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Architect-HIV Ag/Ab combo chemiluminescence assay is globally recognized for its sensitivity but has a notable false-positive rate. In this study, we aim to evaluate the performance of a new cost-effective screening alternative, the chemiluminescence Ag/Ab combo assay (CL-900i-HIV) from Mindray, China. We selected 195 archived samples categorized according to the INNO-LIA™ HIV I/II, the gold standard confirmatory assay. These samples included true positive ( n  = 38; positive by Architect-HIV & INNO-LIA-HIV), true negative ( n  = 101; negative by Architect-HIV & INNO-LIA-HIV), false positive ( n  = 20; positive by Architect-HIV & negative by INNO-LIA-HIV), and indeterminate results ( n  = 26). We tested all samples using the Mindray CL-900i-HIV and all positive Architect-HIV samples ( n  = 80) were confirmed by PCR. Compared to INNO-LIA™ HIVI/II line immunoassay confirmatory assay, Mindray CL-900i-HIV demonstrated a sensitivity of 100% (95% CI 90.7–100), specificity of 100% (95% CI 97.0–100), overall percent agreement (OPA) of 100% (95% CI 97.7–100.0), and perfect agreement with the INNO-LIA confirmatory assay (κ = 1.00). Additionally, Mindray’s CL-900i-HIV exhibited a significantly lower false-positive rate (8.75%) compared to Architect-HIV’s (55%). Mindray CL900i demonstrated high sensitivity and very low false-positive rate, thus, has the potential to serve as an excellent, cost-effective surrogate for HIV screening, overcoming the limitations of existing automated assays.

BackgroundInfluenza imposes a substantial global health burden, particularly among high-risk populations such as the elderly, young children, and individuals with chronic conditions. In Saudi Arabia, a national influenza sentinel surveillance program was established in 2017 to monitor respiratory virus trends, yet comprehensive estimates of the influenza-associated burden remain limited. This study aims to address this gap by quantifying influenza-associated severe acute respiratory infection (SARI) hospitalization rates and estimating the broader influenza burden across severity levels.MethodsData from four sentinel hospitals in three regions of Saudi Arabia were analyzed across three influenza seasons: 2017–2018, 2018–2019, and 2022–2023. Weekly SARI case counts were combined with census population data to calculate SARI hospitalization rates per 100,000 population. Influenza positivity rates, derived from laboratory-confirmed cases, were used to estimate influenza-associated SARI hospitalization rates, stratified by age and season. The John Hopkins University/WHO Seasonal Influenza Burden Disease Estimator (Flutool) was employed to extrapolate national estimates of influenza-associated hospitalizations, deaths, and mild/moderate cases. Confidence intervals and age-specific stratifications were computed to enhance precision and comparability.ResultsThe average annual SARI hospitalization rate was 294 per 100,000 population (95% CI: 288–300). Influenza-associated SARI hospitalization rates averaged 48 per 100,000 population (95% CI: 45–50), with the highest burden observed in individuals aged 65 years and older (269 per 100,000, 95% CI: 240–301) and children aged 0–4 years (118 per 100,000, 95% CI: 107–131). Seasonal variation was noted, with the highest rates in the 2017–2018 season. National estimates suggested a substantial burden, with influenza-associated hospitalizations totaling 17,678 in 2017–2018, 7,683 in 2018–2019, and 13,982 in 2022–2023. The flutool analysis estimated annual influenza-associated deaths ranging from 30 to 4,441 and mild/moderate cases reaching up to 6.3 million in the most severe season.ConclusionsThis study demonstrates a significant burden of influenza-associated SARI hospitalizations in Saudi Arabia, with the highest rates observed in the elderly and young children. Seasonal variation was evident, highlighting the urgent need to enhance influenza vaccination coverage, particularly among high-risk groups such as the elderly and young children, to reduce severe outcomes. Expanding sentinel surveillance to more regions and incorporating detailed clinical and economic data are recommended to better inform public health policies. Strengthening pandemic preparedness and tailoring vaccination campaigns based on seasonality and age-specific risk will be critical for mitigating the influenza burden in Saudi Arabia.

Errors in the preparation and administration of intravenous medications are significant contributors to morbidity and mortality rates in medical practice. Early reporting and the implementation of preventive measures can mitigate these errors. This study aims to identify patterns and frequencies of errors in IV medication preparation and administration, along with associated factors, at Omdurman Military Hospital in Khartoum, Sudan. This observational, descriptive, cross-sectional study was conducted in the emergency department of Omdurman Military Hospital from January to May 2022. We observed 60 nurses responsible for intravenous drug preparation and administration using a pretested questionnaire and checklist on multiple occasions. The data was analyzed by SPSS and the descriptive and inferential statistics were applied. Our findings reveal that 98% of the nurses reported a lack of formal training in IV drug preparation and administration. The observed preparation area was characterized as untidy in 59.6% of observations, and 52.5% were conducted in crowded environments. We identified six distinct types of errors during drug preparation, with the most common being the absence of aseptic techniques (63.2%) and the failure to check drug expiry dates before administration (99%). In contrast, five types of administration errors were reported, with the most prevalent being incorrect administration rates (68.7%) and the absence of post-administration side-effect assessments (84.8%). Additionally, 83.3% of nurses did not label the unused portion of a drug intended for the next dose. This study identifies a total of 11 different types of errors in IV drug preparation and administration, some of which are associated with the hospital's work environment. The lack of formal training among 98% of the nurses stands out as a significant contributor to the increasing frequency of these errors.

This study aims investigate and explore the importance of using realia in teaching English language vocabulary and to what extent is used .the population of the study is the basic school English teachers at the Red sea state) The researcher adopt he analytical descriptive method . The questionnaire was used as a tool for gathering data. This study aims to raise the teachers ‹ awareness and significance of using realia in teaching English language vocabulary .Using realia has a vital role on pupil vocabulary achievement. The majority of teachers have positive opinion toward using realia and some if them have negative ones. The study illustrated through analysis of questionnaire some findings and recommendations. The most important one is the course book doesn›t provide intensive drill focusing on vocabulary. The study found that The lesson which is taught through realia it will be stored in long term memory. The basic school should be equipped with all needed tools, also the Ministry of Education should care for providing all kinds of teaching visual aids and modern techniques to improve English language vocabulary. The researcher recommends further study to be conducted on using realia in teaching Vocabulary

As urban centers evolve into smart cities, sustainable mobility emerges as a cornerstone for ensuring environmental integrity and enhancing quality of life. Autonomous vehicles (AVs) play a pivotal role in this transformation, with the potential to significantly improve efficiency and safety, and reduce environmental impacts. This study introduces a novel Multi-Agent Actor–Critic (MA2C) algorithm tailored for multi-AV lane-changing in mixed-traffic scenarios, a critical component of intelligent transportation systems in smart cities. By incorporating a local reward system that values efficiency, safety, and passenger comfort, and a parameter-sharing scheme that encourages inter-agent collaboration, our MA2C algorithm presents a comprehensive approach to urban traffic management. The MA2C algorithm leverages reinforcement learning to optimize lane-changing decisions, ensuring optimal traffic flow and enhancing both environmental sustainability and urban living standards. The actor–critic architecture is refined to minimize variances in urban traffic conditions, enhancing predictability and safety. The study extends to simulating realistic human-driven vehicle (HDV) behavior using the Intelligent Driver Model (IDM) and the model of Minimizing Overall Braking Induced by Lane changes (MOBIL), contributing to more accurate and effective traffic management strategies. Empirical results indicate that the MA2C algorithm outperforms existing state-of-the-art models in managing lane changes, passenger comfort, and inter-vehicle cooperation, essential for the dynamic environment of smart cities. The success of the MA2C algorithm in facilitating seamless interaction between AVs and HDVs holds promise for more fluid urban traffic conditions, reduced congestion, and lower emissions. This research contributes to the growing body of knowledge on autonomous driving within the framework of sustainable smart cities, focusing on the integration of AVs into the urban fabric. It underscores the potential of machine learning and artificial intelligence in developing transportation systems that are not only efficient and safe but also sustainable, supporting the broader goals of creating resilient, adaptive, and environmentally friendly urban spaces.

Purpose - The purpose of this paper is to examine consumer attitudes toward online shopping in Jordan. The paper introduces an integrated model which includes trust, perceived benefits, perceived web quality, and electronic word of mouth (eWOM) along with their relationships in order to examine their effects on consumer attitudes toward online shopping. Design/methodology/approach - A structured and self-administered online survey was employed targeting online shoppers of a reputable online retailer in Jordan; i.e. MarkaVIP. A sample of 273 online shoppers was involved in the online survey. A series of exploratory and confirmatory factor analyses were used to assess the research constructs, unidimensionality, validity, and composite reliability. Structural path model analysis was also used to test the hypothesized relationships of the research model. Findings - The empirical findings of this study indicate that consumer attitudes toward online shopping is determined by trust and perceived benefits. Trust is a product of perceived web quality and eWOM and that the latter is a function of perceived web quality. Hence, trust and perceived benefits are key predictors of consumer attitudes toward online shopping, according to the results. Further, the authors also found that higher levels of perceived web quality lead to higher levels of trust in an online shopping web site. Perceived web quality was found to be a direct predictor of trust, and the former positively and significantly influences perceived benefits. Also, the authors found that 28 percent of the variation in online shopping attitudes was caused by perceived benefits and trust. Research limitations/implications - The research sample included only early adopters who are usually described as personal innovators and risk takers. Future research is encouraged to focus on other groups such as non-adopters to understand their online shopping attitudes. Another limitation is derived from the geographical context of the current study; that is Jordan. The findings are not necessarily applicable to other Arab countries and the rest of the world. Therefore, replications of the current study in different countries would most likely strengthen and validate its findings. Also, the study is cross-sectional which does not show how attitudes of consumers may change over time. The authors encourage future studies to employ a longitudinal design to understand the changes in consumers' attitudes toward using online shopping over time. Finally, this study examined only one case in point and thus findings cannot be generalized to other online shopping web sites. Future research is highly encouraged to examine consumers' attitudes toward other online shopping web sites inside and outside Jordan. Practical implications - The paper supports the importance of trust and perceived benefits as key drivers of attitudes toward online shopping in emerging markets like Jordan. It further underlines the importance of perceived web quality contribution to perceived benefits and trust as well as the key role of the later in forming online shoppers' attitudes. Online retailers' executives and managers can benefit from such findings for future e-marketing strategies and acquire new customers to achieve long-term performance objectives. Originality/value - This paper is one of the very few attempts that examined attitudes toward online shopping in the Arab world. Importantly, it revealed the drivers of online shoppers' attitudes in Jordan. National and international online retailers planning to expand their operations to Jordan or to the Middle East Region have now valuable empirical evidence concerning the determinants of online shopping attitudes and online shoppers' behavior in Jordan upon which e-marketing strategies can be formulated and implemented.

This study presents a cutting-edge framework for assessing earthquake vulnerability and risk in residential areas of Al-Seeb, Muscat Governorate (Sultanate of Oman). Drawing upon a rich dataset encompassing seismic, geotechnical, structural, environmental, and socioeconomic parameters, thematic vulnerability maps were developed using a GIS-based analytic hierarchy process (GIS-AHP). These were systematically integrated to produce comprehensive risk matrices. It has been noted that the Rusayl industrial estate emerged as a critical hotspot due to the clustering of industrial facilities and fuel stations near densely populated zones, amplifying hazard proximity. Physical vulnerability patterns largely mirrored geotechnical characteristics but were further shaped by urban density and infrastructure quality. A risk index was derived for each grid cell, enabling the formulation of a detailed microzonation map that categorizes Al-Seeb into five distinct risk zones. Central urban areas like Al-Hail North and segments of Old Al-Khoud plunged within the highest vulnerability category, while parts of Al-Mawaleh North exhibited a blend of high and very high risk, primarily due to aging infrastructure and insufficient retrofitting. Interestingly, Al-Maabilah showed signs of structural resilience, with 60% of buildings experiencing minor damage and only 20% sustaining major impacts. The robust database generated offers critical insights for policymakers, planners, and stakeholders, serving as a strategic tool for informed decision-making. The study’s outcomes align well with Oman Vision 2040 and contribute directly to the goals of sustainable and disaster-resilient urban development outlined in the United Nation’s Sustainable Development Goal (UN-SDG) 11. By embedding these insights into national urban planning and construction policies, the study supports risk-informed development and financial risk reduction for any futuristic projects in the Sultanate of Oman. In response to the shortcomings and delays of previous research, the present study is the first of its kind in the Arabian region, significantly contributing to the establishment of a sustainable and resilient Omani society.

The purpose of this study was to compare the clinical and subjective oral health indicators of type 2 diabetic patients (T2DM) with age and gender matched non-diabetic controls. A second aim was to identify clinical and subjective oral health indicators that discriminate between well-controlled and poorly controlled T2DM patients as well as between patients with long and short duration of the disease. A total of 457 individuals participated in the study (154 T2DM cases and 303 non-diabetic controls). The T2DM group was sub-divided according to metabolic control [(well-controlled: glycosylated haemoglobin test 8%), (poorly controlled: glycosylated haemoglobin test > 8%)] and according to duration of T2DM [(long duration: >10 years), (short duration: 10 years)]. Participants were interviewed using a structured questionnaire including socio-demographics, lifestyle and oral health related quality of life factors. The clinical examination comprised full mouth probing depths, plaque index, tooth mobility index, furcation involvement and coronal and root surface caries. The T2DM patients presented with more probing depths 4 mm, furcation involvement, tooth mobility, missing teeth, and oral impacts on daily performance (OIDP). The corresponding adjusted odds ratios and their 95% confidence intervals were 4.07 (1.74-9.49), 2.96 (1.36-6.45), 5.90 (2.26-15.39), 0.23 (0.08-0.63) and 3.46 (1.61-7.42), respectively. Moreover, the odds ratio was 2.60 (1.21-5.55) for the poorly controlled T2DM patients to have high levels of mobility index and 2.94 (1.24-6.94) for those with long duration of T2DM to have high decayed, missed and filled teeth (DMFT) values. This study revealed that chronic periodontitis, tooth mobility, furcation involvement and OIDP were more prevalent among T2DM patients compared to their non-diabetic controls.

The relationship between diabetes and periodontal disease is bidirectional, but information about the effect of chronic periodontitis on the levels of the glucoregulatory biomarkers locally in gingival crevicular fluid (GCF) is limited. The aim of this study was to compare the levels of 10 glucoregulatory biomarkers in GCF, firstly in subjects with type 2 diabetes (T2DM) presenting with and without chronic periodontitis and secondly, in subjects without diabetes, with and without chronic periodontitis. The material comprised a total of 152 subjects, stratified as: 54 with T2DM and chronic periodontitis (G1), 24 with T2DM (G2), 30 with chronic periodontitis (G3) and 44 without T2DM or periodontitis (G4). The levels of the biomarkers were measured using multiplex biometric immunoassays. Periodontal pocket depths were recorded in mm. Subsets G1 and G2 and subsets G3 and G4 were compared independently. Among T2DM subjects, GIP, GLP-1 and glucagon were significantly up-regulated in G1 compared to G2. Moreover, there were no statistical differences between the two groups regarding C-peptide, insulin, ghrelin, leptin and PAI-1. Comparisons among individuals without T2DM revealed significantly lower amounts of C-peptide and ghrelin in G3 than in G4. The number of sites with pocket depth ≥ 4mm correlated negatively with C-peptide (Spearman's correlation co-efficient: -0.240, P < 0.01) and positively with GIP and visfatin (Spearman's correlation co-efficient: 0.255 and 0.241, respectively, P < 0.01). The results demonstrate that chronic periodontitis adversely influences the GCF levels of glucoregulatory biomarkers, as it is associated with disturbed levels of biomarkers related to the onset of T2DM and its medical complications.