Saudi Arabia Research Articles

Examining the Association between Social Media Use and Dietary Habits among College Students in Riyadh, Saudi Arabia.

Food culture plays a vital role in societal dynamics, with various factors influencing dietary choices beyond hunger. Among these factors are external eating, triggered by environmental cues, and emotional eating, which are common stress-coping mechanisms among college students. Social media has a significant impact on nutrition by providing access to food-related content, which can lead to restrictive diets or unhealthy eating habits. High social media engagement is associated with an increased risk of chronic diet-related conditions such as metabolic syndrome. This study investigated the association between social media use and dietary habits among college students in Riyadh, Saudi Arabia. The cross-sectional study surveyed 401 participants online. The findings revealed that 74.6% of participants were women, with a mean age of 20.75 years. A significant portion (51.9%) reported spending over four hours daily on social media, with TikTok, Instagram, and YouTube being the primary sources of nutritional information. Statistical analysis indicated significant differences in dietary scores related to having children, medical conditions, and social media usage time. This study highlights the negative impact of extensive social media use on dietary habits and suggests the need for targeted public health interventions. Recommendations include promoting reliable nutrition-related content on social media, offering affordable healthy food options on campuses, and conducting further research to establish causality between social media use and dietary habits.

Modeling the Contribution of Grit, Enjoyment, and Boredom to Predict English as a Foreign Language Students' Willingness to Communicate in a Blended Learning Environment.

The complex relationships between emotions experienced by learners and learners' personality traits, such as grit, that influence students' willingness to communicate in a second language (L2 WTC) have come under increasing attention. To date, investigators have focused primarily on WTC and the role of emotions in traditional face-to-face settings rather than in blended learning environments. To expand this research, we examined whether grit, foreign language enjoyment (FLE), and foreign language boredom (FLB) among university-level EFL students would be predictive of L2 WTC in a hybrid online and face-to-face learning setting. We studied 345 participants (252 females and 93 males) enrolled in English courses in a blended learning environment from three public universities in Saudi Arabia. We utilized structural equation modeling (SEM) to test a model that combined grit with two emotions (enjoyment and boredom) and L2 WTC. Our results revealed that FLB had the largest relationship to students' L2 WTC followed by FLE and grit, respectively. In this paper, we discuss these results and present some pedagogical implications of these data for teachers and learners of English as a foreign language (EFL).

The Saudi Arabian legal system’s approach to white-collar crimes: challenges and potential reforms

The Saudi Arabian legal system’s approach to white-collar crimes: challenges and potential reforms

Framework and policy recommendations for the design of metaverse platforms in support of Saudi Vision 2030

Framework and policy recommendations for the design of metaverse platforms in support of Saudi Vision 2030

Morphological Characterization of Culex Quinquefasciatus (Diptera: Culicidae) Pupae in the Eastern Province of Saudi Arabia.

Over the last 30 years, several mosquito-borne diseases have spread worldwide, threatening human and animal health, including lymphatic filariasis. Lymphatic filariasis is a major public health issue in tropical regions like Saudi Arabia, caused by parasitic worms. The parasitic worms Wuchereria bancrofti and Brugia malayi are transmitted by Culex quinquefasciatus. Cx. quinquefasciatus is a potential vector for various arboviruses like encephalitis virus and West Nile virus, along with protozoa like Plasmodium relictum that cause bird malaria. With the increasing number of mosquito species, there is an increased need for additional species identification. More attention is being directed to the immature stage, specifically the pupae, due to their valuable characteristics for species identification. Cx. quinquefaciatus, one of the nine Culicine species found in Saudi Arabia, lacks a complete description of its pupal stage and only has partial descriptions of other developmental stages, making identification challenging. This study aimed to investigate the morphological characteristics of Cx. quinquefaciatus pupae, focusing on the cephalothorax, trumpet, abdomen, paddle, and genital lobes, as well as the distribution and arrangement of setal branching and chaetotaxy. The pupae were collected from Qaryat Al Ulya Governorate, Eastern region, KSA, and maintained in a Biology Laboratory at the University of Hafr Al Batin from September to October 2022. The findings of this study have provided the essential characteristics regarding the distinguishing features of Cx. quinquefaciatus pupae to distinguish it from other closely related species. This identification could assist field entomologists in enhancing their efficiency by classifying mosquitoes during virus outbreaks.

Impact of biological therapies on clinical outcomes in patients with severe eosinophilic asthma with chronic rhinosinusitis: an observational study from Saudi Arabia

BackgroundWe aimed to study the impact of biological therapies in Saudi Arabia on patients with severe asthma (SA) combined with chronic rhinosinusitis (CRS) in terms of clinical outcomes.MethodsThis is a retrospective observational cohort research that was undertaken at the severe asthma clinics of the Armed Forces Hospital of the Southern Region (AFHSR) and King Khalid University Hospital, Abha, from March to September 2022 to delineate the effects of 3 biological therapies (dupilumab, benralizumab, and omalizumab) in adults with SA and concomitant CRS. Clinical outcomes assessed included asthma exacerbation frequency, hospitalization rates, use of oral corticosteroids (OCs), and the asthma control test (ACT) scores before and 1 year after biological therapies.ResultsEighty patients were enrolled, with a mean age of 46.68. There were 45 (56%) females and 35 (44%) males. There was a notifiable decrease in the frequency of exacerbations and hospitalization and in the number of patients who received OCs after 6 and 12 months of biological therapies compared to pre-biological therapies, respectively (p < 0.001 each), while there was a significant increase in the ACT scores at 6 and 12 months post-biological therapies, compared to pre-biological therapies, respectively (p < 0.001). These significant differences were maintained with all the 3 biologics used.ConclusionsResults from the first study from two large Saudi Arabian tertiary centers for patients with SA and CRS agree with and support those of worldwide real-life ones. One-year follow-up showed the effectiveness of the 3 drugs in terms of reduced frequency of asthma hospitalizations and exacerbations, the use of OCs, and improved ACT scores. Further prospective multicenter studies are warranted.

Trientine Tetrahydrochloride, From Bench to Bedside: A Narrative Review.

Trientine tetrahydrochloride (TETA-4HCl, Cuvrior®) is a copper chelating agent with the active moiety triethylenetetramine (trientine), developed by Orphalan, Inc. to address the unmet needs in the treatment of Wilson disease. The journey from bench to bedside builds upon the documented safety profile of trientine hydrochloride capsules developed initially to meet the needs of individuals intolerant to D-penicillamine (DPA). Trientine hydrochloride capsules are inherently unstable requiring strict cold chain storage conditions from production, transportation, and use at home by the patient. Trientine tetrahydrochloride has a distinctive, patent-protected unique polymorphic form, which permits the production at scale of film-coated scored tablets deemed room temperature stable for 36 months. Trientine tetrahydrochloride is supported by a well-characterized pharmacodynamic, pharmacokinetic, and metabolic profile demonstrating reliable and predictable dose linearity and dose proportionality kinetics. Trientine tetrahydrochloride is the only trientine formulation that has been compared with DPA in a prospective randomized clinical trial, demonstrating non-inferiority to DPA in adults with stable Wilson disease. On 28 April, 2022, the US Food and Drug Administration approved TETA-4HCl for use in adult patients with Wilson disease who are de-coppered and tolerant to DPA. Health authorities in multiple countries worldwide have approved TETA-4HCl for the treatment of adults and children aged 5 years or more who are intolerant to DPA including the European Union, UK, Saudi Arabia, Switzerland, Colombia, Australia, New Zealand, and China. This article aims to provide a comprehensive narrative review of the key milestones in the development of TETA-4HCl.

The levels of polycyclic aromatic hydrocarbons in traditional cigarettes and E-cigarettes in Saudi Arabia markets: a comparative risk assessment study

BackgroundTwo validated and effective extraction techniques have been developed to ascertain the presence of polycyclic aromatic hydrocarbons (PAHs) in traditional cigarettes and E-cigarettes. PAHs are a class of chemicals that occur naturally, and these contaminants may cause cancer and other harmful effects in human beings. Traditional cigarettes and E-cigarettes contain many PAHs.MethodIn terms of linearity, limit of detection, limit of quantification, accuracy (%), and precision (%), the two in-house lab setups for 7PAHs extraction from traditional cigarettes and E-cigarette were validated using high-performance liquid chromatography-fluorescence detection.ResultsThe concentration of Σ7PAHs for traditional cigarettes and E-cigarettes ranged from 6.23 ± 0.04 ng/cig to 75.61 ± 0.02 ng/cig, and non-detectable to 3.56 ± 2.71 ng/puff. The PAHs recovery in traditional cigarettes and E-cigarettes ranged from 92.74–110.45%, and 97.20–111.74%. The toxicity of equivalent (TEQs) of carcinogens revealed that traditional cigarettes brands have higher TEQs than E-cigarettes.ConclusionThis study highlights the detection of 7PAHs levels and its risk assessment in product brands for traditional cigarettes and E-cigarettes marketed in Saudi Arabia. The results suggested that the developed methods are a precise and versatile approach for measuring 7PAHs in traditional cigarettes and E-cigarettes.

An intuitive approach to cybersecurity risk assessment for non-governmental organizations

Purpose This study proposes a guided tool for cybersecurity risk assessment tailored for nongovernmental organizations (NGOs), enabling them to comply with cybersecurity policies despite limitations in security awareness, funding and expertise. Design/methodology/approach A digital transformation is indispensable for ensuring the sustainable operation of NGOs. Embracing a digital manifesto necessitates an awareness of cybersecurity risks, highlighting the critical need for a robust cybersecurity risk assessment methodology. Initial research phases revealed significant shortages in security awareness, funding and expertise. Consequently, this study introduces an intuitive approach tailored specifically for NGOs, supported by a customized tool designed to address their unique requirements. The NIST cybersecurity risk assessment framework and National Cyber-security Authority (NCA) were adopted to define the risk assessment approach. The efficacy of this approach is evaluated qualitatively through a case study involving three NGOs in Saudi Arabia, aimed at assessing their capability to utilize the tool effectively. Following the implementation, a Likert-scale survey gauged satisfaction among NGOs regarding the tool’s utility. Findings Results from the case study indicate high satisfaction, affirming its alignment with their operational needs and enhancement of compliance with NCA controls. Furthermore, the use of the tool enhances the awareness of NCA’s cybercity requirements and controls. Originality/value Based on theoretical and empirical grounds, this research proposes a novel design of security assessment framework tailored for NGO requirements and supported by initiative tool enabling complying with cybersecurity policies and enhances the awareness of cybersecurity controls.

Morphometric and Soil Erosion Characterization Based on Geospatial Analysis and Drainage Basin Prioritization of the Rabigh Area Along the Eastern Red Sea Coastal Plain, Saudi Arabia

Soil erosion is one of the most significant problems in global environmental development. Assigning, analyzing, and quantifying the main physical characteristics of drainage basins are powerful keys in identifying regions where there is a higher risk of soil erosion and where prompt mitigation actions are needed. Drainage basins and their drainage systems are ideally defined using the analysis morphometric parameters and their quantitative description. The present study aims to analyze morphometric parameters to prioritize drainage basins that are prone to erosion. Topographic sheets and remotely sensed digital elevation model (DEM) datasets have been prepared and analyzed using geospatial techniques to delineate drainage basins of different sizes and extract different ordered drainage systems. Based on the analysis of morphometric parameters, the Rabigh area was divided into 12 drainage basins, which significantly contribute to determining soil erosion priority levels. The present study selected and applied the most effective morphometric parameters to rank and prioritize the drainage basins of the study area after considering the crucial quantitative characteristics, such as linear, relief, and areal aspects. For each single basin, the compound factor was assigned from several morphometric parameters and applied to rank the Rabigh area. The results confirm that Basins 1, 4, 11, and 12 require a high level of soil erosion priority over an area of 2107 km2; however, Basins 3, 8, 9, and 10 have little degradation and a low level of soil erosion priority. Therefore, in the regions where high soil erosion is a factor, mitigation techniques such as terracing, filter strips, contouring, and other effective and useful structural and non-structural methods should be applied.

Clinical whole Exome Sequencing Reveals Novel Homozygous Missense Variant in the PMPCA Gene causing Autosomal Recessive Spinocerebellar Ataxia

Background &amp; Objective: Autosomal recessive cerebellar ataxias (ARCA) are rare heterogenous neurodegenerative disorders characterized by degeneration of the cerebellum and spinal cord with an early onset before the age of 20 years. PMPCA (MIM: 613036), is a key enzyme in mitochondrial protein processing which is critical for cell survival and growth. Our objective was to investigate Peptidase, Mitochondrial Processing Subunit Alpha (PMPCA) mutations linked with Spinocerebellar ataxia, autosomal recessive 2 (SCAR2). Method: In the current study, Whole Exome Sequencing (WES) was done followed by Sanger sequencing for the validation of the WES results. Results: WES results identified a novel homozygous variant, NM_015160.2: c.802C&gt;T p.(Arg268Trp) in PMPCA gene. Mutation in this gene leads to progressive cerebellar ataxia with fine motor skills difficulties, intentional tremors, slow slurred speech and learning difficulties in a 12-year-old Saudi patient. WES results were further validated by Sanger sequencing technique. Conclusions: Identified phenotype in our case was similar as previously described for SCAR2 related conditions. To our knowledge, this is the first reported mutation in PMPCA gene leading to SCAR2 in Saudi Arabia. These findings will enrich the scarce literature, further provide a new insight on the role of PMPCA gene-related disorders leading to SCAR2 and expand the disease concept. In addition, this will help to establish a database for the disease and its causative factors will further help in controlling diseases resulting from consanguinity in Saudi population. doi: https://doi.org/10.12669/pjms.40.10.10474 How to cite this: Bagabir HA, Abdulkareem AA, Muthaffar OY, Shirah BH, Naseer MI. Clinical whole Exome Sequencing Reveals Novel Homozygous Missense Variant in the PMPCA Gene causing Autosomal Recessive Spinocerebellar Ataxia. Pak J Med Sci. 2024;40(10):2243-2250. doi: https://doi.org/10.12669/pjms.40.10.10474 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Groundwater renewal time by environmental tritium isotopes as a tracer for sustainable water resource management

Studying groundwater renewal time is a valuable tool to deepen the comprehension of sustainable groundwater resources specific to arid regions. Tritium is a radioactive isotope of hydrogen often used as an environmental tracer to study groundwater renewal time. The present work reports groundwater renewal times by the environmental tracer tritium to understand sustainable water resources in arid regions. First, groundwater samples were collected from wells in northeastern arid regions of Saudi Arabia. Then, an electrolysis process was employed to significantly increase the tritium level from twenty-five to thirty times the original concentration. Subsequently, the enriched water was analyzed using a liquid scintillation counter under optimized measurement conditions to determine the tritium concentration precisely. Two internationally recognized tritium laboratories conducted independent assessments to validate the estimated tritium levels. The verified tritium concentration was then used to estimate the groundwater renewal time using the Morgenstern and Pimenta curves. The results suggest that most of the monitored wells in the surveyed areas are more than a century old. Conversely, a few monitoring wells exhibit renewal times of several hundred years and may be considered nonrenewable water sources. These studies help to understand the geochemical characteristics of arid regions to ensure the sustainable management and protection of groundwater resources.

Pattern of Prescribing Proton Pump Inhibitors: Evaluating Appropriateness and Factors Contributing to Their Adverse Effect Reaction Risk

Background/Objectives: Proton pump inhibitors (PPIs) are amongst the most commonly prescribed classes of medication. However, inappropriate PPI use can lead to several adverse drug reactions (ADRs). Limited data exist on factors contributing to the risk of ADRs associated with PPI prescribing patterns in the Eastern Region of Saudi Arabia. This retrospective, cross-sectional study aimed to assess the prevalence and the pattern of PPI use and to identify factors contributing to the risk of ADRs. Methods: Data were collected from electronic medical records of patients at Al-Qateef Central Hospital from January 2020 to December 2021. The inclusion criteria included patients aged ≥40 years attending an outpatient medical care clinic. PPI prescribing patterns were categorized based on their dosage intensity into low-dose, medium-dose (MD), and high-dose (HD) categories. Binary and multinominal logistic regression models were used to determine the relationship between PPI prescribing patterns and use, categorized by MD or HD, and patient characteristics, adjusted for significant covariates. Results are presented as adjusted odds ratio (OR) with corresponding 95% confidence intervals (95% CI). Results: The study included 41,084 patients. The prevalence of PPI prescribing was 31%. PPI users were more frequently found to be females than males (52% vs. 50%, p = 0.013); they were also likely to be prescribed more medications (7 vs. 6, p &lt; 0.001), but less likely to have gastritis-related diseases (34% vs. 32%, p &lt; 0.001) compared to non-users. PPI HD users were more likely male (56% vs. 43%, p &lt; 0.001), older (53 vs. 52 years, p &lt; 0.001), and prescribed more medications (11.8 vs. 2.8, p &lt; 0.001) compared to MD users. PPI usage was associated with concurrent use of antiplatelet drugs (OR = 1.08, 95% CI 1.01–1.15). An increasing number of prescribed medications was associated with HD usage (OR = 1.13, 95% CI 1.12–1.14), but negatively associated with MD usage (OR = 0.7 95% CI 0.69–0.71). Female gender was negatively associated with HD usage (OR = 0.85, 95% CI 0.79–0.91). Conclusions: Our findings indicate that 31% of the included cohort were prescribed PPI. Inappropriate PPI prescribing related to the drug’s omission is a concern as PPI non-users presented with valid indications such as gastritis. Male gender and increasing NPM were the common factors contributing to increased risk of PPI ADR. This study points to the importance of re-evaluating PPI use to ensure effective therapy with minimum risks of ADR.

Continental-scale sediment mixing and dispersal across northern Gondwana: detrital zircon U-Pb-O-Hf isotopic evidence from the Cambro-Ordovician sandstones overlying the Arabian Shield

ABSTRACT The juvenile Neoproterozoic basement of the Arabian Shield is overlain with angular unconformity by a voluminous Cambro-Ordovician cover sequence known as the Saq Formation and Wajid Group. Provenance studies of this vast siliciclastic cover over the Saudi Arabian part of the Arabian-Nubian Shield (ANS) have to date been based solely on U-Pb zircon data and heavy minerals. We present the first combined in-situ U-Pb, δ18O and Lu-Hf isotopic data for detrital zircon from the Saq and Wajid units exposed along the northeastern margin and southern part of the Arabian Shield. U-Pb age spectra reveal prominent age peaks at ca. 0.8–0.55 Ga and 1.1–0.9 Ga with subordinate peaks at ca. 2.2–1.7 Ga and 2.7–2.5 Ga. The δ18O secular variation mirrors global compilations with Archaean zircon defining a restricted δ18O range of ca. 4.0–8.0 ‰ and younger zircon showing wide variation in δ18O up to ca. 14 ‰. The ca. 0.8–0.55 Ga age peak has the largest variation in εHf(t) with about half of all these Neoproterozoic zircon grains being juvenile (εHf(t) > 5), which are interpreted to be sourced from the juvenile terranes of the ANS. Neoproterozoic zircon with evolved εHf(t) signatures require a more distal source beyond the ANS. As extensive ca. 1.1–0.9 Ga crust is lacking in the vicinity of the ANS, the ca. 1.1–0.9 Ga age peak is interpreted to be derived from either contemporaneous orogenic belts in Central Africa or recycled from older sedimentary rocks containing these age components. Extreme variations in δ18O of post – Archaean zircon, together with the evolved εHf(t), indicate crustal thickening and increased incorporation of supracrustal material associated with collisional orogenesis. The remarkable similarities in age spectra and isotopic compositions of the Saq Formation and Wajid Group sandstones with those from other regions in northern Gondwana indicate a continental–scale homogenization and dispersion process.

First Report of Fire Blight Caused by Erwinia amylovora on Pear in Saudi Arabia.

In the spring of 2020 and 2021, pear trees (Pyrus communis cv. Williams) in orchards (27°46'36.0"N 42°29'44.7"E, 30°00'00.2"N 40°15'11.8"E, and 28°44'52.9"N 36°18'47.8" E) in Hail, Al Jouf, and Tabuk regions exhibited fire blight symptoms. After removing bark, the affected trees showed shoot blight, brown-blighted shoot tips and blossom blight, dead flowers on the stems, and reddish-colored cankers. The disease incidence varied from 10% to 25%. Pathogen was isolated from 21 symptomatic samples including fruits, flowers, and shoots. Bacteria were isolated from washed tissues on King's B (KB) and semi-selective CCT media (Ishimaru and Klos, 1984). After 48 hours, colonies resembling Erwinia amylovora on KB media were 1.5-2 mm in diameter, white, circular, slightly convex, with a smooth surface, and exhibited no fluorescence under ultraviolet light. Colonies on CCT after 72 h were 3-4 mm in diameter, mucoid with shiny surfaces, semitransparent, speckled with craters, and slightly violet. All isolates were purified by subculturing on KB. All isolates were Gram-negative and rod-shaped, fermentative of glucose, positive for catalase and negative for oxidase, and potato rot. They induced a hypersensitive reaction when infiltrated in tobacco leaves (cv. Xanthi). Based on morphology and biochemical tests (EPPO, 2004), the strains were identified as Erwinia sp. Twenty-six strains from Saudi Arabia (SA) and the reference strain (NCPPB 683T) hydrolyzed gelatin and formed white, highly mucous colonies on the levan medium. These strains could not reduce nitrate to nitrite and tested negative for urease and indole production. All the isolates and the reference strain were confirmed to be E. amylovora based on a PCR 0.9-kb DNA fragment amplification with a species-specific primer set, A/B targets pEA29 (Bereswill et al. 1992). 16S-rDNA fragments from Saudi isolates were amplified with 27F and 1492R primers (Lane, 1991). Purified amplicons from PCR were sequenced (OR717505 and OR743536-OR743560), and a BLAST search of the GenBank database revealed 100% (927/927) homology with E. amylovora strain CP066796.1. The housekeeping gene rpoB was PCR amplified with primers CM7-F and CM31b-R (Rezzonico et al. 2012), and the products were sequenced (PP465516-PP465541). BLAST analysis showed 100% (944/944 nt) and 96.19% (908/944 nt) identities with the sequences of E. amylovora ATCC 15580 CP066796.1 and E. pyrifoliae CP201486 CP103445.1, respectively. To fulfill Koch's postulates, SA strains were inoculated on five healthy 3-month-old clones of apple (Malus domestica cv. Gala) per strain with a 10-μl bacterial suspension containing 107 colony-forming units per milliliter by injecting directly in the veins of the upper second leaf plus 5 healthy plants injected with sterile distilled water as control. Plants were incubated at 28°C for six days under a 12-hour light regime. Observed symptoms were similar to the ones observed in the field. The experiment was replicated twice. Bacterial colonies on CCT media were re-isolated from the inoculated apple rootstocks and confirmed by the A/B primer set. To our knowledge, this is the first peer-reviewed report of E. amylovora in SA since the fire blight-like symptoms were observed in SA in 2013 (Alhudaib, 2013). Further research will identify new host plants for the fire blight pathogen within SA which is important due to the importation of pome fruit seedlings (quince, apple, and pear) from neighboring Jordan where E. aylovora was reported (Tehabsim et al. 1992).

Strategic environmental assessment for sustainable coastal zone management in Saudi Arabia, aligning with vision 2030

AbstractThis research examines the role of Strategic Environmental Assessment (SEA) in promoting sustainable coastal zone management in Saudi Arabia, in alignment with Vision 2030. Focusing on key coastal regions, namely the Red Sea and Arabian Gulf, the study explores SEA’s capacity to guide development activities toward long-term environmental sustainability. Through a comparative analysis of SEA and traditional Environmental Impact Assessments (EIA), the study emphasizes SEA’s proactive, integrative, and participatory approach to decision-making. The findings illustrate how SEA enhances the strategic alignment of national environmental objectives by fostering resilient and sustainable strategies that balance development with conservation in Saudi Arabia’s coastal zones. Ultimately, SEA is identified as a crucial instrument in achieving Vision 2030’s sustainability goals, offering a pathway to safeguard coastal ecosystems while supporting economic growth.

The Impact of Administrative Decisions on Commercial Freedom in Saudi Arabia: A Legal Study

This legal study examines the impact of administrative decisions on commercial freedom in Saudi Arabia, exploring the intricate relationship between regulatory frameworks and business operations. The research analyzes the historical context of commercial freedom in the kingdom, tracing its evolution from traditional practices to the current legal landscape. It delves into the constitutional provisions and relevant legislation that shape administrative decision-making processes affecting commercial activities. Through case studies, the study illustrates practical implications of administrative decisions on various aspects of business operations, including visa regulations, residence permits, zoning laws, and regulatory compliance. The research identifies key challenges to commercial freedom, such as regulatory barriers and administrative obstacles, while also highlighting opportunities for enhancement, including improved transparency and modernized regulations. The study emphasizes the crucial roles of key stakeholders - government, private enterprises, and civil society organizations - in shaping commercial freedom. It proposes recommendations for reform, focusing on legislative changes, institutional improvements, and fostering an entrepreneurial culture. While acknowledging Saudi Arabia's progress in developing its commercial legislation and regulatory system, the research identifies areas for improvement. It concludes that the kingdom's efforts to balance regulatory oversight with business needs, coupled with its economic diversification goals, suggest a positive trajectory for commercial freedom. However, success depends on continued reform, stakeholder engagement, and adaptation to global economic trends while respecting local cultural and religious values. This study provides valuable insights for policymakers, business leaders, and researchers interested in understanding and enhancing commercial freedom in Saudi Arabia.

Factors influencing human papillomavirus vaccine uptake among parents and teachers of schoolgirls in Saudi Arabia: a cross-sectional study

IntroductionCervical cancer is a highly prevalent disease among women worldwide. However, the advent of a vaccine against HPV, the main cause of the disease, has prevented its spread. The acceptability of the HPV vaccine to different sectors of the Saudi community has yet to be clarified. Since parents and teachers are major influencers in the decision-making process of vaccination for HPV, this study aimed to assess the knowledge and attitudes of teachers and parents toward cervical cancer, HPV, and the HPV vaccine, and unraveled the factors that would influence recommending the vaccine.MethodsA cross sectional study was done among 927 individuals (373 teachers and 356 parents). A newly developed validated questionnaire was used to collect data on knowledge, attitude, and factors influencing cervical cancer, HPV, HPV vaccine. The relationship between different factors with knowledge and attitude were assessed using univariate and multivariate analysis.ResultsOf the study participants, 94% were females, with a median (Interquartile range) age of 38(31–44) years, 12.2% were teachers, 38.7% were parents and 49.1% were parents and teachers. The majority (78.5%) were married, and 75.6% had at least one child. Among those with children, 88.6% had at least one girl, and among those with girls, 72.2% had at least one girl aged between 10 and 18 years. The total median (IQR) knowledge score was 9 [(−5)–(−26)] and the total median (IQR) attitude score was 49 (43–56). The knowledge score significantly increased by receiving postgraduate education, working in the health or education sectors, if a person knew someone diagnosed with cervical cancer, having girls in the age group of 10–18 years, reading about medical issues or having previously heard about the HPV vaccine. The attitude score significantly increased by high knowledge score and decreased if the person has previously diagnosed with cervical cancer.ConclusionPhysician’s recommendation and the amount of information on the HPV vaccine, opinions about vaccines in general, and government decrees are the main factors influencing decision on HPV vaccine Uptake. This study emphasizes the role of healthcare providers, awareness of cervical cancer, HPV and its vaccine, and social status, in favoring vaccine uptake in Saudi Arabia.

Burnout level evaluation of undergraduate dental college students at middle eastern university

BackgroundPressure faced by dental students from academic activities, clinical skills training, and patient care may lead to high stress and potential burnout, negatively impacting their well-being and patient safety.AimThe study aimed to explore the burnout level of dental students at Qassim University, Saudi Arabia and to identify the factors that are associated with the level of burnout.MethodsThe descriptive cross-sectional study was carried out at Dental College, Qassim University, Saudi Arabia, from January to February 2024. The study was conducted to evaluate burnout levels among first to final-year undergraduate dental students enrolled at Qassim University using a pre-validated questionnaire; Burnout Clinical Subtype Questionnaire, via Google Forms. Analysis was performed with IBM SPSS-24, utilizing descriptive statistics and non-parametric tests, Mann-Whitney-U and Kruskal-Wallis. A multiple linear regression analysis was conducted to predict Burnout from demographic and academic factors.Results151 participants responded to the survey, with 49.7% male and 50.3% female. Results showed that burnout scores increased significantly (p < 0.05) with age and decreased family support. Males had lower burnout levels in comparison to their counterparts. The survey had three domains: Overload, Neglect, and Development, with ‘Overload’ having the highest mean score of 17.79 and a median score of 17.00. Age showed significant difference (p < .05) in the burnout scores amongst the groups across all three domains. 70.9% of the participants agreed that they invested an unhealthy amount of time towards their studies. The multiple regression model statistically significantly predicted Burnout, F (21, 129) = 2.190, p = .004, adj. R2 = 0.143. Gender was significant predictor, with female students reporting lower burnout scores compared to males (B=-5.633, p = .012). Family support also emerged as significant, with students reporting merely good family support showing higher burnout scores compared to those reporting very good family support (B = 6.147, p = .009).ConclusionFactors like age, family support and gender were found to have a significant with burnout levels and its domains. The study highlighted overload as the main contributing the most towards burnout in dental students of Qassim University, emphasizing the importance of tailored interventions to promote student well-being.

Key Predictors of Patient Satisfaction and Loyalty in Saudi Healthcare Facilities: A Cross-Sectional Analysis

Background: Patient satisfaction and loyalty are essential indicators of healthcare quality, directly impacting patient outcomes and the long-term success of healthcare facilities. Despite the growing importance of patient-centered care in Saudi Arabia, there is limited research exploring the factors that influence patient satisfaction and loyalty, particularly in the Riyadh region. Aim: This study aims to identify the key factors influencing patient satisfaction and loyalty among Saudi patients attending public and private healthcare facilities in the Riyadh region. The study focuses on how healthcare service quality, communication, and demographic factors contribute to patient satisfaction and loyalty. Methods: A cross-sectional study was conducted with a sample of 350 Saudi patients from 10 healthcare facilities in Riyadh. Data were collected using the Patient Satisfaction Questionnaire (PSQ-18) and the Patient Loyalty Questionnaire (PLQ). Descriptive statistics, Pearson correlation, and multiple linear regression were employed to identify predictors of patient satisfaction and loyalty. Results: Significant predictors of patient satisfaction included general satisfaction (β = 0.48, p &lt; 0.001), communication (β = 0.35, p &lt; 0.001), and the frequency of healthcare visits (β = 0.13, p = 0.011). Private healthcare facilities had higher satisfaction (p &lt; 0.001) and loyalty scores (p &lt; 0.001) compared to public facilities. Patient loyalty was strongly predicted by general satisfaction (β = 0.55, p &lt; 0.001) and communication (β = 0.42, p &lt; 0.001). Conclusions: Communication quality and patient satisfaction are key drivers of patient loyalty in Saudi healthcare facilities. Private facilities outperform public ones in patient satisfaction and loyalty. These findings emphasize the need for healthcare providers to enhance communication and service quality to foster patient loyalty. Tailored approaches to meet the diverse needs of patients, particularly in terms of education and visit frequency, are crucial for improving healthcare outcomes in Saudi Arabia.