Background: Ventilator-associated pneumonia (VAP) is a prevalent cause of morbidity and mortality in intensive care units (ICUs). Defined as a nosocomial pneumonia that occurs more than 48 hours after mechanical ventilation initiation, VAP poses significant clinical challenges. While awareness of evidence-based practices is crucial, a gap often exists between knowledge and actual practice among nursing staff. Enhanced adherence to VAP prevention protocols has been linked to reduced incidence rates. Purpose: This study aims to assess the level of nurses’ knowledge and compliance regarding the prevention of VAP in the intensive care unit of King Fahad General Hospital in Saudi Arabia. Method: A descriptive research design was employed, involving 120 ICU nurses selected through convenience non-probability sampling. Result: A total of 96 participants were recruited in this study. The level of knowledge about VAP prevention among ICU nurses was almost good as there were about 57.3% (n=55) of the nurse participants had a good and adequate information. There was significant statistical difference in the mean knowledge score based on the academic qualification but, there was no statistical difference in mean of compliance based on academic qualification. Conclusion: Insufficient nursing knowledge and compliance about VAP assessment and prevention is a serious safety concern in all healthcare settings. The study highlighted that ICU nurses showed (good) moderate knowledge towards VAP prevention.

This work investigated the potential synergy between Fly Ash (FA) and Ground Granulated Blast Furnace Slag (GGBFS) as binder solids in the manufacturing of Geopolymer Concrete (GPC), a concrete that does not contain Ordinary Portland Cement (OPC). At a ratio of 1:1, the ideal mixture of binder solids was attained. Based on absolute volume, the mix design was created using techniques akin to those found in ACI 211.1. In order to investigate the impact on the evolution of strengths, the alkaline activator content (AAC) to binder solid ratio—which is comparable to the water/binder ratio in OPC concrete—was varied in the ratios of 0.25, 0.3, 0.35, 0.4, and 0.5. For every mixture, the ratio of sodium hydroxide to sodium silicate was maintained at 1.5. To evaluate the functional relationships between the response variable (strength) and the independent variables (GPC constituents), a nonlinear regression analysis was conducted. Experimental results on workability for all mixes are in agreement with ACI 211.1 criteria. In all mixes, GPC specimens exhibited higher compressive strengths than OPC specimens; with a maximum value of 73.67 Mpa and 72.67 Mpa respectively. Nonlinear regression results provide equations that predict the strengths with excellent correlation. In addition to F-statistics that are statistically significant within acceptable probabilities.

The developmental transition of late adolescence, characterized by profound identity formation and neurocognitive maturation, has been complicated by the ubiquity of the digital landscape. This study investigates the impact of internet overuse on the psychological well-being (PWB) and self-regulated learning (SRL) of adolescents in Kerala, India. Utilizing a pre-test post-test control group design, the research evaluates the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) as an intervention. A sample of 120 adolescents (N=120), screened for moderate to severe internet addiction, was equally divided into experimental and control groups. The findings indicate that excessive internet use significantly impairs both psychological well-being and self-regulated learning among adolescents, irrespective of gender or residential background. The 8-week MBCT intervention yielded statistically significant improvements in both Psychological Well-being (p <.001) and Self-Regulated Learning (p <.001) compared to the control group. These findings suggest that integrating mindfulness-based cognitive strategies into educational curricula can effectively counteract the cognitive fragmentation and emotional dysregulation associated with hyper-connectivity, offering a scalable pathway for adolescent holistic health.

Pure anterior dislocation of the hip in its obturator variety is extremely rare. It typically results from high-energy trauma and can jeopardize the functional prognosis of the hip if reduction is not performed urgently. We report the case of a motorcyclist who sustained an isolated anteroinferior (obturator) hip dislocation. The patient underwent reduction 4 hours after the trauma, with good clinical and radiological outcomes observed at an 18-month follow-up.

Background: Enteral feeding intolerance (EFI) is a critical concern in critically ill patients, associated with complications like vomiting, elevated gastric residual volumes (GRV), and delayed gastric emptying. Despite its prevalence, EFI lacks a universally accepted definition and standardized management protocols, leading to inconsistent practices among healthcare providers. Aim: This study aimed to evaluate nurses’ knowledge at Ibri Hospital regarding EFI, including its definition, causes, symptoms, and the feasibility of oral medication administration during intolerance episodes. Evidence-based recommendations were proposed to improve enteral feeding practices. Methods: A cross-sectional descriptive design was used, involving 170 nurses from inpatient departments at Ibri Hospital. Data were collected via a validated online questionnaire and analyzed using SPSS. Key knowledge areas assessed included EFI indicators, GRV thresholds, and clinical management practices. Convenience sampling was employed. Results: The study revealed variability in nurses’ understanding of EFI indicators and GRV thresholds. Vomiting was the most recognized EFI indicator, though only 62% identified it correctly. GRV threshold knowledge varied, with 61% selecting context-dependent measurements. Pediatric ward nurses demonstrated the highest knowledge, while operating theater staff scored the lowest. Training had minimal impact, except for improved recognition of vomiting as an indicator (p = 0.025). Nurses favoring early feeding initiation and timely restarting showed higher knowledge scores. Conclusions: Significant knowledge gaps and inconsistencies in EFI practices were identified. Recommendations include developing evidence-based EFI protocols, regular interdisciplinary training, and promoting collaborative decision-making. Future research should validate findings and assess the impact of standardized EFI protocols on patient outcomes.

The paper uses Systemic Functional Linguistics (henceforth SFL) to conduct a transitivity analysis of the clause in the siLozi language (K21) spoken in Zambia. The paper explores how the experience of the material and non-material world is construed through the grammar of the clause. The paper draws insights from Martin and Rose’s (2003) SFL to analyse the clause in siLozi in terms of what kind of clausal activities are undertaken in the siLozi clause’s PRTs, PRSes and CIRs; how the PRTs in these PRS-types are described; how they are classified and what they are composed of. The transitivity study of the clause in siLozi reveals that just like in English, the siLozi language expresses its clausal experience through the three major PRS-types namely MaPs, MePs and RePs. The minor PRS-types – VePs, BePs and ExPs – not only exist in siLozi but also construe experience both uniquely and also similar to English. Furthermore, the discourse structures in the process-types are deliberately selected and situated for various reasons. The findings have implications in using SFL transitivity in the teaching of some aspects of grammar such as comprehension in siLozi in schools in Zambia and in other countries like Namibia where siLozi is taught.

Aim: To analyze the mental foramen dimensions and location for gender determination in a sample of Yemeni population. Methods: This is a retrospective study performed on 420 maxillofacial CBCT scans, 210 males and 210 females with age ranged from 20 to 60- years old. Osteometric analysis of the dimensions, shape and position of the mental foramen was performed. Results: In comparison between males and females, all mental foramen (MF) measurements were statistically significant except at the distance from the superior mental foramen to the alveolar crest. The all measurements of males were higher than females. MF with round shape was the most common between both males and females. The most common location of the MF was presented below the apices of the 2nd premolars. Conclusions: We can be concluded that the vertical and horizontal dimensions the MF and the distance from the lower border of the MF to the lower border of the mandible exhibits gender dimorphism in the Yemeni population. The shape and horizontal position of the MF do not show any difference denoting that they cannot be used for identification of gender.

Adult patients seeking orthodontic treatment consistently have aesthetic concerns, even throughout the course of the treatment. This has lead to the introduction of Lingual Orthodontics in 1970s by Dr. Craven Kurz of USA and Dr. Kinya Fujita of Japan. Lingual orthodontics, in addition to its aesthetic benefits, offers several other advantages. The cooperation and confidence level of the patient has increased with the invisible appliances. The Anchorage control, indirect bonding and biomechanics is completely different from labial technique. In this article the concept of lingual orthodontics has been highlighted. The article shows a case report with lingual technique treated in the department of orthodontics at Farhat Hached University Hospital.

Aim of the study: To assess the attitude and knowledge among Yemeni parents toward their child’s oral health practice and habits with associated factors. Subjects and methods: This study was carried out using three hundred self-administered structured questionnaires for parents or guardians. Demographic variables, knowledge of dental health, oral health, and dietary practices concerning dental care, and attitudes toward oral health were assessed. The correlation between sociodemographic status and oral health knowledge and practice was evaluated. Result: results showed that the mean caregiver's level of knowledge is 53.9%. Most mothers have good knowledge about the age of primary teeth eruption 71.9% and exfoliation 64.9%, the significance of primary teeth 78.4%, what causes the most common dental disease affects teeth 91.8%, and the importance of cleaning teeth 85.4%. 68.4% Cleaned their teeth, and most of them 78.4% remained to encourage their children to clean their teeth. Mothers have bad knowledge about the time to start brushing their children’s teeth 46.8% and the role of fluoride in preventing dental caries 32.2%. There was a statistically significant correlation between the level of knowledge and the mother’s education level and occupation. Conclusion: Yemeni mothers have average knowledge of their children’s oral health status. There was a statistically significant relation between the mother’s education level and the level of knowledge. The mother's education level group (Professional) ranked first with a knowledge level (73%).

Transfection is a critical technique for introducing nucleic acids—such as DNA, RNA, or oligonucleotides—into cells and plays a pivotal role in diverse research fields, including gene therapy, recombinant protein production, and functional genomics. This meta-analysis examines the fundamental mechanisms, methodologies, and challenges associated with transfection, highlighting advances in both viral and non-viral delivery systems, optimization techniques, and clinical applications. Viral vectors, including adenovirus, retrovirus, and lentivirus, offer high efficiency and are frequently used in gene therapy applications, while non-viral methods, such as lipid-mediated transfection, polyethylenimine (PEI), dendrimer complexes, electroporation, microinjection, and biolistic delivery, provide safer alternatives but often exhibit lower efficiency, necessitating optimization. Lipid-based transfection remains one of the most widely used methods, particularly lipofection, due to its ease of use and efficiency in commonly used cell lines like HEK293 and HeLa cells. Electroporation is effective for challenging cell types, such as primary neurons and stem cells, though high cell mortality rates necessitate careful optimization. Transfection has significantly contributed to gene therapy, particularly for genetic disorders such as cystic fibrosis, hemophilia, and spinal muscular atrophy, with viral vectors employed in CAR-T cell therapy for cancer treatment showing promising results in hematological malignancies. Recent advances in mRNA transfection have revolutionized vaccine development, exemplified by mRNA vaccines for COVID-19, demonstrating the potential for further therapeutic applications. However, challenges remain, including achieving high transfection efficiency while maintaining cell viability, especially in primary cells and stem cells, which are more resistant to transfection than immortalized cell lines. Cytotoxicity and off-target effects limit the clinical utility of transfection, particularly in gene therapy, where insertional mutagenesis poses significant safety risks. The cost of scaling transfection for therapeutic applications, such as CAR-T cell production, remains prohibitive. Future research will focus on overcoming these limitations while advancing the clinical applications of transfection for therapeutic gene delivery and personalized medicine. Overall, as new materials, technologies, and optimization strategies are developed, the efficacy, safety, and applicability of transfection techniques will likely improve, enhancing their role as cornerstones of molecular biology and biotechnology.

Distalization is a common orthodontic technique used to address Class II malocclusions, particularly those where there is an overjet due to maxillary protrusion. It’s performed to correct average to moderate class 2 malocclusions (<3mm) by retracting the maxillary teeth. This technique should be preferred in patients presenting a class II malocclusion due to maxillary protrusion or in adult patients undergoing compromise treatment. The following case report describes an adult female patient with class II subdivision in the left side treated by clear aligner (invisalign) by distalization and class II elastics. Sequential distalization protocol was used starting with the second molar, once the second molar has moved two-thirds of the desired distance, the first molar is distalized, followed by the premolars and canines. Finally, the four incisors are retracted to complete the treatment.

Aim of the study: To study salivary immunoglobulin A and lysozyme levels and their relation to dental caries status in a group of Yemeni asthmatic children. Subjects and methods: One hundred children of both genders were enrolled in this study, aged 6-10 years. The cases were divided into two main groups: fifty asthmatic children and fifty healthy children. Every child was examined for dental caries and assessed according to WHO criteria (1997) using defs for primary teeth and DMFS for permanent teeth. Salivary samples were collected from each child in each group and analyzed for sIgA and lysozyme. The relation between them and dental caries status for primary and permanent teeth was evaluated. Results: Results showed that there was no statistically significant difference between gender distributions of asthmatic and healthy children. In addition, there was no statistically significant difference between the mean sIgA levels of both groups. There was a statistically significant difference between asthmatic and healthy children regarding lysozyme levels. This difference in mean lysozyme levels was higher in asthmatic than healthy children. Asthmatic children showed statistically significant differences regarding defs and DMFS scores, which were lower in asthmatics than healthy children. For asthmatic children, there was a statistically significant positive correlation between defs scores and sIgA levels and a statistically significant negative correlation with lysozyme. In asthmatic children, a statistically significant positive correlation existed between DMFS scores and age and sIgA levels. For healthy children, there was a statistically significant positive correlation between DMFS scores and both age and sIgA levels. Conclusion: In children with allergic asthma the salivary concentrations of sIgA and lysozyme were significantly higher and the defs and DMFS scores were lower than in healthy children.

Background: Family Medicine research is any study that addresses questions of importance to physicians with the intent to improve the care of patients. Research is essential to enhance the role of family physicians in health care systems, to improve the optimal functioning of health care systems, and to improve the health of populations in general, also serve as the basis to aid in policy-making. Aim: This study aimed to highlight the willingness of family physicians towards conducting research. Subjects and Method: Descriptive cross-sectional study with an analytic element conducted for a period from the 1st of March through the 31st of May 2021. The target population included all family physicians in Iraq. A total of 297 participants were recruited for this study. Participants were asked to fill out an electronically distributed questionnaire specially constructed for the sake of the study. Results: Females constituted 79% of the sample and 82% of the participants were less than or equal to 40 years of age. The specialists in family medicine constituted 70% of the participants; 81.5% had medical experience less than or equal to 15 years, and 52.9% worked for more than 30 hours per week. The mean of the participant response regarding the attitude questionnaire was 45.03 (±9.21). The participants with a positive attitude were 167 (56.2%). Applying multivariate binary logistic regression, the only significant association was between attitude and frequency of reading medical articles. Lack of time was the main stated barrier that obstacles to research conduction among family physicians. Conclusion: More than half of the participants had a positive attitude towards research conduction. Lack of time and health care support were the main barriers to research conduction. Increasing the frequency of research reading was the main predictor of research conduction.

Eyelid tumors are the set of lesions or growths that develop within the eyelids. They can be benign or malignant. We report the case of a 57-year-old patient who consults for a lower palpebral mass in the left eye. On examination, a nodular mass of firm consistency was found. The rest of the left and contralateral palpebral contour was normal. Management consisted of surgical resection of the tumor and histopathological examination. Anapathomopatologic examination found an inflammatory infiltrate made up of lymphoplasmacyte and neutrophil polynuclear cells in favor of a rearranged papilloma. The post-operative effects were simple and the healing took place without complications. Surgical excision allows the tumor to heal. Treatment is essentially surgical and is based on reconstruction after removal of the tumor.

The Electronic Medical Records (EMR) system has become an essential component in the digital transformation of the healthcare sector, replacing manual record-keeping with a more efficient digital system. This study aims to analyze the quality of EMR services at the Emergency Department (IGD) of Rumah Sakit Bhayangkara TK I Pusdokkes Polri, with a focus on the challenges affecting the efficiency of the EMR system's use. The research method used is quantitative analytic with a cross-sectional design, involving 60 EMR users who provided data through interviews, observations, and questionnaires. The results show that the majority of respondents are aged 20-35 years and predominantly work as nurses. Although most respondents express high satisfaction with the quality of the EMR, there are several technical issues, such as server and network disruptions, that affect the system's efficiency. Further analysis indicates that the main factors influencing user satisfaction are data accuracy and time efficiency in record-keeping. The p-value for the relationship between data accuracy and user satisfaction is 0.03, which indicates a statistically significant relationship. The p-value for time efficiency in record-keeping is 0.02, also showing a significant relationship with user satisfaction. The study concludes that EMR can improve medical service efficiency and quality; however, improvements in technical issues, particularly server and network infrastructure, as well as user training, are essential to optimize this system.