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The significance of Pantoea agglomerans bacteria in diseases linked to healthcare is underappreciated due to a shortage of information on their spread. This is the first study in Saudi Arabia to examine the possible contribution of medical students' cell phones (CPs) to the transmission of P. agglomerans to hospitalized patients and to evaluate their antibiotic susceptibility profiles. In total, 250 CPs were swabbed. P. agglomerans was isolated and identified using standard techniques. The suspected colonies were confirmed by the Vitek 2 compact system. The isolates' antimicrobial susceptibility profiles were assessed using Epsilon assays, and the results were interpreted according to Clinical and Laboratory Standards Institute guidelines. The frequency of P. agglomerans contamination of CPs was found to be relatively high (20.40%; 51 isolates/250 samples). Many isolates showed varying degrees of reduced sensitivity to ampicillin, aztreonam, cefazolin, cefotaxime, cefuroxime, and ertapenem antibiotics. To implement optimal infection prevention and control policies regarding the possibility of antibiotic-resistant P. agglomerans transmission through medical students' contact points with hospitalized patients during their frequent activities in healthcare settings, health policymakers may find value in utilizing this study's results. [ABSTRACT FROM AUTHOR]

TABLE OF CONTENTS I. INTRODUCTION 290 II. OVERVIEW OF ZAKAT 292 III. KEEPING ADMINISTRATIVE AND COMPLIANCE COSTS LOW 295 A. Zakat is Primarily a Wealth Tax 296 B. Zakat is [...], Recently there has been increased interest in wealth taxes, which tax the value of personal assets. Although wealth taxes have advantages relative to income taxes, wealth taxes also can create problematic administrative and compliance issues. This article examines a nearly 1400-year-old wealth tax: zakat, which is a key component of an Islamic socio-economic system and a main form of worship. The article examines many of the primary traditional zakdt calculation, collection, and distribution practices. It argues that these practices were consistent with largely minimizing the administrative and compliance costs of the zakdt system in the agrarian and mercantile economy of seventh century CE Arabia, sometimes even at the expense of equity. Because of dramatic economic, financial, and societal changes over the last 1400 years, however, many of the administrative and compliance issues regarding zakdt have changed greatly. As a result, the necessary tradeoffs between equity and administrative and compliance costs have been altered as well. This arguably affects how zakdt should be calculated, collected, and distributed today.

Infection with tuberculosis (TB) has been a leading cause of death worldwide. The accurate detection of Mycobacterium tuberculosis (M. tuberculosis) is integral for the prevention and control programs for TB disease. Host-encoded microRNAs (miRNAs) are known to be triggered upon TB infection, raising possibilities of their utility as biomarkers. Here, we investigated the value of miRNAs in pointing active TB (ATB) and predicting the progression from latent TB (LTB) to ATB infection. We then constructed signaling pathways predicted to be involved in TB disease pathobiology. Our analyses identified miR-21-5p, miR-29a-3p and miR-361-5p as being down regulated in ATB and upregulated in LTB compared to healthy subjects with an area under the curve (AUC) of > 0.9, indicating potentially promising biomarker. Pathways related to estrogen signaling, TNF and apoptosis signaling were enriched targets for those miRNAs. This study provides evidence for the significance of miRNA as diagnostic and prognostic markers for ATB and LTB infections in humans. These results could be extrapolated and validated using future large-scale studies. [ABSTRACT FROM AUTHOR]

ABSTRACT Advertisements and product labels for a wide range of consumer and investment products have highlighted product characteristics that some people erroneously believe make them superior to competitor goods and [...]

Purpose: A number of disinfectants and sanitisers are used in dentistry, and there are numerous commercial solutions available. Nonetheless, because each cleaning solution has its own set of indications and limits, there is no one-size-fits-all approach for processing all types of dental equipment. Functional water, such as electrolysed hypochlorite microbubbled water, efficiently eliminates and sterilises biofilms. The objective of the study was to evaluate whether ozonated water could be used to sterilise and disinfect dental-unit water pipelines (DUWP) that had been contaminated with micro-organisms, including Gram-positive and Gram-negative bacilli and cocci. Materials and Methods: Three different groups were formed: group A - ozonated water (Cantoosh); group B - 1% povidine iodine; and group C: conventional distilled water. Group A was the test group, group B the control group, and group C was the positive control group. The water sterilising system was replaced with the appropriate sterilising agent as per the allocated group classification, with 2 min of purging, so that the complete DUWP was filled with the water sterilising system. Samples were collected and analysed, along with a 2-min purge after 24 h, 7 days and 21 days, at the 3 outlet (OL) points: the 3-way syringe at the dental tray(OL1), the cup filler (OL2), and the 3-way syringe of the assistant zone (OL3). Repeated measures ANOVA was used to test for statistical significance between colony-forming units of control and experimental groups (p < 0.05). Results: The cup filler yielded higher counts than did the 3-way syringe at the dental tray (OL1) (6.40 and 8.05 on the log scale, respectively). A statistically significant difference in the CFUs was also observed between samples taken after 24 h vs 21 days between groups A, B and C. Conclusion: The findings showed that exposing DUWP tube systems to ozonated water for an extended length of time drastically lowered the number of microorganisms adhering to their surfaces. [ABSTRACT FROM AUTHOR]

Although self-service facilities (SSFs) have been used on a large scale worldwide, they can be easily contaminated by microorganisms from the hands of their sequential users. This research aimed to study the prevalence and antimicrobial susceptibility/resistance of bacteria contaminating SSFs in Sakaka, Aljouf, Saudi Arabia. We randomly swabbed the surfaces of 200 SSFs, then used the suitable culture media, standard microbiological methods, and the MicroScan WalkAway Microbiology System, including the identification/antimicrobial susceptibility testing-combo panels. A high SSFs' bacterial contamination load was detected (78.00%). Ninety percent of the samples collected in the afternoon, during the maximum workload of the SSFs, yielded bacterial growth (p < 0.001 *). Most of the contaminated SSFs were supermarket payment machines, self-pumping equipment at gas stations (p = 0.004 *), online banking service machines (p = 0.026 *), and barcode scanners in supermarkets. In the antiseptic-deficient areas, 55.1% of the contaminated SSFs were detected (p = 0.008 *). Fifty percent of the contaminated SSFs were not decontaminated. The most common bacterial contaminants were Escherichia coli (70 isolates), Klebsiella pneumoniae (66 isolates), Staphylococcus epidermidis (34 isolates), methicillin-resistant Staphylococcus aureus (18 isolates), and methicillin-sensitive Staphylococcus aureus (14 isolates), representing 31.53%, 29.73%, 15.32%, 8.11%, and 6.31% of the isolates, respectively. Variable degrees of reduced sensitivity to some antimicrobials were detected among the bacterial isolates. The SSFs represent potential risks for the exchange of antimicrobial-resistant bacteria between the out-hospital environment and the hospitals through the hands of the public. As technology and science advance, there is an urgent need to deploy creative and automated techniques for decontaminating SSFs and make use of recent advancements in materials science for producing antibacterial surfaces. [ABSTRACT FROM AUTHOR]

Short-term health insurance policies—made available with longer durations during the Trump Administration—offer substantially fewer consumer protections than do Affordable Care Act ("ACA")–compliant policies. Federal regulations require short-term policies' sellers to disclose possible ACA noncompliance to prospective buyers. This controlled experiment finds, however, that the federally required disclosure does not substantially improve consumer understanding of these policies' coverage limitations. The experiment also finds that an enhanced disclosure greatly improves this understanding. Importantly, consumers' preferences for ACA-compliant policies also increased with their comprehension of the coverage differences. Thus, the study demonstrates not only that easily implemented changes in the federally required disclosure would improve consumer understanding of the coverage differences but also that the improved understanding matters to consumers. However, even the enhanced disclosure left many respondents mistaken about some key limitations of short-term policies, suggesting that policymakers should consider other strategies to protect buyers of short-term health insurance. [ABSTRACT FROM AUTHOR]

Ethanol-producing dysbiotic gut microbiota could accelerate the progress of non-alcoholic fatty liver disease (NAFLD). Metformin demonstrated some benefits in NAFLD. In the present study, we tested the ability of metformin to modify ethanol-producing gut bacterial strains and, consequently, retard the progress of NAFLD. This 12-week study included forty mice divided into four groups (n = 10); normal diet, Western diet, Western diet with intraperitoneal metformin, and Western diet with oral metformin. Oral metformin has a slight advantage over intraperitoneal metformin in ameliorating the Western diet–induced changes in liver function tests and serum levels of different cytokines (IL-1β, IL-6, IL-17, and TNF-α). Changes in liver histology, fibrosis, lipid content, Ki67, and TNF-α were all corrected as well. Faecal ethanol contents were increased by the Western diet but did not improve after treatment with metformin although the numbers of ethanol-producing Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) were decreased by oral metformin. Metformin did not affect bacterial ethanol production. It does not seem that modification of ethanol-producing K. pneumoniae and E. coli bacterial strains by metformin could have a significant impact on the therapeutic potentials of metformin in this experimental model of NAFLD. [ABSTRACT FROM AUTHOR]

Reboxetine (REB) and sertraline (SER) are antidepressants. The antifungal potential of these drugs against planktonic Candida has been recently reported with limited data about their effects on Candidal biofilms. Biofilms are self-derived extracellular matrixes produced by the microbial population that is attached to biotic surfaces, such as vaginal and oral mucosa, or abiotic surfaces, such as biomedical devices, resulting in persistent fungal infections. The commonly prescribed antifungals, azoles, are usually less effective when biofilms are formed, and most of the prescribed antifungals are only fungistatic. Therefore, the current study investigates the antifungal potentials of REB and SER, alone and in combination with fluconazole (FLC) and itraconazole (ITR) against Candidal biofilms. Using proper controls, Candida species (Candida albicans, C. albicans; Candida krusei, C. krusei; and Candida glabrata, C. glabrata) were used to form biofilms in 96-well microplates. Serial dilutions corresponding to concentrations ranging from 2 to 4096 µg/mL of the target drugs (REB, SER, FLC, ITR) were prepared and added to the plates. Impairment of the biofilm biomass and biofilm metabolic viability was detected using the crystal violet (CV) assay and 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, respectively. In the checkerboard assay, the sessile fractional inhibitory concentration index (SFICI) was calculated to evaluate the effects of drug combinations. SER was more effective in reducing the biomass than REB for C. albicans and C. glabrata, but both were equal for C. krusei. For the reduction in metabolic activity in C. albicans and C. glabrata, SER had a slight advantage over REB. In C. krusei, REB was slightly more potent. Overall, FLC and ITR were almost equal and produced more significant reductions in metabolic activity when compared to SER and REB, except for C. glabrata, where SER was almost equal to FLC. Synergism was detected between REB + FLC and REB + ITR against biofilm cells of C. albicans. Synergism was detected between REB + ITR against biofilm cells of C. krusei. Synergism was detected between REB + FLC and REB + ITR against biofilm cells of C. albicans, C. krusei, and C. glabrata. The results of the present study support the potential of SER and REB as anti-Candidal biofilm agents that are beneficial as a new antifungal to combat Candidal resistance. [ABSTRACT FROM AUTHOR]

Recruiting and retaining sufficient participants is one of the biggest challenges researchers face while conducting clinical trials (CTs). This is due to the fact of misconceptions and insufficient knowledge concerning CTs among the public. The present cross-sectional study was conducted from April 2021 to May 2022. We evaluated knowledge and attitude among 480 participants using a pretested Arabic questionnaire. The correlation between knowledge and attitude score was tested through Spearman's correlation test, and the logistic regression test evaluated the associated factors for knowledge and attitude. Of the studied participants, 63.5% were male and belonged to the age group less than 30 years (39.6%). Nearly two-thirds (64.6%) of them had never heard of CT. More than half of the participants had poor knowledge (57.1%) and attitude (73.5%) towards CTs. Participants' knowledge scores were significantly associated with education level (p = 0.031) and previous participation in health-related research (p = 0.007). Attitude scores were significantly related to marital status (p = 0.035) and the presence of chronic diseases (p = 0.008). Furthermore, we found a significant positive correlation between knowledge and attitude scores (p < 0.001, Spearman's rho = 0.329). The present study revealed that most of the study population had poor knowledge and moderate attitudes towards CT. Targeted health education programs at different public places are recommended to improve the public's knowledge of the importance of CT participation. In addition, exploratory and mixed-methods surveys in other regions of KSA is required to recognize the region-specific health education needs. [ABSTRACT FROM AUTHOR]

(1) Backgrounds and Objectives: The global battle to contain the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is still ongoing. This cross-sectional study aimed to detect the seroprevalence of anti-SARS-CoV-2 IgM/IgG among previously symptomatic/asymptomatic and vaccinated/unvaccinated inhabitants of Sakaka City, Aljouf, Saudi Arabia. (2) Methods: Blood samples of 400 participants were tested for the presence of anti-SARS-CoV-2 IgM/IgG using colloidal gold immuno-chromatography lateral flow immunoassay cards. (3) Results: The prevalence of anti-SARS-CoV-2 IgM and IgG positivity was 45.8% and 42.3%, respectively. Statistically significant correlations (p < 0.05) were found between the previous RT-PCR testing for SARS-CoV-2-RNA and positivity for IgM and/or IgG. The highest seroprevalence of IgM and IgG were detected among smokers, participants aged ≥40 years, and patients with chronic diseases. Although most of the participants (58.5%) did not previously experience COVID-19 like symptoms, the anti-SARS-CoV-2 IgM and IgG seropositivity amongst them was 49.1% and 25.6%, respectively, with higher seroprevalence among males than females. At the time of the study, the SARS-CoV-2 vaccination rate at our locality in Saudi Arabia was 43.8% with statistically significant correlation (p < 0.001) between being vaccinated and anti-SARS-CoV-2 IgM and/or IgG positivity, with more positivity after receiving the second vaccine dose. (4) Conclusions: Public assessment reflects the real scale of the disease exposure among the community and helps in identifying the asymptomatic carriers that constitute a major problem for controlling the SARS-CoV-2. To limit the spread of the virus, rigorous implementation of large-scale SARS-CoV-2 vaccination and anti-SARS-CoV-2 serological testing strategies should be empowered. [ABSTRACT FROM AUTHOR]

Aims: The aim was to evaluate the role of HLA‐DP/DQ single‐nucleotide polymorphisms (SNPs) in Helicobacter pylori infection in Kafrelsheikh governorate, Egypt. Methods and results: The study enrolled 120 persons; 48 naïve H. pylori‐infected patients, 42 relapsers and 30 H. pylori‐free controls. Gastroscopy, H. pylori stool antigen, anti‐CagA and anti‐VacA antibodies were determined. Genotyping of HLA‐DPA1rs3077 (A/G) SNP and HLA‐DQ‐rs3920(A/G) SNP was done using real‐time PCR. The antibody profile against H. pylori showed that 85.7% of patients with recurrent infection have IgG against CagA (p = 0.001*). There was a significant association between the occurrence of H. pylori infection and both HLA‐DPA1rs3077AA and HLA‐DQ‐rs3920AG genotypes. Concerning H. pylori relapse, the HLA‐DQ‐rs3920AG genotype was detected in 78.6% of patients with recurrent infection (p = 0.002*). Patients carrying this genotype tend to be relapsers 9.8 times more than patients carrying other genotypes. Conclusions: HLA‐DPA1rs3077AA and/or HLA‐DQ‐rs3920AG genotypes could be risk factors for the occurrence of H. pylori infection. HLA‐DQ‐rs3920AG genotype is markedly linked to recurrent H. pylori infection. Significance and impact of the study: Host factors as HLA gene polymorphism could be a predisposing factor for susceptibility, recurrence or chronicity of H. pylori and should be studied in different ethnic groups. [ABSTRACT FROM AUTHOR]

Introduction: Severe acute respiratory syndrome - Coronavirus-2 (SARS-CoV-2) is mainly transmitted via respiratory secretions through coughing, sneezing, or contact with contaminated surfaces. This virus can be present in feces and many body fluids. The study aimed to screen the hospital environment as a potential source for SARS-CoV-2 transmission and identify the hospital zones with the highest contamination levels. Methodology: Swabs were collected from different sites in the hospital before and after routine cleaning/disinfection, transported in vials containing 1-3 mL of viral transport medium, and stored at -80 °C as soon as possible until the time of testing. The real-time reverse-transcription PCR (rRT-PCR) system targeting RNA-dependent RNA polymerase and E genes was used to detect the SARS-CoV-2 RNA. Results: Moderate environmental contamination by SARS-CoV-2 RNA was detected by rRT-PCR before routine cleaning/disinfection (52% of the swabs were positive). The hospital surfaces with the highest contamination levels were elevators' buttons, sinks and faucets' handles at the waiting rooms, patient's room and bathroom, call buttons and telephones in the patient's room, toilet bowl surface, the doorknob and light switches at the X-ray room, and the computer keyboard at the staffroom. All the swabs collected after routine cleaning/disinfection were negative for SARS-CoV-2 RNA by rRT-PCR. Conclusions: The hospital environment is a high-risk area that can be contaminated by SARS-CoV-2 through contact, respiratory, and maybe fecal shedding of the virus. To limit this fatal virus transmission, strict adherence to proper hand hygiene with frequent optimal decontamination of hospital environmental surfaces is essential. [ABSTRACT FROM AUTHOR]

Introduction: Saudi Arabia can be considered a hot spot for Methicillin-resistant Staphylococcus aureus (MRSA) infections with significant regional variations. As far as we know, this is the first study to evaluate the prevalence of MRSA in clinical samples obtained from Turaif general hospital (TGH), Northern Area-Saudi Arabia, and screening the resistance profile to the most regularly used antimicrobials as an indicator for evaluation of the implemented infection control measures. Methodology: Totally, 410 Samples were collected from patients in TGH with clinically suspected nosocomial infections. MRSA isolates were identified by the classical bacteriological, biochemical, and cefoxitin-based methods as recommended by the Clinical Laboratory Standard Institute. Confirmation of isolates and testing of their antimicrobial susceptibilities were performed by the automated Vitek 2 compact system. Results: Totally, 130 nosocomial isolates were detected. Staphylococcus aureus (29.23%) was the most frequently isolated Gram-positive pathogen. MRSA represented 39.47% of Staphylococcus aureus and 11.54 % of all isolates. MRSA-causing surgical site infections were the most predominant type of MRSA nosocomial infections representing (25.00%). Recent antibiotic therapy, prolonged hospital stays, and indwelling devices were significant risk factors for the development of MRSA infections. Although all MRSA isolates were sensitive to vancomycin, teicoplanin, linezolid, Fosfomycin, and tigecycline, many isolates were resistant to other tested antimicrobials. Conclusions: Hospital administrators should strengthen the ideal use of antibiotics according to the local hospital policy to control the selective drug pressure on Staphylococcus aureus strains with minimizing exposure to the risk factors by implementing the proper infection control policies. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the prevalence, antibiotic susceptibility and toxigenic activity of Clostridioides difficile (C. difficile) detected in water samples collected from Mansoura city, Egypt. Methods: A total of 200 water samples were collected. Standard microbiological methods including enrichment/selective cultures were used for isolation and identification of C. difficile. Epsilon tests were used to detect resistance/susceptibility of the iso- lates to clindamycin, metronidazole and vancomycin antibiotics. Xpect CD Toxin A/B test was used to detect their toxigenicity. Results: Prevalence of C. difficile isolates was 19.0% (38 isolates / 200 collected samples) and the majority (78.9%) of them were toxigenic. Distribution of isolates was as follows; 17 from water supply intake pipe (13 of them were toxigenic), 13 from waste water treatment (12 of them were toxigenic), 5 from house tap water (two of them were toxigenic) and three from public swimming pool (all of them were toxigenic). Variable degrees of resistance to clindamycin and metronidazole were detected. All isolates were sensitive to vancomycin. Conclusion: The study has illustrated that C. difficile is widespread in water sources including the municipal water supply from domestic housing and swimming pool water samples. Water can be a source for antibiotic resistant toxin producing C. difficile transmission. [ABSTRACT FROM AUTHOR]

There is a possible link between exposure to Triclosan (TCS) and changes in antimicrobial susceptibility. The change in the tolerance of clinical Escherichia coli (n=45) isolates to the biocide TCS, changes in antibiotic resistance and differences in the efflux pump mechanism were analyzed. 45 E. coli isolates were obtained. The minimum inhibitory concentration (MIC), the minimum bactericidal concentration (MBC) of TCS, and the expression of four efflux pump encoding genes in antibiotic resistant isolates were determined before and after TCS adaptation. The number of TCS-tolerant isolates was 11 (24.4%). After adaptation, the percentage of tolerant isolates increased to 42.2% (n=19). A significant change (p<0.05) in antimicrobial resistance of the tested isolates (n=45) before and after TCS adaptation was detected for ceftazidime, ceftriaxone, ertapenem, imipenem, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin and doxycycline. Among the new TCS tolerant isolates (n=8). there was an increase in TCS MIC as well as the MBC after TSC adaptation. The adapted isolates exhibited a significant increase in the expression of mdfA and norE genes (p=<0.001). There is a strong correlation between efflux pump gene overexpression and susceptibility to TCS and other antimicrobials. [ABSTRACT FROM AUTHOR]

BOTOX is a neurotoxin used in the management of dystonia as it blocks Ach release resulting in temporary muscle paralysis. It could be used for correction of gummy smile resultant from over functioning elevator muscles of the upper lip. The current study aimed to investigate botulinum toxin as a treatment modality of patients with gummy smile. This study enrolled 37 patients; gingival display was assessed as the vertical distance from the gingival zenith of the upper central incisor to the upper lip inferior border. Before Botox, the gingival display during smile ranged between 6-9 mm and 5-7 mm at the incisor and buccal regions, respectively. One week after Botox administration, a significant reduction in gingival display was observed. During smiling, the mean gingival display between maxillary central incisors and upper lip was approximately 1.5± 0.2 mm. In addition, the gingival display at the incisor and the buccal regions was ranged between 1.2 to 2 mm and 1-1.6 mm, respectively. Botulinum toxin injection is simple, effective, painless, conservative way for correction of gummy smile, and achieving high patient satisfaction. It can be used for subjects with excessive gingival display without invasive surgical procedures. [ABSTRACT FROM AUTHOR]

Information on the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has amplified quickly since its spread; however, many issues remain unclear. SARS-CoV-2 is mainly transmitted through respiratory secretions. However, the potential for SARS-CoV-2 sexual transmission by semen is worthy of study. The cell-receptors of SARS-CoV-2, the angiotensin-converting enzyme-2 receptors, are highly expressed in human testis and may enable this virus to cause testicular tissue damage with bad effect on male fertility. SARS-CoV-2 presentation ranges from asymptomatic carriage to acute respiratory distress and fatal pneumonia, and elderly persons with underlying comorbidities usually suffer from a severe clinical picture. Asymptomatic individuals can spread the virus through their respiratory secretions and possibly through sexual transmission. SARS-CoV-2 can persist viable if cryopreserved in semen samples in sperm cryobankes. As far as I know, there is a gap in knowledge about SARSCoV- 2 transmission through semen, indicating the need for further research. This review attempts to understand the SARS-CoV-2 sexual transmission by semen. One recent study confirmed the theoretical risk of SARS-CoV-2 transmission by semen, but few studies negate this theory. Given that, an increasing number of asymptomatic and reactivated SARS-CoV-2 cases are being reported, attention to semen safety and SARS-CoV-2 transmission should be considered particularly in high-risk areas, to ensure the safety of male gametes for artificial reproduction and the general public. Avoiding cryopreservation of male gametes, condom use or even abstinence might be of paramount importance for these persons. [ABSTRACT FROM AUTHOR]

Advertisements of many goods and services feature testimonials from consumers who have had atypically positive experiences with them. However, substantial evidence suggests that consumers often erroneously assume that advertised atypical results are typical. Thus, the Federal Trade Commission ("FTC") requires advertisements of atypical results also to disclose the typical results. However, the FTC has created an exception for advertisements featuring atypically positive opinions regarding a product. The exception exists because the FTC assumes that consumers believe that advertised opinions only necessarily represent the opinions of the people expressing the opinions, not the typical consumer opinion regarding the product. To test the FTC's assumption, we conduct two controlled experiments. We find evidence that, contrary to the FTC's assumption, consumers often believe that an advertised opinion is the typical consumer opinion. In addition, we find evidence that requiring these advertisements to also disclose the typical consumer opinion would cause consumers to greatly discount advertised atypical opinions. [ABSTRACT FROM AUTHOR]

The relative high burden of morbidity and mortality caused by Staphylococcus aureus (SA) in healthcare and community settings is a major concern worldwide. It can cause invasive infections, sepsis and deaths. Despite progress in methicillin-resistant S. aureus (MRSA) prevention in healthcare settings, there is a critical need for assessment of the problem in both healthcare and community settings. This study was conducted for examining the prevalence, risk factors and antimicrobial susceptibility of MRSA in Mansoura University Hospitals (MUHs), Egypt. Samples were collected from patients in MUHs with clinically suspected nosocomial infections. MRSA isolates were identified by the standard bacteriological methods, biochemical reactions and disc diffusion method as recommended by the Clinical & Laboratory Standards Institute (CLSI), then confirmed by MecA gene PCR. A total of 2006 isolates was obtained. SA (32%) was the most frequently isolated pathogen. MRSA (130 isolates) represented 20% of SA and 6.48 % of all isolates. The mecA PCR identified SA as MRSA in 99.2% of cases. MRSA was isolated with another organism (mostly Gram-negative bacilli) from 40.8% of cases while 59.2% of MRSA was isolated alone. The most important reported risk factors for MRSA infections were prolonged hospital stays, recent antibiotic therapy, ICU admission, indwelling devices and presence of surgical sutures. MRSA was resistant to many antibiotics but sensitive to vancomycin in 99.2% of cases. Minimizing exposure to the risk factors with rapid diagnosis of MRSA infections are essential for early initiation of appropriate antibiotic treatment and limitation of the non-optimal use of glycopeptides and deaths. [ABSTRACT FROM AUTHOR]

Cytokine storm is one of the leading causes of death in patients with COVID-19. Metformin has been shown to inhibit the action of a wide range of proinflammatory cytokines such as IL-6, and TNF-α which may ultimately affect cytokine storm due to Covid-19. The present study analyzed the anti-inflammatory effect of oral and intraperitoneal (IP) metformin administration routes in a mouse model of lipopolysaccharide (LPS)-induced cytokine storm. A total of 60 female BALB/c mice were randomly assigned to one of six groups: i) Control; ii) LPS model; iii) oral saline + LPS; iv) oral metformin + LPS; v) IP saline + LPS; and vi) IP metformin + LPS. Metformin or saline were administered to the mice for 30 days, after which an IP injection of 0.5 mg/kg LPS induced a cytokine storm in the five treatment groups. Mice were sacrificed and serum cytokine levels were measured. Pretreatment of mice with either oral or IP metformin significantly reduced the increase in IL-1, IL-6 and TNF-α following LPS injection. Both metformin administration routes significantly reduced IL-1 and TNF-α levels, although IP metformin appeared to be significantly more effective at reducing IL-6 levels compared with oral metformin. Neither the oral or IP route of administration of metformin demonstrated a significant effect on IL-17 levels. Based on its ability to suppress the proinflammatory LPS-induced cytokine storm, metformin may have future potential benefits in ameliorating human diseases caused by elevated cytokine levels. [ABSTRACT FROM AUTHOR]

Introduction: The Ministry of Health in Saudi Arabia provides comprehensive antenatal care for all pregnant women with all required investigations. However, it does not include urine culture for diagnosis of asymptomatic bacteriuria (ASB). This is the first study to evaluate the prevalence of ASB among pregnant females, identify the causative organisms and determine their antibiotic susceptibility patterns in the Maternity and Children's Hospital, Arar, Saudi Arabia. Methodology: This cross-sectional study included 400 pregnant women attending an antenatal clinic. Two midstream urine samples were aseptically collected and screened using standard microbiological techniques including microscopic examination, dipstick testing, and urine culture. In order to interpret the urine culture results, ≥ 105 CFUs/mL was considered significant bacteriuria. Identification of the isolates and their antibiotic sensitivity testing was performed using the Vitek 2 system (BioMérieux, Marcy l'Etoile, France) with the available test kits. Results: The prevalence of ASB was 8.25% (35/400). Significant positive correlations (p < 0.05) were detected between positive urine culture results and random blood sugar, leucocytes, nitrites, pus cells, urine red blood cells, epithelial cells, and mucus. Escherichia coli was the most common causative organism (45.7%), followed by Staphylococcus aureus (22.9%). Klebsiella pneumoniae represented 11.4% of the isolates. Most of the isolated Gram-positive organisms were sensitive to many of the tested antibiotics; most of the detected Gram-negative isolates were resistant. Conclusions: ASB caused by antibiotic resistant organisms is alarming. Screening for ASB during pregnancy using urine culture and sensitivity testing is of vital importance to improve the maternal and neonatal outcome. [ABSTRACT FROM AUTHOR]

Advertisements for products and services ranging from weight-loss programs to mutual funds regularly feature the results of people who used the advertised items. However, these advertisements often present the results only of people who had atypically positive experiences. These advertisements harm consumers and investors, who greatly underestimate the advertised results' atypicality. Because advertisements of past results are used for a wide range of products and services, they are regulated by a number of federal agencies. These agencies have taken different regulatory approaches to advertisements of atypical results, primarily requiring them to include additional disclosures. This Article presents evidence that these and other disclosures cannot prevent advertisements of atypical results from deceiving consumers and investors. Indeed, the very purpose of these advertisements is to mislead people regarding their own likely results. Thus, in light of the harm these advertisements cause and the minimal useful information they provide, the prohibition of advertisements of atypical results should be seriously considered. [ABSTRACT FROM AUTHOR]

People regularly rely on advisors who have conflicts of interest. The law often requires advisors to disclose these conflicts. Despite these disclosures, people generally insufficiently discount conflicted advice. This might be partly due to people interpreting the very fact that the advisor is disclosing a conflict of interest as a sign that the advisor is trustworthy, undermining the purpose and effectiveness of the disclosure. This article presents the results of an experiment indicating that requiring advisors to also disclose that they are legally required to disclose their conflict of interest makes people discount their advice more. This occurs, at least in part, because such advisors are viewed as less trustworthy than advisors who merely disclose their conflict of interest without also stating that the disclosure is legally required. [ABSTRACT FROM AUTHOR]

The article looks at the findings of the of the controlled experiment which examines the effects of legally mandated disclosures on U.S. consumers' optimism regarding the redeeming mail-in rebates and their willingness to purchase rebated products.

Introduction: Enterobacteriaceae that produce extended-spectrum beta-lactamase (ESBL) are quickly spreading, posing a threat to world healthcare. Methodology: 138 gram-negative bacteria were collected from different samples (stool, urine, wound, blood, tracheal aspirate, catheter tip, vaginal swab, sputum, and tracheal aspirate) from hospitalized patients. Samples were subcultured and identified in accordance with their biochemical reactions and culture characteristics. Against all the isolated Enterobacteriaceae, an antimicrobial susceptibility test was performed. VITEK®2 system, phenotypic confirmation, and Double-Disk Synergy Test (DDST) had been utilized to identify the ESBLs. Results: Of the 138 samples studied, the prevalence of ESBL-producing infections among the clinical samples of the present study was 26.8 % (n = 37). E. coli was the commonest ESBL producer at 51.4% (n = 19) followed by K. pneumoniae at 27% (n = 10). The potential risk factors for the ESBL development that produces bacteria were as follows, patients with the presence of indwelling devices, previous history of hospital admission, and usage of antibiotics. ESBL is statistically (p = 0.05) higher among the patients with indwelling devices, ICU admission, who had a previous hospital admission in the last 6 months as well as who was given antibiotics (quinolones and/or cephalosporins) in the last 6 months. One hundred thirty-two (95.7%) of ESBL isolates were resistant to amoxicillin, while the lowest resistance was for fosfomycin (15.2%). Conclusions: ESBL-producing Enterobacteriaceae are highly prevalent in Turaif General Hospital setting with some potential risk factors. A strict policy to be made available on the usage of antimicrobials in hospitals and clinics should be established. [ABSTRACT FROM AUTHOR]

Mutual fund companies routinely advertise the past returns of their strong-performing, actively-managed equity funds. These performance advertisements imply that the advertised high past returns are likely to continue. Indeed, investors flock to these funds despite high past returns being a poor predictor of high future returns. Thus, fund performance advertising is inherently and materially misleading and violates federal securities antifraud standards. In addition, the SEC-mandated warning in these advertisements that "past performance does not guarantee future results" fails to temper investors' focus on past returns. The SEC should do more to prevent investors from being misled by fund performance advertisements. It should at least require a stronger warning that makes clear that high returns by actively-managed mutual funds generally do not persist. The SEC should also seriously consider reinstating its prior prohibition of performance advertisements. Such a ban would help investors focus on more important fund characteristics, such a fund's costs, risk, and the extent to which the fund's investment objective matches that of the investor. [ABSTRACT FROM AUTHOR]

More than $11 trillion is invested in mutual funds in the United States. Mutual fund investors flock to funds with high past returns, despite there being little, if any, relationship between high past returns and high future returns. Because fund management fees are based on the amount of assets invested in their funds, however, fund companies regularly advertise the returns of their high-performing funds. The SEC requires these advertisements to contain a disclaimer warning that past returns do not guarantee future returns and that investors could lose money in the funds. This article presents the results of an experiment that finds that this SEC-mandated disclaimer is completely ineffective. The disclaimer neither reduces investors' propensity to invest in advertised funds nor diminishes their expectations regarding the funds' future returns. The experiment also suggests, however, that a stronger disclaimer—one that informs investors that high fund returns generally do not persist—would be much more effective. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has reached over 276 million people globally with 5.3 million deaths as of 22nd December 2021. COVID-19-associated acute and long-term neurological manifestations are well recognized. The exact profile and the timing of neurological events in relation to the onset of infection are worth exploring. The aim of the current body of work was to determine the frequency, pattern, and temporal profile of neurological manifestations in a cohort of Egyptian patients with confirmed COVID-19 infection. Methods: This was a prospective study conducted on 582 hospitalized COVID-19 patients within the first two weeks of the diagnosis of COVID-19 to detect any specific or non-specific neurological events. Results: The patients' mean (SD) age was 46.74 (17.26) years, and 340 (58.42%) patients were females. The most commonly encountered COVID-19 symptoms were fever (90.72%), cough (82.99%), and fatigue (76.98%). Neurological events (NE) detected in 283 patients (48.63%) and were significantly associated with a severe COVID-19 at the onset (OR: 3.13; 95% CI: 2.18–4.51; p < 0.0001) and with a higher mortality (OR: 2.56; 95% CI: 1.48–5.46; p = 0.019). The most frequently reported NEs were headaches (n = 167) and myalgias (n = 126). Neurological syndromes included stroke (n = 14), encephalitis (n = 12), encephalopathy (n = 11), transverse myelitis (n = 6) and Guillain-Barré syndrome (n = 4). Conclusions: Neurological involvement is common (48.63%) in COVID-19 patients within the first two weeks of the illness. This includes neurological symptoms such as anosmia, headaches, as well as a constellation of neurological syndromes such as stroke, encephalitis, transverse myelitis, and Guillain-Barré syndrome. Severity of acute COVID-19 illness and older age are the main risk factors. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is a chronic autoimmune illness with a growing prevalence in many populations. Few studies have examined genetic predisposition to SLE, so we aimed to examine the clinical impact of the genetic polymorphisms MECP2 rs2734647and TIRAP rs8177374 on the outcomes and therapeutic precision of SLE with and without nephritis. This study included 110 SLE patients—divided into 63 with lupus nephritis (LN), and 47 without nephritis—and 100 controls. Laboratory measurements including CRP, ESR, ACR, CBC, anti-ds-DNA, vitamin A, C3, and C4 were carried out, along with genotyping of MECP2 rs2734647and TIRAP rs8177374 by real-time PCR and sequencing. Treg %, vitamin A, C3, and C4 were lower, whereas Th17 % was higher, in patients vs. controls (p < 0.001). The T allele of MECP2 rs2734647 was higher in LN than in non-nephritis and control subjects. Moreover, the T allele of TIRAP rs8177374 was higher in LN than in non-nephritis and control subjects. The MECP2 and TIRAP genes could play a role in predisposition to SLE, and can also predict disease progress to nephritis, helping to personalize medicine. [ABSTRACT FROM AUTHOR]

Introduction: Acute transverse myelitis (ATM) is an uncommon inflammatory, intramedullary, disorder of the spinal cord. Spastic paraplegia, impaired sphincter functions, and sensory loss, with sensory level, are the clinical manifestations of this devastating disorder. The utilization of magnetic resonant imaging (MRI) contributes to the surge in the diagnosis of more ATM cases. Although the causes of ATM are numerous, both Mycoplasma pneumoniae and Schistosoma mansoni are uncommon causes and their co-existence in the same patient has not been reported before in Saudi Arabia. Case Summary: We report a 25-year-old ATM male patient presented with a history of sudden onset severe low back pain. Within four hours from the onset of the back pain, he became completely paraplegic with impaired functions of the bowel and urinary bladder sphincter. Furthermore, he lost all modalities of sensory functions in the lower limbs. His examination revealed spastic complete paraplegia with sensory level at T6. Clinical neurological examination revealed normal upper limbs and brain functions. The MRI of the cervico-dorsal spine showed extensive longitudinal hyperintense lesion extending from the upper cervical segments to the lower dorsal segments (extensive longitudinal transverse myelitis). A post-infectious immune-mediated predisposition was highly suspected due to the very high titers of anti-Mycoplasma pneumoniae IgM and IgG that were detected. The immunosuppressant therapy did not improve his paraplegia. A spinal cord biopsy revealed the presence of several Schistosoma mansoni ova surrounded by chronic inflammatory reactions and reactive gliosis. Conclusions: Both Mycoplasma pneumoniae and Schistosoma mansoni should be investigated in cases with extensive longitudinal ATM. [ABSTRACT FROM AUTHOR]

Introduction: Efforts have been made to contain COVID-19. Human behavior, affected by knowledge and perceptions, may influence the course of disease. Methodology: A structured questionnaire was used to collect data from 422 participants. It consisted of 28 questions in four sections; seven questions about sociodemographic characteristics of participants, 12 questions to estimate level of knowledge about COVID-19, six questions to evaluate attitudes toward disease, and three questions to assess practices to prevent disease transmission. Results: Their overall understanding of COVID-19 was satisfactory. 69% of the participants had satisfactory levels of knowledge, and the main sources of information were social media platforms (79.70%) and television (70.90%). There was a significant difference in knowledge as a function of gender (p = 0.50), occupation (p = 0.012), and smoking (p = 0.041). The participants held optimistic attitudes and adopted appropriate protective measures. Most participants agreed that COVID-19 can cause death (64.7%), poses greater risks to elderly (93.4%) and those with chronic diseases (96.7%), it is mandatory to quarantine infected individuals (98.1%), preventive health measures are important (97.6%), and health authorities will succeed in controlling the pandemic (67.5%). There was a statistically significant association between satisfactory levels of knowledge and the practice of wearing masks and the adoption of protective measures (avoiding crowded places, frequent hand washing). Conclusions: Residents of Al-Jouf region in Saudi Arabia have satisfactory levels of knowledge, optimistic attitudes, and good practice during the rapid rise period of the pandemic. Awareness campaigns will improve any misbeliefs and risky behaviors. [ABSTRACT FROM AUTHOR]