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Background Graves’ disease is the most prevalent cause of hyperthyroidism globally, with technetium-99m pertechnetate widely utilized in its diagnosis. Dynamic scintigraphy using technetium-99m pertechnetate has shown promise for early detection of Graves’ disease, particularly in subclinical presentations, but lacks standardized evaluation. This study aims to explore the utility of a dynamic technetium-99m pertechnetate scintigraphy protocol in hyperthyroidism, focusing on its diagnostic advantages and potential clinical applications. Case presentation The cases described involved adult male and female patients aged 34–40 years of Saudi Middle Eastern ethnicity. Conclusions Dynamic flow imaging using technetium-99m pertechnetate represents a promising diagnostic approach for Graves’ disease, particularly in challenging subclinical cases. This protocol has the potential to refine diagnostic accuracy and guide treatment decisions. Further validation through larger studies is warranted to establish its clinical utility.

Background: Patient-centered care (PCC) plays a vital role in improving healthcare outcomes by addressing the individual needs and preferences of patients. Despite its significance, challenges to the implementation of PCC in nursing remain, impacting communication and the overall quality of care.Methods: This literature review examines empirical studies on nurse-patient interactions across various healthcare environments. Relevant articles published in English were sourced from databases such as CINAHL, PubMed, and Medline, with a focus on identifying barriers and facilitators of patient-centered communication. Key themes were extracted and used to develop a conceptual framework, the Patient-Centered Care and Communication Continuum (PC4) Model.Results: The review identified four primary categories of barriers: those related to institutional and healthcare systems, communication issues, environmental factors, and personal and behavioral obstacles. Common challenges include insufficient staffing, time limitations, lack of communication training, and cultural differences between nurses and patients. The findings emphasize the importance of effective communication in achieving successful PCC, noting that enhanced nurse-patient interactions promote patient engagement and satisfaction.Conclusion: Overcoming the identified barriers is essential to improving patient-centered care in nursing practice. The PC4 Model offers a useful framework for understanding and enhancing nurse-patient communication. By prioritizing effective communication and creating a supportive healthcare environment, nurses can better meet the needs of patients and families, leading to improved health outcomes.

Obstructive sleep apnea (OSA) is a common yet underdiagnosed sleep-related breathing disorder with significant health implications. Despite its clinical relevance, data on population-level knowledge of OSA in Saudi Arabia remain limited. A nationwide cross-sectional survey was conducted between November 28th, 2023, and October 18th, 2024, to assess the level of public knowledge and awareness about OSA among the general population in Saudi Arabia. A total of 16,662 participants completed the survey, with a mean age of 31 years. Obesity (15.8%) was the most commonly self-reported health condition. Most respondents rated their sleep quality as good (36.2%) or acceptable (28.9%), while only 7.5% reported consistent physical activity. Overall, only 12.9% of participants demonstrated good knowledge of OSA. Males were more likely to have good knowledge than females (OR: 1.20, 95% CI: 1.07-1.33, p = 0.001). Residents of the Northern region had significantly higher awareness compared to those in the Central region (OR: 1.39, 95% CI: 1.18-1.64, p < 0.001). Lower educational attainment was associated with reduced awareness: diploma holders (OR: 0.58, 95% CI: 0.50-0.68, p < 0.001) and primary/intermediate education (OR: 0.61, 95% CI: 0.47-0.80, p < 0.001). Former smokers were more knowledgeable than current smokers (OR: 2.03, 95% CI: 1.69-2.44, p < 0.001). Participants with obesity had significantly higher odds of good knowledge compared to those with normal BMI (OR: 1.55, 95% CI: 1.27-1.88, p < 0.001). Public knowledge about OSA in Saudi Arabia is considerably low, with awareness varying significantly by gender, region, education level, smoking status, and BMI. Targeted public health initiatives are essential to enhance understanding, promote early detection, and improve management of OSA across the population.

Schizophrenia (SCZ), a multifactorial neuropsychiatric disorder, is treated with inefficient antipsychotics and linked to poor treatment outcomes. This study, therefore, investigated the combined administration of prodigiosin (PDG) and selenium (Na 2 SeO 3 ) against SCZ induced by amphetamine (AMPH) in rats. Animals were allocated into four groups corresponding to their respective 7-day treatments: control, AMPH (2 mg/kg), PDG (300 mg/kg) + Na 2 SeO 3 (2 mg/kg), and AMPH + PDG + Na 2 SeO 3 . The model group exhibited biochemical, molecular, and histopathological changes similar to those of the SCZ group. Contrastingly, co-administration of PDG and Na 2 SeO 3 significantly increased the time for social interaction and decreased AChE and dopamine. It also downregulated the gene expression of NMDAR1 and restored neurotrophin (BDNF and NGF) levels. Further, PDG combined with Na 2 SeO 3 improved the antioxidant defence of the hippocampus by boosting the activities of SOD, CAT, GPx, and GR. These findings were accompanied by an increased GSH, alongside decreased MDA and NO levels. Furthermore, schizophrenic rats having received PDG and Na 2 SeO 3 displayed markedly lower IL-1β and TNF-α levels compared to the model group. Interestingly, remarkable declines in the Bax (pro-apoptotic) and increases in Bcl-2 (anti-apoptotic) levels were observed in the SCZ group that received PDG and Na 2 SeO 3 . The hippocampal histological examination confirmed these changes. Collectively, these findings show that the co-administration of PDG and Na 2 SeO 3 may have a promising therapeutic effect for SCZ. This is mediated by mechanisms related to the modulation of cholinergic, dopaminergic, and glutaric neurotransmission and neurotrophic factors, alongside the suppression of oxidative damage, neuroinflammation, and apoptosis machinery.

Dietary nitrate supplementation, which improves skeletal muscle oxygen utilisation, vascular endothelial function and exercise capacity in people with chronic obstructive pulmonary disease, may benefit other lung conditions. In a double-blind, placebo-controlled, crossover study, in 19 adults with Group 3 pulmonary hypertension who desaturated during exercise, 140 mL of nitrate-rich beetroot juice improved endurance shuttle walk time compared with nitrate-depleted beetroot juice placebo (median (IQR) ESWT NR-BRJ 197 (140–273) s vs PL-BRJ 174 (107–229) s; median difference (MD) (95% CI) 30 (6.19 to 91.07) s, p=0.0281), endothelial function, flow-mediated dilatation (+3.40±5.47% vs −1.33±4.78; MD (95% CI) 4.73 (1.44 to 8.02), p=0.007) and lowered mean arterial blood pressure (−3.9 (−7.4 to −0.4) mm Hg, p=0.028).

Glucagon-like peptide-1 receptor agonists (GLP-1-RAs) are a novel class of medications promising for treating type 2 diabetes mellitus (T2DM) and obesity-related conditions such as cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). This comprehensive literature review examines available research on these medications, focusing on their mechanisms of action, clinical effectiveness, safety profiles, and socioeconomic implications. A comprehensive search was performed using the PubMed, EMBASE, and Cochrane Library databases. Although initially developed for glucose management, these drugs have also demonstrated efficacy in promoting weight loss and reducing the risk of CVD. GLP-1-RAs function similarly to naturally occurring incretins. They stimulate insulin secretion in response to glucose levels, inhibit glucagon release, delay stomach emptying, and generate a sense of fullness via brain pathways. Head-to-head clinical studies have indicated that GLP-1-RAs outperform conventional antidiabetic medicines in terms of glycemic management and weight reduction. According to cardiovascular outcome studies, various drugs in this category have been found to reduce the frequency of severe adverse cardiovascular events. A common side effect is gastrointestinal toxicity, which can be mitigated by gradually increasing the dose. Personalized treatment is likely because the effectiveness, safety, and dose regimens of currently available GLP-1-RAs differ. GLP-1-RAs are a superior choice for patients with T2DM, especially those who already have CVD or require weight-control support. The high cost of these drugs creates hurdles to access and fair healthcare. Current research mainly focuses on increasing therapeutic uses and producing orally delivered medicines with greater potency and bioavailability. Integrating GLP-1-RAs into clinical practice can enhance patient outcomes and reduce the community burden of cardiometabolic disease.

Acne vulgaris, a prevalent dermatological condition, often results in long-term complications such as scarring and hyperpigmentation. While extensive research has focused on treatment modalities, there is a notable gap in understanding the factors contributing to the development of acne scarring and post-inflammatory hyperpigmentation (PIH). This study was conducted to identify the factors contributing to the development of acne scarring and post-inflammatory hyperpigmentation (PIH). This retrospective cohort study, conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia, analyzed data from patients with acne vulgaris between 2016 and 2023 using the hospital's health information system, BESTCare. Statistical analysis was performed using RStudio (R version 4.3.1). We constructed a multivariable, multinomial logistic regression model to assess the independent predictors of four acne complication groups; no scarring/PIH, scarring alone, PIH alone, and acne scarring with PIH. Among 417 analyzed participants, 95 participants had acne scarring (22.8%), 93 participants had PIH alone (22.3%), and 151 participants had both acne scarring with PIH (36.2%), and only 78 participants did not develop scarring or PIH (18.7%). Isotretinoin use and papules acne were associated with increased risk of acne complications. While adapalene gel was protective against acne scarring only. This retrospective study sheds light on factors influencing acne scarring and PIH among Acne Vulgaris patients. Our findings provide valuable insights for tailoring interventions and advancing our understanding of acne vulgaris complications in the future.

Timetabling problem is among the most difficult operational tasks and is an important step in raising industrial productivity, capability, and capacity. Such tasks are usually tackled using metaheuristics techniques that provide an intelligent way of suggesting solutions or decision-making. Swarm intelligence techniques including Particle Swarm Optimization (PSO) have proved to be effective examples. Different recent experiments showed that the PSO algorithm is reliable for timetabling in many applications such as educational and personnel timetabling, machine scheduling, etc. However, having an optimal solution is extremely challenging but having a sub-optimal solution using heuristics or metaheuristics is guaranteed. This research paper seeks the enhancement of the PSO algorithm for an efficient timetabling task. This algorithm aims at generating a feasible timetable within a reasonable time. This enhanced version is a hybrid dynamic adaptive PSO algorithm that is tested on a round-robin tournament known as ITC2021 which is dedicated to sports timetabling. The competition includes several soft and hard constraints to be satisfied in order to build a feasible or sub-optimal timetable. It consists of three categories of complexities, namely early, test, and middle instances. Results showed that the proposed dynamic adaptive PSO has obtained feasible timetables for almost all of the instances. The feasibility is measured by minimizing the violation of hard constraints to zero. The performance of the dynamic adaptive PSO is evaluated by the consumed computational time to produce a solution of feasible timetable, consistency, and robustness. The dynamic adaptive PSO showed a robust and consistent performance in producing a diversity of timetables in a reasonable computational time.

Background: While efforts have been made to control meningococcal disease or carriage during mass gatherings (MGs), it is still a significant problem. This meta-analysis aims to assess the prevalence and predictors of meningitis carriage during MGs and travel. Methodology: PubMed, Scopus, Embase, and Cochrane were searched from their conception to January 2025. Cohort and cross-sectional studies assessing the prevalence of meningitis carriage and its serotype related to MGs and/or travel, and risk factors associated with its spread, were considered. The Newcastle–Ottawa scale was used for the quality assessment of studies. Results: Out of 1301 studies, 25 were considered for this meta-analysis. The largest geographic area involved was Saudi Arabia. A meta-analysis of 24 studies identified a pooled prevalence rate of meningococcal disease or carriage of 15.9% (95%CI: 4.45–27.4%) and the most frequent infecting organisms to be Serotype C (13.9%; 95%CI: −14.7 to 42.5; 4 studies) and A (11.5%; 95%CI: −2.13 to 25.2; 9 studies) among those at MGs or traveling. Age, gender, smoking history, and the vaccination status did not affect the infection risk. Conclusions: There is an increased prevalence of meningococcal disease and carriage, especially Serogroups A and C, associated with MGs and travel. New interventions and methodologies should be undertaken to control and prevent meningococcal disease or carriage transmission during such events.

Various feature selection algorithms are usually employed to improve classification models’ overall performance. Optimization algorithms typically accompany such algorithms to select the optimal set of features. Among the most currently attractive trends within optimization algorithms are hybrid metaheuristics. The present paper presents two Stages of Local Search models for feature selection based on WOA (Whale Optimization Algorithm) and Great Deluge (GD). GD Algorithm is integrated with the WOA algorithm to improve exploitation by identifying the most promising regions during the search. Another version is employed using the best solution found by the WOA algorithm and exploited by the GD algorithm. In addition, disruptive selection (DS) is employed to select the solutions from the population for local search. DS is chosen to maintain the diversity of the population via enhancing low and high-quality solutions. Fifteen (15) standard benchmark datasets provided by the University of California Irvine (UCI) repository were used in evaluating the proposed approaches’ performance. Next, a comparison was made with four population-based algorithms as wrapper feature selection methods from the literature. The proposed techniques have proved their efficiency in enhancing classification accuracy compared to other wrapper methods. Hence, the WOA can search effectively in the feature space and choose the most relevant attributes for classification tasks.