University of Ha'il

BACKGROUND: Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. METHODS: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. FINDINGS: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change -0·2% [95% UI -1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by -15·4% [-16·8 to -14·3], while avoidable MSVI showed no change (0·5% [-0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7-18·0]), followed by glaucoma (3·6 million cases [2·8-4·4]), undercorrected refractive error (2·3 million cases [1·8-2·8]), age-related macular degeneration (1·8 million cases [1·3-2·4]), and diabetic retinopathy (0·86 million cases [0·59-1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2-101·0]) and cataract (78·8 million cases [67·2-91·4]). INTERPRETATION: Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached. FUNDING: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg.

<h3>Importance</h3> Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. <h3>Objective</h3> To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. <h3>Evidence Review</h3> We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. <h3>Findings</h3> In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). <h3>Conclusions and Relevance</h3> The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.

Recently, there has been observed an increasing awareness within business communities on the significance of going green and adopting various environment management techniques. As the corporate world is going global, the business is experiencing a shift from a conventional financial structure to a modern capacity-based economy which is ready to explore green economic facets of business. Today, Green Human Resource Management (GHRM) has become a key business strategy for the significant organizations where Human Resource Departments play an active part in going green at the office. The paper largely focuses upon the various Green Human Resource Practices pursued by the organizations all over the world and, explains the simplified meaning of GHRM. The study also adds to the extant literature by discussing future direction of some GHRM functions. Finally, the paper suggests some potentially prolific HR initiatives for Green organizations.

In this paper, a generalized formulation for intelligent energy management of a microgrid is proposed using artificial intelligence techniques jointly with linear-programming-based multiobjective optimization. The proposed multiobjective intelligent energy management aims to minimize the operation cost and the environmental impact of a microgrid, taking into account its preoperational variables as future availability of renewable energies and load demand (LD). An artificial neural network ensemble is developed to predict 24-h-ahead photovoltaic generation and 1-h-ahead wind power generation and LD. The proposed machine learning is characterized by enhanced learning model and generalization capability. The efficiency of the microgrid operation strongly depends on the battery scheduling process, which cannot be achieved through conventional optimization formulation. In this paper, a fuzzy logic expert system is used for battery scheduling. The proposed approach can handle uncertainties regarding to the fuzzy environment of the overall microgrid operation and the uncertainty related to the forecasted parameters. The results show considerable minimization on operation cost and emission level compared to literature microgrid energy management approaches based on opportunity charging and Heuristic Flowchart (HF) battery management.

Nanoparticles typically have dimensions of less than 100 nm. Scientists around the world have recently become interested in nanotechnology because of its potential applications in a wide range of fields, including catalysis, gas sensing, renewable energy, electronics, medicine, diagnostics, medication delivery, cosmetics, the construction industry, and the food industry. The sizes and forms of nanoparticles (NPs) are the primary determinants of their properties. Nanoparticles’ unique characteristics may be explored for use in electronics (transistors, LEDs, reusable catalysts), energy (oil recovery), medicine (imaging, tumor detection, drug administration), and more. For the aforementioned applications, the synthesis of nanoparticles with an appropriate size, structure, monodispersity, and morphology is essential. New procedures have been developed in nanotechnology that are safe for the environment and can be used to reliably create nanoparticles and nanomaterials. This research aims to illustrate top-down and bottom-up strategies for nanomaterial production, and numerous characterization methodologies, nanoparticle features, and sector-specific applications of nanotechnology.

The commercial fifth-generation (5G) wireless communications networks have already been deployed with the aim of providing high data rates. However, the rapid growth in the number of smart devices and the emergence of the Internet of Everything (IoE) applications, which require an ultra-reliable and low-latency communication, will result in a substantial burden on the 5G wireless networks. As such, the data rate that could be supplied by 5G networks will unlikely sustain the enormous ongoing data traffic explosion. This has motivated research into continuing to advance the existing wireless networks toward the future generation of cellular systems, known as sixth generation (6G). Therefore, it is essential to provide a prospective vision of the 6G and the key enabling technologies for realizing future networks. To this end, this paper presents a comprehensive review/survey of the future evolution of 6G networks. Specifically, the objective of the paper is to provide a comprehensive review/survey about the key enabling technologies for 6G networks, which include a discussion about the main operation principles of each technology, envisioned potential applications, current state-of-the-art research, and the related technical challenges. Overall, this paper provides useful information for industries and academic researchers and discusses the potentials for opening up new research directions.

Myeloid-derived suppressor cells (MDSCs) are innate immune cells that acquire the capacity to suppress adaptive immune responses during cancer. It remains elusive how MDSCs differ from their normal myeloid counterparts, which limits our ability to specifically detect and therapeutically target MDSCs during cancer. Here, we sought to determine the molecular features of breast cancer-associated MDSCs using the widely studied mouse model based on the mouse mammary tumor virus (MMTV) promoter-driven expression of the polyomavirus middle T oncoprotein (MMTV-PyMT). To identify MDSCs in an unbiased manner, we used single-cell RNA sequencing to compare MDSC-containing splenic myeloid cells from breast tumor-bearing mice with wild-type controls. Our computational analysis of 14,646 single-cell transcriptomes revealed that MDSCs emerge through an aberrant neutrophil maturation trajectory in the spleen that confers them an immunosuppressive cell state. We establish the MDSC-specific gene signature and identify CD84 as a surface marker for improved detection and enrichment of MDSCs in breast cancers.

The current prominence and future promises of the Internet of Things (IoT), Internet of Everything (IoE) and Internet of Nano Things (IoNT) are extensively reviewed and a summary survey report is presented. The analysis clearly distinguishes between IoT and IoE which are wrongly considered to be the same by many people. Upon examining the current advancement in the fields of IoT, IoE and IoNT, the paper presents scenarios for the possible future expansion of their applications.

Multiple drug-resistant bacteria are a severe and growing public health concern. Because relatively few antibiotics have been approved over recent years and because of the inability of existing antibiotics to combat bacterial infections fully, demand for unconventional biocides is intense. Metallic nanoparticles (NPs) offer a novel potential means of fighting bacteria. Although metallic NPs exert their effects through membrane protein damage, superoxide radicals and the generation of ions that interfere with the cell granules leading to the formation of condensed particles, their antimicrobial potential, and mechanisms of action are still debated. This article discusses the action of metallic NPs as antibacterial agents, their mechanism of action, and their effect on bacterial drug resistance. Based on encouraging data about the antibacterial effects of NP/antibiotic combinations, we propose that this concept be thoroughly researched to identify means of combating drug-resistant bacteria.

A commonly held view is that nanocarriers conjugated to polyethylene glycol (PEG) are non-immunogenic. However, many studies have reported that unexpected immune responses have occurred against PEG-conjugated nanocarriers. One unanticipated response is the rapid clearance of PEGylated nanocarriers upon repeat administration, called the accelerated blood clearance (ABC) phenomenon. ABC involves the production of antibodies toward nanocarrier components, including PEG, which reduces the safety and effectiveness of encapsulated therapeutic agents. Another immune response is the hypersensitivity or infusion reaction referred to as complement (C) activation-related pseudoallergy (CARPA). Such immunogenicity and adverse reactivities of PEGylated nanocarriers may be of potential concern for the clinical use of PEGylated therapeutics. Accordingly, screening of the immunogenicity and CARPA reactogenicity of nanocarrier-based therapeutics should be a prerequisite before they can proceed into clinical studies. This review presents PEGylated liposomes, immunogenicity of PEG, the ABC phenomenon, C activation and lipid-induced CARPA from a toxicological point of view, and also addresses the factors that influence these adverse interactions with the immune system.

Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. Findings: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries. Conclusions and Relevance: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

Background: Conventional nanoparticle synthesis methods involve harsh conditions, high costs, and environmental pollution. In this context, researchers are actively searching for sustainable, eco-friendly alternatives to conventional chemical synthesis methods. This has led to the development of green synthesis procedures among which the exploration of the plant-mediated synthesis of nanoparticles experienced a great development. Especially, because plant extracts can work as reducing and stabilizing agents. This opens up new possibilities for cost-effective, environmentally-friendly nanoparticle synthesis with enhanced size uniformity and stability. Moreover, bio-inspired nanoparticles derived from plants exhibit intriguing pharmacological properties, making them highly promising for use in medical applications due to their biocompatibility and nano-dimension. Objective: This study investigates the role of specific phytochemicals, such as phenolic compounds, terpenoids, and proteins, in plant-mediated nanoparticle synthesis together with their influence on particle size, stability, and properties. Additionally, we highlight the potential applications of these bio-derived nanoparticles, particularly with regard to drug delivery, disease management, agriculture, bioremediation, and application in other industries. Methodology: Extensive research on scientific databases identified green synthesis methods, specifically plant-mediated synthesis, with a focus on understanding the contributions of phytochemicals like phenolic compounds, terpenoids, and proteins. The database search covered the field's development over the past 15 years. Results: Insights gained from this exploration highlight plant-mediated green synthesis for cost-effective nanoparticle production with significant pharmacological properties. Utilizing renewable biological resources and controlling nanoparticle characteristics through biomolecule interactions offer promising avenues for future research and applications. Conclusion: This review delves into the scientific intricacies of plant-mediated synthesis of nanoparticles, highlighting the advantages of this approach over the traditional chemical synthesis methods. The study showcases the immense potential of green synthesis for medical and other applications, aiming to inspire further research in this exciting area and promote a more sustainable future.

Manual identification of brain tumors is an error-prone and tedious process for radiologists; therefore, it is crucial to adopt an automated system. The binary classification process, such as malignant or benign is relatively trivial; whereas, the multimodal brain tumors classification (T1, T2, T1CE, and Flair) is a challenging task for radiologists. Here, we present an automated multimodal classification method using deep learning for brain tumor type classification. The proposed method consists of five core steps. In the first step, the linear contrast stretching is employed using edge-based histogram equalization and discrete cosine transform (DCT). In the second step, deep learning feature extraction is performed. By utilizing transfer learning, two pre-trained convolutional neural network (CNN) models, namely VGG16 and VGG19, were used for feature extraction. In the third step, a correntropy-based joint learning approach was implemented along with the extreme learning machine (ELM) for the selection of best features. In the fourth step, the partial least square (PLS)-based robust covariant features were fused in one matrix. The combined matrix was fed to ELM for final classification. The proposed method was validated on the BraTS datasets and an accuracy of 97.8%, 96.9%, 92.5% for BraTs2015, BraTs2017, and BraTs2018, respectively, was achieved.

Use of dyes as well as colorants in industrial processes has extensively increased. Effluents from various industries such as textile, paint, food, etc. are reported to have a diverse range of colorants. The effluents from these industries are often released into natural water bodies, causing serious water and environmental pollution, to which humans and other species are constantly exposed. Continued changes in climate have also affected water availability for people around the world. Thus, advanced treatments and removal of harmful contaminants from municipal and industrial wastewater are becoming increasingly important. Removal of dyes and colorants from wastewater can be done in a variety of ways, including physical, chemical, and biological treatments. These technologies, however, differ in terms of efficiency, cost, and environmental effect. There are many technological and economic challenges for the wastewater treatment methods currently available. The search for the most suitable strategy for successful degradation or removal of dyes from effluents is an urgent requirement. Previously published research suggests that the use of enzymes for dye removal is a more economic and effective strategy as compared to traditional techniques. Nanoparticles, with their exceptional physicochemical features, have the potential to tackle the problem of wastewater purification in a less energy-intensive way. However, extensive standardization would be a necessity for the use of different nanoparticles. Therefore, intense research in the use of enzymes and nanoparticle-based technologies may provide much needed technological solution for the remediation of a diverse range of dyes from wastewater.

The liposome, a closed phospholipid bilayered vesicular system, has received considerable attention as a pharmaceutical carrier of great potential over the past 30 years. The ability of liposomes to encapsulate both hydrophilic and hydrophobic drugs, coupled with their biocompatibility and biodegradability, make liposomes attractive vehicles in the field of drug delivery. In addition, great technical advances such as remote drug loading, triggered release liposomes, ligand-targeted liposomes, liposomes containing combinations of drugs, and so on, have led to the widespread use of liposomes in diverse areas as delivery vehicles for anti-cancer, bio-active molecules, diagnostics, and therapeutic agents. In this review, we summarize design optimization of liposomal systems and invaluable applications of liposomes as effective delivery systems.

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

<p style="text-align: justify;"><strong>Objective:</strong> The study is to evaluate Yemeni medical and pharmacy students&rsquo; knowledge and attitude regarding generic medicines. <strong>Method:</strong> A cross-sectional survey was used to collect data from final-year medical and pharmacy students at six public and private universities in Yemen. The questionnaire was distributed among the students through their course coordinators. Students were clearly informed about the objective of the study and their written consents were taken before the survey. The responses were entered in SPSS, and descriptive and inferential analyses were carried out. <strong>Results:</strong> The response rate was 60.1%. Overall the half of participants&rsquo; perception regarding generic medicine was positive. Perceptions of pharmacy students&rsquo; regarding generic medicines were better than those of the medical students. <strong>Conclusion:</strong> The present study concluded that both studied groups had insufficient knowledge about quality, safety and bioequivalence of generic medicines. The medical students showed poorer knowledge than pharmacy students which need to give more attention from educators regarding the use of generic medicines. <p style="text-align: justify;"><strong>Key words:</strong> Generic drugs, Medical students, Perception, Pharmacy students, Yemen.

The unique biological and physicochemical characteristics of biogenic (green-synthesized) nanomaterials (NMs) have attracted significant interest in different fields, with applications in the agrochemical, food, medication delivery, cosmetics, cellular imaging, and biomedical industries. To synthesize biogenic nanomaterials, green synthesis techniques use microorganisms, plant extracts, or proteins as bio-capping and bio-reducing agents and their role as bio-nanofactories for material synthesis at the nanoscale size. Green chemistry is environmentally benign, biocompatible, nontoxic, and economically effective. By taking into account the findings from recent investigations, we shed light on the most recent developments in the green synthesis of nanomaterials using different types of microbes and plants. Additionally, we cover different applications of green-synthesized nanomaterials in the food and textile industries, water treatment, and biomedical applications. Furthermore, we discuss the future perspectives of the green synthesis of nanomaterials to advance their production and applications.

Nile River is the valued natural and exclusive source of fresh water in Egypt, where the drinking water supply is limited to the river. The water quality of 24 sites between Aswan and Cairo along the Nile was investigated. To evaluate the suitability of water for aquatic life and drinking purposes, the indices of water quality (WQI), heavy metal pollution (HPI) and contamination (Cd) were computed. The water quality variations were mainly related to inorganic nutrients and heavy metals, where, the sites affected by intensive load of urban, agricultural and industrial wastewater showed serious deterioration of water quality compared with other sites. The anthropogenic impact sites showed high HPI and Cd values and associated with high risks, where, most of the studied metals often exceeded the drinking water and aquatic life limits. The aquatic WQI indicated that the Nile water quality deteriorated and extended from poor to marginal, while drinking WQI varied from marginal to good. Accordingly, the river becoming unfit for aquatic life and the situation is getting worse by decreases in the water budget from the Nile in Egypt by building of the Grand Ethiopian Renaissance Dam, where the dilution strength of the Nile system will reduce.

Background: Lack of adherence to anti-diabetic medications use is linked with suboptimal glycemic control which in turn leads to increase rate of diabetic complications. The adherence to anti-diabetic medications among adult diabetic patients in Sana'a city has not been yet evaluated.&#x0D; Objective: This study, therefore, assessed the extent to which diabetic patients are adherent to their antidiabetic medications and explored the factors underlying such adherence attitude in Sana’a City, Yemen.&#x0D; Methods: A cross-sectional method was conducted among a sample of 365 diabetic patients attending public and private hospitals from March to April 2017 in Sana'a City-Yemen. Random patients were selected and data regarding their treatment adherence were obtained using a questionnaire. Adherence to diabetes medications was measured using medication adherence index followed by structured interviews. Descriptive analysis was used to compare between different groups of diabetic patients. Bivariate analyses were conducted to evaluate the associations between clinical variables.&#x0D; Results: The cross-sectional study included 365 patients (263 males; 102 females). A high level of medication adherence rate to anti-diabetic drugs in the present study was (70%). The adherence rate was not similar in both genders where males were more adherent than females. The most common reason for non-adherence was forgetfulness (n= 67; 61%). While the lowest factor for non-adherence was associated with ineffective (n= 7; 6%). Adherence was strongly associated with diabetes duration, monthly income, blood sugar monitoring, communication with physician, and patient’s knowledge regarding importance of medication use (p &lt;0.05).&#x0D; Conclusions: The degree of adherence in patients with diabetes in Sana’a to anti-diabetic medication was shown to be mostly suboptimal. The medication adherence levels are still crucial strategy for optimal treatment against diabetes. However, additional studies on strategies to improve adherence rate and health care should be carried out in the future.