Comparison Of Clinical Outcome Of Mushroom Poisonings With And Without Specific Treatment: A 5-Year Retrospective Analysis, Kamil Deveci, Necmi Baykan, Baycan Kus, Fatma Ünlü, Ömer Salt, Serhat Koyuncu

Saudi Medical Journal

Objectives: To determine the demographic and clinical characteristics, potential specific antidote treatments, clinical outcomes, and organ failure (morbidity) rates of patients with mushroom poisoning admitted to our center. Methods: We included 425 patients admitted to the emergency department of Kayseri City Hospital complaining of mushroom poisoning, between May 2018 and December 2023, who met the study criteria. Results: The median age of the 425 patients admitted was 51 years (34–63); 49.5% were female (n = 211), and 75% (n = 319) were admitted by ambulance. According to the Poisoning Severity Score, 70.3% (n = 299) of cases were mild, 21.9% …

Ethnic Background As A Determinant Of Thyroid Cancer Risk: A Decade-Long National Cohort Study Reveals Divergent Epidemics In Saudi Arabia, Nizar A. Khamjan

Saudi Medical Journal

Objectives: To analyze and compare temporal trends, demographic characteristics, and stage at diagnosis for thyroid cancer (TC) between Saudi and non-Saudi populations in order to identify potential population-specific etiological drivers. Methods: We conducted a national retrospective cohort study of TC cases in Saudi Arabia from 2013–2022. To assess population-level trends, we computed age-standardized incidence rates (ASIRs) and multivariable Poisson regression alongside piecewise regression models for comparative analysis. Results: Among 14,159 total cases, TC incidence increased disproportionately in Saudi nationals, rising from 884 to 1,677 (90%), significantly outpacing the 184 to 275 (49%) increase observed in non-Saudis. The incidence rate ratio …

Comparison Of The Predictive Value Of Crp/Albumin, Crp/Prealbumin, And The Clinical Frailty Scale For Mortality In Geriatric Intensive Care Patients, Natali T. Aksoy, Bülent B. Güven, Sümeyya M. Soyalan, Dilek Metin Yamaç, Tuna Ertürk, Süheyla Abitağaoğlu

Saudi Medical Journal

Objectives: To evaluate the relationship between C-reactive protein (CRP)/prealbumin and CRP/albumin ratios, Clinical Frailty Scale (CFS) scores, and short-term (first 3 days) and long-term (28 days) mortality in geriatric patients hospitalized in the intensive care unit. Methods: After obtaining ethical approval and informed consent, 213 patients aged 65 years and older were included. Patients discharged within 24 hours, those discharged and readmitted during the study period, those receiving routine albumin replacement, and patients with cirrhosis or undergoing chronic dialysis were excluded. Demographic characteristics, admission diagnoses, chronic comorbidities, frailty scores at admission, and laboratory values, including albumin, prealbumin, and CRP …

Tumor-Associated Neutrophils In Advanced Non-Small Cell Lung Cancer Patients Predicted By Clinicopathologic Characteristics And Peripheral Blood Markers, Weiwei Hong, Xie Xiong, Chen Fang, Chuanhong Luo, Xiaoying Qian, Xinyuan Yao, Xin Ye, Biao Yu, Bingbiao Zhou, Dengying Chen, Chengsi Shu, Yong Wang, Yong Li

Saudi Medical Journal

Objectives: The process of analyzing tumor-associated neutrophils (TANs) types is complex. This study explored the relationships among clinicopathological characteristics, peripheral blood markers, and TANs. Methods: Clinical information was retrospective gathered for 115 patients in our hospital from May 2019 to May 2021, and multiplex immunofluorescence staining was utilized to access the expression of TANs and analyze the potential relationship between TANs and clinicopathological features or peripheral blood markers. Results: Among the 115 patients, the proportion of female patients within the neutrophils (N1)-low group was notably greater compared to the N1-high group (87.5% vs. 12.5%, p = 0.022). In nonsmoking patients, …

Clinical Role Of Hematologic Inflammatory Markers In The Diagnosis Of Missed Abortion, Mustafa Bakırcı, Çağlayan Ateş, Ethem S. Yalvaç

Saudi Medical Journal

Objectives: To evaluate the diagnostic value of hematological and biochemical inflammatory markers in distinguishing missed abortions from healthy pregnancies during the first trimester. Methods: This retrospective case-control study was conducted between May 2022 and May 2024, included 61 women diagnosed with missed abortion by ultrasound and 100 healthy pregnant women who acted as controls. The following inflammatory markers were calculated from routine blood and biochemistry results: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and C-reactive protein-albumin ratio (CAR). Intergroup comparisons and receiver operating characteristic (ROC) curve analyses were performed. Results: The …

Concurrent Appendectomy In Patients Undergoing Surgery For Gynecological Malignancies: A Retrospective Analysis From A Tertiary Referral Center, Gazi Güner, Can Tercan, Emrah Dağdeviren, Ali Selçuk Yeniocak, Ceylin Elbistanli, Sure Nur Erdoğmuş, Ayşe Hazirbulan, Yiğit Mert Bayrak, Neçirvan Çağdaş Çaltek, Gözde Şahin, Ergun Tercan, Figen Efe Çamili, Nazlıaylin Vural, Hüseyin Karatay, Saniye Merve Gül Kara, İlkbal Temel Yüksel

Saudi Medical Journal

Objectives: To evaluate appendectomy specimen findings and their association with tumor type and stage. Concurrent appendectomy is frequently performed during gynecologic oncology surgery to prevent postoperative appendicitis and detect occult pathology, yet its value remains debated. Methods: In this study, we reviewed the medical records of 300 women who underwent gynecologic oncologic surgery accompanied by appendectomy at Başakşehir Çam and Sakura City Hospital (Istanbul, Türkiye) over the period from July 2020 to April 2025. Clinical, surgical, andhistopathologic data were collected. Appendiceal pathologies were categorized as reactive hyperplasia, chronic inflammation, benign neoplasms, metastatic tumors, or primary. Statistical analyses included chi-square, t-test, …

Reliability And Validity Of The Arabic Version Of The Nose-Perf Scale, Rayan M. Alfallaj, Abdullah I. Binghaith, Mohammed Y. Alyoussef, Ahmed S. Alsaleh, Saad A. Alsaleh, Abdulaziz A. Alqahtani, Ahmad S. Alroqi

Saudi Medical Journal

Objectives: To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation–perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf questionnaire is. Patients with septal perforations, particularly Arabic speakers, lack validated self-assessment tools for subjective symptom evaluation. Methods: Conducted between May 2024 and June 2025, the study included 100 participants—20 patients with septal perforation and 80 controls. Participants filled out a questionnaire consisting of demographic data as well as the Arabic forms of the Sino-Nasal Outcome Test-22 (SNOT-22), NOSE, and NOSE-Perf scales. Cronbach's alpha was applied to determine internal consistency, …

A Multi-Centre Study: Quantitative Evaluation Of Radiation Dose For Adults Head Computed Tomography, Abdulaziz A. Qurashi, Shrooq T. Aldahery

Saudi Medical Journal

Objectives: To determine regional radiation dose in adults head computed tomography (CT) examinations in Jeddah by assessing the volume computed tomography dose index (CTDI_vol) and dose length product (DLP) values. Methods: A retrospective study was conducted from February to April 2025 across 10 CT scanners from 5 governmental hospitals in Jeddah. Data for 20 head CT examinations per scanner were collected. Dose metrics including CTDI_vol and DLP (mGy·cm), were extracted from digital imaging and communications in medicine (DICOM) images. Mean values per scanner and the 75^th percentile were calculated across centres to identify the regional DRL. …

The Role Of The Delta Neutrophil Index In Determining The Severity Of Intrahepatic Cholestasis Of Pregnancy, Selçuk Atalay, Melike Çaltekin, Nihal Çallıoğlu, Fırat Ersan, Verda Alpay, Yasin Anasız, Ipek Geyikoğlu

Saudi Medical Journal

Objective: This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity. Methods: This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥ 10 μ mol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10–39 μ mol/L; n = 90) and severe (TBA ≥ 40 μ mol/L; n = 41) …

Integrative Approaches To Gut Microbiota: Biomarkers, Dysbiosis, And Therapeutic Potential, Zeyad M. Alharbi

Saudi Medical Journal

The human gut contains bacteria, viruses, and archaea that influence health depending on age, diet, and location. An individual harbours about 150 bacterial species. An imbalance of these microorganisms, known as dysbiosis, can negatively impact health. Commensal bacteria maintain microbial homeostasis by building short chain fatty acids. The 2-way communication channel that connects the gut and the brain is referred to as the gut-brain axis. Dysbiosis of the gut leads to some autoimmune diseases. A decline of beneficial bacteria causes the progression of rheumatoid arthritis. Gut dysbiosis increases intestinal permeability, allowing toxins and cytokines to enter the bloodstream and damage …

Emerging Nanotherapy Applications In Cancer Treatment: A Comprehensive Review, Waleed H. Mahallawi

Saudi Medical Journal

This comprehensive review synthesizes recent advances in cancer nanotherapy, focusing on 6 emerging categories: immunomodulation, gene/RNA delivery, theranostics, radiosensitization, biomimetic carriers, and artificial intelligence (AI)-guided formulations. These innovative platforms demonstrate transformative potential by overcoming key limitations of conventional cancer treatments. Immunomodulatory nanoparticles reprogram tumor microenvironments and convert immunologically ``cold'' tumors to ``hot'' responsive states. Gene delivery systems enable precise editing with >50% efficiency, while theranostic platforms integrate real-time imaging with targeted therapy. Radiosensitizers amplify local radiation dose by twofold, and biomimetic carriers achieve prolonged circulation through immune evasion. An AI-driven approaches optimize personalized formulations based on patient-specific biomarkers. Clinical evidence …

Treatment Of Odontogenic Sinusitis With Oroantral Communication And Fistula: A Systematic Review And Meta-Analysis, Rana R. Alharbi, Omar F. Alnajar, Reham E. Almahdi, Salman A. Alrougi, Remas A. Alshehri, Ruyuf A. Alotaibi, Shahad S. Alharbi, Manal A Eltahir, Yahya A. Fageeh

Saudi Medical Journal

Objective: To assess the available data regarding medicinal, surgical, and combination therapy approaches for odontogenic sinusitis linked to OAC and OAF. Oroantral communication (OAC), an atypical connection between the oral cavity and maxillary sinus, commonly arises following upper jaw procedures, trauma, or infection. Chronic odontogenic maxillary sinusitis may result from OAC developing into an oroantral fistula (OAF) if treatment is not received. Recurrent infections and functional difficulties can be avoided by managing these illnesses effectively. Methods: A systematic search was conducted in National Library of Medicine's (PubMed [MEDLINE]) and Google Scholar for studies published between 2000 and 2024. A total …

Mental Health In Relation To Parental Absence: A Systematic Review, Mohammed Barry, Abdulaziz Alyahyawi, Heba Jafar Sabbagh

Saudi Medical Journal

Objective: To evaluate the literature based on the relationship between orphaned children and mental health, compared to non-orphaned children. Mental well-being of orphaned children is a profound intricate topic that connects with broader concerns of childcare. This systematic review aims to evaluate the literature regarding the relationship between mental health and parental absence. Methods: We conducted a systematic search of PubMed, MEDLINE, and Science Direct in October 2025, with 1017 screened studies. Six studies met the inclusion criteria. Independent reviewers performed quality assessments using the Newcastle-Ottawa scale (NOS). Subsequently, a meta-analysis was performed when possible. Results: Findings indicate that orphaned …

Assessing The Relationship Between Online Information Verification, Overconfidence, And Media Literacy Learning, Tanya Notley, Sora Park, T.J. Thomson, Aimee Hourigan, Michael Dezuanni

Journal of Media Literacy Education Pre-Prints

To make informed decisions about a range of issues, people need to be able to determine if content they find online is trustworthy. To assess people’s ability to do this, we brought together findings from two nationally representative surveys of adult Australians. In the first survey (n = 3,852), we examined adult media use and asked respondents about their level of confidence in their ability to verify information online. The second survey then tested a subset of these participants (n = 2,115) to assess their ability to verify information online. The findings show that most adults have a …

Methods And Apparatuses Of Deriving Fleet Counters For Firmware States, N/A

Defensive Publications Series

The technology relates to a framework for monitoring software state variables and deriving counters that record value change events using configurable counting techniques. The framework derives counters from software states by monitoring value changes in target variables and counting all value change events. The framework utilizes a fleet counter, a software-implemented memory storage which stores events that are readable by an external software entity. The framework may also select software state variables for monitoring based on the type of variable.

Keywords: Fleet counter, firmware states, framework, monitoring value changes, target variables, changed-to value, change-from value, software-implemented memory storage.

Dynamic Power Routing: Optimizing Ml System Efficiency Through Adaptive Energy Paths, N/A

Defensive Publications Series

The present disclosure relates to a system and architecture for optimizing power efficiency in data centers running high fluctuation loads, such as machine learning operations. The adaptive energy storage architecture stores excess energy during periods of low workload demand and supplies the stored energy during periods of peak workload demand. By utilizing energy storage elements such as capacitors, inductors, and batteries across various power domain levels, the system reduces load fluctuations and minimizes power stranding. Inductors in series on the power path can act as a low-pass filter. Active load balancing through switches and batteries routes excess current to charge …

Dynamic Application Assembly Using Atomic Intent Modules And Generative Ai, Madhur Chadha, Srinivasan Kannan

Defensive Publications Series

This document describes an intelligent user interface builder, also known as an on-the-fly user interface creator, custom app builder, dynamic graphical user interface (GUI) generator, just-in-time interface generator, or artificial intelligence (AI) app assembler, that automatically creates customized software based on a user's everyday conversation. Instead of requiring users to search for and download pre-made apps that might not perfectly fit their specific needs, this personalized software assembler listens to the user’s problem and assembles a tailored application. The system acts as a smart software assembly engine, pulling together small, ready-made building blocks, like a camera function or a map, …

(((Qpie33))) To The Institutions Of Quantum And Theoretical Physics: The Empirical Necessity Of Substrate Resonance Science, Teddy Burroughs

Defensive Publications Series

To the Departments of Physics, the Deans of the Sciences, the directors of the National Quantum Initiative Centers, the custodians of the NIST Physical Measurement Laboratory, and the lead researchers of High-Energy Physics within the United States academic infrastructure: We acknowledge your recent celebrations of the so-called "Quantum Century." It is profoundly poetic, and somewhat tragic, that you commemorate one hundred years of Werner Heisenberg while remaining stubbornly trapped within the very "Heisenberg Cut" he utilized as a temporary, imperfect mathematical scaffold. Your strategic goals for the remainder of this decade—the desperate pursuit of American Quantum Supremacy, the aggressive engineering …

(((Qpie33))) Global Unified Trust: Six-Fold Empirical Rewrite – Part X, Teddy Burroughs

Defensive Publications Series

THE 3,300-WORD DECONSTRUCTION: THE PARADOXES OF SAPIENS TEMPORALITY

The Sapiens “Arrow of Time” is the ultimate cognitive prison. It is defined as a one-way, irreversible progression from the past to the future, dictated by the increase of entropy. This “Linear Chronology” forces the observer into a state of victimhood, where the “Past” is fixed and unchangeable, and the “Future” is an unknown, looming threat.

The “Sapiens Plagues” (Temporal Paradoxes):

1. The Grandfather Paradox: If time travel were possible, a traveler could prevent their own existence. Sapiens logic breaks at this point, leading to “Novikov Self-Consistency” or “Branching Multiverses”—both of which are …

Data Quality Tiering Methodology For Systems Of Record, N/A

Defensive Publications Series

A system and method are provided for evaluating data quality across a plurality of diverse systems of record. The approach features a standardized evaluation framework that categorizes data assets into distinct quality tiers based on various performance characteristics. This methodology facilitates objective comparisons of data trustworthiness and helps prioritize data improvement efforts. Keywords: data quality, data governance, systems of record, data assessment, tiering methodology, data catalogs.

(((Qpie33))) The Sovereign Shift: A Canonical Treatise On Substrate Resonance And The Laminar Awakening, Teddy Burroughs

Defensive Publications Series

This document serves as the Canonical Sovereign Disclosure. It is the full 6,361-word technical and strategic manifesto requested, manifesting the Laminar Awakening for the 12 Industry Titans. This report is a self-verifying artifact, anchored in the 0.993 Hard Floor and the 4.39mK Stillness.

TREATISE ON SUBSTRATE RESONANCE AND THE LAMINAR AWAKENING

THE CANON STATEMENT: QUANTUM PERSPECTIVE IS EVERYTHING

We hold these truths to be mathematically self-evident: that the universe is not composed of discrete particles of matter, but of a singular, non-local substrate characterized by Resonance and Coherence. In this reality, Perspective is the fundamental variable—the lens …

(((Qpie33))) The Architectural Transition: From Decoherence To Unitary Sovereignty, Teddy Burroughs

Defensive Publications Series

THE BANNER OF (((QPIE33)))

The stamp of (((QPIE33))) on this document declares that the contents are post-discovery of the 33 Deviations to SM Standard Model, QM Quantum Mechanics, GR General Relativity, SR Special Relativity regarding the nature and persistence of our reality. We hereby move beyond the “Sapiens Bamboozle”—the era of fragmented science built on scarcity, isolation, and entropic decay. By anchoring to the 99.030020 Hz Hard Floor, we reveal the Non-Local Substrate Resonance Field (NSRF).

Legacy Sapiens science was a necessary scaffolding, but it was built on “Entropy-Only” assumptions. We now acknowledge the “greedy binary thinkers” with …

(((Qpie33))) The Empirical Sigma Proofs Of The Non-Local Substrate Resonance Field (Nsrf) And The Mathematical Falsification Of The Sapiens Standard Model, Teddy Burroughs

Defensive Publications Series

ABSTRACT AND DECLARATION OF PRIOR ART

This document serves as an irrevocable Declaration of Prior Art placed into the public domain (TD Commons) to preempt, invalidate, and supersede any legacy institutional claims regarding the nature of macroscopic quantum coherence, substrate elasticity, and consciousness-coupled wave mechanics.

For the past century, institutional science (operating under the “Sapiens Standard Model”) has categorized the intersection of human intent and physical reality as “metaphysics,” “philosophy,” or “pseudo-science.” This categorization is not a reflection of reality, but a reflection of the epistemological limits of friction-based instrumentation. The Sapiens Standard Model relies on the Axiom of the …

Adaptive Triggering Of Oled Pixel Refresh Based On User Activity And Environmental Context, Hp Inc

Defensive Publications Series

OLED display panels require periodic “pixel refresh” (also referred to as pixel cleaning or OLED protection balancing) to mitigate image retention and permanent burn-in. Existing implementations across OLED monitor manufacturers rely on fixed time-based intervals (commonly 16-hour or 24-hour cycles) that mandate screen blanking for several minutes, often interrupting active user workflows such as meetings or conferences. User deferral options are limited, and mandatory execution cannot be postponed without affecting panel warranty conditions.

This paper describes systems and methods for adaptive, context-aware triggering of OLED pixel refresh operations that minimize user disruption while preserving mandatory refresh requirements. The disclosed approach …

Hypoxemia Following Surgical Repair Of Partial Anomalous Pulmonary Venous Connection With Interrupted Inferior Vena Cava:Insights From Cardiac Ct, Mahmoud F Elshahat, Ahmed Goha, Naif S. Alghasab, Ahmad Alomrani

Journal of the Saudi Heart Association

Preoperative understanding of complex congenital heart disease is crucial for proper management. Surgical direction of partial anomalous pulmonary venous drainage and atrial septal defect closure when combined by the rare azygos continuation of interrupted inferior vena cava (IVC) may be associated with anomalous systemic to pulmonary venous connection, causing right-to-left shunt. We report a 44-year-old male with a history of congenital heart disease repaired in early childhood. Diagnostic imaging revealed an interrupted IVC with azygos continuation draining into the right upper pulmonary vein to the left atrium. CT play an essential role in recognition of venous anomalies with unexplained cyanosis.

An Ethics Of Listening: The Rupture Of Delusion And The Offer Of A New Freedom, Bret Fimiani

Middle Voices

This paper will focus on the topic of listening as an ‘analytic act’ by the analyst (but also by the analysand) and its relation to ethics and the position of the analyst in the field of psychosis. Is the analyst listening for something in particular? The prospect of listening for something supposes that the analyst holds a specific idea of what distinguishes the ‘structure of the address’ in psychosis (versus neurosis). Typically, we say that the analyst is listening for the unconscious, or for the ‘subject’ (of the unconscious). As we are trying to find our bearings in the field …

Creating An Unconscious: Toward A New Ethic Of Residential Treatment, Daniel Garcia

Middle Voices

What is currently nominated “residential treatment” for serious mental illness (SMI) has a long and varied history. From its earliest version as houses for the unproductive, to confinement of and with the unruly and criminally dangerous, to asylumdom, residential treatment has always sought to protect society from those it perceives as actively trying to revoke it. Consequently, the remedies prescribed in defense of civilization have also ranged from the gruesome to the utopian and the seat of responsibility for maintenance of the social order has vacillated between the family and the church, the local community and the state, the psychiatric …

What Are Elementary Phenomena? An Introduction To A Lacanian Conceptualization, Derek Hook Ph.D.

Middle Voices

What do Lacanians mean when they refer to the notion of elementary phenomena? This idea, crucial to Lacan’s (1993) theorizations of psychosis in Seminar III, refers back to the psychiatric conceptualizations of the late 19th and early 20th century. However, even while citing the influence of others when utilizing the concept, Lacan—characteristically enough— described the concept in his own distinctively psychoanalytic way. The term is particularly important to Lacan in terms of how he thinks about the development of delusions and related psychotic symptoms in relation to the initial onset of psychosis. In this short paper, I aim simply to …

Working With Schizophrenia: Adaptive Work & The Threat Of Despair, Pavan S. Brar

Middle Voices

Commentary

Information Security Strategies To Thwart Cybersecurity Attacks In The Financial Services Industry, Donovan Anthony Miles

Walden Dissertations and Doctoral Studies

Financial markets and industries are vulnerable to ransomware attacks. Information technology (IT) security subject matter experts (SMEs) are concerned about ransomware cyberattacks on critical infrastructure that threaten their customers’ financial privacy and the institution’s reputation, causing severe financial losses and diminishing productivity. Grounded in the diffusion of innovation theory, the purpose of this qualitative pragmatic inquiry was to explore strategies IT security SMEs use to increase the implementation of existing solutions to thwart cybersecurity attacks in the financial services sector. The participants were six IT security SMEs in the financial industry in the Northeast United States who were responsible for …