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This work conducts a rigorous examination of the economic influence of tourism in Saudi Arabia, with a particular focus on predicting tourist spending patterns and classifying spending behaviors during the COVID-19 pandemic period and its implications for sustainable development. Utilizing authentic datasets obtained from the Saudi Tourism Authority for the years 2015 to 2021, the research employs a variety of machine learning (ML) algorithms, including Decision Trees, Random Forests, K-Neighbors Classifiers, Gaussian Naive Bayes, and Support Vector Classifiers, all meticulously fine-tuned to optimize model performance. Additionally, the ARIMA model is expertly adjusted to forecast the economic landscape of tourism from 2022 to 2030, providing a robust predictive framework for future trends. The research framework is comprehensive, encompassing diligent data collection and purification, exploratory data analysis (EDA), and extensive calibration of ML algorithms through hyperparameter tuning. This thorough process tailors the predictive models to the unique dynamics of Saudi Arabia’s tourism industry, resulting in robust forecasts and insights. The findings reveal the growth trajectory of the tourism sector, highlighted by nearly 965,073 thousand tourist visits and 7,335,538 thousand overnights, with an aggregate tourist expenditure of SAR 2,246,491 million. These figures, coupled with an average expenditure of SAR 89,443 per trip and SAR 9198 per night, form a solid statistical basis for the employed predictive models. Furthermore, this research expands on how ML and AI innovations contribute to sustainable tourism practices, addressing key aspects such as resource management, economic resilience, and environmental stewardship. By integrating predictive analytics and AI-driven operational efficiencies, the study provides strategic insights for future planning and decision-making, aiming to support stakeholders in developing resilient and sustainable strategies for the tourism sector. This approach not only enhances the capacity for navigating economic complexities in a post-pandemic context, but also reinforces Saudi Arabia’s position as a premier tourism destination, with a strong emphasis on sustainability leading into 2030 and beyond.

Introduction The global COVID-19 pandemic has triggered an unprecedented public health crisis, emphasizing the need to understand factors influencing disease outcomes. This study explores the role of genetic variations in blood group antigens, particularly ABO and RhD, in shaping mortality rates among critically ill COVID-19 patients in the southern region of Saudi Arabia. Methods Utilizing a retrospective, noninterventional approach, we analyzed medical records of 594 COVID-19 patients admitted to the intensive care unit (ICU) at Aseer Central Hospital from August 2020 to April 2021. The cohort, with a mean age of 60.5 years, consisted of a predominantly male population. Results The study encompassed a diverse age range of 18 to 103 years, with a mean age of 60.5 ± 17.3 years. Of the 594 patients, 398 (67%) were male, and only 5 (0.8%) had a history of smoking. Blood group distribution revealed 275 (48.4%) with O-, 189 (33.3%) with A+, and 51 (9%) with AB- types. Predominant chronic conditions included diabetes mellitus (35.5%). Tragically, 320 patients (54.6%) experienced mortality, with a 100% mortality rate for the B+ blood group and 92.9% for O- blood group. Conclusion This analysis establishes significant statistical links, underscoring the pivotal role of blood type, particularly the Rh factor, in influencing mortality risk among critically ill COVID-19 patients. These findings contribute valuable insights into risk stratification and personalized care for severe cases, emphasizing the importance of genetic considerations in understanding disease outcomes.

Background and Objectives: The link between celiac disease (CD) and type 1 diabetes (T1D) has been well-documented in the medical literature and is thought to be due to a shared genetic predisposition in addition to environmental triggers. This study aimed to determine the seroprevalence and biopsy-proven CD (PBCD) prevalence in individuals with T1D from Saudi Arabia and identify their clinical characteristics and the impact on glycemic control. Materials and Methods: A total of 969 children and adolescents with confirmed T1D were investigated. Prospective and retrospective data were collected to include clinical, anthropometric, and biochemical data. Total IgA and anti-TTG-IgA antibodies were screened to detect seropositive cases. Upper intestinal endoscopy and biopsy were performed to find BPCD. Results: The seroprevalence of CD was 14.6% (141/969), while BPCD prevalence was 7.5%. Females had a higher prevalence than males: 17.8% vs. 9.8%, p < 0.001. The CD group had lower HbA1c and more frequent hypoglycemia than the seronegative group. Conclusions: This study highlighted the high prevalence of CD in T1D Saudi patients. CD has multiple effects on glycemic control, growth, and puberty in children and adolescents with T1D. We emphasize the importance of early screening for CD at the time of diabetes diagnosis and periodically after that or if any atypical features present, especially anemia, growth delay, underweight, or frequent hypoglycemia.

Familial partial lipodystrophies (FPLDs) are very rare inherited disorders characterized by partial loss of adipose tissue from the upper and lower extremities. At least seven subtypes of FPLD have been identified and are mostly dominantly inherited. FPLD type 3 is caused by mutations in the PPARγ gene, which encodes for the protein peroxisome proliferator-activated receptor gamma (PPARγ). We identified a Saudi female with PFLD3 presented with partial lipoatrophy, uncontrolled diabetes, severe hypertriglyceridemia, and recurrent pancreatitis. The clinical and biochemical findings in this proband were described before and after treatment with Pioglitazone in addition to the conventional treatment. DNA extraction and whole exome sequencing (WES) were performed to detect the variant. The mutant gene was subjected to Sanger analysis to confirm the results. We applied five specific computational prediction tools to assess the pathogenicity of variation, namely the MT, DANN, CADD, BayesDel, and fitCons tools. We assessed protein modeling and stability with the AlphaFold-generated structures for both wild-type and mutant proteins. Finally, we conducted molecular docking using the AutoDock Vina virtual docking. Upon whole exome sequencing, a c.1024C>T p.(Gln342Ter) missense mutation was detected in the PPARγ gene associated with FPLD3. This variant is a novel mutation that has not been described in all genome databases. Sanger analysis confirmed the heterogenicity and pathogenicity of this variant. All five computational prediction tools indicate that this variant is considered highly pathogenic. Our patient showed a dramatic response to Pioglitazone, a synthetic PPARγ agonist. From structural modeling, we found that the enhanced binding affinity of the mutant PPARγ protein to Pioglitazone likely improves the activation of PPARγ, enhancing its transcriptional activity and resulting in better clinical outcomes. These findings extend the spectrum of PPARγ mutations responsible for FPLD3 and highlight the potential for personalized treatment strategies based on genetic mutations.

Background and Objectives: The prevalence of disordered eating behaviors (DEBs) in type 1 diabetes (T1D) has been studied globally; however, data from Saudi Arabia and Arab-speaking countries are scarce. This study aimed to measure the prevalence of DEBs and associated clinical characteristics in adolescents and young adults with T1D, and the impact of DEBs on glycemic parameters. Materials and Methods: A total of 265 adolescents and young adults with T1D (aged 12–25 years) were recruited randomly from the registry at the Jazan Endocrinology and Diabetes Center, Saudi Arabia. Participants completed the Diabetes Eating Problem Survey–Revised (DEPS-R) questionnaire. Other measures included hemoglobin A1c (HbA1c) in addition to sociodemographic, anthropometric, and clinical data. Results: The prevalence of DEBs among T1D was 27.2%. Females (32.5%) had a higher proportion of DEBs than males (18.6%) (p = 0.01). About 27% of the participants reported insulin restriction. A history of hospital admission in the previous 6 months due to DKA and frequent hypoglycemia was more frequently reported in T1D participants with DEBs compared to those without (p = 0.03). Participants with DEBs had higher HbA1c and higher BMI compared to those without DEBs. Conclusions: Adolescents and young adults with T1D with disordered eating and insulin restriction have higher glycated hemoglobin, and are at higher risk of DKA. Routine screening for DEBs should be an essential element in diabetes care, especially among highly vulnerable groups.

Disordered eating behaviors (DEBs) in type 1 diabetes (T1D) have been studied globally in different age groups. However, there is no validated diabetes-specific questionnaire in the Arabic language for the screening of DEBs. This study aimed to translate the Diabetes Eating Problem Survey–Revised scale (DEPS-R) into the Arabic language and study its psychometric properties in adolescents with T1D. We adopted the forward–backward procedure to translate the DEPS-R questionnaire into Arabic. The validation study enrolled 258 Saudi adolescents with T1D aged 12–18 years who completed the Arabic DEPS-R questionnaire and the EAT-26. The Arabic DEPS-R showed good construct validity and reliability (Cronbach’s alpha = 0.86). The factor analysis revealed a three-factor structure of DEPS-R which explains 54.4 % of the variance. In total, 30.6% of the participants are at high risk for DEBs (DEPS-R score ≥ 20). The psychometric properties of the Arabic DEPS-R are satisfactory, consistent with the original scale and translations in other languages. These results support the validity of the Arabic DEPS-R for assessment of DEBs in the T1D Arabic population.

COVID-19 and influenza pose serious health risks, and vaccine hesitancy is a major global health challenge. This study examined how the COVID-19 pandemic influenced public awareness and willingness to receive the flu vaccine in Jeddah, the Kingdom of Saudi Arabia (KSA). A cross-sectional web-based survey was conducted in Jeddah from October 2023 to May 2024. The survey targeted individuals aged 18 or older residing in Jeddah. Of the 487 responses, 400 met the inclusion criteria. The survey, administered in Arabic, included 20 questions on demographics, awareness, and attitudes toward vaccines. Among the participants, 72.3% were men and 54.5% were aged 18-24 years. Furthermore, 67% reported increased vaccination awareness after post-COVID-19, and 48.25% did not experience increased hesitation. Nearly all participants (94%) had heard of the influenza vaccine; however, 51.5% were unaware of its role in reducing hospitalization. Only 64% reported they would have been more likely to receive the vaccine if they had been aware of this benefit. Trust in healthcare providers' recommendations was low. Significant associations are observed between age and awareness of the influenza vaccine, and between age and perceived adequacy of vaccine information. Healthcare workers differ significantly from non-healthcare workers in their vaccine-related beliefs. The COVID-19 pandemic increased awareness of vaccines, particularly for influenza. However, hesitancy persists, driven by concerns about vaccine content and distrust toward health recommendations. Addressing these concerns is crucial for improving vaccine uptake in KSA.

Background: Collaboration between emergency departments (ED) and radiology is essential for timely and accurate diagnosis, particularly in acute care settings. Joint protocols have been developed to streamline workflows, reduce delays, and improve patient outcomes. However, their implementation faces several challenges, necessitating further investigation into their effectiveness and potential. Objective: This study examines the effectiveness of joint protocols between ED and radiology, focusing on their impact on diagnostic accuracy, timeliness, operational efficiency, and patient outcomes. It also explores the modern challenges and opportunities associated with their implementation. Methods: A systematic review of existing literature and case studies was conducted to evaluate the impact of joint protocols. The analysis included key performance metrics such as time-to-diagnosis, patient throughput, communication efficiency, and resource utilization. Results: The findings indicate that joint protocols significantly improve diagnostic timeliness and accuracy, enhance multidisciplinary communication, and reduce patient waiting times. However, challenges such as technological integration, resistance to change, and ED overcrowding persist. Emerging opportunities, including artificial intelligence, interoperable systems, and standardization efforts, provide a pathway to overcoming these obstacles and maximizing the benefits of joint protocols. Conclusion: Joint protocols between ED and radiology departments are effective in improving patient care and operational efficiency. Addressing implementation challenges and leveraging modern technological advancements are critical for optimizing their potential. These protocols represent a key strategy for enhancing emergency care delivery and ensuring better patient outcomes in an increasingly complex healthcare landscape.