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Background and Objectives: Abdominal obesity significantly impacts postural control and fall risk, yet its specific association with stepping reaction time (SRT), a critical component of balance recovery, remains underexplored in obese individuals. This study investigated the relationship between abdominal circumference (AC) and SRT while considering gender and body mass index (BMI). Materials and Methods: Cross-sectional observational study conducted at Majmaah University Virtual Reality Laboratory using advanced motion capture technology. In this cross-sectional study, 199 adults (104 males, 89 females) underwent AC measurement and SRT assessment using the Stability and Balance Learning Environment Apparatus (STABLE) with motion capture technology. Multiple linear regression analyses were performed to identify associations between the variables. Results: The regression model for right SRT was statistically significant (F(8, 184) = 10.24, p < 0.001), explaining 30.8% of variance. Limits of stability with legs apart was negatively associated with right SRT (β = −0.144, p = 0.039), while left SRT was strongly associated (β = 0.451, p < 0.001). AC did not show any association with either right or left SRT. Males demonstrated significantly faster left SRT than females (b = −0.061, p = 0.048), and age was positively associated with left SRT (β = 0.203, p = 0.002). Conclusions: While AC shows correlation with overall obesity measures, it is not significantly associated with stepping reaction time when evaluated concurrently with balance performance and demographic factors. Limits of stability, age, and gender were more consistently associated with stepping reaction time. The cross-sectional design of this study precludes causal inference; longitudinal investigations are necessary to confirm these associations before implementing targeted fall prevention strategies.

Purpose Congenital microcephaly (CM) is an important birth defect with long term neurological sequelae. We aimed to perform detailed phenotypic and genomic analysis of patients with Mendelian forms of CM. Methods Clinical phenotyping, targeted or exome sequencing, and autozygome analysis. Results We describe 150 patients (104 families) with 56 Mendelian forms of CM. Our data show little overlap with the genetic causes of postnatal microcephaly. We also show that a broad definition of primary microcephaly —as an autosomal recessive form of nonsyndromic CM with severe postnatal deceleration of occipitofrontal circumference—is highly sensitive but has a limited specificity. In addition, we expand the overlap between primary microcephaly and microcephalic primordial dwarfism both clinically (short stature in >52% of patients with primary microcephaly) and molecularly (e.g., we report the first instance of CEP135 -related microcephalic primordial dwarfism). We expand the allelic and locus heterogeneity of CM by reporting 37 novel likely disease-causing variants in 27 disease genes, confirming the candidacy of ANKLE2, YARS , FRMD4A , and THG1L , and proposing the candidacy of BPTF , MAP1B , CCNH , and PPFIBP1 . Conclusion Our study refines the phenotype of CM, expands its genetics heterogeneity, and informs the workup of children born with this developmental brain defect.

Herein, hydrothermal fabrication of CdO-g-C3N4 photocatalyst for a substantially better photocatalytic recital in water splitting is presented. The XRD analysis confirms the cubic phase of CdO-g-C3N4, whereas FTIR and UV-VIS studies revealed the presence of respective groups and a median band gap energy (2.55 eV) of the photocatalyst, respectively, which further enhanced its photo-electrochemical (PEC) properties. The SEM displays the oblong structures of g-C3N4 sheets and nano rod-like morphology of CdO and CdO-g-C3N4, respectively. The HR-TEM exhibits morphology & orientation of the grains and substantiates the polycrystal-line nature of CdO-g-C3N4 nanocomposite. The photocatalytic water-splitting concert is evaluated by PEC experiments under 1 SUN visible light irradiation. Linear sweep voltammetry (LSV), chronoamperometry (CA), and electrochemical impedance spectroscopy (EIS) comprehend the CdO-g-C3N4 as a hydrogen evolution photocatalyst. A photocurrent density beyond ≥5 mA/cm2 is recorded from CdO-g-C3N4, which is 5–6 folds greater than pure CdO and g-C3N4. The efficient separation and transfer of charges allocated to CdO-g-C3N4 and fabricating heterojunctions between g-C3N4 and CdO suppresses the unfavorable electron-hole pairs recombination process. Thus, it recesses charge transfer resistance, augmenting enhanced photocatalytic performance under 1 SUN irradiation.

Growing evidence suggests a bidirectional relationship between mental and oral health, with psychological distress having a detrimental impact on oral health behaviors and outcomes, and poor oral health exacerbating mental health symptoms. This study aimed to examine the relationship between depressive and anxiety symptoms and oral health-related quality of life (OHRQoL) among adults in Riyadh, Saudi Arabia. A cross-sectional study was conducted using a self-administered online questionnaire distributed to adults residing in Riyadh. The survey incorporated validated instruments: the Patient Health Questionnaire-9 (PHQ-9) to assess depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) scale to measure anxiety symptoms, and the Oral Health Impact Profile-14 (OHIP-14) to evaluate OHRQoL. Descriptive statistics and multivariable linear regression analyses were carried out using RStudio (version 2024.9.1.394, Boston, MA, USA) with R version 4.4.2. Statistical significance was set at  < 0.05. The analysis included 650 participants. Moderate-to-severe anxiety and depression were reported by 33.7% and 41.1% of participants, respectively. Higher PHQ-9 and GAD-7 scores were significantly associated with higher OHIP-14 scores (  < 0.001). In multivariable regression analysis, severe depression (  = 8.24) and severe anxiety (  = 5.71) demonstrated the strongest associations with increased OHIP-14 scores. Additionally, age ≥ 45 years and monthly family income between 10,000 and 20,000 SAR were independently associated with poorer OHRQoL. Severe depression and anxiety symptoms were independently associated with poorer OHRQoL among adults in Riyadh. These findings support integrating mental health assessments into oral healthcare services to enhance comprehensive, patient-centered care.

To describe our experience with a large cohort (411 patients from 288 families) of various forms of skeletal dysplasia who were molecularly characterized. Detailed phenotyping and next-generation sequencing (panel and exome). Our analysis revealed 224 pathogenic/likely pathogenic variants (54 (24%) of which are novel) in 123 genes with established or tentative links to skeletal dysplasia. In addition, we propose 5 genes as candidate disease genes with suggestive biological links (WNT3A, SUCO, RIN1, DIP2C, and PAN2). Phenotypically, we note that our cohort spans 36 established phenotypic categories by the International Skeletal Dysplasia Nosology, as well as 18 novel skeletal dysplasia phenotypes that could not be classified under these categories, e.g., the novel C3orf17-related skeletal dysplasia. We also describe novel phenotypic aspects of well-known disease genes, e.g., PGAP3-related Toriello–Carey syndrome–like phenotype. We note a strong founder effect for many genes in our cohort, which allowed us to calculate a minimum disease burden for the autosomal recessive forms of skeletal dysplasia in our population (7.16E-04), which is much higher than the global average. By expanding the phenotypic, allelic, and locus heterogeneity of skeletal dysplasia in humans, we hope our study will improve the diagnostic rate of patients with these conditions.

Medical tourism (MT) has become a significant phenomenon, garnering the interest of experts in fields such as marketing, medicine, and health geography. MT refers to individuals who travel abroad specifically for medical treatment and healthcare services. The growth of medical tourism aligns with the overall rise in global travel and tourism. The medical tourism market is expanding rapidly, with an annual growth rate of 10.8%, projected to reach $248.2 billion and accommodate 21.1 million medical tourists worldwide by 2024. Countries that are prominent in medical tourism include Thailand, Mexico, India, and Turkey. In Jordan, the medical tourism sector has generated over a billion dollars annually, with approximately 224,800 medical tourists expected in 2024. This sector can be divided into two main categories: clinical medical tourism, which takes place in hospitals, and therapeutic medical tourism, which occurs at natural sites like the Dead Sea and Ma'in Hot Springs. The current study aims to evaluate the impact of marketing elements \"4Ps\" (Product, Price, Place, Promotion) on attracting medical tourists to Jordan. The research adopts a quantitative approach, focusing on numerical data, statistical analyses, and conclusions. Additionally, the study is primarily descriptive. The study's population consists of all medical tourists arriving in Jordan for treatment at private hospitals, totalling 92,500 by May 2025. A sample size of 383 medical tourists was selected using simple random sampling. Data were collected via a fully structured questionnaire based on a five-point Likert scale. The study concludes that pricing and promotion significantly influence the attraction of medical tourists to Jordan. Conversely, no significant impact was found for the medical product and place (distribution) regarding their attraction to these tourists. Finally, the study recommends implementing a geographical pricing strategy and utilizing sales promotion tools in the targeted markets.

Background: Cerebellar ataxia, mental retardation, and disequilibrium syndrome (CAMRQ) is a heterogeneous group of genetic disorders that have been grouped by shared clinical features; all of these features are transmitted via an autosomal recessive mechanism. Four variants of this syndrome have been identified so far, and each one differs in terms of both clinical and genotypical features. CAMRQ4 is a rare genetic disorder characterized by mental retardation, ataxia or an inability to walk, dysarthria and, in some patients, quadrupedal gait. Methods: We investigated three Saudi families with CAMRQ4. Blood samples were collected from the affected patients, their parents, and healthy siblings. DNA was extracted from whole blood, and whole-exome sequencing was performed. Findings were confirmed by segregation analysis, which was performed on other family members. Results: Thus far, 17 patients have been affected by CAMRQ4. Genetic analysis of all patients, including our current patients, showed a mutation in the aminophospholipid transporter, class I, type 8A, member 2 gene (ATP8A2). A series of common phenotypical features have been reported in these patients, with few exceptions. Ataxia, mental retardation, and hypotonia were present in all patients, consanguinity in 90% and abnormal movements in 50%. Moreover, 40% achieved ambulation at least once in their lifetime, 40% had microcephaly, whereas 30% were mute. Magnetic resonance imaging (MRI) of the brain was normal in 60% of patients. Conclusions: We described the largest cohort of patients with CAMRQ4 syndrome and identified three novel mutations. CAMRQ4 syndrome should be suspected in patients presenting with ataxia, intellectual disability, hypotonia, microcephaly, choreoathetoid movements, ophthalmoplegia, and global developmental delay, even if brain MRI appears normal.

Gaucher disease is the most common sphingolipid storage disease and is present in all ethnic groups. Its symptoms span all systems including the cardiovascular system. The health care provider should be vigilant regarding this potentially fatal complication. Gaucher disease type IIIC has been linked to causing oculomotor apraxia and cardiac calcification. We report a Saudi girl who developed valvular and aortic calcification in late childhood and died as a result of her cardiovascular complications. This report further strengthens the association and reminds the clinicians that patients with D409H mutation need echocardiographic evaluation annually.

Cultural Intelligence (CI) refers to the motivation and ability to understand and deal with cultural differences. As such, it is assumed to play a role in the effectiveness of social contact and communication between people from different cultures. Given its relevance to international relations, it is imperative to test which individual and group factors are associated with CI. Therefore, in the present study we examine cross-cultural and gender differences in CI. In one of their classes at their university, students (N = 829) from Egypt and Saudi Arabia completed a multidimensional measure of CI. The results showed an interesting pattern of interactions between country and gender, which indicated that Egyptian men did not significantly differ from co-national women, but Saudi men scored significantly lower than women. We suggest that the different patterns of results in the two countries may partly arise from different levels of exposure to different cultures and partly from subtle differences in the constitution of the samples. Knowledge of individual and group differences in cultural intelligence may potentially contribute to explaining differential levels of success in individuals or countries in dealing with cultural differences.

The study aimed to measure the impact of marketing literacy on the awareness of Riyadh Season visitors regarding deception and commercial fraud at a 0.05 significance level. The independent variable is marketing literacy, while the dependent variable, visitors' awareness, consists of three sub-variables: skills, knowledge, and situations. The population for this study includes all visitors to Riyadh Season 2025, which is expected to reach 16 million people. Data were collected using a purposive sampling technique, resulting in a sample size of 386 non- Saudi visitors. A five-point Likert scale was employed for the assessment. The results indicated that visitors' awareness is significantly influenced by marketing situations, more so than by marketing skills and knowledge. The study found that both pre-marketing and post-marketing conditions during the Riyadh Season have a strong impact on visitors' awareness of negative practices. Finally, the study offers several recommendations to enhance awareness among visitors, including educational market visits, strengthening supervision by authorities, activating the role of the Consumer Protection Association, and establishing a tourism court.