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Outbreaks of Monkeypox (mpox) in over 100 non-endemic countries in 2022 represented a serious global health concern. Once a neglected disease, mpox has become a global public health issue. A42R profilin-like protein from mpox (PDB ID: 4QWO) represents a potential new lead for drug development and may interact with various synthetic and natural compounds. In this report, the interaction of A42R profilin-like protein with six phytochemicals found in the medicinal plant Ficus religiosa (abundant in India) was examined. Based on the predicted and compared protein–ligand binding energies, biological properties, IC50 values and toxicity, two compounds, kaempferol (C-1) and piperine (C-4), were selected. ADMET characteristics and quantitative structure–activity relationship (QSAR) of these two compounds were determined, and molecular dynamics (MD) simulations were performed. In silico examination of the kaempferol (C-1) and piperine (C-4) interactions with A42R profilin-like protein gave best-pose ligand-binding energies of –6.98 and –5.57 kcal/mol, respectively. The predicted IC50 of C-1 was 7.63 μM and 82 μM for C-4. Toxicity data indicated that kaempferol and piperine are non-mutagenic, and the QSAR data revealed that piperlongumine (5.92) and piperine (5.25) had higher log P values than the other compounds examined. MD simulations of A42R profilin-like protein in complex with C-1 and C-4 were performed to examine the stability of the ligand–protein interactions. As/C and C-4 showed the highest affinity and activities, they may be suitable lead candidates for developing mpox therapeutic drugs. This study should facilitate discovering and synthesizing innovative therapeutics to address other infectious diseases.

In this study, we introduce an algorithm that utilizes the Haar wavelet collocation method to solve the time-dependent Emden–Fowler equation. This proposed method effectively addresses both linear and nonlinear partial differential equations. It is a numerical technique where the differential equation is discretized using Haar basis functions. A difference scheme is also applied to approximate the time derivative. By leveraging Haar functions and the difference scheme, we form a system of equations, which is then solved for Haar coefficients using MATLAB software. The effectiveness of this technique is demonstrated through various examples. Numerical simulations are performed, and the results are presented in graphical and tabular formats. We also provide a convergence analysis and an error analysis for this method. Furthermore, approximate solutions are compared with those obtained from other methods to highlight the accuracy, efficiency, and computational convenience of this technique.

The emergence of higher-dimensional evolution equations in dissimilar scientific arenas has been on the rise recently with a vast concentration in optical fiber communications, shallow water waves, plasma physics, and fluid dynamics. Therefore, the present study deploys certain improved analytical methods to perform a solitonic analysis of the newly introduced three-dimensional nonlinear dynamical equations (all within the current year, 2024), which comprise the new (3 + 1) Kairat-II nonlinear equation, the latest (3 + 1) Kairat-X nonlinear equation, the new (3 + 1) Boussinesq type nonlinear equation, and the new (3 + 1) generalized nonlinear Korteweg–de Vries equation. Certainly, a solitonic analysis, or rather, the admittance of diverse solitonic solutions by these new models of interest, will greatly augment the findings at hand, which mainly deliberate on the satisfaction of the Painleve integrability property and the existence of solitonic structures using the classical Hirota method. Lastly, this study is relevant to contemporary research in many nonlinear scientific fields, like hyper-elasticity, material science, optical fibers, optics, and propagation of waves in nonlinear media, thereby unearthing several concealed features.

Background: The protozoan parasite Toxoplasma gondii may cause serious illness in the immunocompromised. The Toxoplasma gondii seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is associated with outcomes that have not be fully elucidated, hence the need for a better understanding of the pooled seroprevalence and associated maternal and fetal outcomes. Objective: The objective was to conduct a systematic literature review and determine the pooled prevalence of WHO Eastern Mediterranean Regional countries’ pregnant women’s seroprevalence of Toxoplasma gondii and the maternal–fetal outcomes. Methods: This quantitative study examined WHO Eastern Mediterranean countries’ maternal–fetal outcomes and Toxoplasma gondii prevalence in pregnant women. The targeted population was pregnant women, while the primary outcome was seropositivity of Toxoplasma gondii, while other outcomes such as maternal and fetal associations and risk factors were determined PubMed, SCOPUS, MEDLINE, and Index Medicus for the Eastern Mediterranean Region (IMEMR) databases were searched up until 30 January 2023. The search terms used were “Toxoplasma gondii” OR “Toxoplasma infection” AND “Pregnant woman” or pregnan* OR Antenatal OR Prenatal OR Gravidity OR Parturition OR Maternal AND WHO Eastern Mediterranean Region). OpenMeta-Analyst and Jamovi were used to analyze the generated data. Results: In total, 95 of 2947 articles meeting the inclusion criteria examined Toxoplasma gondii prevalence in pregnant women from WHO Eastern Mediterranean countries. The pooled prevalence of Toxoplasma gondii in pregnant women was 36.5% (95%CI: 32.6–40.4) with a median value of 35.64%, range values of 1.38–75.30%, with 99.61% heterogeneity. The pooled seroprevalence of IgG of Toxoplasma gondii was 33.5% (95%CI: 29.8–37.2) with a median value of 33.51%, and a range values of 1.38–69.92%; the pooled seroprevalence of IgM was 3.6% (95%CI: 3.1–4.1)) with a median value of 3.62 and range values of 0.20–17.47%, while cases of pooled seroprevalence of both IgG and IgM positivity was 3.0% (95%CI: 1.9–4.4) with a median value of 2.05 and a range values of 0.05–16.62%. Of the Toxoplasma gondii seropositive women, 1281/3389 (34.8%) 174/1765 (32.9%), 1311/3101 (43.7%), and 715/1683 (40.8%) of them had contact with cats, drank unprocessed milk, ate raw or undercooked meat and ate unwashed raw vegetables, respectively. The maternal–fetal outcomes associated with Toxoplasma gondii seropositivity were a history of abortions, miscarriage, stillbirth, intrauterine fetal death, and premature birth, which were found in 868/2990 (32.5%), 112/300 (36.1%), 111/375 (25.7%), 3/157 (1.9%) and 96/362 (20.1%) of women who tested positive for Toxoplasma gondii antibodies. Conclusion: The study found a high proportion of Toxoplasma gondii seroprevalence in pregnant women in the WHO Eastern Mediterranean Region, which may be linked to poor outcomes for mothers and their babies. Thus, pregnant women require monitoring and comprehensive prevention strategies for Toxoplasma gondii infection.

Sleep is influenced by various factors, including social, economic, genetic, and medical factors, and work and study schedules. Medical students are highly susceptible to sleep-related problems. In this study, we aimed to evaluate the sleep patterns and quality of medical students and determine their correlation with academic achievement. This cross-sectional study was conducted at the King Abdulaziz University between November 2022 and April 2023. The participants completed an online questionnaire distributed to all medical students via social media channels. The questionnaire included the Pittsburgh Sleep Quality Index to assess sleep quality and Epworth Sleepiness Scale to measure excessive daytime sleepiness (EDS). Academic performance was self-reported by students based on their grade point average. Of the 274 participants, 54.0% were males with a mean age of 22.81 years. Only 21.5% of students reported normal sleep quality during the previous month, with almost 78.5% reporting poor sleep quality and 40.9% experiencing EDS. Notably, no associations were observed between the sleep quality and sleep-wake patterns and academic performance of the students (p = 0.324 and 0.784, respectively). These findings highlight the substantial prevalence of poor sleep quality and EDS among Saudi medical students, consistent with global trends. Unexpectedly, no significant correlation was observed between sleep quality and student academic performance. These findings suggest that the demanding nature of medical education significantly impacts the sleep patterns and overall well-being of students., Competing Interests: Declarations. Ethics Approval and Consent to Participate: Ethical approval was obtained from the Unit of Biomedical Ethics at King Abdulaziz University with reference no: 604 − 22. Consent to participate weas obtained using the google form. Consent for Publication: All authors read and approved the final manuscript. Competing Interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: This in-vitro study was conducted to assess the fracture resistance of resin-bonded ceramic endocrowns with different designs at varying intracoronal depths., Materials and Methods: Forty-eight (n = 48) extracted mandibular first molar teeth were randomly divided into four groups (n = 12). In the control group, the specimens remained untreated. Whereas the specimens in the test groups A, B, and C were decapitated 2 mm above the cementoenamel junction (CEJ) and endodontically treated. The test groups were prepared with a butt-joint design in a standardised manner with varying intracoronal depths. Groups A, B, and C were prepared to receive lithium disilicate endocrown with intracoronal cores at 0 mm, 2 mm, and 4 mm, respectively. Crowns were fabricated as a non-anatomical design with a thickness of 3 mm. After ceramic bonding procedures, specimens underwent thermocyclic ageing prior to the fracture resistance test. Specimens were loaded at a 15-degree angle using the Universal Testing Machine and the failure modes were observed. One-way analysis of variance (ANOVA) and Chi-square were utilised for data statistical analyses., Results: Significant statistical results in fracture resistance tests were found in all experimental groups. The highest load was found in group B, followed by group C, and lastly group A (P 0.05). Although endocrowns with no extension had the lowest fracture resistance, they showed a favourable cohesive failure with statistically no significant difference from the control group., Conclusion: In bonded ceramic endocrowns, the fracture resistance is not newcessarily proportional to the intracanal depth. The intrcoronal cores of 4 mm did not show the highest fracture resistance, and their mode of failure was catastrophic compared to endocrowns with no intracoronal extensions.

Two-dimensional transition metal dichalcogenides (2D TMDCs) can be combined with organic semiconductors to form hybrid van der Waals heterostructures. Specially, non-fullerene acceptors (NFAs) stand out due to their excellent absorption and exciton diffusion properties. Here, we couple monolayer tungsten diselenide (ML-WSe 2 ) with two well performing NFAs, ITIC, and IT-4F (fluorinated ITIC) to achieve hybrid architectures. Using steady state and time resolved spectroscopic techniques, we reveal sub-picosecond free charge generation in the heterostructure of ML-WSe 2 with ITIC, where however, bimolecular recombination of spin uncorrelated charge carriers with possible contributions from geminate charge recombination cause rapid formation of low-lying triplet (T 1 ) states in ITIC. Importantly, this unwanted process is effectively suppressed when the fluorinated derivative of ITIC, IT-4F, is deposited on ML-WSe 2 . We observe a similar scenario when replacing the ML-TMDC with copper thiocyanate (CuSCN) as the hole acceptor meaning that triplet state formation is not driven by the spin-orbit coupling of ML-WSe 2 . From ab initio calculations based on density functional theory, we interpret the high triplet formation in the ML-WSe 2 /ITIC hybrid bilayer due to changes in the nature and energies of the interfacial charge transfer (CT) levels. Our results highlight the delicate balance between excitons and charges in such inorganic/NFA heterostructures.

Rapid, nondestructive characterization techniques for evaluating the degree of crystallinity and phase segregation of organic semiconductor blend thin films are highly desired for in-line, automated optoelectronic device fabrication facilities. Here, it is demonstrated that reflection polarized optical microscopy (POM), a simple technique capable of imaging local anisotropy of materials, is capable of determining the relative degree of crystallinity and phase segregation of thin films of polymer:fullerene blends. While previous works on POM of organic semiconductors have largely employed the transmission geometry, it is demonstrated that reflection POM provides 3× greater contrast. The optimal configuration is described to maximize contrast from POM images of polymer:fullerene films, which requires Köhler illumination and slightly uncrossed polarizers, with an uncrossing angle of ±3°. It is quantitatively demonstrated that contrast in POM images directly correlates with 1) the degree of polymer crystallinity and 2) the degree of phase segregation between polymer and fullerene domains. The origin of the bright and dark domains in POM is identified as arising from symmetry-broken liquid crystalline phases (i.e., dark conglomerates), and it is proven that they have no correlation with surface topography. The use of reflection POM as a rapid diagnostic tool for automated device fabrication facilities is discussed., (© 2024 The Author(s). Macromolecular Rapid Communications published by Wiley‐VCH GmbH.)

This comprehensive review examines exercise as a therapeutic intervention for managing chronic diseases. It explores the physiological mechanisms behind physical activity's beneficial effects and its impact on various conditions, including cardiovascular disease, diabetes mellitus, obesity, and mental health disorders. Drawing from current literature and research findings, this review highlights how regular exercise significantly reduces mortality rates, improves disease outcomes, and enhances the overall quality of life for those with chronic illnesses. It discusses specific exercise recommendations for different conditions, emphasizing the importance of tailored physical activity programs. The review also addresses exercise's potential as a cost-effective and accessible treatment option, which may complement or, in some cases, reduce the need for pharmacological interventions. Ultimately, this review aims to equip healthcare professionals with a thorough understanding of exercise's therapeutic potential in chronic disease management, supporting the integration of physical activity into comprehensive treatment plans., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Fairag et al.)

Background/Objectives : Alzheimer's disease (AD) is the most common form of dementia and affects approximately 50 million individuals worldwide. Interest in coconut oil (CO) as a potential dietary intervention has surged owing to its substantial medium-chain triglyceride (MCT) content. Therefore, sustaining cognitive function and potentially slowing the progression of AD are crucial. This systematic review and meta-analysis evaluated the effects of CO and its bioactive metabolites on AD and dementia. Methods : The review protocol is registered in PROSPERO (CRD42023450435). Relevant research articles published between January 2015 and June 2023 were systematically searched. Seven studies met the predetermined eligibility criteria. Thematic analysis was utilized to synthesis the data about the qualitative features, while meta-analysis was employed for the quantitative findings. A meta-analysis was conducted to assess the standardized mean difference (SMD) and the corresponding 95% confidence interval (CI). Forest plots were generated using Review Manager 5.3 (RevMan 5.3). Results : The analysis revealed that all studies showed consistent results regarding the effects of CO on cognitive scores, with little variability in the true effects of CO on cognitive scores across the studies included in the meta-analysis. Conclusions : CO improved cognitive scores in patients with AD compared with those in the control group ( p < 0.05). The results of this study add to the increasing amount of evidence indicating that MCTs found in CO might be a way to improve abilities and potentially slow the advancement of AD. The findings of this study may encourage the development of targeted dietary strategies and interventions for individuals at risk of or diagnosed with AD.

An organic photoelectrochemical transistor (OPECT) is an organic electrochemical transistor (OECT) that utilizes light to toggle between ON and OFF states. The current response to light and voltage fluxes in aqueous media renders the OPECT ideal for the development of next-generation bioelectronic devices, including light-assisted biosensors, light-controlled logic gates, and artificial photoreceptors. However, existing OPECT architectures are complex, often requiring photoactive nanostructures prepared through labor-intensive synthetic methods, and despite this complexity, their performance remains limited. In this study, we develop aqueous electrolyte-compatible optoelectronic transistors using a single n-type semiconducting polymer. The n-type film performs multiple tasks: (1) gating the channel, (2) generating a photovoltage in response to light, and (3) coupling and transporting cations and electrons in the channel. We systematically investigate the photoelectrochemical properties of a range of n-type polymeric mixed conductors to understand the material requirements for maximizing phototransistor performance. Our findings contribute to the identification of crucial material and device properties necessary for constructing high-performance OPECTs with simplified design features and a direct interface with biological systems.

Attention-deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in childhood. This study investigates the quality of life (QoL) of parents of children with ADHD, the discrimination they encounter, and their sources of information about the disorder. This cross-sectional study was conducted using an online questionnaire through Google Forms from March to April 2023. Study participants were recruited using a convenient sampling technique from patient records in 4 regions of Saudi Arabia. The questionnaire was sent through commonly used social media. QoL was assessed through the validated Arabic version of the World Health Organization Quality of Life Instrument, Short Form questionnaire. A total of 100 participants were recruited for this study. Most of the participants were from the southern region (80%, n = 80), 66.0% (n = 66) were mothers, 66.0% (n = 66) were married and 64% (n = 64) had a college degree. The mean scores of the physical, psychological, mental, environmental, total scales, and general QoL were (57.18 ± 13.67, 62.58 ± 17.49, 63.33 ± 23.12, 23.07 ± 12.87, 51.54 ± 14.34, 3.69 ± 1.06, respectively). Half of the population studied experienced discrimination with no significant differences between mothers and fathers (64% vs 68%, P = .833). The main source of information on ADHD was the Internet (49%) followed by schools (11%), and relatives (10%). Fifty-four percent of the participants have participated in workshops or seminars on neurodevelopmental disorders and 39.0% believed that schools and institutions are sufficiently equipped to support children with ADHD. ADHD had a profound impact on the QoL of parents, with a substantial portion facing discrimination due to their child condition. Additionally, parents showed a strong desire to acquire more information about ADHD, highlighting the need for a comprehensive understanding and support surrounding this condition., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The illnesses associated with changes in barometric pressure can be classified into three types: acute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema. HAPE is a rare form of pulmonary edema that occurs in susceptible individuals after arriving at altitudes over 2500 m above sea level (m). Only a few studies have reported classical HAPE among children with underlying cardiopulmonary comorbidities. In this study, we report two pediatric cases of classical HAPE that occurred immediately upon arriving at Abha city (with an average elevation of 2270 m above sea level). Notably, both patients possessed underlying chronic lung diseases, raising crucial questions about susceptibility factors and the early onset manifestations of HAPE., Case: Two pediatric cases of HAPE are presented. The first patient, with a medical history of repaired right congenital diaphragmatic hernia and subsequent right lung hypoplasia, developed HAPE following their ascent to a high altitude. The second patient, diagnosed with diffuse lung disease of unknown etiology, experienced HAPE after a rapid high-altitude ascent. Both patients resided in low-altitude areas prior to ascent. The initial emergency room assessment revealed that both patients had severe hypoxia with respiratory distress that mandated the initiation of respiratory support and 100% oxygen therapy. They required intensive care unit admission, improved after 5 days of hospitalization, and were sent home in good condition., Conclusion: HAPE is a complex, potentially life-threatening high-altitude illness with diverse clinical presentations and variable risk factors. This case report sheds light on a potential predisposition factor-pre-existing lung disease-in children experiencing severe HAPE. While further validation is crucial, this valuable insight opens doors for improved preventative strategies and informed medical decisions for children with pre-existing lung conditions traveling to high altitudes.

Objective: This study aims to compare the polysomnographic features between Arab-Indian and Benin phenotypes of sickle cell disease (SCD)., Materials and Methods: This prospective cross-sectional study was conducted in the Children's Hospital at King Fahad MedicalCity, in Riyadhwhere childrenwere recruited fromthe pediatric hematology clinic and pediatric sleepmedicine. All families were approached and patients who met the inclusion criteria and agreed to participate were included in the study., Results: Eighty four children (37 of whom were females) with SCD were included in the study. Their median (interquartile) age was 9 (6.65, 11) years and their body mass index z score was -1.45 (-2.195, -1.45). The evidence of obstructive sleep apnea (OSA) was more prominent in the Benin phenotype (66.7%) in comparison to those of the Arab-Indian (35.2%) phenotype ( p = 0.006). Additionally, 56.7% of Benin had moderate to severe OSA whereas Arab-Indian had 18% with a ( p = 0.0003). Controlling for other factors, the odds ratio (confidence interval) of having OSA in Benin phenotype was 4.68 (1.42-15.38) times higher as compared to Arab-Indian phenotype., Conclusion: The risk of having OSA as well as the severity of OSA is higher in Benin phenotype as compared to Arab-Indian phenotype which indicates the presence of potential OSA risk factors other than the SCD itself.

Background: During the COVID-19 pandemic, countries around the world implemented various interventions to manage the spread of respiratory illnesses, including influenza. However, there is a lack of studies that have assessed the influence of COVID-19 on influenza prevalence in Saudi Arabia. In this study, we aimed to evaluate the prevalence of positive influenza cases before and during the COVID-19 pandemic in relation to the mitigation measures and policy initiatives in Saudi Arabia., Methods: A multicenter, time-series cross-sectional study was conducted to evaluate influenza prevalence before and during the COVID-19 pandemic between 01/01/2017 and 31/12/2021. This study included all patients who were screened for influenza infection at healthcare facilities across Saudi Arabia using polymerase chain reaction (PCR). The primary outcome was to determine the prevalence of influenza infections before and during the COVID-19 pandemic, while the secondary outcome was to describe the demographic data and comorbidities of the included patients in both periods., Results: During the study period, 5238 cases were identified based on a positive PCR result for influenza virus. The yearly number of influenza cases in the pre-COVID-19 period was 1123 (2.03 %), 1075 (1.63 %), and 1883 (2.20 %) cases in 2017, 2018, and 2019, respectively. On the other hand, the number of cases during the COVID-19 pandemic was 417 (0.63 %) and 740 (1.27 %) in 2020 and 2021, respectively, with a comparable number of performed tests. Patients infected with the influenza virus between 2020 and 2021 were older than patients who were infected before the COVID-19 pandemic., Conclusion: The study found a lower number of influenza cases during the COVID-19 pandemic, with no clear peak during November and December 2020 and 2021., Competing Interests: Declaration of Competing Interest No author has a conflict of interest in this study., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Conjugated polymer films, which can conduct both ionic and electronic charges, are central to building soft electronic sensors and actuators. Despite the possible interplay between light absorption and the mixed conductivity of these materials in aqueous biological media, no single polymer film has been utilized to create a solar-switchable organic bioelectronic circuit that relies on a fully reversible and redox reaction-free potentiometric photodetection and current modulation. Here we demonstrate that the absorption of light by an electron and cation-transporting polymer film reversibly modulates its electrochemical potential and conductivity in an aqueous electrolyte, which is harnessed to design an n-type photo-electrochemical transistor (n-OPECT). By controlling the intensity of light incident on the n-type polymeric gate electrode, we generate transistor output characteristics that mimic the modulation of the polymeric channel current achieved through gate voltage control. The micron-scale n-OPECT exhibits a high signal-to-noise ratio and an excellent sensitivity to low light intensities. We demonstrate three direct applications of the n-OPECT, i.e., a photoplethysmogram recorder, a light-controlled inverter circuit, and a light-gated artificial synapse, underscoring the suitability of this platform for a myriad of biomedical applications that involve light intensity changes., (© 2023. Springer Nature Limited.)

Background: Despite insufficient evidence, vitamin D has been used as adjunctive therapy in critically ill patients with COVID-19. This study evaluates the effectiveness and safety of vitamin D as an adjunctive therapy in critically ill COVID-19 patients., Methods: A multicenter retrospective cohort study that included all adult COVID-19 patients admitted to the intensive care units (ICUs) between March 2020 and July 2021. Patients were categorized into two groups based on their vitamin D use throughout their ICU stay (control vs. vitamin D). The primary endpoint was in-hospital mortality. Secondary outcomes were the length of stay (LOS), mechanical ventilation (MV) duration, and ICU-acquired complications. Propensity score (PS) matching (1:1) was used based on the predefined criteria. Multivariable logistic, Cox proportional hazards, and negative binomial regression analyses were employed as appropriate., Results: A total of 1,435 patients were included in the study. Vitamin D was initiated in 177 patients (12.3%), whereas 1,258 patients did not receive it. A total of 288 patients were matched (1:1) using PS. The in-hospital mortality showed no difference between patients who received vitamin D and the control group (HR 1.22, 95% CI 0.87-1.71; p = 0.26). However, MV duration and ICU LOS were longer in the vitamin D group (beta coefficient 0.24 (95% CI 0.00-0.47), p = 0.05 and beta coefficient 0.16 (95% CI -0.01 to 0.33), p = 0.07, respectively). As an exploratory outcome, patients who received vitamin D were more likely to develop major bleeding than those who did not [OR 3.48 (95% CI 1.10, 10.94), p = 0.03]., Conclusion: The use of vitamin D as adjunctive therapy in COVID-19 critically ill patients was not associated with survival benefits but was linked with longer MV duration, ICU LOS, and higher odds of major bleeding., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Al Sulaiman, Korayem, Aljuhani, Altebainawi, Shawaqfeh, Alarfaj, Alharbi, Ageeli, Alissa, Vishwakarma, Ibrahim, Alenazi, Alghnam, Alshehri, Alshammari, Alhubaishi, Aldhaeefi, Alamri, Syed, Khan, Alalawi, Alanazi, Alresayes, Albarqi and Al Ghamdi.)

Background: This study aimed to determine the prevalence and associated characteristics of needle stick and sharp injuries (NSSIs) among King Salman Armed Forces Hospital (KSAFH) personnel., Methods: Data was collected by reviewing all reported NSSIs among KSAFH personnel between January 2020 to December 2022., Results: The prevalence of NSSIs was 2.05%, with nurses being the most commonly affected. Most injuries occurred in patients' rooms/wards and among health care workers (HCWs) aged < 40 years. Of the injured workers, 93.8% were immunized against hepatitis B virus (HBV)., Conclusion: Educational and training programs targeting high-risk age groups and professions should be developed. Policies related to locations and situations where injuries occur frequently should be reviewed regularly to reduce the risk of NSSIs., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alshehri et al.)

Electronic Drug Alarms and Drug Utilization Reviews (DURs) are crucial in improving patient safety by reducing the dispensing of contraindicated medications and minimizing adverse drug events. The DUR system often generates low-level alerts, making it challenging for pharmacists and doctors to discern more critical alerts. This can result in alert fatigue, causing burnout and jeopardizing patient safety. A cross-sectional study was conducted in a tertiary hospital to explore pharmacists' perspectives and experience with the DUR system. This study aimed to identify their responses to alerts indicating a need to change the original prescription and the difficulties encountered. Out of all the participants, 85% had prior experience with DUR alerts. However, 40% of them expressed dissatisfaction with the alerts. Moreover, 88% of the participants received highly frequent DUR alerts, but only 40% believed that DUR alerts could identify rare adverse drug reactions. Additionally, only 27% of the participants altered their prescriptions based on alerts for the MAOI/serotonin modulator. The survey showed that 66% of participants believe improvements are necessary for the DUR system. Specifically, 77% of participants felt that more information is needed on overlapping prescriptions, 82% on patients with chronic diseases, and 82% on potential reactions caused by co-administration. At the same time, 75% raised concern about the need for backup for any server breakdown. Positive perceptions about DUR lead to changing the prescription in response to an alert. Therefore, improving the DUR system is crucial to prevent pharmacists from missing important alerts and to increase their awareness of clinically significant alarm signals. By doing so, we can optimize patient safety and contribute to providing high-quality healthcare services.

Scope: A prospective study of 34492 participants shows an inverse association between (+)-catechin intake and coronary heart disease. The effects of (+)-catechin on atherosclerosis and associated risk factors are poorly understood and are investigated., Methods and Results: (+)-Catechin attenuates reactive oxygen species production in human macrophages, endothelial cells and vascular smooth muscle cells, chemokine-driven monocytic migration, and proliferation of human macrophages and their expression of several pro-atherogenic genes. (+)-Catechin also improves oxidized LDL-mediated mitochondrial membrane depolarization in endothelial cells and attenuates growth factor-induced smooth muscle cell migration. In C57BL/6J mice fed high fat diet (HFD) for 3 weeks, (+)-catechin attenuates plasma levels of triacylglycerol and interleukin (IL)-1β and IL-2, produces anti-atherogenic changes in liver gene expression, and reduces levels of white blood cells, myeloid-derived suppressor cells, Lin - Sca + c-Kit + cells, and common lymphoid progenitor cells within the bone marrow. In LDL receptor deficient mice fed HFD for 12 weeks, (+)-catechin attenuates atherosclerotic plaque burden and inflammation with reduced macrophage content and increased markers of plaque stability; smooth muscle cell and collagen content., Conclusion: This study provides novel, detailed insights into the cardio-protective actions of (+)-catechin together with underlying molecular mechanisms and supports further assessments of its beneficial effects in human trials., (© 2023 The Authors. Molecular Nutrition & Food Research published by Wiley-VCH GmbH.)

Background The number of people suffering from depression has increased in recent times. In the Aseer region alone, 3.8% of the population suffers from depression, and one of the causes is believed to be dry eye disease (DED). Objectives This research aims to investigate the relationship between depression and dry eye disease among people living in Saudi Arabia's Aseer region. Methodology The study is cross-sectional, and data was collected from 401 participants living in Aseer, Saudi Arabia. Data was collected with the help of a well-structured questionnaire, and results are extracted by analyzing the model using SPSS. Findings The study discovered a positive and significant relationship between dry eye disease and depression. A total of 36.7% of the participants had dry eye symptoms and 23.7% were diagnosed with depression, stress, or anxiety. Conclusion Our study concludes that patients suffering from dry eye disease are more likely to get depressed because, according to our analysis, there is a correlation between dry eye disease and depression. Dry eye disease is a condition that is not only affecting the elderly but the young alike. Saudi Arabia's healthcare authority should create awareness about this health issue with the help of seminars, print, and social media., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alamri et al.)

Introduction: The oral cavity is one of the most common sites impacted by hematopoietic stem cell transplantation (HSCT) with acute complications including mucositis, bleeding, salivary gland dysfunction, infection, and taste alteration. These complications may result in significant morbidity and can negatively impact outcomes such as length of stay and overall costs. As such, oral care during HSCT for prevention and management of oral toxicities is a standard component of transplant protocols at all centers. The objective of this study was to evaluate the current oral care practices for patients during HSCT at different transplant centers within the Eastern Mediterranean region., Material and Methods: An internet-based survey was directed to 30 transplant centers in the Eastern Mediterranean region. The survey included five sections asking questions related to (1) transplant center demographics; (2) current oral care protocol used at the center and type of collaboration (if any) with a dental service; (3) use of standardized oral assessment tools and grading systems for mucositis; (4) consultations for management of oral complications; and (5) oral health needs at each center. Data are presented as averages and percentages., Results: A total of 16 responses from 11 countries were collected and analyzed, indicating a response rate of 53%. Eight centers reported that a dentist was part of the HSCT team, with four reporting oral medicine specialists specifically being part of the team. Almost all centers (15/16; 93%) had an affiliated dental service to facilitate pre-HSCT dental clearance with an established dental clearance protocol at 14 centers (87%). Dental extraction was associated with the highest concern for bleeding and the need for platelet transfusion. With respect to infection risk, antibiotic prophylaxis was considered in the setting of low neutrophil counts with restorative dentistry and extraction. All centers provide daily reinforcement of oral hygiene regimen. The most frequently used mouth oral rinses included sodium bicarbonate (68%) and chlorhexidine gluconate (62%), in addition to ice chips for dry mouth (62%). The most frequently used mucositis assessment tools were the World Health Organization scale (7/16; 43%) and visual analogue scale for pain (6/16; 37%). Mucositis pain was managed with lidocaine solution (68.8%), magic mouth wash (68.8%) and/or systemic pain medications (75%)., Conclusions: Scope and implementation of oral care protocols prior to and during HSCT varied between transplant centers. The lack of a universal protocol may contribute to gaps in oral healthcare needs and management for this group of patients. Further dissemination of and education around available oral care guidelines is warranted., Clinical Relevance: Considering oral care during HSCT a standard component of transplant protocols, the current study highlights the common oral care practices for patients at centers within the Eastern Mediterranean region.

Background: To evaluate the effect of amalgam contamination, different surface treatments, and adhesive protocols on dentin microleakage to bulk-fill composite resin material., Methods: Forty teeth were fixed in (polyvinyl siloxane) PVS molds, and the Class II cavities were placed on mesial and distal aspects. Thirty teeth were restored by amalgam and thermocycled to 10,000 cycles (5 and 55 °C, 30-s dwell time). The rest were restored with Filtek one Bulk Fill composite without amalgam predecessor. Samples were divided into: G1 (dentin pretreated with 2% chlorhexidine gluconate), G2 (0.5 mm of dentin was removed), G3 (no surface modification), and G4 (control, where composite was bonded to sound dentin without amalgam predecessor.). Single Bond Universal Adhesive system was used to bond the composite material, by using the etch-and-rinse protocol in the mesial cavity preparation and self-etch protocol in the distal. Specimens underwent thermocycling for 5000 cycles, then embedded in silver nitrate and sectioned for stereomicroscope examination. Descriptive statistics, Mann-Whitney U test, and Kruskal-Wallis test were used to analyze the results at p < 0.05., Results: The highest microleakage score values (4.00) were found in the G2, and G4 in etch-and-rinse protocol. While the lowest scores were found in G2 when using self-etching protocol (1.5). Lower microleakage values were associated with the chlorhexidine treatment group for both adhesive protocols. No significant differences were found between amalgam contaminated and non-contaminated groups., Conclusions: Amalgam contamination did not affect microleakage. Self-etching adhesive protocol significantly reduced microleakage for all groups irrespective of the surface treatment. Chlorhexidine pretreatment improved microleakage for both adhesive protocols but had no significant effect., (© 2022. The Author(s).)

Although in vitro model systems are useful for investigation of atherosclerosis-associated processes, they represent simplification of complex events that occur in vivo, which involve interactions between many different cell types together with their environment. The use of animal model systems is important for more in-depth insights of the molecular mechanisms underlying atherosclerosis and for identifying potential targets for agents that can prevent plaque formation and even reverse existing disease. This chapter will provide a survey of such animal models and associated techniques that are routinely used for research of atherosclerosis in vivo., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Vancomycin is a commonly used antibiotic in critically ill patients for various indications. Critical illness imposes pharmacokinetic-pharmacodynamics challenges, which makes optimizing vancomycin in this population cumbersome. Data are scarce on the clinical impact of time to therapeutic trough levels of vancomycin in critically ill patients.  This study aims to evaluate the timing to achieve therapeutic trough level of vancomycin on 30-day mortality in critically ill patients., Method: A retrospective cohort study was conducted for all adult critically ill patients with confirmed Gram-positive infection who received IV vancomycin between January 1, 2017, and December 31, 2020. We compared early (< 48 h) versus late (≥ 48 h) attainment of vancomycin therapeutic trough levels. The primary outcome was the 30-day mortality in critically ill patients. Secondary outcomes were the development of resistant organisms, microorganisms eradication within 4-5 days of vancomycin initiation, acute kidney injury (AKI), and length of stay (LOS). Propensity score-matched (1:1 ratio) used based on patient's age, serum creatinine, and albumin values at baseline., Results: A total of 326 patients were included; 110 patients attained the therapeutic trough levels within 48 h of vancomycin initiation. Late achievement of the therapeutic trough levels was associated with higher 30-day mortality (HR: 2.54; 95% CI [1.24-5.22]; p = 0.01). Additionally, patients who achieved therapeutic trough levels of vancomycin late were more likely to develop AKI (OR = 2.59; 95% CI [1.01-6.65]; p = 0.04). Other outcomes were not statistically significant between the two groups., Conclusion: Early achievement of vancomycin therapeutic levels in patients with confirmed Gram-positive infection was associated with possible survival benefits., (© 2021. The Author(s).)

Background: The last two decades have witnessed a burgeoning rise in the prevalence of diabetes globally. It has already reached epidemic proportions in Saudi Arabia, with reported high risk among women. As a result, diabetes monitoring and self-management programs are being highly prioritized for diabetes control and management., Objective: To investigate measuring and sharing practices of the self-monitoring of blood glucose (SMBG) among patients with type 1 or 2 diabetes using insulin., Methods: A cross-sectional study was conducted on a sample of 203 patients attending primary care clinics at a tertiary care center. The questionnaire assessed the measuring, recording, and sharing of SMBG practices of patients having diabetes with their physicians. The methods used for recording and sharing were categorized into paper-based and electronic-based. In addition, the determinants of the different methods used and frequency of sharing were analyzed., Results: The overall monitoring prevalence was 95% (193/203), and 57% (117/203) of participants shared the SMBG results. Among the 193 individuals that performed self-monitoring, 138 (72%) performed daily monitoring, and 147 (76%) recorded their blood sugar levels. Almost 55% (81/147) used paper-based materials like notebooks and paper for recording, while the rest (66/147, 45%) used digital devices like laptops and smartphones. A shift towards the use of digital devices and smart applications was observed in patients below 50 years of age. The digitally recorded blood glucose measurements were being shared thrice more often than the recordings made on paper or in notebooks (OR [odds ratio] 2.8; P=.01). Patients >50 years of age (OR 2.3; P=.02), with lesser formal education, married (OR 4.2; P<.001), with smaller family size (OR 2.6; P=.01), having type 2 diabetes (OR 4.1; P<.001) and any comorbid conditions (OR 2.6; P=.01) were associated with higher odds of using paper-based sharing methods. Only the female gender and type 2 diabetes were associated with increased frequency of sharing, while uncontrolled diabetes, the presence of other comorbidities, and duration of diabetes did not show any influence., Conclusions: Good monitoring and optimal sharing practices were found. Sharing using electronic devices can be emphasized. Diabetes self-management programs can incorporate the use of digital technology in training sessions. Digital literacy and its applications in health care may enhance SMBG practices resulting in better diabetes control., (©Amr Jamal, Shabana Tharkar, Weam Saleh Babaier, Shrooq Faisal Alsomali, Allulu Saad Alsulayhim, Monera Abdulkareem Alayuni, Nada Abdulaziz Aldakheel, Safa Sultan Al-Osaimi, Norah Alshehri, Mohammed Batais. Originally published in JMIR Diabetes (https://diabetes.jmir.org), 27.10.2021.)

Purpose: To evaluate the effect of amalgam contamination, different surface treatments, and adhesive protocols on dentin shear bond strength (SBS) to bulk-fill composite resin material., Materials and Methods: Eighty teeth were fixed in molds, and the dentin was exposed and then polished. Sixty teeth were restored by amalgam and thermocycled to 10,000 cycles (5°C and 55°C, 30-second dwell time). The rest were restored with composite materials without amalgam predecessor. The samples were divided into G1 (with dentin pretreatment with 2% chlorhexidine gluconate), G2 (0.5 mm of dentin was removed), G3 (no surface modification), and G4 (samples were restored with bulk-fill composite). The bonded specimens were subdivided based on the adhesive protocol of the universal adhesive system used into etch-and-rinse and self-etch groups. Acid etching was done using 32% phosphoric acid. Composite resin was used for build-up using mold and glass. Specimens were cured and left for 24 h in distilled water at room temperature for polymerization reaction, underwent thermocycling for 5000 cycles, and were subjected to knife-edge shear bond testing. Descriptive statistics, independent t -tests, and one-way analysis of variance followed by pairwise comparisons were used to analyze the results., Results: The highest mean SBS values were found in the control group where acid etching was used (24.46±2.24 MPa), followed by self-etching in the same group (21.92±2.54 MPa). Lower SBS values were associated with the amalgam-contaminated group. The lowest values were found in the dentin refreshment group when the self-etching mode was used (13.59±1.73 MPa). Chlorhexidine treatment improved the mean SBS value compared with the no treatment or dentin refreshment groups for both adhesive protocols., Conclusion: Amalgam contamination may affect SBS values. Acid etching improved SBS for non-contaminated dentin. Chlorhexidine improved SBS for amalgam-contaminated dentin as a surface treatment but had no significant effect., Competing Interests: The authors declare no conflicts of interest in this work., (© 2021 Alshehri and Bin-Shuwaish.)

Context: Azithromycin has anti-Ureaplasma and anti-inflammatory properties that might help reduce lung injury in preterm infants., Objective: To test the efficacy and safety of prophylactic or therapeutic azithromycin in preventing bronchopulmonary dysplasia (BPD) in preterm infants with unknown or proven Ureaplasma status., Methods: We searched PubMed, Web of Science, and Cochrane Library until 13 September 2020. Two authors independently assessed the eligibility, risk of bias, and extracted the data. We performed a random-effects model meta-analysis to yield pooled relative risk (RR) or mean difference (MD) with 95% confidence interval (CI). We used the Cochrane GRADE methodology for summarizing the results., Results: We included five randomized clinical trials. The meta-analysis revealed no significant differences in BPD (RR, 0.92; 95% CI, 0.71, 1.19; low-quality evidence), death (RR, 0.75; 95% CI, 0.52, 1.10; low-quality evidence), and BPD or death (RR, 0.90; 95% CI, 0.74, 1.10; low-quality evidence). However, a significantly lower BPD or death (RR, 0.83; 95% CI, 0.70, 0.99) and a trend toward lower BPD (RR, 0.83; 95% CI, 0.66, 1.03) with azithromycin therapy was noted in Ureoplasma positive neonates. No differences in secondary outcomes were noted, except for significantly lower supplemental oxygen days with azithromycin (MD, -6.06; 95% CI, -7.40, -4.72; moderate-quality evidence). The test for subgroup differences between short (<7 days) and long (>7 days) course of azithromycin were nonsignificant for all the outcomes., Conclusion: Low-quality evidence suggests azithromycin therapy reduces BPD or death in preterm infants with positive Ureoplasma, but not in all preterm infants., (© 2020 Wiley Periodicals LLC.)