High-Polyphenol Fruit and Vegetable Consumption and Cardiovascular Disease (CVD) Risk Factors Among Adults in Jeddah, Saudi Arabia.

BACKGROUND: Polyphenols found in food is a potential modifiable factor in disease prevention, especially when it comes to cardiovascular diseases (CVDs). This study aimed to determine the total polyphenol intake from fruits and vegetables (FV) in patients at King of Abdulaziz University Hospital, Jeddah, Saudi Arabia, and its association with vascular risk biomarkers. METHODS: A cross-sectional study was done on 151 adult patients with at least one CVD risk factor. Data about demographics, smoking status, physical activity, height and weight, waist-to-hip ratio (WHR), waist circumference (WC), disease history, current disease (CD), and amount of polyphenol intake (mg/100 g) from rich polyphenol FV sources were collected. RESULTS: Of the participants, 127 (84.1%) were females, 49 (32.5%) had an age ranging from 45 to 54 years, and 110 (72.8%) were married. Of them, 54 (35.8%) had a bachelor's education, and 64 (42.4%) were employed. Moreover, 89 (59.3%) were physically inactive, 18 (11.9%) were smokers, 105 (69.5%) were obese, 116 (76.9%) had high WC, and 103 (68.2%), 109 (72.2%), and 90 (59.6%) had a family history of diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia, respectively. The mean total polyphenol consumption/gm was significantly higher among older and married participants, and patients with HTN had a significantly lower mean total polyphenol consumption/gm. A significant positive correlation was found between the total polyphenol consumption/gm and participants' age. CONCLUSION: The consumption of polyphenols was associated with age, marital status, and blood pressure. Polyphenols from FV may have a preventive effect against cardiovascular illnesses. Including a range of foods high in polyphenols in a balanced diet is still a potential way to support cardiovascular health.

Abdominal Obesity-Metabolic Syndrome 3 Misclassified as Type 1 Diabetes Mellitus.

Age is no longer the most important differentiating feature between type 1 and type 2 diabetes, as obesity and metabolic syndrome are on the rise in the pediatric population. Here we present a case of a 30-year-old male individual initially diagnosed with uncontrolled type 1 diabetes mellitus (T1DM) since the age of 15, and treatment with high insulin doses has been unsuccessful. He was later identified as having abdominal obesity-metabolic syndrome 3 (AOMS3) based on strong family history and the presence of insulin resistance features. AOMS3 is characterized by early-onset coronary artery disease, central obesity, hypertension, and diabetes. Early detection of this condition is crucial to implement timely interventions and preventing the onset of complications.

The impact of alcohol hand sanitizer use on skin health between healthcare worker: Cross-sectional study.

BACKGROUND: 2020 Coronavirus disease 2019 (COVID-19) has become a global health crisis, so hand alcohol-based sanitizers have become essential to preventive measures. Previous studies reported that hand sanitizers could kill bacteria and viruses; however, using them excessively can lead to health problems if misused. In light of sanitizer overuse, the availability of various products and qualities in the market, and the absence of data on skin problems, we conducted a survey study about the impact of commonly used sanitizers on skin health, particularly on hands. The study aimed to determine the prevalence and the correlation between hand sanitizer and skin health during the COVID-19 pandemic at the National Guard Institute- Jeddah, Saudi Arabia. METHODS: A cross-sectional study was conducted using a self-administered online questionnaire by sending an invitation link to students and employees of the National Guard Institute- Jeddah, Saudi Arabia, in 2021. A chi-squared test was used to obtain differences concerning awareness of hand sanitizer use/type and hand skin health. RESULTS: In the total 216 participants, there were considerably more skin conditions reported by women (62.5%) and respondents ages 31-40 (36.6%). For the types of hand sanitizers, 89.8%, 40.9%, 30.2%, 4.7%, and 6% were recorded: gel, spray, wipes, foam, and others, respectively, and the survey applicants were filled by 60.6% of non-medical workers. According to the survey, 32.9% of participants experienced a hand crack, which was the most common hand side effect. The handwashing frequency was reported between 3 to 7 times per day during the COVID-19 pandemic, and 9.3% of participants used hand sanitizers more than 10 times daily. CONCLUSION: It was found that during the pandemic, skin changes were common among the NGHA population and healthcare workers. Consequently, the adverse health effects of these hand sanitizers on human health may result in multiple infections and toxicity. The present study provides appropriate knowledge on the types and ingredients of hand sanitizers as essential factors for skin health, preventing health risks during this pandemic.

Parental Knowledge of Appendicitis and Its Management Options Among Children of Makkah Region, Saudi Arabia.

BACKGROUND: Despite decades of studies, appendicitis in children still presents several uncertainties regarding optimal treatment. OBJECTIVES: To assess parental understanding of appendicitis, along with its risks and treatment, and to determine attitudes to operative and non-operative treatment of uncomplicated appendicitis. METHODS: This is a cross-sectional study. The current study has targeted all parents who visited the pediatric outpatient departments or clinics at three different hospitals in Makkah and Jeddah City, including Maternity and Children Hospital (MCH) in Makkah, King Fahad Armed Force Hospital (KFAFH), and Saudi German Private Hospital (SGH) in Jeddah. Data was collected via an online Google form and was analyzed by using SPSS. RESULTS: A total of 408 subjects were involved in this study. The majority of them were females (74.5%); 25.5% were males. Most of the study participants aged between 25 and 34 years. Our results found that the average knowledge score of the study population was 4.1±1.81 out of 11. Only 23.5% of them had good knowledge about appendicitis. More than half of the respondents identified the appendix as a part of the digestive system and most of the study population were aware of the current treatment for appendicitis, which is surgery (80.9%). Female participants and respondents who knew someone that has been treated for appendicitis were significantly associated with a better level of knowledge about appendicitis (P-values: 0.011 and 0.033, respectively). Moreover, we found that educational level significantly influenced preference for treatment with antibiotics and surgery if appendicitis happened again (P-value: 0.049). CONCLUSION: The study population had poor knowledge of appendicitis and its management options. The highlighted criteria of self-reported relevance to parents should be addressed in all appendicitis counseling and consent. We advocate for the establishment of national public awareness campaigns, as well as increased research and clinical trials. Understanding lay views of treatment alternatives and efficacy will influence future approaches to appendicitis therapy by analyzing the community's preference for emerging treatment modalities and identifying future directions for patient-centered clinical trials.

Keratin 19 binds and regulates cytoplasmic HNRNPK mRNA targets in triple-negative breast cancer.

BACKGROUND: Heterogeneous nuclear ribonucleoprotein K (HNRNPK) regulates pre-mRNA processing and long non-coding RNA localization in the nucleus. It was previously shown that shuttling of HNRNPK to the cytoplasm promotes cell proliferation and cancer metastasis. However, the mechanism of HNRNPK cytoplasmic localization, its cytoplasmic RNA ligands, and impact on post-transcriptional gene regulation remain uncharacterized. RESULTS: Here we show that the intermediate filament protein Keratin 19 (K19) directly interacts with HNRNPK and sequesters it in the cytoplasm. Correspondingly, in K19 knockout breast cancer cells, HNRNPK does not localize in the cytoplasm, resulting in reduced cell proliferation. We comprehensively mapped HNRNPK binding sites on mRNAs and showed that, in the cytoplasm, K19-mediated HNRNPK-retention increases the abundance of target mRNAs bound to the 3' untranslated region (3'UTR) at the expected cytidine-rich (C-rich) sequence elements. Furthermore, these mRNAs protected by HNRNPK in the cytoplasm are typically involved in cancer progression and include the p53 signaling pathway that is dysregulated upon HNRNPK knockdown (HNRNPK KD) or K19 knockout (KRT19 KO). CONCLUSIONS: This study identifies how a cytoskeletal protein can directly regulate gene expression by controlling the subcellular localization of RNA-binding proteins to support pathways involved in cancer progression.

Knowledge, Attitude, and Practice of Contraception Use Among Childbearing Women in Makkah Region, Saudi Arabia.

Introduction The rapid growth of the Saudi Arabian economy led to socio-demographic changes, with an increasing need for birth spacing and the use of contraceptives. This study evaluated the knowledge, attitude, and practice of contraception use in the Makkah region of Saudi Arabia. Methods This cross-sectional study used an online questionnaire involving women aged 18-49 in Makkah, Saudi Arabia. Descriptive analyses were performed and the Chi-squared test was used to compare variables. A p-value of < 0.05 was considered statistically significant. Results The study included 352 women aged 32±9.1 years with a response rate of 91%. Among them, 72.1% had a diploma or bachelor's degree, and two-thirds were married (63.4%). Nearly all respondents had heard of contraception before (96.9%). However, only 44.3% knew contraception is a method of family planning, and 23.9% knew it prevents unwanted pregnancy. During the period of conducting the research, 37.8% reported using some contraception. Oral contraceptive pills (OCP) (97.2%, 33.8%), intrauterine devices (IUD) (97.2%, 22.7%), and male condoms (92.9%, 16.9%) were the most known and popular contraception methods used. Respondents' primary sources of information regarding contraception were relatives or friends (38.3%) and websites (30.2%), and 61.9% needed education on family planning. We found that women with multiple children were significantly more likely to practice family planning (p=0.005). Conclusion We found that participants were aware of and had a good attitude toward family planning. However, they had poor knowledge and poor practice of family planning. Raising awareness and education are recommended to improve knowledge and practice of family planning.

Perception of virtual clinics among Saudi adults with type 1 diabetes during the COVID-19 pandemic.

BACKGROUND AND AIMS: We aimed to assess patient perception toward the rapid implementation of virtual phone clinics among Saudi adult patients with type 1 diabetes mellitus (T1DM) during the coronavirus disease (COVID-19) pandemic. METHODS: This cross-sectional, web-based study included Saudi adult patients with T1DM who attended at least one virtual phone visit with the diabetes clinic at King Abdulaziz Medical City, Jeddah, Saudi Arabia, between August 1 and December 31, 2020. Patients anonymously answered a Google form-created Arabic questionnaire. Information about patient characteristics, outcome, and perception of the virtual phone visit were obtained. Data were presented using descriptive statistics, chi-square, one-way ANOVA, independent t-, and Welch's t-tests. RESULTS: The questionnaire was sent to 281 patients, of whom 201 completed it. 59.2% patients were satisfied with their overall virtual phone clinic experience, and 75.6% preferred to continue attending the virtual phone clinics in the future. The average perception value of patients toward virtual phone clinics was 67.76 ± 19.9, suggesting good perception among the majority. Negative or neutral views of current health, asking to be physically seen, and missing a virtual appointment were associated with significantly lower average patient perception value (p < 0.001). CONCLUSIONS: Most Saudi patients with T1DM have adapted to virtual phone consultations, exhibiting good satisfaction and perception, and high preference to continue using this system in the future. The utilization of the service to assist patients with diabetes is highly encouraged, especially during the COVID-19 pandemic. Strategies need to be developed to further enhance the patient experience.

Keratin 19 maintains E-cadherin localization at the cell surface and stabilizes cell-cell adhesion of MCF7 cells.

A cytoskeletal protein keratin 19 (K19) is highly expressed in breast cancer but its effects on breast cancer cell mechanics are unclear. In MCF7 cells where K19 expression is ablated,we found that K19 is required to maintain rounded epithelial-like shape and tight cell-cell adhesion. A loss of K19 also lowered cell surface E-cadherin levels. Inhibiting internalization restored cell-cell adhesion of KRT19  knockout cells, suggesting that E-cadherin internalization contributed to defective adhesion. Ultimately, while K19 inhibited cell migration and invasion, it was required for cells to form colonies in suspension. Our results suggest that K19 stabilizes E-cadherin complexes at the cell membrane to maintain cell-cell adhesion which inhibits cell invasiveness but provides growth and survival advantages for circulating tumor cells.

Keratin 19 regulates cell cycle pathway and sensitivity of breast cancer cells to CDK inhibitors.

Keratin 19 (K19) belongs to the keratin family of proteins, which maintains structural integrity of epithelia. In cancer, K19 is highly expressed in several types where it serves as a diagnostic marker. Despite the positive correlation between higher expression of K19 in tumor and worse patient survival, the role of K19 in breast cancer remains unclear. Therefore, we ablated K19 expression in MCF7 breast cancer cells and found that K19 was required for cell proliferation. Transcriptome analyses of KRT19 knockout cells identified defects in cell cycle progression and levels of target genes of E2F1, a key transcriptional factor for the transition into S phase. Furthermore, proper levels of cyclin dependent kinases (CDKs) and cyclins, including D-type cyclins critical for E2F1 activation, were dependent on K19 expression, and K19-cyclin D co-expression was observed in human breast cancer tissues. Importantly, K19 interacts with cyclin D3, and a loss of K19 resulted in decreased protein stability of cyclin D3 and sensitivity of cells towards CDK inhibitor-induced cell death. Overall, these findings reveal a novel function of K19 in the regulation of cell cycle program and suggest that K19 may be used to predict the efficacy of CDK inhibitors for treatments of breast cancer.

Composition and content of phenolic acids and avenanthramides in commercial oat products: Are oats an important polyphenol source for consumers?

Oats contain a range of phenolic acids and avenanthramides which may have health benefits. Analysis of 22 commercial oat products (oat bran concentrate, oat bran, flaked oats, rolled oats and oatcakes) using HPLC-DAD detected eleven bound and thirteen free + conjugated phenolic acids and avenanthramides. The oat products (excluding concentrate) provided between 15.79 and 25.05 mg total phenolic acids (9.9-19.33 mg bound, 4.96-5.72 mg free + conjugated) and between 1.1 and 2 mg of avenanthramides in a 40 g portion while an 11 g portion of oat concentrate provided 16.7 mg of total phenolic acids (15.17 mg bound, 1.53 mg free + conjugated) and 1.2 mg of avenanthramides. The compositions and concentrations of the components in the different products were broadly similar, with the major component being ferulic acid (58-78.1%). The results show that commercial oat products are a source of phenolic acids and avenanthramides for consumers.

Intermediate Filaments as Effectors of Cancer Development and Metastasis: A Focus on Keratins, Vimentin, and Nestin.

Intermediate filament (IF) proteins make up the largest family of cytoskeletal proteins in metazoans, and are traditionally known for their roles in fostering structural integrity in cells and tissues. Remarkably, individual IF genes are tightly regulated in a fashion that reflects the type of tissue, its developmental and differentiation stages, and biological context. In cancer, IF proteins serve as diagnostic markers, as tumor cells partially retain their original signature expression of IF proteins. However, there are also characteristic alterations in IF gene expression and protein regulation. The use of high throughput analytics suggests that tumor-associated alterations in IF gene expression have prognostic value. Parallel research is also showing that IF proteins directly and significantly impact several key cellular properties, including proliferation, death, migration, and invasiveness, with a demonstrated impact on the development, progression, and characteristics of various tumors. In this review, we draw from recent studies focused on three IF proteins most associated with cancer (keratins, vimentin, and nestin) to highlight how several "hallmarks of cancer" described by Hanahan and Weinberg are impacted by IF proteins. The evidence already in hand establishes that IF proteins function beyond their classical roles as markers and serve as effectors of tumorigenesis.

Oat bran, but not its isolated bioactive ß-glucans or polyphenols, have a bifidogenic effect in an in vitro fermentation model of the gut microbiota.

Wholegrain oats are known to modulate the human gut microbiota and have prebiotic properties (increase the growth of some health-promoting bacterial genera within the colon). Research to date mainly attributes these effects to the fibre content; however, oat is also a rich dietary source of polyphenols, which may contribute to the positive modulation of gut microbiota. In vitro anaerobic batch-culture experiments were performed over 24 h to evaluate the impact of two different doses (1 and 3 % (w/v)) of oat bran, matched concentrations of ß-glucan extract or polyphenol mix, on the human faecal microbiota composition using 16S RNA gene sequencing and SCFA analysis. Supplementation with oats increased the abundance of Proteobacteria (P <0·01) at 10 h, Bacteroidetes (P <0·05) at 24 h and concentrations of acetic and propionic acid increased at 10 and 24 h compared with the NC. Fermentation of the 1 % (w/v) oat bran resulted in significant increase in SCFA production at 24 h (86 (sd 27) v. 28 (sd 5) mm; P <0·05) and a bifidogenic effect, increasing the relative abundance of Bifidobacterium unassigned at 10 h and Bifidobacterium adolescentis (P <0·05) at 10 and 24 h compared with NC. Considering the ß-glucan treatment induced an increase in the phylum Bacteroidetes at 24 h, it explains the Bacteriodetes effects of oats as a food matrix. The polyphenol mix induced an increase in Enterobacteriaceae family at 24 h. In conclusion, in this study, we found that oats increased bifidobacteria, acetic acid and propionic acid, and this is mediated by the synergy of all oat compounds within the complex food matrix, rather than its main bioactive ß-glucan or polyphenols. Thus, oats as a whole food led to the greatest impact on the microbiota.

Excretion of Avenanthramides, Phenolic Acids and their Major Metabolites Following Intake of Oat Bran.

SCOPE: Wholegrain has been associated with reduced chronic disease mortality, with oat intake particularly notable for lowering blood cholesterol and glycemia. To better understand the complex nutrient profile of oats, we studied urinary excretion of phenolic acids and avenanthramides after ingestion of oat bran in humans. METHODS AND RESULTS: After a 2-d (poly)phenol-low diet, seven healthy men provided urine 12 h before and 48 h after consuming 60 g oat bran (7.8 µmol avenanthramides, 139.2 µmol phenolic acids) or a phenolic-low (traces of phenolics) control in a crossover design. Analysis by ultra-high performance liquid chromatography (UPLC)-MS/MS showed that oat bran intake resulted in an elevation in urinary excretion of 30 phenolics relative to the control, suggesting that they are oat bran-derived. Mean excretion levels were elevated between 0-2 and 4-8 h, following oat bran intake, and amounted to a total of 33.7 ± 7.3 µmol total excretion (mean recovery: 22.9 ± 5.0%), relative to control. The predominant metabolites included: vanillic acid, 4- and 3-hydroxyhippuric acids, and sulfate-conjugates of benzoic and ferulic acids, which accounted collectively for two thirds of total excretion. CONCLUSION: Oat bran phenolics follow a relatively rapid urinary excretion, with 30 metabolites excreted within 8 h of intake. These levels of excretion suggest that bound phenolics are, in part, rapidly released by the microbiota.