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This research aims to examine whether corporate Twitter messages and tone have an effect on corporate stock return (RET) for the Saudi Stock Exchange "Tadawul". The study also investigates whether the association differs across large- and small-sized firms. We used a sample of 11,099 firm-daily observations for non-financial firms that were traded on the Saudi Stock Exchange "Tadawul" across the period 1 April 2020 to 31 December 2020. Using panel ordinary least square (OLS) and two-stage least square (2SLS), we found that corporate Twitter (currently renamed 'X') messages is positively and significantly associated with stock return (RET). The findings also suggest that the message tone increases the stock returns. Furthermore, our results show different effects of Twitter messages and tone on stock return across small- and large-sized firms. In addition, our findings show that Twitter tone is positively associated with RET when the firm is large in size. However, when the firm is small, Twitter messages has a stronger effect on RET. Our findings provide policy implications for regulators and investors. Regulators might monitor the information in accurate ways. Also, investors might start to show interest in Twitter channels to follow the firm's news. [ABSTRACT FROM AUTHOR]

Background: Limited data evaluated the outcomes of extracorporeal membrane oxygenation (ECMO) in patients with prosthetic valves. This study aimed to compare the outcomes of ECMO support for postcardiotomy cardiogenic shock in patients with mechanical versus bioprosthetic valves. Methods: This retrospective study included patients with ECMO support for postcardiotomy cardiogenic shock after valve replacement. Patients were grouped into bioprosthetic (n = 49) and mechanical valve (n = 22) groups. Results: There were no differences in ECMO duration, inotropic support, intra-aortic balloon pump (IABP), stroke, duration of ICU, and hospital stay between groups. Postoperative thrombosis occurred in 2 patients with bioprosthetic valves (5.41%) and 2 with mechanical valves (14.29%), p =.30. All patients with thrombosis had central ECMO cannulation, concomitant IABP, and inotropic support during ECMO. All thrombi were related to the mitral valve. Three patients with thrombi had hospital mortality. Survival at 6, 12, and 36 months for bioprosthetic valve patients was 30.88%, 28.55%, and 25.34% and for mechanical valves was 36.36% for all time intervals (Log-rank p =.93). One patient had bioprosthetic aortic valve endocarditis after 1 year. Three patients with bioprosthetic valves had structural valve degeneration after 1, 2, and 5 years. Conclusions: Outcomes of ECMO in patients with prosthetic valves are comparable between bioprosthetic and mechanical valves. Thrombosis might occur in both valve types and was associated with high mortality. ECMO could affect the long-term durability of the bioprosthetic valves. [ABSTRACT FROM AUTHOR]

The main objective of this study is to examine the influences of two novel characteristics of the foremost executive firm managers, i.e., the environmental and cultural values of CEOs, on corporate climate change performance. Employing a sample of firms listed in the FTSE250 covering the 2008–2018 period, we found that firms run by CEOs with environmentally friendly backgrounds and high 'green' cultural values are more inclined to aim for better (lower) greenhouse gas emissions. The findings hold after accounting for other relevant governance characteristics, accounting and market indicators, highly carbon-intensive industries, and potential endogeneity issues. Intriguingly, we also found that the effect of CEO environmental values is more pronounced than that of CEO cultural values. Our findings have implications for corporate management and regulators of climate change concerns and corporate environmental performance. That is, firm management is advised to assign CEOs with environmentally friendly backgrounds and high 'green' cultural values to lower greenhouse gas emissions. [ABSTRACT FROM AUTHOR]

To ensure firm's survival through impermanent market turbulences, corporations need to secure investors' kindness and empathy to adjust their stock prices. Being environmentally responsible seems to be an appealing quality for that purpose. Our research aims to explore the association between firm greenhouse gas (GHG) emission and its downside tail risk, using panel data comprising the FTSE350 firms during the 2008-2018 period. We found that firms that emit more GHG are likely to be harshly penalized by the shareholders through the higher likelihood of extreme negative stock returns, i.e. tail risk. Intriguingly, the association tends to be evidenced after the Paris Agreement 2015 and for firms operating in industries with high emission intensity. The research provides implications for firms to focus on enhancing their environmental performances for higher market trust, rewards, and generosity, especially during their financial downturns or negative market events. [ABSTRACT FROM AUTHOR]

Background: The optimal venoarterial extracorporeal membrane oxygenation (VA ECMO) cannulation strategy in patients with postcardiotomy cardiogenic shock is still debatable. Studies evaluating the effect of cannulation strategy on long-term survival are scarce. Objectives: We investigated the impact of central versus peripheral cannulation strategy for ECMO insertion on hospital outcomes and survival in postcardiotomy cardiogenic shock patients. Methods: This retrospective study involved 101 patients who had either central or peripheral ECMO due to postcardiotomy shock between June 2009 and December 2020. Study endpoints were limb ischemia, bleeding, blood transfusion, wound infection, and overall survival. Results: Eighty-four patients received central (c) ECMO, and 17 patients had peripheral (p) ECMO. In the group of pECMO, limb ischemia was significantly higher (5 [29.41%] vs 6 [7.14%]; p =.01). Other endpoints were similar in both groups. Thirty-day mortality was nonsignificantly different between both cohorts (cECMO 34 [41.67%] vs pECMO 10 [58.82%]; p =.29). However, overall survival was better with cECMO (Log-rank p =.02). Patients' age [HR: 1.04 (95% CI: 1.02–1.06); p =.001], pECMO [HR: 1.98 (95% CI: 1.11–3.55), p =.002] and presence of infective endocarditis [HR: 3.54 (95% CI: 1.52–8.24), p =.03] were significant predictors of overall mortality. Conclusions: Peripheral ECMO was associated with an increased risk of limb ischemia; however, bleeding, blood transfusion, infection, and 30-day mortality were comparable to central ECMO. Central cannulation was associated with a better 1-year survival rate. Therefore, central cannulation might be the preferred strategy for patients with postcardiotomy cardiogenic shock. [ABSTRACT FROM AUTHOR]

Embracing corporate sustainability has emerged as a crucial strategy for companies to bolster their competitive edge and reputation. This research delves into the connection between environmental, social, and governance practices (ESG) and the cost of debt, as well as the moderating role of financial distress within this connection. By analyzing data from Saudi-listed firms between 2013 and 2021, we discovered that ESG practices have a notable negative impact on borrowing costs. This implies that organizations with increased transparency in their ESG disclosure gain access to external financial resources under more favorable terms. Additionally, we observed that the effect of ESG on the cost of debt is significantly and negatively moderated by the financial distress encountered by a firm. To bolster the credibility of these findings, dynamic generalized method of moments (GMM) models were utilized to address any potential endogeneity concerns, thereby enhancing the strength and resilience of the outcomes. The findings of this paper hold substantial value for investors, lenders, corporate management, and policymakers when considering the implementation and significance of a company's ESG practices. [ABSTRACT FROM AUTHOR]

In recent years, many Real Estate Investment Trusts (REIT) have issued to initial public offerings (IPO) in the Saudi Stock Exchange "Tadawul." Occasionally, trust fund issuers such as REITs may face challenges in selling their shares to the public. One of the challenges related to underpricing is trading the stock on the first day of the market. This study investigates the relationship between REIT characteristics and share underpricing for a sample of REITs that are listed on the Saudi Stock Exchange "Tadawul." The purpose of the study is to focus on one of the challenges that is related to the IPOs of REITs. Using a sample of 17 IPOs of REITs listed on the Saudi Arabian Stock Exchange "Tadawul" for the period between 2016 and 2020, we show significant negative associations between the number of IPO underwriters, number of shares subscribed, and the firms' dividend payouts and REITs' underpricing. The result also shows a significant positive association between the number of subscription days and REITs' underpricing. The research should provide significant implications for regulators and market participants in the light of the public offering and the REIT sector. [ABSTRACT FROM AUTHOR]

We examine the role of female directors on firm cost of equity in the context of US-listed firms, and further explore the mediating impact of debt financing policy on such association. Using a dataset of 4619 non-financial firm-year observations covering the period of 2008–2019, we find that firms with female directors on boards are likely to exhibit a lower cost of equity, through relying on a less risky financing decision. The indirect effect is found to take up around 45% of the female-cost of equity association. In addition, our analysis also indicates that the lower debt financing levels are realised only if female representation reaches a critical mass of around 28%. Our findings provide important implications for firms in balancing the gender ratio within their boards to level out their risk-taking through their financing decisions. [ABSTRACT FROM AUTHOR]

This study examines whether firms can influence their cost of equity (COE) by broadly disseminating their carbon information over Twitter. We study firms' dissemination decisions of carbon information by developing a comprehensive measure of carbon information that a firm makes on Twitter, referred to as iCarbon. Using a sample of 1,737 firm‐year observations for 584 nonfinancial firms with a Twitter account and listed on the U.S. NASDAQ stock exchange over the period 2009–2015, we find that iCarbon is significantly and negatively associated with COE. Our results are consistent after determining the effect of Bloomberg's environmental and environmental, social, and governance disclosure. The findings also hold when using alternative measures of COE and iCarbon. [ABSTRACT FROM AUTHOR]

Background. The Middle East respiratory syndrome (MERS) coronavirus causes isolated cases and outbreaks of severe respiratory disease. Essential features of the natural history of disease are poorly understood. Methods. We studied 37 adult patients infected with MERS coronavirus for viral load in the lower and upper respiratory tracts (LRT and URT, respectively), blood, stool, and urine. Antibodies and serum neutralizing activities were determined over the course of disease. Results. One hundred ninety-nine LRT samples collected during the 3 weeks following diagnosis yielded virus RNA in 93% of tests. Average (maximum) viral loads were 5 × 106 (6 × 1010) copies/mL. Viral loads ( positive detection frequencies) in 84 URT samples were 1.9 × 104 copies/mL (47.6%). Thirty-three percent of all 108 serum samples tested yielded viral RNA. Only 14.6% of stool and 2.4% of urine samples yielded viral RNA. All seroconversions occurred during the first 2 weeks after diagnosis, which corresponds to the second and third week after symptom onset. Immunoglobulin M detection provided no advantage in sensitivity over immunoglobulin G (IgG) detection. All surviving patients, but only slightly more than half of all fatal cases, produced IgG and neutralizing antibodies. The levels of IgG and neutralizing antibodies were weakly and inversely correlated with LRT viral loads. Presence of antibodies did not lead to the elimination of virus from LRT. Conclusions. The timing and intensity of respiratory viral shedding in patients with MERS closely matches that of those with severe acute respiratory syndrome. Blood viral RNA does not seem to be infectious. Extrapulmonary loci of virus replication seem possible. Neutralizing antibodies do not suffice to clear the infection. [ABSTRACT FROM AUTHOR]

Background: Recommendations regarding vancomycin dosing and monitoring in critically ill patients on continuous renal replacement therapy (CRRT) are limited. This is a retrospective study to assess the adequacy of current vancomycin dosing and monitoring practice for patients on CRRT in a tertiary hospital in Riyadh, Saudi Arabia. Methods: A retrospective chart review of adult patients admitted between 1 April 2011 and 30 March 2013 to critical care and received intravenous vancomycin therapy whilst on CRRT was performed. Results: A total of 68 patients received intravenous vancomycin therapy whilst on CRRT, of which 32 met the inclusion criteria. Fifty-one percent were males and median (range) age was 62.5 (19 - 90) years. Median APACHE II score was 33.5 (22-43) and median Charlson Comorbidity Score was 4 (0-8). The mean (± standard deviation) dose of vancomycin was 879.9 mg (± 281.2 mg) for an average duration of 5.9 days (± 3.7 days). All patients received continuous veno-venous haemofiltration (CVVH). A total of 55 vancomycin level readings were available from the study population, ranging from 6.6 to 41.3, with wide variations within the same sampling time frames. Vancomycin levels of > 15 mg/L or were achieved at least once in 24 patients (75.0%), but only 11 patients (34.3%) had 2 or more serum vancomycin level readings of 15 mg/L or more. Conclusion: Therapeutic vancomycin levels are difficult to maintain in critically ill patients who are receiving IV vancomycin therapy whilst on CRRT. Aggressive dosing schedules and frequent monitoring are required to ensure adequate vancomycin therapy in this setting. [ABSTRACT FROM AUTHOR]

Background: A testicular torsion is an acute surgical emergency which needs a prompt work up. Neonatal testicular torsion is an uncommon event. Aim of the work: This article aim to describe a case report of a neonate presented with testicular torsion and contralateral hydrocele. Results: Clinical and radiological management were discussed. Conclusion: The case demonstrated that the possibility of uncommon presentation of acute scrotum such as testicular torsion with contralateral hydrocele can occur. [ABSTRACT FROM AUTHOR]

Summary Background Middle East respiratory syndrome coronavirus (MERS-CoV) infection is associated with high mortality and has no approved antiviral therapy. We aimed to compare ribavirin and interferon alfa-2a treatment for patients with severe MERS-CoV infection with a supportive therapy only. Methods In this retrospective cohort study, we included adults (aged ≥16 years) with laboratory-confirmed MERS-CoV infection and pneumonia needing ventilation support, diagnosed between Oct 23, 2012, and May 1, 2014, at the Prince Sultan Military Medical City (Riyadh, Saudi Arabia). All patients received appropriate supportive care and regular clinical and laboratory monitoring, but patients diagnosed after Sept 16, 2013, were also given oral ribavirin (dose based on calculated creatinine clearance, for 8–10 days) and subcutaneous pegylated interferon alfa-2a (180 μg per week for 2 weeks). The primary endpoint was 14-day and 28-day survival from the date of MERS-CoV infection diagnosis. We used χ 2 and Fischer's exact test to analyse categorical variables and the t test to analyse continuous variables. Findings We analysed 20 patients who received ribavirin and interferon (treatment group; initiated a median of 3 days [range 0–8] after diagnosis) and 24 who did not (comparator group). Baseline clinical and laboratory characteristics were similar between groups, apart from baseline absolute neutrophil count, which was significantly lower in the comparator group (5·88 × 10 9 /L [SD 3·95] vs 9·88 × 10 9 /L [6·63]; p=0·023). 14 (70%) of 20 patients in the treatment group had survived after 14 days, compared with seven (29%) of 24 in the comparator group (p=0·004). After 28 days, six (30%) of 20 and four (17%) of 24, respectively, had survived (p=0·54). Adverse effects were similar between groups, apart from reduction in haemoglobin, which was significantly greater in the treatment group than in the comparator group (4·32 g/L [SD 2·47] vs 2·14 g/L [1·90]; p=0·002). Interpretation In patients with severe MERS-CoV infection, ribavirin and interferon alfa-2a therapy is associated with significantly improved survival at 14 days, but not at 28 days. Further assessment in appropriately designed randomised trials is recommended. Funding None. [ABSTRACT FROM AUTHOR]