed that patient engagement improved healthcare outcomes, and about 7% believed that patient engagement was unimportant or not extremely important. Responses of physicians and nurses differed significantly from those of patients and family members with regards to the extent of the patient-physician/nurse relationship, the perception of involvement, and the degree of partnership and shared leadership. CONCLUSION: We assessed patient experiences of engagement with health care service and physicians' and nurses' perceptions of that engagement. Most patients/family members reported good engagement. Although most physicians and nurses believed that patient engagement improved the healthcare outcomes, some believed that improving healthcare outcomes through patient engagement was not important or not extremely important.