Muhammad Daniyal

A systematic and straightforward triage system is significant for the proper and timely care of patients within the emergency department (ED). The Canadian Triage and Acuity Scale (CTAS) is a well-recognized and validated triage system that gives priority to patient care with respect to severity of illness. This study aimed to evaluate the impact of a CTAS educational intervention on emergency nurses’ triage knowledge, skills, and attitudes in a tertiary hospital in Saudi Arabia, while identifying demographic predictors of workforce competency using explainable machine learning approaches. Among 110 eligible nurses, 85 emergency nurses participated, who were selected by convenience sampling. The study used a one-group pre-posttest design methodology, and a triage-training workshop was presented on CTAS by face-to-face education through PowerPoint slides and a video projector. At the end of each session, questions and answers on practical examples were asked. We analyzed the data using paired t-tests and multiple machine learning (ML) models with SHAP interpretation to identify key predictive demographic factors. We observed significant improvements in knowledge (12.6 ± 3.2 vs. 7.2 ± 4.1, p < 0.001), skills (85.9 ± 9.5 vs. 61.9 ± 13.2, p < 0.001), and attitude (65.8 ± 7.2 vs. 46.5 ± 8.9, p < 0.001). The neural network slightly achieved better performance in predicting Triage Knowledge (TAK) and Triage Skills (TAS), while the random forest model showed slightly closer fit for Triage Attitude (TAA). These models yielded the lowest RMSE values of 3.03 for TAK, 14.32 for TAS, and 8.44 for TAA, respectively. Within the trained neural network, higher years of experience were associated with increased predicted skill and attitude scores (SHAP values + 4.53 and + 4.36, respectively), while showing a slight negative association with predicted knowledge (–0.29). Similarly, a higher educational level had a positive association with predicted skill scores (SHAP + 12.02). The study showed that the triage education program improved the emergency nurses’ triage CTAS knowledge, attitude, and skills in the short term, with a potential role in strengthening emergency care preparedness. We suggest having more and regular standardized triage training programs should be integrated into emergency nursing professional development and national healthcare quality strategies.

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Medical institutions have a structured program that provides residents with in-depth research training. The main aim of this study is to explore residents&

Benralizumab, a monoclonal antibody, targets eosinophils by blocking an interleukin-5 receptor, improving severe allergic asthma. Severe eosinophilic asthma affects about 10% of asthma patients and often requires high-dose corticosteroids, which are linked to adrenal insufficiency and poor outcomes. This study will perform a detailed review and meta-analysis to evaluate the effectiveness and safety of benralizumab in eosinophilic asthma. The analysis included relevant RCTs identified through systematic searches of PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from April 2013 to January 2024. The study included variables such as exacerbation, Asthma Control Questionnaire (ACQ), forced expiratory volume (FEV₁), and adverse events. A total of 5502 patients with eosinophilic asthma were enrolled across 15 randomized-controlled trials; 3061 received benralizumab and 2441 received placebo. A meta-analysis showed that benralizumab significantly improved FEV₁ compared with control, with a pooled mean difference of 0.107 L (95% CI 0.059, 0.155; p < 0.001). Using a random-effects model with Hartung-Knapp adjustment, the pooled mean difference was - 0.174 (95% CI - 0.326, - 0.022; p = 0.030), indicating a statistically significant improvement in ACQ while the pooled odds ratio (OR) for adverse effects was 0.93 (95% CI 0.71, 1.23; p = 0.583) showing no statistically significant difference between benralizumab and control in the risk of adverse effects. The meta-analysis indicated that benralizumab provides significant improvement in lung function (FEV₁) and asthma control (ACQ) compared to placebo in severe eosinophilic asthma. Clinically, the average FEV₁ improvement of approximately 0.11 L represents a small but valuable gain for patients with significant baseline obstruction, though it falls below the threshold for a minimal clinically important difference (MCID) in ACQ scores. However, substantial heterogeneity was observed across studies, demonstrating that these pooled estimates represent average effects and that individual patient responses may vary considerably. PROSPERO CRD42024548225.

Domestic violence (DV) is a serious concern with wide-ranging psychosocial consequences, including impacts on mental health, physical well-being, and social relationships. While domestic abuse and DV are related and often used interchangeably, intimate partner violence (IPV) refers more specifically to abuse occurring between current or former intimate partners. The aim of the study is to explore how DV affects both women and their children and how women cope with abuse within the cultural and social setting. A qualitative study was performed using in-depth, semi-structured interviews with eight Saudi women who had experienced DV. Purposive sampling was used to select participants and interviews were conducted in Arabic, audio-recorded with consent, and transcribed verbatim. Data were analyzed thematically following Braun and Clarke's six-phase framework. Coding and theme development were performed and discrepancies were resolved through discussion to ensure consistency and credibility. The results identified three major themes: the impact of DV on women, the impact on their children, and the coping strategies women used. DV had emotional, physical, and social reported effects on both women and their children. Participants moved from silent endurance to active resistance. Most of them lacked emotional support from family and friends due to stigma and the controlling behavior of their partners. Besides this, the women showed strength and found ways to protect their children from harm. The study concluded that participants reported deep effects of DV on their sense of self-worth, particularly inadequate social support. These findings reflect the lived experiences of the participants and should be interpreted within the scope of a qualitative design. It further emphasizes the need for culturally appropriate services and public health interventions that address the wide-reaching effects of DV.

Cardiometabolic diseases (CMDs) are a leading cause of global mortality, with an increasing prevalence in the Arab world, particularly among older patients

Air pollution is a serious environmental factor associated with higher rates of illness and death from respiratory, cardiovascular, and other non-communica