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The Ni1−x CuxFe2O4 (where x = 0, 0.05, 0.10, 0.15) nano ferrite powder was synthesized through chemical co-precipitation method, NaOH and acid oleic as raw materials. The XRD patterns confirmed the spinal structure phase purity of materials. XRD results showed that lattice parameter decreases with the increase of copper concentration by increasing copper concentration in the parent material. Scanning electron microscopy (SEM) was used to determine the morphology and particle size. SEM analysis indicated that all the samples are in nano size and homogeneous. AC electrical properties of nanoparticles were investigated by employing impedance spectroscopy. The real and the imaginary parts of impedance, permittivity, modulus along with the real part of ac conductivity, and tan delta were measured and analyzed for all synthesized samples in 1 Hz to 7 MHz for different voltages at 300 K.

Nawaf Osaywid Alrashidi,1 Wafy Abdulrahman Albrak,1 Shaker Osaywid Alreshidi,2 Lama Abdulrahman Alaradi,3 Hatim Adam Nagi Adam,3 Naif Mamdouh Alali,4 Faris Hashem,4 Hani Basher Albalawi,4 Ahmed Yousef Alothman,5 Shaima Sulaiman Alharbi2 1College of Medicine, University of Ha’il, Ha’il, Saudi Arabia; 2Department of Ophthalmology, College of Medicine, Majmaah University, Majmaah, Saudi Arabia; 3Department of Community Medicine, College of Medicine, University of Ha’il, Ha’il, Saudi Arabia; 4Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia; 5Ophthalmology Department, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Faris Hashem, Email fhashem@ut.edu.saPurpose: The study aims to assess the perception of optical spectacles use among the Ha’il region population in Saudi Arabia.Patients and Methods: A cross-sectional survey was distributed via various social media applications to the residents of the Ha’il region. An online questionnaire was designed and included informed consent and questions assessing the participants’ perceptions about wearing eyeglasses, contact lenses, and general eye health.Results: 32.4% of the participants think that long-term eyeglasses wearing worsens vision, and 43% think eyeglasses wearing improves vision. 75.2% believe that long-term use of glasses could cause lifetime dependency on eyeglasses. Regarding contact lenses, 45.9% believe that long-term wearing worsens vision, and 24.1% think long-term wearing of contact lenses improves vision. 60% think long-term use of lenses causes lifetime dependency on those contact lenses.Conclusion: Our results highlighted the misconceptions among the study population regarding wearing prescribed eyeglasses and contact lenses. Thus, education programs and media are warranted to correct the misconceptions about spectacles and raise the awareness about refractive errors and treatment options.Keywords: refractive errors, vision impairment, eyeglasses, contact lenses

Khalid A Al-Regaiey, Syed Shahid Habib, Ahmed R Alshamasi, Abdullah F Alnuwaybit, Bader A Alwhaibi, Naif M Alsulais, Abdullah I Alothman, Faisal M Alomar, Muhammad Iqbal Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Khalid A Al-Regaiey; Muhammad Iqbal, Email kalregaiey@ksu.edu.sa; imuhammad@ksu.edu.saObjective: Gremlin 1 is a novel adipokine that plays an important role in obesity and type 2 diabetes mellitus (T2DM). In the current study, we aimed to evaluate plasma levels of Gremlin 1 in diabetic and non-diabetic Saudi adult females and its correlation with body composition, glycemic control and lipid profile.Methods: A case–control study was conducted among 41 T2DM and 31 non-diabetic adult age matched females (controls). All patients underwent body composition by bioelectrical impedance analysis, with a commercially available body analyzer. Fasting venous samples were analyzed for glycemic markers and lipids, while plasma Gremlin 1 was measured by ELISA. The results were compared between the two groups and correlated with other anthropometric and adiposity parameters.Results: Gremlin 1 levels were elevated in T2DM patients (345 ± 26 ng/mL) when compared to control subjects (272 ± 16 ng/mL, p < 0.05). Diabetic patients having poor glycemic control had significantly higher Gremlin 1 levels (382 ± 34 ng/mL) compared to patients with good glycemic control (291 ± 37 ng/mL, p < 0.05). Pearson correlation analysis revealed a positive correlation of Gremlin 1 with fat mass (r = 0.246, p = 0.012), HbA1C (r = 0.262, p = 0.008) and HOMA-IR index (r = 0.321, p = 0.001).Conclusion: Our study demonstrates an important role of Gremlin 1 in glycemic control and body adiposity in the pathophysiology of obesity and T2DM. Gremlin 1 may emerge as a promising biomarker and therapeutic target in obesity and T2DM.Keywords: Gremlin 1, adiposity, diabetes mellitus, HbA1C, HOMA-IR

Nanoparticles synthesized from plants are being explored for cancer treatment therapies all over the world. This study reported the eco-friendly and low-cost method for the green synthesis of silver nanoparticles (AgNPs) from Adansonia digitata fruit as a reducing and capping agent. The anti-cancer potential of synthesized particles was explored against HTC116 and SW480 colon cancer cell lines. Prepared AgNPs were characterized by ultraviolet-visible spectroscopy, zeta potential, transmission electronic microscopy, scanning electronic microscopy, Fourier transform infrared, and energy-dispersive spectrum. The cytotoxicity was determined with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and expression levels of four genes (CTNNB1, APC, LRP5, and LRP6) were checked by reverse transcription polymerase chain reaction. The sharp peak of surface plasmon resonance at 400 nm confirms the formation of AgNPs. Dynamic light scattering showed average sizes of 16.34 nm with a polydispersity index of 0.193. A. digitata AgNPs were spherical with slight aggregated. AgNPs were more cytotoxic than A. digitata extract and decrease the expression of CTNNB1 and LRP6 genes while LRP5 gene expression was increased in both cell lines. APC gene expression was decreased in SW480 but increased in HTC116 with treatment. Overall, this study suggested that AgNPs synthesized by A. digitata fruit extract can be an attractive candidate for anticancer applications.

Ebrahim Mahmoud,1 Sarah Al Mansour,1 Mohammad Bosaeed,1– 3 Ahmad Alharbi,1 Abdulrahman Alsaedy,1,2 Sameera Aljohani,2,4 Bassam Alalwan,4 Adel Alothman1,2, † 1Division of Infectious Diseases, Department of Medicine, King Abdulaziz Medical City - Riyadh, Riyadh, Saudi Arabia; 2College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; 4Department of Pathology & Laboratory Medicine, King Abdulaziz Medical City - Riyadh, Riyadh, Saudi Arabia†Doctor Adel Al Othman passed away on June 8, 2020Correspondence: Ebrahim MahmoudDivision of Infectious Diseases, Department of Medicine, King Abdulaziz Medical City - Riyadh, P.O. Box 22490, Riyadh 11426, Saudi ArabiaTel +966 500081418Email emahmoud85@gmail.comAbstract: While methicillin-resistant Staphylococcus aureus (MRSA) bacteremia has poor outcomes, we describe our experience with Ceftobiprole mainly as a combination therapy for the treatment of MRSA bacteremia. All the cases of MRSA bacteremia in our center at the King Abdulaziz Medical City (KAMC), Riyadh, that had undergone Ceftobiprole treatment were included. We had six cases of MRSA bacteremia between 2018 and 2019, secondary to different infectious syndromes including endocarditis. There was a severe infection that required intensive care unit (ICU) admission in four cases. Ceftobiprole is used in combination with vancomycin in four cases. On day 14, all cases had a favorable outcome with microbiological and clinical improvement. However, three patients died after months of suffering from bacteremia from unrelated causes for the infection. The clinical outcome in our series of treatment of MRSA bacteremia using Ceftobiprole was favorable. Further studies for the evaluation of the use of Ceftobiprole in MRSA bacteremia should be encouraged.Keywords: methicillin-resistant Staphylococcus aureus, bacteremia, Ceftobiprole, treatment

Early childhood education is an institutional introduction of children to the world, making it essential for policymakers, educators and society to find the best way to provide such an introduction. Following a new policy in Saudi Arabia, daycare centres have been renamed 'hospitality centres', bringing a set of duties and rights rooted deep in the ethics of hospitality. However, empirical research on nursery provision is generally lacking in Saudi Arabia. Therefore, this study examined the experiences of children and caregivers in two children's hospitality centres in the capital city of Riyadh. Through in-depth, semi-structured interviews and field observations, the authors observed and listened to the experiences of educators and children in two of the new hospitality centres. Open and focused coding of the interviews and structured observations helped to identify the way the ethics of hospitality manifested itself in the daily experiences of the caregivers/hosts and the children/guests. The results demonstrated the complexity of the situations in which the ethics of hospitality encountered reality.

This study reports the findings of extensive ethnographic research in which six preschoolers were observed for 2 years at a preschool in Saudi Arabia. Drawing on the sociocultural perspectives of literacy learning, this study focuses on the early literacy practices in the Saudi home context of two preschoolers and their mothers. The data described in this study were derived from mind maps created with the children and interviews with their mothers. Several sociocultural concepts were used as analytical frameworks following a thematic approach. This study suggests that early literacy is a social and cultural practice embedded and constructed in a sociocultural context. Moreover, the findings indicate how children's early literacy practices at home occur within a social process through interactions with adults and siblings and how these practices reflect Saudi Arabian Islamic culture and identity. Furthermore, the findings highlight the significance of using participatory techniques (mind maps) to hear children's voices in research.

Abdulhakeem O Althaqafi,1 Madonna J Matar,2 Rima Moghnieh,3 Adel F Alothman,4 Thamer H Alenazi,5 Fayssal Farahat,1 Shelby Corman,6 Caitlyn T Solem,6 Nirvana Raghubir,7 Cynthia Macahilig,8 Seema Haider,9 Jennifer M Stephens6 1Department of Infection Prevention and Control, King Abdullah International Medical Research Center, King Saud bin AbdulAziz University for Health Sciences, Jeddah, Kingdom of Saudi Arabia; 2Department of Infectious Disease, Notre Dame de Secours University Hospital, Byblos, 3Makassed General Hospital, Beirut, Lebanese Republic; 4Department of Medicine, King Abdulaziz Medical City, Central Region, Ministry of National Guard Health Affairs, 5Infection Prevention & Control Department, King Abdulaziz Medical City-Riyadh (KAMC), Kingdom of Saudi Arabia; 6Real World Evidence: Data Analytics Center of Excellence, Pharmerit International, Bethesda, MD, 7Medical Affairs, Pfizer, New York, NY, 8Medical Data Analytics, Parsippany, NJ, 9Outcomes & Evidence, Global Health and Value, Pfizer, Groton, CT, USA Objectives: The objective of this study is to describe the real-world treatment patterns and burden of suspected or confirmed methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in Saudi Arabia and Lebanon. Methods: A retrospective chart review study evaluated 2011–2012 data from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of MRSA pneumonia, which was culture proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients to capture demographics (eg, age and comorbidities), treatment patterns (eg, timing and use of antimicrobials), hospital resource utilization (eg, length of stay), and clinical outcomes (eg, clinical status at discharge and mortality). Descriptive results were reported using frequencies or proportions for categorical variables and mean and standard deviation for continuous variables. Results: Chart-level data were collected for 93 patients with MRSA pneumonia, 50 in Saudi Arabia and 43 in Lebanon. The average age of the patients was 56 years, and 60% were male. The most common comorbidities were diabetes (39%), congestive heart failure (30%), coronary artery disease (29%), and chronic obstructive pulmonary disease (28%). Patients most frequently had positive cultures from pulmonary (87%) and blood (27%) samples. All isolates were sensitive to vancomycin, teicoplanin, and linezolid, and only one-third of the isolates tested were sensitive to ciprofloxacin. Beta-lactams (inactive therapy for MRSA) were prescribed 21% of the time across all lines of therapy, with 42% of patients receiving first-line beta-lactams. Fifteen percent of patients did not receive any antibiotics that were considered to be MRSA active. The mean hospital length of stay was 32 days, and in-hospital mortality was 30%. Conclusion: The treatment for MRSA pneumonia in Saudi Arabia and Lebanon may be suboptimal with inactive therapy prescribed a substantial proportion of the time. The information gathered from this Middle East sample provides important perspectives on the current treatment patterns. Keywords: MRSA, resource use, mortality, length of stay, antibiotics, Middle East

Madonna J Matar,1 Rima Moghnieh,2 Adel F Alothman,3 Abdulhakeem O Althaqafi,4 Thamer H Alenazi,3 Fayssal M Farahat,4 Shelby Corman,5 Caitlyn T Solem,5 Nirvana Raghubir,6 Cynthia Macahilig,7 Seema Haider,8 Jennifer M Stephens5 1Department of Infectious Diseases, Notre Dame des Secours University Hospital, Jbeil, Lebanon; 2Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon; 3College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 4King Abdullah International Medical Research Center, Infection Prevention and Control, King AbdulAziz Medical City, King Saud bin AbdulAziz University for Health Sciences, Jeddah, Saudi Arabia; 5Pharmerit International, Real-World Evidence/Data Analytics, Bethesda, MD, 6Pfizer, New York, NY, 7Medical Data Analytics, Parsippany, NJ, 8Pfizer, Groton, CT, USA Objectives: To describe treatment patterns and medical resource use for methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (cSSTI) in Saudi Arabia and Lebanon in terms of drug selection against the infecting pathogen as well as hospital resource utilization and clinical outcomes among patients with these infections. Methods: This retrospective chart review study evaluated 2011–2012 data from five hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of MRSA cSSTI, which was culture-proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients with each infection type to capture demographics, treatment patterns, hospital resource utilization, and clinical outcomes. Statistical analysis was descriptive. Results: Data were abstracted from medical records of 87 patients with MRSA cSSTI; mean age 52.4±25.9 years and 61% male. Only 64% of patients received an MRSA active initial therapy, with 56% of first-line regimens containing older beta-lactams. The mean total length of stay was 26.3 days, with the majority (19.1 days) spent in general wards. Surgical procedures included incision and drainage (22% of patients), debridement (14%), and amputation (5%). Mechanical ventilation was required by 9% of patients, with a mean duration of 18 days per patient. Hemodialysis was required by four patients (5%), two of whom were reported to have moderate to severe renal disease on admission, for a mean of 5.5 days. Inpatient mortality was 8%. Thirty-nine percent were prescribed at least one antibiotic at discharge, with the most commonly prescribed discharge antibiotics being clindamycin (44%), ciprofloxacin (18%), trimethoprim/sulfamethoxazole (12%), and linezolid (9%). Conclusion: This Middle Eastern real-world study of resource use and treatment patterns in MRSA cSSTI indicates that management of this condition could be further optimized in terms of drug selection and resource utilization. Keywords: antibiotics, length of stay, Saudi Arabia, Lebanon, skin, skin structure infections

Adel F Alothman,1 Abdulhakeem O Althaqafi,2 Madonna J Matar,3 Rima Moghnieh,4 Thamer H Alenazi,1 Fayssal M Farahat,2 Shelby Corman,5 Caitlyn T Solem,5 Nirvana Raghubir,6 Cynthia Macahilig,7 Claudie Charbonneau,8 Jennifer M Stephens5 1College of Medicine, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Department of Infection Prevention and Control, King Abdullah International Medical Research Center, King Saud bin AbdulAziz University for Health Sciences, King AbdulAziz Medical City, Jeddah, Saudi Arabia; 3Department of Infectious Disease, Notre Dame de Secours University Hospital, Byblos, Lebanon; 4Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon; 5Real-world Evidence/Data Analytics Center of Excellence, Pharmerit International, Bethesda, MD, USA; 6Pfizer, New York, NY, 7Medical Data Analytics, Parsippany, NJ, USA; 8Pfizer International Operation, Paris, France Objectives: The objective of this study was to document the burden and treatment patterns associated with invasive fungal infections (IFIs) due to Candida and Aspergillus species in Saudi Arabia and Lebanon. Methods: A retrospective chart review study was conducted using data recorded from 2011 to 2012 from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of IFI due to Candida or Aspergillus, which was culture proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients to capture demographics, treatment patterns, hospital resource utilization, and clinical outcomes. Descriptive results were reported. Results: Five hospitals participated and provided data on 102 patients with IFI (51 from Lebanon and 51 from Saudi Arabia). The mean age of the patients was 55 years, and 55% were males. Comorbidities included diabetes (41%), coronary artery disease (24%), leukemia (19%), moderate-to-severe renal disease (16%), congestive heart failure (15%), and chronic obstructive pulmonary disease (15%). Twenty percent of patients received corticosteroids prior to admission and 26% had received chemotherapy in the past 90 days. Inpatient mortality was 42%, and the mean hospital length of stay was 32.4±28.6 days. Fifty-five percent of patients required intensive care unit admission (17.2±14.1 days), 37% required mechanical ventilation (13.7±13.2 days), and 11% required dialysis (14.6±14.2 days). The most commonly used first-line antifungal was fluconazole. Conclusion: Patients with IFI in Saudi Arabia and Lebanon frequently have multiple medical comorbidities and may not have traditionally observed IFI risk factors. Efforts to increase use of rapid diagnostic tests and appropriate antifungal treatments may impact the substantial mortality and high length of stay observed in these patients. Keywords: Candida, Aspergillus, length of stay, resource use, antifungal, mortality

This study reports the findings of extensive ethnographic research in which six preschoolers were observed for 2 years at a preschool in Saudi Arabia. Drawing on the sociocultural perspectives of literacy learning, this study focuses on the early literacy practices in the Saudi home context of two preschoolers and their mothers. The data described in this study were derived from mind maps created with the children and interviews with their mothers. Several sociocultural concepts were used as analytical frameworks following a thematic approach. This study suggests that early literacy is a social and cultural practice embedded and constructed in a sociocultural context. Moreover, the findings indicate how children&apos;s early literacy practices at home occur within a social process through interactions with adults and siblings and how these practices reflect Saudi Arabian Islamic culture and identity. Furthermore, the findings highlight the significance of using participatory techniques (mind maps) to hear children&apos;s voices in research. Keywords Early literacy practices * Children&apos;s perspectives * Participatory research methods * Home context, 1 Introduction Early literacy experiences significantly influence children's confidence, independence, and other fundamental skills throughout life (Lonigan et al., 2011; Roskos & Christie, 2011). Early literacy development in Arabic is [...]