Tracking the epidemiological trends of female breast cancer in Saudi Arabia since 1990 and forecasting future statistics using global burden of disease data, time-series analysis.

BACKGROUND: Female breast cancer stands as the prime type of cancer in the Kingdom of Saudi Arabia (KSA), with a high incidence and mortality rates. This study assessed the burden of female breast cancer in KSA by analyzing and forecasting its incidence, mortality, and disability-adjusted life years (DALYs). METHODS: We retrieved data from the Global Burden of Disease (GBD) about female breast cancer from 1990 to 2021. Time-series analysis used the autoregressive integrated moving average (ARIMA) model to forecast female breast cancer statistics from 2022 to 2026. RESULTS: From 1990 to 2021, KSA reported 77,513 cases of female breast cancer. The age groups with the highest number of cases are 45-49 years, followed by 40-44 years, 50-54 years, and 35-39 years. The analysis also showed fewer cases in the younger age groups, with the lowest number in the less than 20-year-old age group. From 1990 to 2021, KSA reported 19,440 deaths due to breast cancer, increasing from 201 cases in 1990 to 1,190 cases in 2021. The age-standardized incidence rate/100,000 of breast cancer increased from 15.4 (95% confidence interval (CI) 11.2-21.0) in 1990 to 46.0 (95%CI 34.5-61.5) in 2021. The forecasted incidence rate of female breast cancer will be 46.5 (95%CI 45.8-46.5) in 2022 and 49.6 (95%CI 46.8-52.3) in 2026. The age-standardized death rate per 100,000 Saudi women with breast cancer increased from 6.73 (95%CI 6.73-9.03) in 1990 to 9.77 (95%CI 7.63-13.00) in 2021. The forecasted female breast cancer death rate will slightly decrease to 9.67 (95%CI 9.49-9.84) in 2022 and to 9.26 (95%CI 8.37-10.15) in 2026. DALYs increased from 229.2 (95%CI 165.7-313.6) in 1990 to 346.1 (95%CI 253.9-467.2) in 2021. The forecasted DALYs of female breast cancer will slightly decrease to 343.3 (95%CI 337.2-349.5) in 2022 reaching 332.1 (95%CI 301.2-363.1) in 2026. CONCLUSIONS: Female breast cancer is still a significant public health burden that challenges the health system in KSA, current policies and interventions should be fashioned to alleviate the disease morbidity and mortality and mitigate its future burden.

Bifurcation, chaos, and stability analysis to the second fractional WBBM model.

This manuscript investigates bifurcation, chaos, and stability analysis for a significant model in the research of shallow water waves, known as the second 3D fractional Wazwaz-Benjamin-Bona-Mahony (WBBM) model. The dynamical system for the above-mentioned nonlinear structure is obtained by employing the Galilean transformation to fulfill the research objectives. Subsequent analysis includes planar dynamic systems techniques to investigate bifurcations, chaos, and sensitivities within the model. Our findings reveal diverse features, including quasi-periodic, periodic, and chaotic motion within the governing nonlinear problem. Additionally, diverse soliton structures, like bright solitons, dark solitons, kink waves, and anti-kink waves, are thoroughly explored through visual illustrations. Interestingly, our results highlight the importance of chaos analysis in understanding complex system dynamics, prediction, and stability. Our techniques' efficiency, conciseness, and effectiveness advance our understanding of this model and suggest broader applications for exploring nonlinear systems. In addition to improving our understanding of shallow water nonlinear dynamics, including waveform features, bifurcation analysis, sensitivity, and stability, this study reveals insights into dynamic properties and wave patterns.

Perception and awareness of the public about presbyopia and its corrective approaches in Saudi Arabia: a population-based survey.

BACKGROUND: This study investigated patients' awareness of presbyopia and its management approaches and their preferred methods for near vision correction. METHODS: In Saudi Arabia, 785 participants (aged between 35 and 60 years) completed a structured survey online, consisting of hard copies and direct interviews. The survey consisted of twenty-eight items divided into three parts. It was designed to record participants' awareness of and preferences for presbyopia and its refractive corrections. Nonparametric tests and descriptive analyses were conducted to analyse participants' responses. RESULT: Approximately half of the participants had difficulty with near vision activities, such as reading newspapers or using mobile phones. Among all the participants, 76% were not aware of presbyopia. The prevalence of uncorrected presbyopia was 48% of the 785. The majority (82%) felt that spectacles were acceptable for correction of presbyopia. Most reported that they did not experience social stigma when using reading spectacles (87% of participants). When asked if they were aware of management approaches other than spectacles, 72% responded with not at all. Most participants had no earlier knowledge of the use of multifocal contact lenses or eye drops for presbyopia correction (67% and 82%, respectively). In the present study, some tendencies to use corrective approaches to presbyopia other than spectacles were noted. Finally, participants' age, sex, region, education, and income had a statistically significant impact on essential parts of their responses (p < 0.05). CONCLUSION: Presbyopia is a highly prevalent age-related ocular disorder, and a significant percentage of cases are uncorrected due to a lack of awareness or reluctance to wear spectacles. More efficient health education about presbyopia and its corrective alternatives is urgently needed.

Diagnostic ultrasonography and antimicrobial resistance of different pathogens associated with canine and feline lower urinary tract disorders.

There is a significant issue concerning the dissemination of antimicrobial-resistant bacteria within companion animals. Urinary tract infections (UTIs) are a common problem in veterinary medicine for which empirical antibiotics are utilized. This study aimed to investigate the antimicrobial resistance of different uropathogens associated with UTIs in canine and feline cases. A total of 146 dogs and 162 cats suffered from lower urinary tract disorders were subjected to ultrasonographic and microbiological examination. Cystitis, urinary sediment, and cystic calculi are the most common ultrasonographic abnormalities associated with bacterial UTIs. Bacterial UTIs were obtained in 36.98 % and 25.92 % of cases in dogs and cats, respectively. A low rate of mixed infection was detected in canine cases (3.7 %). E. coli was the most prevalent pathogen isolated from 46.4 % and 66.7 % of canine and feline isolates, respectively followed by Proteus spp. in canine isolates (16.1 %) and Klebsiella spp. in feline isolates (14.3 %). Staphylococcus spp. was isolated from canine cases only with the detection of methicillin-resistant Staphylococcus pseudintermedius (MRSP) strains at 3.6 %. The majority of the isolated strains were resistant to various antibiotic classes, particularly ß-lactams. All gram-negative bacteria were susceptible to amikacin, whereas gram-positive strains exhibited 100 % sensitivity to nitrofurantoin and linezolid. Different bacterial species displayed low resistance to carbapenems and fluoroquinolones. Multi-drug resistance was reported in canine and feline strains at 64.3 % and 54.8 %, respectively. These findings prove the crucial necessity to restrict antibiotic consumption depending on urine culture and antibiotic sensitivity tests.

Utilizing Competency-Based Education to Evaluate the Research Skills of Nursing Students: A Systematic Review and Meta-Analysis.

Exploring and implementing competency-based education approaches to assess research skills are necessary to close the gap between research and practice, promote lifelong learning among future nurses, and improve research literacy. This study aims to assess the effectiveness of competency-based education in improving the assessment of research skills among nursing students. A systematic review and meta-analysis of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Population, Intervention, Comparison, Outcomes and Study (PICOS) eligibility criteria were used to select original studies published between 2017 and 2023. As a first step in the data-handling process, titles and abstracts of all articles retrieved by the search strategy were screened for relevance, and the irrelevant articles were discarded. The screening process was conducted by two authors independently, and the final decisions were made together. A meta-analysis was performed to assess the effectiveness of competency-based education in improving the assessment of research skills among nursing students. Five quantitative studies were appraised using the Joanna Briggs Institute checklist. The effect size was 0.69 ± 0.35 (P = 0.05), which indicates a high effect on research competency among nursing students who attend courses or training in research matters, after transforming data to correlation coefficient resulting in r = 0.5. The study encourages research literacy among nursing students. Through competency-based learning, students are exposed to a variety of research methodologies, ethical issues, and scientific writing conventions. This exposure enhances their capacity to understand, assess, and apply research evidence, empowering them to become knowledgeable consumers and field contributors. While making evidence-based decisions, nurses with research competencies can actively incorporate the most recent research findings into their clinical practice. Furthermore, nurses with strong research abilities can influence health policy and practice.

Green radiography: Exploring perceptions, practices, and barriers to sustainability.

INTRODUCTION: Previous research has delved into the attitudes and behaviors of diverse professions regarding environmental sustainability. However, there needs to be more research specifically targeting radiographers. This study aims to survey radiographers' perceptions, practices, and barriers to change concerning environmental sustainability in radiology. METHODS: Institutional ethical approval was obtained (IRB-COHS-FAC-110-2024) and data collection was conducted using Google Forms (Google Inc., Mountain View, CA). The survey targeted 104 practicing radiographers across several countries. Questions were structured around five domains to gather insights into demographics, training in global warming and climate change, perceptions of sustainability and climate change, sustainability barriers, and current radiology practices on sustainability. Data analysis utilized descriptive and d inferential statistics. RESULTS: One hundred and four radiographers completed the study. Females had a significantly higher attendance rate in environmental protection campaigns (P = 0.01). The majority of respondents (68%) believe in climate change's knowledge and impact on the natural world. Our survey findings demonstrate that 74% of respondents believe there's a need to improve sustainability practices. The most commonly used strategies to decrease energy consumption and emissions were low-energy lighting (60%), real-time power monitoring tools (41%), and energy-efficient heating systems (32%). A significant concern regarding sustainability emerges among respondents: time (50%) and lack of leadership (48%) are prevalent concerns among the identified barriers. CONCLUSION: Participants are recognising the importance of environmental sustainability in radiology, but lack of leadership, support, authority, and facility limitations hinder their adoption. IMPACT ON PRACTICE: Radiology must prioritize environmental sustainability by providing resources and training for radiographers and collaborating with healthcare professionals, policymakers, and environmental experts to develop comprehensive strategies for a sustainable healthcare system.

Recent advancements in wastewater treatment via anaerobic fermentation process: A systematic review.

This manuscript delves into the realm of wastewater treatment, with a particular emphasis on anaerobic fermentation processes, especially dark, photo, and dark-photo fermentation processes, which have not been covered and overviewed previously in the literature regarding the treatment of wastewater. Moreover, the study conducts a bibliometric analysis for the first time to elucidate the research landscape of anaerobic fermentation utilization in wastewater purification. Furthermore, microorganisms, ranging from microalgae to bacteria and fungi, emphasizing the integration of these agents for enhanced efficiency, are all discussed and compared. Various bioreactors, such as dark and photo fermentation bioreactors, including tubular photo bioreactors, are scrutinized for their design and operational intricacies. The results illustrated that using clostridium pasteurianum CH4 and Rhodopseudomonas palustris WP3-5 in a combined dark-photo fermentation process can treat wastewater to a pH of nearly 7 with over 90% COD removal. Also, integrating Chlorella sp and Activated sludge can potentially treat synthetic wastewater to COD, P, and N percentage removal rates of 99%,86%, and 79%, respectively. Finally, the paper extends to discuss the limitations and future prospects of dark-photo fermentation processes, offering insights into the road ahead for researchers and scientists.

Governance of noncommunicable diseases in Afghanistan.

Background: Noncommunicable diseases (NCDs) are the main reasons of mortality worldwide. One of every two person is dying due to NCDs in Afghanistan. International policy actors, mainly the World Health Organization (WHO), published several reports and declarations on controlling and preventing NCDs. This study aimed to provide a situation for governance of NCDs in Afghanistan and proper solutions for identified challenges. Methods: We conducted qualitative research utilizing interpretive phenomenology. A self-developed questionnaire was developed to conduct the semi-structured interviews with 39 experts from Afghanistan. The results were analyzed using a deductive framework analysis. Six building block framework of health system developed by the WHO was used as predefined framework for this study. Results: The governance building block of health system consists of five subthemes including policy making, planning, organizing, stewardship, and control. We identified main strengths, weaknesses, opportunities, and challenges for these subthemes. The experts also provided key recommendations to address the challenges. Conclusions: Management of NCDs is a neglected part of the health system in Afghanistan. Strengthening evidence-based policy making with technical and indigenous planning, establishing responsive units with adequate financial and human resources within different ministries to address "health in all policies" concept, passing and implementing national laws and regulations to support national strategies for prevention and control of NCDs, and establishing decentralized monitoring systems to control the implementation of these strategies are the main recommendations of this study. Local government and international policy actors should invest and support the development of a multisectoral coordination system at national level for Afghanistan.

Staged endovascular and open surgical approach for treatment of a giant left upper back arteriovenous malformation.

We present a case of a symptomatic, giant, left upper back arteriovenous malformation that was treated through a staged endovascular and open approach. Through a series of embolizations, followed by resection, we were able to preserve the limb and upper back neurovascular supply, demonstrating an approach to preserve sensation and function and improving quality of life.

Knowledge of Health Students Regarding Nutritional Deficiencies in Patients With Celiac Disease in Jazan Region: A Cross-Sectional Study.

INTRODUCTION: In Saudi Arabia, the prevalence of celiac disease (CeD) was 2.7% greater than the global pooled prevalence of 1.4%. Patients who strictly adhere to a lifetime gluten-free diet (GFD) may develop nutritional deficiencies potentially contributing to obesity, increased cardiovascular risk, and lower bone density. Therefore, this study aims to assess the knowledge of health students in the Jazan region regarding nutritional deficiencies in patients with CeD who are on a GFD and to determine the associated socio-demographic factors. METHODS: A descriptive cross-sectional study was conducted among health college students of Jazan University, including students from the College of Medicine, Pharmacy, Nursing, Dentistry, Public Health and Health Informatics, and Allied Health Sciences, aged 18 and above, excluding internship students, students who did not complete the survey, and those who refused to participate. The minimum calculated sample size was 368. The questionnaire was adopted from the literature and translated into Arabic. It contained a socio-demographic section and a knowledge section that included 12 questions focusing on the content of macro- and micronutrients in a GFD and the impact of the diet on the health of patients with CeD. RESULTS: The study included 369 participants, with 235 (64%) aged 17-22, 280 (76%) being females, and 341 (92%) being single. The College of Medicine and the College of Applied Medical Sciences had the highest representation, and the College of Dentistry was the lowest. Most participants were in the fourth year (30%) and sixth year (24%). The grade point average (GPA) had a median of 4.3. Approximately 59.1% were aware of nutritional deficiencies among CeD patients. None of the sociodemographic factors were associated with health students' knowledge regarding CeD. Participants from the College of Pharmacy had a lower knowledge of CeD nutrient deficiencies than those from the College of Medicine. (OR: 0.45, 95% CI: 0.22, 0.90). Most students stated that CeD patients should be advised to take multivitamin drugs and vitamin D supplements. Most acknowledged vitamin D, vitamin B12, and folic acid deficiencies in CeD patients. Similarly, most were aware of iron and calcium deficiencies, with a small percentage aware of zinc and copper. CONCLUSION: Approximately 59.1% had an acceptable level of knowledge, which is considered a low knowledge level among students who will be future physicians and healthcare workers to whom CeD will represent the first-line disease exposed to. Rising knowledge and awareness among those students will guarantee correct diagnosis, treatment, and better outcomes among CeD patients, thus decreasing the disease burden and increasing the quality of those patients.

Functionalized pyrazole: Synthesis, Insecticide Evaluation & Molecular Docking Studies of Some New Pyrazole Derivatives against the Cotton leafworm, Spodoptera littoralis.

5-(Cyanomethyl)-3-((5,5-dimethyl-3-oxocyclohex-1-en-1-yl)amino)-1H-pyrazole-4-carbonitrile (3) is used as a key for the synthesis of arylidenes 5a-fvia its reaction with some aldehydes 4a-f. 5-[(5,5-Dimethyl-3-oxocyclohex-1-en-1-yl)amino]-3-(2-imino-2H-chromen-3-yl)-1H-pyrazole-4-carbonitrile (7) was synthesized via the reaction of compound (3) with 2-hydroxybenzaldehyde in EtOH/piperidine. The target compounds were tested against cotton leafworm larvae in their second and fourth instar. The available data demonstrated that the LC50 values for commercial phenylpyrazole were 3.37 mg/L and 4.55 mg/L for the most affected synthesized compound, 5b. The chemical structure of compound 5b has two cyano moieties, a pyrazole ring and a chlorophenyl, which may be increasing it efficiency. Evaluation of the latent effects of the examined synthesized compounds on various biological parameters, including adult longevity, pupal weight, proportion of normal, deformed pupae, adult emergency, fecundity, and egg hatchability, was done in an additional effort to slightly improve insecticidal compounds. Twelve synthesized compounds were subjected to a molecular docking analysis against glutamate-activated chloride channels. Twelve artificial compounds with the PDB ID of 4COF were subjected to a molecular docking study against the gamma-aminobutyric acid receptor (GABA).

A Wireless, Multicolor Fluorescence Image Sensor Implant for Real-Time Monitoring in Cancer Therapy.

Real-time monitoring of dynamic biological processes in the body is critical to understanding disease progression and treatment response. This data, for instance, can help address the lower than 50% response rates to cancer immunotherapy. However, current clinical imaging modalities lack the molecular contrast, resolution, and chronic usability for rapid and accurate response assessments. Here, we present a fully wireless image sensor featuring a 2.5×5 mm2 CMOS integrated circuit for multicolor fluorescence imaging deep in tissue. The sensor operates wirelessly via ultrasound (US) at 5 cm depth in oil, harvesting energy with 221 mW/cm2 incident US power density (31% of FDA limits) and backscattering data at 13 kbps with a bit error rate <10-6. In-situ fluorescence excitation is provided by micro-laser diodes controlled with a programmable on-chip driver. An optical frontend combining a multi-bandpass interference filter and a fiber optic plate provides >6 OD excitation blocking and enables three-color imaging for detecting multiple cell types. A 36×40-pixel array captures images with <125 µm resolution. We demonstrate wireless, dual-color fluorescence imaging of both effector and suppressor immune cells in ex vivo mouse tumor samples with and without immunotherapy. These results show promise for providing rapid insight into therapeutic response and resistance, guiding personalized medicine.

Real-Time multifaceted artificial intelligence vs In-Person instruction in teaching surgical technical skills: a randomized controlled trial.

Trainees develop surgical technical skills by learning from experts who provide context for successful task completion, identify potential risks, and guide correct instrument handling. This expert-guided training faces significant limitations in objectively assessing skills in real-time and tracking learning. It is unknown whether AI systems can effectively replicate nuanced real-time feedback, risk identification, and guidance in mastering surgical technical skills that expert instructors offer. This randomized controlled trial compared real-time AI feedback to in-person expert instruction. Ninety-seven medical trainees completed a 90-min simulation training with five practice tumor resections followed by a realistic brain tumor resection. They were randomly assigned into 1-real-time AI feedback, 2-in-person expert instruction, and 3-no real-time feedback. Performance was assessed using a composite-score and Objective Structured Assessment of Technical Skills rating, rated by blinded experts. Training with real-time AI feedback (n = 33) resulted in significantly better performance outcomes compared to no real-time feedback (n = 32) and in-person instruction (n = 32), .266, [95% CI .107 .425], p < .001; .332, [95% CI .173 .491], p = .005, respectively. Learning from AI resulted in similar OSATS ratings (4.30 vs 4.11, p = 1) compared to in-person training with expert instruction. Intelligent systems may refine the way operating skills are taught, providing tailored, quantifiable feedback and actionable instructions in real-time.

Isothermal and non-isothermal transport properties of diluted fullerene binary and ternary aromatic solvent mixtures.

We present mass transport properties of C60 fullerene in five aromatic solvents, methylnaphthalene, toluene and three xylene isomers. Optical beam deflection and thermogravitational column techniques were used to determine molecular diffusion, thermodiffusion and Soret coefficients. All thermo-optical properties necessary to determine the abovementioned coefficients are also given at a mean working temperature of 298.15 K and an atmospheric pressure of 0.101 MPa. The magnitude of all transport properties is governed by the molecular weight ratio. In the particular case of the isomers, experiments revealed that movement under isothermal conditions (described by molecular diffusion) is dominated by density, while under non-isothermal conditions viscous forces affect the displacement (thermodiffusion depends on the dynamic viscosity). In the case of the Soret coefficients, as a combination of both, density is the dominant parameter and also the moment of inertia.

Leaving Against Medical Advice: Current Problems and Plausible Solutions.

Leave against medical advice (LAMA) is defined as 'a decision to leave the hospital before the treating physician recommends discharge', and is associated with higher rates of readmission, longer subsequent hospitalization, and worse health outcomes. In addition to this, they also contribute to poor healthcare resource utilization. We conducted a single-center audit to establish patient demographics and contributing factors of patients leaving against medical advice from our emergency department (ED). We benchmarked our data against locally available clinical policy guidelines. We interrogated our electronic health record system (known as Salamtak®), which is a Cerner-based platform (Cerner Corporation, Kansas City, MO 64138) for patients who signed LAMA from ED from 2018 to 2023. We selected a convenience pilot sample of 120 subjects. Based on a literature review, we identified patient demographics (age, gender, nationality, socioeconomic status, marital status, religion), possible contributing factors (time of attendance, insurance status, length of ED stay), and patient outcomes (reattendances within 1 week and mortality) to evaluate. Based on locally available guidance, we formulated six criteria to audit with a standard set at 100% for each. A team of emergency medicine residents collected data that was anonymized on an Excel spreadsheet (Microsoft Excel, Microsoft Corporation. (2018). Basic descriptive statistics were used to collate results. About 93 patients (77.5%) were 16 years and above, and 27 patients (22.5%) were below 16 years. There was a slight preponderance of males (64 patients, 53.3%) than females (56 patients, 46.6%). The majority of LAMA cases presented in the evening and night (97 patients, 80.8%). About 57 (47.5%) patients had an ED length of stay of 3 hours or more. The average ED length of stay for these patients was 3.4 hours. About 73 patients (60.3%) were insured. Out of 120 patients, only 12 (10%) had a mental capacity assessment documented. The commonest reason for signing LAMA was a social reason in 45 (37.5%) cases. In the remaining cases, the causes were a combination of family, financial, waiting, or other/undocumented reasons). When faced with a decision to LAMA, the involvement of a Public Relationship Officer (PRO) was only documented to be consulted in seven (5.8%) cases. About 14 cases were re-attended within 1 week (11.6%) and no mortalities were reported in any of the reattendances. LAMA is a not-so-rare phenomenon often occurring in EDs, and often a cause of trepidation for healthcare workers. Treating this as an aberrant behavior on the part of the patient, or laying the responsibility for this action on the healthcare provider is primitive, counter-productive, and not patient-centric. Familiarity with local guidelines around this contentious area is essential. Revised nomenclature like 'premature discharge' may be less stigmatizing for the patient. Where possible, a harm reduction approach should be used and frontline healthcare workers must be prepared with an escalation plan. In the United Arab Emirates, familiarity with Wadeema's Law as a child protection measure is essential.

RETRACTED: External pop-out versus classic technique for delivery of the fetal head during elective cesarean section: A randomized clinical trial.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the Editor-in-Chief and the Journal's Ethics Committee. After post-publication investigation, issues related to the following were identified in the article: To facilitate a thorough examination and ensure the accuracy of the information reported in the article, the authors were asked for the raw data of the article. In the absence of an answer from the authors, a decision to retract the article was made in accordance with the journal's commitment to upholding the highest standards of scientific integrity and accuracy in published research.

Measuring Cannabis Reinforcement among Young Adults: A Mixed Methods Examination.

Introduction: Increasing reinforcement received from cannabis-free activities, relative to reinforcement from cannabis-related activities, is one way to reduce harmful cannabis use. Thus, accurate measurement of cannabis reinforcement is important. Using convergent mixed methods, we developed the Adolescent Reinforcement Survey Schedule-Cannabis Use Version (ARSS-CUV). ARSS-CUV, adapted from the alcohol use version, measures cannabis reinforcement by asking individuals how frequently they engaged in, and how much they enjoyed, different activities when using and not using cannabis. Method: Young adults (N = 65; M age = 20.4 years [SD = 1.8]) completed measures of cannabis use, the ARSS-CUV, and provided feedback on included activities, via focus groups. Following Standards for Educational and Psychological Testing framework, this study examined evidence of measurement validity based on item content. Results: Quantitative findings revealed that peer interactions were the most reinforcing activities, whereas activities related to family were least reinforcing. Qualitative findings indicated some confusion with question wording. Participants also indicated the importance of environmental context when using cannabis and noted who they use cannabis with may be more important than the activity they are doing. Changes were made to survey flow and response choices after participant feedback. Conclusions: ARSS-CUV includes revisions in activities solicited and response format. The revised ARSS-CUV provides opportunities to advance measurement of an important construct (i.e., reinforcement) in the study of cannabis use. Psychometric properties of the ARSS-CUV across different populations and contexts of use (e.g., polysubstance use) should be examined.

Patient satisfaction with Saudi community pharmacy services (Wasfaty System).

Introduction: The healthcare system in KSA has been substantially transformed as part of Vision 2030, including implementation of an electronic prescribing system, called Wasfaty, to enable patients to receive their prescriptions from community pharmacies (CPs). This study assessed patient satisfaction with CPs and the Wasfaty system. Methods: This cross-sectional observational study used existing data from the Saudi Ministry of Health's patient experience program. Data were collected from patients (≥15 years of age) visiting governmental primary care clinics in 2022. Summary statistics were determined and multivariable logistic regression analyses were conducted. Results: The sample included 66,541 patients. More than 70% of patients were satisfied with the services of the CPs and the Wasfaty system. Being older and being female consistently showed a positive association with satisfaction across several services. Whereas patients in preventive clinics had higher odds of satisfaction with medication availability (OR: 1.19, 95% CI: 1.03-1.37) and waiting time (OR: 1.23; 95% CI: 1.03-1.47), patients in chronic disease clinics had lower satisfaction with medication availability (OR: 0.92, 95% CI: 0.85-0.99). Saudi patients had lower odds of being satisfied with multiple services. Conclusions: The overall high satisfaction among patients suggested the success of the Wasfaty system in meeting patient needs and expectations. However, areas for improvement exist to increase patient satisfaction, such as addressing medication shortages and ensuring clear patient-pharmacist communication. The results highlight the importance of continued monitoring and evaluation to support the patient experience with pharmacy services, and to improve patients' journeys, medication adherence, and overall healthcare outcomes.

Strongyloides stercoralis infection in the United Kingdom: a systematic review and meta-analysis of published cases.

Strongyloidiasis is a helminth infection where symptoms vary, and asymptomatic presentation is common. Chronic strongyloidiasis can cause a high mortality 'hyper-infection' in immunocompromised states. Understanding at risk populations and symptomology can guide screening and early treatment to reduce hyper-infection risk. A systematic review of studies describing patients in the United Kingdom with strongyloidiasis a pooled total of 1308 patients. Weighted pooled prevalence (WPP) of asymptomatic cases was 27.7% (95%CI 17.1-39.5%,I2 = 92%,p<0.01]. At risk populations included migrants, returning travellers and armed forced personnel. The most common symptoms reported were abdominal pain (WPP 32.1%,[95%CI 20.5-44.8%],I2 = 93%,p<0.01), rashes (WPP 38.4%,[95%CI 13.1-67.7%],I2 = 99%, p<0.01) and diarrhoea (WPP 12.6% [95%CI 6.7-19.9%],I2=70%,p=0.03). Symptomatology varied with cohort characteristics. Although asymptomatic presentation is common, patients may present with abdominal pain, diarrhoea, or rashes. A low threshold for screening symptomatic individuals in at-risk groups is required.