Digital Commons Network^™

The Application Of Electronic Games In Occupational Therapy Rehabilitation In Saudi Arabia, Alaa Mohammad Arafah, Bdoor Khalid Bajamal, Jumana Fawaz Alharbi, Shahad Hussein Majhoom, Wesam Qurban

Journal of Medical Rehabilitation Science

Objectives: This study explores the application of electronic games in occupational therapy rehabilitation in Saudi Arabia, focusing on therapists' knowledge, usage patterns, and perceived benefits and barriers.
Methodology: A cross-sectional survey was conducted among 103 occupational therapy professionals working in Saudi Arabia. The survey included 25 questions on the use of electronic games in their rehabilitation settings.
Results: The results revealed that only 39.8% of respondents currently use electronic games in clinical practice. Nevertheless, 87.2% of therapists acknowledged increased patient engagement as a major benefit, while 66.7% noted improvements in motor skills and motivation. Additionally, 67% of participants reported receiving …

Epidemiological, Clinicopathological, And Molecular Features Of Melanoma In Oman: A Single-Institution Study, Boris Itkin, Zahida Niaz, Khadiga Mohammed, Tauseef Ali, Syeda Sara Tajammul, Zubair Ahmad, Prashant Ajit Deshpande, Muhammad Rashid Hanif, Maha Al Shaibi, Mohammad Al Hosni

Sultan Qaboos University Medical Journal

Objectives: Published data on melanoma in Oman are scarce. This study aimed to describe epidemiological, clinicopathological and molecular characteristics of melanoma patients in a single institution in Oman. Methods: This retrospective study included patients with a histopathological diagnosis of invasive melanoma who were assessed at Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman, between July 2021 and February 2025. Data on patient demographics, comorbidities, melanoma type, localisation, stage, key histopathological and molecular characteristics were extracted from electronic clinical charts and quantitatively described. Results: A total of 31 patients were included. The median age at diagnosis was 52.9 years …

Factors Contributing To Executive Function In Young Adults, Lindy Janae Stevenson

McNair Scholars Research

Executive functions (EF) are skills used to complete desired behaviors and inhibit undesired ones. These skills are necessary for everyday life, and even more so in higher education and the workplace. This study examined the combined impact of sleep and exercise on five facets of EF in young adults enrolled in undergraduate or graduate courses. It also examined how perceived effort and performance in college classes interact with EF. The first five hypotheses studying sleep and exercise were analyzed using a 2x2 between-groups ANOVA. The data divided participants into those averaging fewer than 7 hours of sleep a night and …

Associations Of Subclinical Hypothyroidism And Thyroid Autoimmunity With Insulin Resistance Independent Of Adiposity: An Analysis Of Nhanes, Iman Taher Hussein

AUIQ Complementary Biological System

A thyroid–inflammation–insulin pathway has been proposed in which thyroid dysfunction promotes inflammation and thereby reduces insulin sensitivity, but adiposity-adjusted population evidence is limited. This cross-sectional analysis examined whether subclinical hypothyroidism (SCH) and thyroid autoimmunity are associated with insulin resistance independently of body mass index (BMI), and whether C-reactive protein (CRP), the only inflammatory biomarker available, is associated with either, using National Health and Nutrition Examination Survey (NHANES) 2007–2012 data. Non-pregnant adults aged 18–60 years with fasting glucose < 126 mg/dL and normal free thyroxine were included; SCH was defined as thyroid-stimulating hormone (TSH) 4.5–10 mIU/L, and insulin resistance was quantified by the homeostasis model assessment (HOMA-IR). Linear regression of log HOMA-IR accounted for the complex survey design (strata, clusters, weights) and was adjusted for age, sex, BMI, and survey cycle, with sensitivity and interaction analyses. Among 2,434 adults (89 with SCH), no association with HOMA-IR was detected for TSH (β = 0.009 per mIU/L; 95% CI -0.014 to 0.032), SCH (β = -0.035; 95% CI -0.186 to 0.115), or thyroid peroxidase …

Implementation Of A Modified Trigger Tool For Adverse Drug Reaction Detection In Pediatric With Covid-19 In Indonesia, Nisa Maria, Avini Risda Khaerani, Indri Yuliani Hamdani, Annisa Lazuardi Larasati, Larasati Arrum Kusumawardani

Pharmaceutical Sciences and Research

Pediatric patients are vulnerable to adverse drug reactions (ADRs), necessitating prompt monitoring of treatment-related adverse events (AEs). This study analyzed ADRs in pediatric COVID-19 patients using a modified trigger tool to identify AEs, followed by causality analysis with the Naranjo Algorithm, and evaluated the tool’s performance. A cross-sectional, single-center retrospective study was conducted at a hospital in Indonesia from August 2020 to July 2021, using total sampling of pediatric patients aged one to≥24 hours with COVID-19. AEs were identified using 23 triggers (15 laboratory result, eight drug-administration). A total of 242 positive triggers were detected among 120 patients (mean two …

Complete Atrioventricular Block Revealing Late-Onset Cardiac Fabry Disease: Diagnostic Role Of Native T1 Mapping, Nouhaila Bentama, Lamyae Bakamel, Jalal Tagueniti, Fatiha Ait Yahya, Brahim Meftout

Journal of the Saudi Heart Association

A 63-year-old man presented with symptomatic complete atrioventricular block requiring urgent pacemaker implantation. Evaluation revealed non-obstructive left ventricular hypertrophy with normal coronary arteries. Cardiac magnetic resonance showed diffusely reduced native T1 values and inferolateral late gadolinium enhancement, suggesting Fabry cardiomyopathy; amyloidosis was excluded by bone scintigraphy. Diagnosis was confirmed by markedly reduced alpha-galactosidase A activity, elevated lyso-Gb3, and a pathogenic hemizygous GLA variant (p.Asn215Ser). Enzyme replacement therapy with agalsidase beta was initiated, with early stabilization of myocardial deformation and septal thickness. This case highlights native T1 mapping as a key diagnostic biomarker in unexplained left ventricular hypertrophy.

Narrative Medicine: Essays On Health And Care Vol 2, Robert B. Hackey, Will Toner, Megan Lessard, Jessica A. Smith, Glorimar De Los Santos Mejia, Jillian M. Spinali, Paige M. Daly, Brianna De La Fuente, Julia M. Renzelmann, Clare C. Diffin

Narrative Medicine: Essays on Health and Care

No abstract provided.

Editor's Note, Robert Hackey

Narrative Medicine: Essays on Health and Care

No abstract provided.

Murine Typhus In Georgia: Historical Context And A Probable Case Of Resurgence Where Previously-Thought Eradicated, Giovanni Mella-Velazquez, Christopher He, Bolanle Akinsola, Judson Miller

Journal of the Georgia Public Health Association

Background: Murine typhus, caused by Rickettsia typhi, is a flea-borne illness historically endemic to the southeastern United States, with initial cases reported in Atlanta, Georgia in 1913. Following vector control efforts, incidence declined significantly, and the disease was removed from the nationally notifiable disease list in 1987. While recent cases have been reported in select regions, murine typhus has not been documented in Georgia for decades. We present a pediatric case in Atlanta that may represent the first reported instance in nearly 40 years, suggesting possible reemergence in the Southeast.

Methods: We conducted a case report analysis of a pediatric …

Physician-Assisted Suicide And Euthanasia: A Discussion, Adam Omelianchuk Phd, Ma, Clinical Ethicist,

History of Medicine Seminar

No abstract provided.

Why Student Research Matters: A Faculty’S Perspective, Ethan Snow

The Journal of Integrative Physiology

As agreeably conveyed by expert accounts, educational theory, primary literature, program data, and other credible sources, students benefit in countless ways from research experiences. While effort-reward imbalances are often ascribed to mentor-mentee relationships, student research also provides faculty with many benefits; however, these outcomes are often overlooked and comparatively undervalued. The purpose of this article is to highlight why student research matters to faculty. The article describes how mentoring student research can cultivate intellectual growth from cognitive responsibility, professional impact through productivity, and fulfillment in reciprocated mentorship. In serving its purpose, this article may guide faculty investment in student research …

The Lateral Recovery Position In Medical Vs Dental Emergencies, John Regis, Steven Saxe, Jason Ciccotelli, Saskia Richter, Jessica Immonen

The Journal of Integrative Physiology

The lateral recovery position is widely used in prehospital and clinical settings to help maintain airway patency in unconscious patients who are breathing spontaneously. Tracheal anatomy and asymmetries in respiratory structures, along with gravitational effects on soft tissues, may influence the efficacy and safety of this positioning. Clinical nuances related to the setting and secondary health concerns interestingly create disagreement on preferred side for lateral placement. This article explores the anatomical and physiological considerations that support the lateral recovery position—focusing on tracheal asymmetry and its implications for airway patency—along with emergency medical practices in medical versus dental emergencies. It also …

Taking Interpretative Phenomenological Analysis Further: Reviewing Recent Developments And Innovations In Ipa Research, Jonathan A. Smith

The Qualitative Report

This paper reviews recent developments in interpretative phenomenological analysis (IPA) research methodology: longitudinal; multi-modal; mixed methods. For each of these developments the paper describes how the innovation is being implemented and the distinctive contribution arising from making these advancements in IPA design. I also provide two detailed examples of studies using each of the advanced methodologies along with suggestions for further reading. The paper also includes briefer discussion of recent changes in some of the terminology employed in IPA analysis and recent guidance on writing and evaluating high quality IPA.

Testing Personalization In Llm-Based Mental Health Support: A Proposed Experimental Design For College Students, Tchalim P. Agninoube, Greg Williams

Annual DBA Scholars Conference

Rising student mental health demand has outpaced campus counseling capacity. This paper proposes a 2x2 between-subjects experimental design to test whether a personalized LLM-based chatbot, grounded in just-in-time adaptive intervention principles and cognitive load theory, provides better short-term anxiety reduction than a standard chatbot across stress and neutral contexts. The personalized chatbot uses wearable stress data, sleep quality, self-reported overwhelm, and support preferences to select between low-load and elaborative support paths. The design contributes a practical framework for evaluating personalization in AI-driven mental health tools and informs scalable, responsible institutional deployment.

Bridging Awareness And Action: A Multilevel Model Of Organizational Learning, Safety Climate, And Sickle Cell Trait Safety Compliance, Kimberly Snowden

Annual DBA Scholars Conference

Despite the existence of NCAA and National Athletic Trainers’ Association guidelines, preventable sickle cell trait (SCT)-related adverse events continue to occur in athletic settings. This study examines how organizational learning capacity, safety climate, leadership commitment, and individual risk perception influence compliance with SCT safety protocols and related safety outcomes. Drawing on Organizational Learning Theory, Safety Climate Theory, and the Health Belief Model, the study proposes a multilevel framework tested through an explanatory sequential mixed-methods design. Findings are expected to identify organizational predictors of compliance and provide practical recommendations to strengthen SCT safety implementation and reduce preventable athlete harm.

Trust But Verify: Testing A Framework For Ai Interrogation In Nursing Education, Michael Chamberlain

AI in the Classroom: A Virtual Summit

Generative AI produces fluent, confident output that is sometimes fabricated. Nursing students increasingly submit work built on sources that do not exist, or that exist and do not support the claims drawn from them. This session reports two semesters of classroom observation testing whether prompt design can address that problem.   The hypothesis was that structuring student prompts to require the AI to validate its own sources would improve detection of hallucinated citations. It did not. Across two sections, students who used the structured format caught fabricated citations at the same rate as students given an open prompt. Structure did change …

Comment On “Advancing Lipid Management: Saudi Heart Association Position Statement On Pcsk9-Targeted Therapies In The Primary And Secondary Prevention Of Cardiovascular Disease”, Ali Faris Altebainawi

Journal of the Saudi Heart Association

No abstract provided.

Ribosomal Biogenesis In Acute Myeloid Leukemia: A Less-Attended Process With Profound Implications For Oncogenesis And Therapeutic Vulnerability, Muhammad-Redha Abdullah-Zawawi, Nadiah Abu, Nurul Syakima Ab Mutalib, Farah Azima Abdul Muttlib, Hafiza Alauddin

Saudi Medical Journal

No abstract provided.

Drooling In Children With Cerebral Palsy: A Retrospective Observational Study Of Clinical Characteristics, Severity, And Treatment, Kamel Awadh Alenazi, Lama Dakhakhni, Nancy Hassan, Wejdan Almuhraj

Saudi Medical Journal

Objectives: To report the characteristics, severity, and treatment of drooling in cerebral palsy (CP) children.
Methods: This retrospective observational study included CP children with active complaints of drooling from the Drooling Clinic, Sultan Bin Abdulaziz Humanitarian City (Riyadh, Saudi Arabia). Drooling severity was assessed via the Modified Drooling Questionnaire (MDQ). The functional motor and manual ability levels were classified via the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS).
Results: In total, 122 patients were identified. Mean age was 6.28 ± 2.71 years, and 67/122 (54.9%) were boys. Gastroesophageal reflux disease was noted in 23/122 (18.9%). …

Sinonasal Inverted Papilloma: Demographics, Recurrence Predictors, And Surgical Outcomes — A 10-Year Retrospective Review At A Tertiary Center In Saudi Arabia, Ali J. Asiry, Majed A. Alali, Nasir A. Magboul, Salem A. Alrasheed, Ibraheem M. Alkanhal, Mohammed A. Alabduljabbar, Raid H. Almadi, Abdullah S. Aldughaither, Faisal S. Alfawaz, Ali Majrashi, Saud Alromaih, Ghassan Alokby, Tamadar Al Doheyan

Saudi Medical Journal

Objectives: To characterize the demographic, clinical, and radiological profile of patients with sinonasal inverted papilloma (IP) managed at a tertiary center in Saudi Arabia, to determine recurrence rates in primary versus revision cases, and to identify factors associated with recurrence.
Methods: This retrospective observational study included 59 adult patients with histopathologically confirmed sinonasal inverted papilloma (IP). Demographic, clinical, radiological, and surgical data were extracted from medical records. Tumors were staged using the Krouse system. Patients were stratified into primary or revision cases, and associations with recurrence were evaluated.
Results: Most patients were men (72.9%) and older than 45 (79.7%) years …

Incidence Rate And Factors Predicting The Recurrent Cerebral Ischemic Events After The First-Ever Ischemic Stroke: A Single-Center Exploratory Study From The Eastern Region Of Saudi Arabia, Azra Zafar, Mustafa Al-Qarni

Saudi Medical Journal

Objective: First-ever ischemic stroke (FIS) patients carry a higher risk of recurrent ischemic strokes (RIS). This study reports the incidence rate and describes the factors predicting recurrences in FIS patients.
Methods: This retrospective study, enrolling patients with FIS, was carried out at the King Fahd Hospital. Association between different variables and RIS was determined by estimating the 95% confidence intervals (95% CI) and odds ratio (OR).
Results: The majority of patients were Saudi (74.1%) and male (72.9%). Over a 5-year follow-up study, the incidence rate was 26.1% (95% confidence interval [CI] = 22.2-30.1) for all recurrences and 22.7% (95% CI …

Beyond Chronological Age: Performance Status And Clinical Frailty Predict Survival In Saudi Geriatric Lymphoma Patients: A Competing Risk Analysis, Musa Fares Alzahrani, Ghazi S. Alotaibi, Sarah S. Sewaralthahab, Fatima A. Alshalati, Ibrahim N. Alrumaih, Badraa A. Muharib, Kazi Nur Asfina, Saleh Ahmed Alkholaif, Shaden A. Albassam, Saleh Abdullah Aljanah, Shahad A. Al Hemidin, Ahmed Y. Jamal, Fadi S. Alakeel, Walid A. Alkeridy, Farjah H. Algahtani, Aamer Aleem

Saudi Medical Journal

Objective: To evaluate the prognostic impact of performance status, frailty, and treatment intensity on survival outcomes in a geriatric lymphoma cohort using a competing risk framework. In Saudi Arabia, despite a growing aging population, there is a lack of literature detailing frailty or survival dynamics for geriatric lymphoma patients.
Methods: We conducted retrospective cohort study in Tertiary center in Riyadh, Saudi Arabia. Geriatric patients (≥ 60 years) diagnosed with lymphoma during 2011–2024 were analyzed. Baseline demographics, laboratory parameters, pathology, and frailty status were extracted. Survival dynamics were modeled using cumulative incidence functions to isolate lymphoma-related mortality (LRM) from age-related competing …

Growth, Methodological Evolution, And Clinical Maturity Of Artificial Intelligence Research In Major Medical Journals, 2018–2025: A Longitudinal Bibliometric Study, Abdulraoof Alsaeedi, Norah Alqarni, Ibrahim Rozi, Mohamed Ibrahim

Saudi Medical Journal

Objectives: To quantify changes in the volume, methods, and clinical maturity of artificial intelligence (AI) and machine learning (ML) research in major medical journals from 2018 through 2025.
Methods: We conducted a longitudinal bibliometric study of PubMed-indexed records from 99 leading clinical and general medical journals. The search was conducted on July 2026. Records were deduplicated and classified as empirical AI/ML research, evidence synthesis, AI discourse, or unclassified. Empirical studies were categorized by model family and clinical maturity. Journal-year Poisson generalized estimating equations used total substantive publications as an offset and clustered observations by journal.
Results: Among 6,891 unique publications, …

Barriers To And Needs For The Implementation Of Artificial Intelligence In Radiation Therapy Planning In Saudi Arabia. A Cross-Sectional Survey, Abdulaziz Alshaikh, Ghadah Alqarni, Abdulaziz Alghamdi, Khalid Alrabiah, Nasser Al-Rajhi, Mohammed Aldehaim

Saudi Medical Journal

Objectives: To assess radiation oncology physicians' perceptions of artificial intelligence (AI) in radiation therapy planning in Saudi Arabia and identify barriers to and support needs for its implementation.
Methods: A cross-sectional online survey was distributed through the Saudi Association of Radiation Oncology email list to 142 physicians from April to May 2026. We analyzed responses using descriptive statistics and exploratory 2-sided Fisher exact tests comparing residents with nonresidents.
Results: Forty-three complete responses were analyzed (response rate: 30.3%). A total of 33 (76.7%) respondents agreed or strongly agreed that AI would improve planning accuracy and efficiency. Nineteen (44.2%) reported no workplace …

Artificial Intelligence Readiness Among Paramedics At The Saudi Red Crescent Authority: A Cross-Sectional Study, Mohammed Jamaan Alsahli

Saudi Medical Journal

Objective: To evaluate AI readiness among paramedics working within the Saudi Red Crescent Authority (SRCA) and examine demographic and professional characteristics related to their readiness.
Methods: This cross-sectional study was conducted among SRCA paramedics. Data were collected through a structured online questionnaire covering demographic and professional features and the validated Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS), which assesses four dimensions: Cognition, Ability, Vision, and Ethics. Comparisons between groups were performed with the Mann-Whitney U and Kruskal-Wallis tests, while correlations were assessed using Spearman's rank correlation, and a multiple linear regression model examined factors independently related to AI …

Artificial Intelligence In Gastrointestinal Precision Medicine: A Critical Appraisal Through The Lens Of Inflammatory Bowel Disease, Abdulrahman G. Alharbi, Abdulrahman A. Aljabri

Saudi Medical Journal

Artificial intelligence (AI) now supports many facets of gastrointestinal and hepatic care, from lesion recognition during endoscopy to the interpretation of large molecular datasets. This review first outlines AI's broader role across gastroenterology and hepatology, and then uses inflammatory bowel disease (IBD) as a case study for AI-assisted multiomics integration. The review applies a consistent evidentiary framework that distinguishes exploratory, retrospective, and prospective study designs. Retrospective genomic and image-based studies report promising discriminative performance for risk classification and lesion detection, but this evidence remains largely exploratory or retrospective, whereas prospective randomized evidence is currently strongest for AI-assisted endoscopic polyp detection. …

Efficacy And Safety Of Botulinum Toxin For The Treatment Of Psoriasis: A Systematic Review And Meta-Analysis, Rahaf A. Alothman, Hussein M. Alshamrani, Mishari T. Alrubaiaan, Ruba M. Alghanmi, Reshale A. Johar, Lina K. Almutairi, Mohammed H. Abduljabbar, Ahmed M. Baabdullah, Sultan S. Alfaer

Saudi Medical Journal

Objective: To evaluate the current literature on Botulinum toxin (BoNT) use in psoriasis treatment, focusing on efficacy and safety. Botulinum toxin, known for its neuroprotective effects, is a promising therapeutic agent for inflammatory skin diseases.
Methods: We searched electronic databases, including MEDLINE, Web of Science, and Google Scholar, from inception until March 2025 to identify randomized controlled trials and cohort studies in English that enrolled patients with psoriasis treated with BoNT injections over their lesions, reported outcomes related to the clinical question, and included raw numbers of outcomes.
Results: Of the 342 retrieved articles, 166 duplicates were removed. Screening of …

Association Of Kirsten Rat Sarcoma Viral Oncogene Homolog Mutation With The Prognosis Of Colorectal Cancer In Arab Countries And Saudi Arabia: A Systematic Review And Meta-Analysis, Mohammed Ageeli Hakami, Hassan Abdullah Albargy

Saudi Medical Journal

Objectives: To quantify the potential impact of Kirsten rat sarcoma (KRAS) mutation on survival outcomes in colorectal cancer (CRC) patients from Arab countries, particularly in Saudi Arabia. As a chief cause of cancer-associated mortality worldwide, CRC shows a rising incidence across Arab countries. Among molecular drivers, KRAS mutation plays a pivotal role in tumor initiation, resistance to therapies, and disease progression. Nonetheless, the prognostic influence of KRAS mutation in Arab populations remains inconclusive.
Methods: Key databases were searched to find appropriate publications. Eligible studies evaluated KRAS mutation’s association with overall survival (OS) in CRC patients from Arab nations. Hazard ratios …

Evaluating The Diagnostic Performance And Clinical Interpretability Of Explainable Ai (Xai) In Digital Histopathology: A Meta-Analysis Of Diagnostic Performance, Bandar S. Alshreef, Yousif A. Kariri

Saudi Medical Journal

Objective: To explore peer-reviewed research on the application of Explainable Artificial Intelligence (XAI) techniques for histopathology-driven cancer risk evaluation, and to address the limitations delaying its transition into routine clinical pathology practice (such as model reliability, clinical interpretability, and governance oversight).
Methods: We conducted a systematic review with quantitative meta-analysis of studies evaluating explainable artificial intelligence (XAI) in histopathology. Searches were performed in Web of Science, Scopus, PubMed, and Google Scholar through November 2025. Eligible studies were assessed for diagnostic performance, explainability approaches, and methodological quality. Of the 47 included studies, 9 provided sufficient quantitative data for meta-analysis. Post-hoc visual …

Machine Learning And Large Language Model Decision Support For Medication-Error Prevention Across The Medication-Use Process: A Systematic Review With Implications For Saudi Arabia, Emad A. Alsaleh, Maram J. Alnemer, Yousef H. A. Alhassan, Asaad A. A. Khalil, Mohammed A. Kaddoura, Azfar Athar Ishaqui, Muhammad B. Maqsood, Adnan Iqbal

Saudi Medical Journal

Objectives: Medication errors are a major source of preventable harm. We systematically reviewed workflow integrated artificial intelligence (AI) decision support (machine learning [ML], natural language processing, computer vision, and large language models [LLMs]) aimed at detecting, intercepting, or preventing medication errors, and considered implications for Saudi Arabia.
Methods: We searched MEDLINE (PubMed), Embase, Scopus, Web of Science Core Collection, IEEE Xplore, and the Cochrane Library for English language studies published from January 2010 to February 2026. Eligible studies used real clinical/pharmacy data and evaluated an AI component designed to prevent or detect medication errors across prescribing/order verification, dispensing, …