Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists: Exploring Their Impact on Diabetes, Obesity, and Cardiovascular Health Through a Comprehensive Literature Review.

Glucagon-like peptide-1 receptor agonists (GLP-1-RAs) are a novel class of medications promising for treating type 2 diabetes mellitus (T2DM) and obesity-related conditions such as cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD). This comprehensive literature review examines available research on these medications, focusing on their mechanisms of action, clinical effectiveness, safety profiles, and socioeconomic implications. A comprehensive search was performed using the PubMed, EMBASE, and Cochrane Library databases. Although initially developed for glucose management, these drugs have also demonstrated efficacy in promoting weight loss and reducing the risk of CVD. GLP-1-RAs function similarly to naturally occurring incretins. They stimulate insulin secretion in response to glucose levels, inhibit glucagon release, delay stomach emptying, and generate a sense of fullness via brain pathways. Head-to-head clinical studies have indicated that GLP-1-RAs outperform conventional antidiabetic medicines in terms of glycemic management and weight reduction. According to cardiovascular outcome studies, various drugs in this category have been found to reduce the frequency of severe adverse cardiovascular events. A common side effect is gastrointestinal toxicity, which can be mitigated by gradually increasing the dose. Personalized treatment is likely because the effectiveness, safety, and dose regimens of currently available GLP-1-RAs differ. GLP-1-RAs are a superior choice for patients with T2DM, especially those who already have CVD or require weight-control support. The high cost of these drugs creates hurdles to access and fair healthcare. Current research mainly focuses on increasing therapeutic uses and producing orally delivered medicines with greater potency and bioavailability. Integrating GLP-1-RAs into clinical practice can enhance patient outcomes and reduce the community burden of cardiometabolic disease.

An Advanced Cardiac Life Support Application Improves Performance during Simulated Cardiac Arrest.

OBJECTIVES: Variability in cardiopulmonary arrest training and management leads to inconsistent outcomes during in-hospital cardiac arrest. Existing clinical decision aids, such as American Heart Association (AHA) advanced cardiovascular life support (ACLS) pocket cards and third-party mobile apps, often lack comprehensive management guidance. We developed a novel, guided ACLS mobile app and evaluated user performance during simulated cardiac arrest according to the 2020 AHA ACLS guidelines via randomized controlled trial. METHODS: Forty-six resident physicians were randomized to lead a simulated code team using the AHA pockets cards (N = 22) or the guided app (N = 24). The primary outcome was successful return of spontaneous circulation (ROSC). Secondary outcomes included code leader stress and confidence, AHA ACLS guideline adherence, and errors. A focus group of 22 residents provided feedback. Statistical analysis included two-sided t-tests and Fisher's exact tests. RESULTS: App users showed significantly higher ROSC rate (50 vs. 18%; p = 0.024), correct thrombolytic administration (54 vs. 23%; p = 0.029), backboard use (96 vs. 27%; p < 0.001), end-tidal CO2 monitoring (58 vs. 27%; p = 0.033), and confidence compared with baseline (1.0 vs 0.3; p = 0.005) compared with controls. A focus group of 22 residents indicated unanimous willingness to use the app, with 82% preferring it over AHA pocket cards. CONCLUSION: Our guided ACLS app shows potential to improve user confidence and adherence to the AHA ACLS guidelines and may help to standardize in-hospital cardiac arrest management. Further validation studies are essential to confirm its efficacy in clinical practice.

Assessment of Knowledge and Practices of Medical Emergencies in Medical and Dental Students of the University of Ha'il, Saudi Arabia: A Cross-Sectional Study.

Aim and background Medical emergencies (MEs) pose urgent threats to life and occur frequently, with primary care providers seeing at least one emergency per year. Common MEs include asthma, anaphylaxis, seizures, and cardiac arrest. However, many medical offices are ill-equipped to handle these emergencies. Practices should obtain appropriate emergency equipment and medications based on their patient population, provider expertise, and proximity to the ER. A lack of emergency preparedness and training can have fatal consequences, so all healthcare providers must be well-prepared to respond. Providing basic life support (BLS) is the crucial first step until definitive treatment is available. The study aimed to assess emergency-related knowledge, its relationship to expertise, and the need for emergency management training among medical/dental students at University of Ha'il (UOH) in Saudi Arabia. Methods The study included 214 participants. It consisted of male and female dental and medical students in their clinical years at the UOH in Saudi Arabia. This targeted sampling approach ensured the study focused on the relevant demographic factors of dental and medical students to provide insights into their level of MR-related knowledge and its relationship to their expertise, as well as their awareness and need for training in ME management. The researchers aimed to assess these factors among the medical and dental students at the UOH. Result Dental and medical students show a strong grasp of emergency care fundamentals, with 78.6% familiar with BLS protocols. Most students correctly identify crucial actions, such as assessing airway, breathing, and circulation (ABCs), and immobilizing the head and neck for spinal injuries. Responses to emergencies include starting chest compressions, calling 911, and administering appropriate treatments for cardiovascular, respiratory, and neurological issues. Despite high competency levels, continuous education is vital to maintain and enhance their preparedness for emergencies. Conclusions Dental and medical students demonstrate a solid understanding of BLS, with 78.6% familiar with protocols and many identifying critical emergency actions. However, inconsistencies in responses highlight the need for ongoing education to improve decision-making and preparedness. Continuous training will ensure these future healthcare professionals are equipped to handle real-world emergencies effectively.

Willingness to Pay for Telemedicine Services Among Uninsured Individuals in Saudi Arabia: A Cross-Sectional Survey.

Purpose: This study aimed to explore the Willingness To Pay (WTP) of uninsured individuals in Saudi Arabia and the factors influencing their decisions regarding telemedicine services. Patients and Methods: This study used a cross-sectional survey design and convenience sampling to gather data from respondents aged 18 years or older who had visited healthcare facilities at least once in the past year and were uninsured. WTP was determined using the contingent valuation method, and a two-part regression model was applied to analyze the factors influencing WTP. Results: The study included 4232 participants and discovered that approximately 17.41% were willing to pay for telemedicine services. Those aged 60 and older, employed in the government or private sector, in higher socioeconomic quintiles, and experiencing chronic health issues showed a positive association with their WTP value. Conversely, individuals aged between 30 and 44 years, married, and unemployed exhibited a negative association with a lower WTP value. Conclusion: The findings indicate that most respondents hesitated to pay for telemedicine services, with a significant influence from sociodemographic characteristics, underscoring the need to promote telemedicine use among underserved populations and address health disparities.

Management Strategies for Hypertensive Crisis: A Systematic Review.

A hypertensive crisis is defined as a sudden and significant rise in blood pressure. The blood pressure reading is 180/120 mmHg or higher. A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke, or other life-threatening medical problems. Investigating the management of the hypertensive crisis was the goal of this study. English-language articles were collected from 2010 to 2024 demonstrating the management of the hypertensive crisis. Overall, there were 15 articles. Surveys and analyses of national databases were the most widely used methods (n=15). The scientific studies documented (1) all investigative studies or reports that included a hypertensive crisis diagnosis, (2) data integrity and reproducibility, and (3) management studies. Other studies show that acute severe hypertension in the hospital is associated with high rates of mortality and morbidity, particularly with new or worsening end-organ damage. The problem is linked to poor medical adherence, but alarmingly low follow-up rates are likely to contribute to a high recurrence rate. The treatment of acute severe hypertension varies according to the hospital unit (medical ward or intensive care unit), medication, and blood pressure targets or thresholds. Because of a lack of evidence-based guidance, arbitrary blood pressure control targets are used, or blood pressure targets are crudely extrapolated from guidelines intended primarily for outpatient management. Patients with acute aortic dissection need to be administered intravenous esmolol within 5 to 10 minutes in order to lower their blood pressure right away. The goal is to maintain a systolic reading of less than 120 mm Hg. Vasodilators such as nitroglycerin or nitroprusside may be administered if the blood pressure persists following beta blocking. Intravenous administration of clevidipine, nicardipine, or phentolamine is required; the initial dose is 5 mg, with subsequent doses given every 10 minutes as necessary to achieve the desired reduction in blood pressure.

The Importance of Molecular Biological Analysis for the Laboratory Diagnostic of Homozygous Haemoglobin Malay.

Haemoglobin (Hb) Malay is variant haemoglobin with a ß++ thalassemia phenotype. The prevalence of Hb Malay in the Malaysian population was 5.5%. We describe a 58-year-old male who presented with symptomatic anaemia to the Hospital Universiti Sains Malaysia. Further history revealed that the patient had anaemia since the age of 28, and on regular follow-up at other hospital. Physical examination revealed pallor, jaundice and hepatosplenomegaly. The full blood count and peripheral blood smear showed hypochromic microcytic anaemia with anisopoikilocytosis, and many target cells. High-performance liquid chromatography results showed a ß thalassemia trait. However, the diagnosis does not alight with the patient's condition. Bone marrow aspirate was completed and showed reactive changes and erythroid hyperplasia. A molecular test was then performed for ß globin gene mutation detection using Multiplex Amplification Refractory Mutation System (M-ARMS) PCR method. This revealed the result as homozygous codon 19 mutation or Hb Malay. Therefore, in this case report we would like to highlight the laboratory approaches, the challenges faced by the usual haematological investigations and the importance role of molecular testing in the diagnosis of severe anaemia.

The dark side of beauty: an in-depth analysis of the health hazards and toxicological impact of synthetic cosmetics and personal care products.

Over the past three decades, the popularity of cosmetic and personal care products has skyrocketed, largely driven by social media influence and the propagation of unrealistic beauty standards, especially among younger demographics. These products, promising enhanced appearance and self-esteem, have become integral to contemporary society. However, users of synthetic, chemical-based cosmetics are exposed to significantly higher risks than those opting for natural alternatives. The use of synthetic products has been associated with a variety of chronic diseases, including cancer, respiratory conditions, neurological disorders, and endocrine disruption. This review explores the toxicological impact of beauty and personal care products on human health, highlighting the dangers posed by various chemicals, the rise of natural ingredients, the intricate effects of chemical mixtures, the advent of nanotechnology in cosmetics, and the urgent need for robust regulatory measures to ensure safety. The paper emphasizes the necessity for thorough safety assessments, ethical ingredient sourcing, consumer education, and collaboration between governments, regulatory bodies, manufacturers, and consumers. As we delve into the latest discoveries and emerging trends in beauty product regulation and safety, it is clear that the protection of public health and well-being is a critical concern in this ever-evolving field.

Determinants of Patient Satisfaction with Discharge Pharmacy Services at a Tertiary Care Center in Jeddah, KSA.

Purpose: Patient satisfaction with pharmacy services, particularly in outpatient and discharge pharmacy settings, has become a vital metric for assessing medical quality. However, there's limited research on patient satisfaction in discharge pharmacy services in the Kingdom of Saudi Arabia (KSA). This study aims to systematically investigate and delineate the various patient-related and non-patient-related factors that significantly impact patient satisfaction in the realm of discharge pharmacy services. Patients and Methods: This cross-sectional study was conducted over three months at King Abdulaziz Medical City in Jeddah (KAMC-J). The sample size was determined using a single population proportion formula, which resulted in a required sample size of 384 patients. A validated questionnaire with a five-point Likert scale evaluated satisfaction from "Strongly Dissatisfied" (1 point) to "Very Satisfied" (5 points) has been used. Data collectors underwent training and obtained written consent from participants, with questionnaire completion taking 5-10 minutes face to face. Results: The study encompassed 437 participants, primarily male (59%) with a college education (45.3%), residing mostly in Jeddah (67.3%). Notably, 84.4% were not healthcare providers, and most visited the pharmacy every six months (44.6%). The patient satisfaction survey revealed high scores for counseling understanding, pharmacist courtesy, and the way the pharmacist answered questions (4.94±0.31, 4.94±0.27, 4.94±0.32; respectively), but lower for understanding possible side effects (4.30±1.30) and pharmacy location (4.57±0.99). In logistic regression, visits lasting 10-15 minutes, and less than 10 minutes were significantly (p<0.05) associated with increased odds of patient satisfaction (OR=6.39, OR=9.45; respectively) Moreover, the medium length hospital stay was associated with decreased odds of patient satisfaction (OR=0.31, p=0.026). Conclusion: In conclusion, the study determined a significant proportion of patients are satisfied with discharge pharmacy services at KAMC-J, with the length of consultation and hospital stay being pivotal to their satisfaction. Addressing these factors, alongside optimizing pharmacist-patient communication and pharmacy service efficiency, can substantially elevate the quality of pharmaceutical care and patient experience.

Elucidating the clinical and genetic spectrum of inositol polyphosphate phosphatase INPP4A-related neurodevelopmental disorder.

PURPOSE: Biallelic INPP4A variants have recently been associated with severe neurodevelopmental disease in single case reports. Here, we expand and elucidate the clinical-genetic spectrum and provide a pathomechanistic explanation for genotype-phenotype correlations. METHODS: Clinical and genomic investigations of 30 individuals were undertaken alongside molecular and in silico modelling and translation reinitiation studies. RESULTS: We characterize a clinically variable disorder with cardinal features including global developmental delay, severe-profound intellectual disability, microcephaly, limb weakness, cerebellar signs and short stature. A more severe presentation associated with biallelic INPP4A variants downstream of exon 4 has additional features of (ponto)cerebellar hypoplasia, reduced cerebral volume, peripheral spasticity, contractures, intractable seizures and cortical visual impairment. Our studies identify the likely pathomechanism of this genotype-phenotype correlation entailing translational reinitiation in exon 4 resulting in an N-terminal truncated INPP4A protein retaining partial functionality, associated with less severe disease. We also identified identical reinitiation site conservation in Inpp4a-/- mouse models displaying similar genotype-phenotype correlation. Additionally, we show fibroblasts from a single affected individual exhibit disrupted endocytic trafficking pathways, indicating the potential biological basis of the condition. CONCLUSION: Our studies comprehensively characterise INPP4A-related neurodevelopmental disorder and suggest genotype-specific clinical assessment guidelines. We propose the potential mechanistic basis of observed genotype-phenotype correlations entails exon 4 translation reinitiation.

Sudden death due to enterotoxemia among Arabian camels (Camelus dromedaries) and associated risk factors.

Background: Sudden death is defined as an unexpected death occurring with no observed antecedent clinical signs. Aim: The current study was performed to notice the tangible causes of sudden death among 51 out of 340 she-camels on a private farm in the eastern region of El Khafgi, Saudi Arabia. Methods: A retrospective cohort study design was conducted to investigate the sudden death of camels through microscopic examination of fecal matter to identify the gastrointestinal parasites, analysis of whole blood thin films to diagnose blood parasites, blood culturing to recognize bacterial infection as Pasteurella multicida, and macroscopic postmortem examination to identify the gastrointestinal adult worm. The quantity and composition of feed were also analyzed. Afterward, a commercial multiscreen Ag-ELISA kit technique determined the toxins of Clostridium perfringens (C. perfringens). Results: The results revealed that the incidence rate of sudden death was 15%. The sudden death occurred due to C. perfringens enterotoxins detected in the rumen, intestinal content, and intestinal wall. The enterotoxins and Alpha toxins were noticed, but the other toxin types, including Beta and Epsilon, could not be detected. All C. perfringens toxins were discovered to be negative in fecal matter. A significant association was reported between sudden death, she-camels age, and feeding habits as risk factors (p = 0.020 and 0.028, respectively). Risk factor assessment by relative risk (RR) revealed that the odds of RR of sudden death occurring among she-camels aged over two years were higher than those less than two years (2.24 CI 95%, 1.093-4.591). Furthermore, the odds RR of sudden death occurring due to exposure of she-camels to a concentrated ration of 18% were higher twice than those not exposed (2.346 CI 95%, 1.039-5.296). Conclusion: Clostridium perfringens enterotoxaemia should be listed as a cause of sudden death in camels and the alteration in diet with 18% concentration feed changes the intestinal environment, which leads to C. perfringens proliferating and yielding potent toxins. More observations and interferences like regular immunization are recommended to reduce the disease and increase the awareness of the farmers of the importance of risk factors.

Impact of Magnesium Supplementation on Blood Pressure: An Umbrella Meta-Analysis of Randomized Controlled Trials.

Background and aim: Conflicting results on the effect of magnesium supplementation on blood pressure have been published in previous meta-analyses; hence, we conducted this umbrella meta-analysis of RCTs to provide a more robust conclusion on its effects. Methods: Four databases including PubMed, Scopus, EMBASE, and Web of Science were searched to find pertinent papers published on international scientific from inception up to July 15, 2024. We utilized STATA version 17.0 to carry out all statistical analyses (Stata Corporation, College Station, TX, US). The random effects model was used to calculate the overall effect size ES and CI. Findings: Ten eligible review papers with 8610 participants studied the influence of magnesium on SBP and DBP. The pooling of their effect sizes resulted in a significant reduction of SBP (ES = -1.25 mmHg; 95% CI: -1.98, -0.51, P = 0.001) and DBP (ES = -1.40 mmHg; 95% CI: -2.04, -0.75, P = 0.000) by magnesium supplementation. In subgroup analysis, a significant reduction in SBP and DBP was observed in magnesium intervention with dosage ≥400 mg/day (ES for SBP = -6.38 mmHg; ES for DBP = -3.71mmHg), as well as in studies with a treatment duration of ≥12 weeks (ES for SBP = -0.42 mmHg; ES for DBP = -0.45 mmHg). Implications: The findings of the present umbrella meta-analysis showed an overall decrease of SBP and DBP with magnesium supplementation, particularly at doses of ≥400 mg/day for ≥12 weeks.

Effectiveness of Hands-On Training Regarding Basic Life Support (BLS) on Knowledge Among Saveetha College of Arts and Science Final Year Students.

Background: Cardiac disorders are major global death causes, necessitating emergency measures in sudden cardiac arrests. Successful cardiopulmonary resuscitation, performed by medical team members, significantly reduces death rates from cardiac arrest, a growing concern across all age groups. Aim: The study evaluates the impact of hands-on basic life support (BLS) training program on final-year students' knowledge of BLS. Materials and Methods: A pre- and post-test study was conducted among 60 students at Saveetha College of Liberal Arts and Science. A convenient sampling technique was used to select the samples. The demographic variables were collected by using multiple-choice questionnaires. Result: Results showed an effective level of knowledge and skill in BLS, indicating the need for further research. Conclusion: The study concludes that the level of knowledge and skill among final-year students of Saveetha College of Arts and Science was found to be effective in gaining knowledge regarding BLS in the post-test.

Strategical Ways for Dental Anxiety Management Prior to Third Molar Extraction.

A patient experiencing moderate to severe anxiety often skips regular check-ups, choosing to visit only when necessary. As a result, their oral health worsens. Various variables can affect anxiety such as age, gender, culture, and previous experiences. One of the most frequent oral surgical procedures is extracting the third molar, which is accompanied by severe pain, tension, and anxiety, the use of invasive equipment, and local anesthetic. A combined effect was found of four factors, including the patient, dental employees, setting, and dental procedure, which can trigger and affect dental anxiety. Both pharmacological and non-pharmacological approaches were explored; as a non-drug approach, anxiety was managed by music therapy. Acupuncture, music, audio-visual aids, and lavender oil showed an effect that helped in reducing anxiety. Patients' dental anxiety can be reduced through behavioral management such as educating the patients before the surgical procedure, relaxation strategies, biofeedback, and exposure therapy. Medications include benzodiazepines, nitrous oxide (N2O), and midazolam. Effective treatment relies on collaboration between the patients and dentists; calm patients not only provide a manageable environment for the dental team but can also result in better treatment outcomes.

Transforming respiratory tract infection diagnosis in the kingdom of saudi arabia through point-of-care testing: A white paper for policy makers.

With the evident increased prevalence of respiratory tract infections (RTIs) such as Respiratory Syncytial Virus (RSV), influenza, Group A Streptococcus (GAS), and COVID-19, the conventional diagnostic methods are considered sub-optimal in providing timely management to patients in the Kingdom of Saudi Arabia (KSA). Gaps in current diagnostics are magnified by the Kingdom's unique demographic composition, comprising 11.9 million foreign workers, and the annual influx of over 10 million pilgrims. Current gaps in timely diagnosis leads to delays in treatment, misuse of antibiotics, and protracted hospital stays, subsequently compromising patient care, and escalating healthcare costs. KSA healthcare stakeholders suggest that the integration of rapid molecular Point-of-Care Testing (POCT) into the Kingdom's healthcare infrastructure is an absolute necessity. This publication serves as an urgent call for action aimed at healthcare policymakers in Saudi Arabia, to review the existing diagnostic challenges and include rapid POCTs in the Saudi healthcare strategy for respiratory infections.

Targeting Polyprotein to Design Potential Multiepitope Vaccine against Omsk Hemorrhagic Fever Virus (OHFV) by Evaluating Allergenicity, Antigenicity, and Toxicity Using Immunoinformatic Approaches.

Omsk Hemorrhagic Fever Virus (OHFV) is an RNA virus with a single-stranded, positive-sense genome. It is classified under the Flaviviridae family. The genome of this virus is 98% similar to the Alkhurma hemorrhagic fever virus (AHFV), which belongs to the same family. Cases of the virus have been reported in various regions of Saudi Arabia. Both OHFV and AHFV have similarities in pathogenic polyprotein targets. No effective and licensed vaccines are available to manage OHFV infections. Therefore, an effective and safe vaccine is required that can activate protective immunity against OHFV. The current study aimed to design a multiepitope subunit vaccine against the OHFV utilizing several immunoinformatic tools. The polyprotein of OHFV was selected and potent antigenic, non-allergenic, and nontoxic cytotoxic T-lymphocyte (CTL), helper T-lymphocyte (HTL), and linear B-lymphocyte (LBL) epitopes were chosen. After screening, eight (8) CTL, five (5) HTL, and six (6) B cell epitopes were joined with each other using different linkers. Adjuvant human beta defensin-2 was also linked to the epitopes to increase vaccine antigenic and immunogenic efficiency. The designed vaccine was docked with Toll-like receptor 4 (TLR4) as it activates and induces primary and secondary immune responses against OHFV. Codon optimization was carried out, which resulted in a CAI value of 0.99 and 53.4% GC contents. In addition, the construct was blindly docked to the TLR4 immune receptor and subjected to conformational dynamics simulation analysis to interpret the intricate affinity and comprehend the time-dependent behavior. Moreover, it was predicted that immune responses to the developed vaccine construct reported formation of strong humoral and cellular immune cells. Therefore, the proposed vaccine may be considered in experimental assays to combat OHFV infections. Laboratory experiments for the above predictions are essential in order to evaluate the effectiveness, safety, and protective properties of the subject in question.

Evolutionary Relationships of Omani Macrotermes subhyalinus, Macrotermitinae.

A study was conducted to investigate the evolutionary relationships of Macrotermes subhyalinus from Oman, in the southeastern part of the Arabian Peninsula. Sequences of the mitochondrial COI and the nuclear large-subunit ribosomal RNA (LSU rRNA, 28S) genes were used to investigate the populations of M. subhyalinus across their distribution in Oman to determine their relationships with other Macrotermes species. Our findings indicate that M. subhyalinus in Oman is a member of an East African clade, distinct from those in West Africa. Analyses of the COI showed that there is base composition bias among the taxa (non-stationarity) that has not been considered in earlier studies. We provide the first report of pseudogene copies of 28S in M. subhyalinus that are differentially amplified.

Aetiologies of Ear Infections Among Patients Who Visited King Fahad Hospital in Al-Baha, Saudi Arabia.

Background Ear infections encompass otitis media (OM) which is a significant cause of hearing loss and otitis externa (OE) which may affect the surrounding tissues leading to serious complications. This study reports the common pathogens causing ear infections. Methods Microbiological, clinical, and demographic data of ear-infected patients who visited King Fahad Hospital in Al-Baha, Saudi Arabia, during the period from January 2019 to June 2023 were enrolled in this study. Result  This study enrolled 307 patients aged 1-94 years, with a median age of 40 years (IQR=22-57). Overall, the detectable infection rate was 81.1% (n=249), while 18.9% (n=58) had no identified aetiology. Of all isolates, 178 (58%) were bacterial, while 71 (23.1%) were fungal. Staphylococcus aureus (S. aureus) followed by Pseudomonas aeruginosa (P. aeruginosa), Enterobacteriaceae, andcoagulase-negative Staphylococcus (CoNS) were the main bacterial isolates. Of the total 63 S. aureus isolates, 21 (33%) were methicillin-resistant (MRSA). A cohort of 227 subjects were diagnosed with either OM (n=178; 79.5%), OE (n=46; 20.5%), or both OM and OE (n=3; 1%). Of those with OM, children constituted 89.1% (41/46) as compared to 75.3% (134/178) of adults (p=0.041). The main isolates from OM patients were S. aureus followed by P. aeruginosa and fungi. Of 49 OE patients, 16 (32.7%) had no identified pathogen, while 15 (30.6%) had fungi, and 13 (29.5%) had P. aeruginosa. Conclusions Ear infections in general were mainly bacterial followed by fungal with a considerable proportion of unidentified aetiology. A significant proportion of S. aureus isolates were MRSA. S. aureus followed by P. aeruginosa and fungi were the main causes of OM, while fungi followed by P. aeruginosa were the main causes of OE.

Enhancement of Electron Transport Characteristics Using MXene-MnFeO3 Nanocomposite Integration with Fullerene Derivatives for the Perovskite-Based Solar Cells and Detectors.

In this study, we prepared a hybrid film incorporating the MnFeO3-decorated conducting two-dimensional (2D) MXene sheet-suspended [6,6]-phenyl-C61-butyric acid methyl ester (PCBM) electron transfer layer (ETL) for the perovskite solar cells (PSCs) and detectors. The incorporation of MXene-MnFeO3 with the PCBM ETL could drive exceptional conducting features for the PSCs. Moreover, the presence of MXene-MnFeO3 facilitated superior charge transfer pathways, thereby enhancing the electron extraction and collection processes. This enhancement was directed to improve the electron mobility within the device, resulting in high photocurrents. The designed interface engineering with the MXene-MnFeO3 nanocomposite-tuned PCBM ETL has produced a remarkable power conversion efficiency of 17.79% ± 0.27. Moreover, X-ray detectors employing PCBM modulated with the MXene-MnFeO3 ETL achieved notable performance metrics including 18.47 µA/cm2 CCD-DCD, 5.53 mA/Gy·cm2 sensitivity, 7.64 × 10-4 cm2/V·s electron mobility, and 1.51 × 1015 cm2/V·s trap density.

Notes on the Ecology and Distribution of Species of the Genera of Bondarzewiaceae (Russulales and Basidiomycota) with an Emphasis on Amylosporus.

The family Bondarzewiaceae is an important and diverse group of macrofungi associated with wood as white rotting fungi, and some species are forest tree pathogens. Currently, there are nine genera and approximately 89 species in the family, distributed in tropical, subtropical, and temperate climates. To address the phylogenetic relationships among the genera, a combined ITS-28S dataset was subjected to maximum likelihood (ML), Bayesian inference (BI), and time divergence analyses using the BEAST package. Both ML and BI analyses revealed two major clades, where one major clade consisted of Amylosporus, Stecchericium, and Wrightoporia austrosinensisa. The second major clade is composed of Bondarzewia, Heterobasidion, Gloiodon, Laurilia, Lauriliella, and Wrightoporia, indicating that these genera are phylogenetically similar. Wrightoporia austrosinensisa recovered outside of Wrightoporia, indicating that this species is phylogenetically different from the rest of the species of the genus. Similarly, time divergence analyses suggest that Bondarzewiaceae diversified around 114 million years ago (mya), possibly during the Early Cretaceous Epoch. The genus Amylosporus is well resolved within the family, with an estimated stem age of divergent around 62 mya, possibly during the Eocene Epoch. Further, the species of the genus are recovered in two sister clades. One sister clade consists of species with pileate basidiomata and generative hyphae with clamp connections, corresponding to the proposed section Amylosporus sect. Amylosporus. The other consists of species having resupinate basidiomata and generative hyphae without clamps, which is treated here as Amylosporus sect. Resupinati. We provided the key taxonomic characters, known distribution, number of species, and stem age of diversification of each section. Furthermore, we also described a new species, Amylosporus wadinaheezicus, from Oman, based on morphological characters of basidiomata and multigene sequence data of ITS, 28S, and Tef1-α. With pileate basidiomata and phylogenetic placement, the new species is classified under the proposed A. sect. Amylosporus. An identification key to the known species of Amylosporus is presented. Ecology and distribution of species of the genera in the family are discussed.

Lacrimal gland enlargement in inactive thyroid eye disease: a case series and literature review.

PURPOSE: This study aimed to evaluate the morphometric and volumetric dimensions of the lacrimal gland in patients with inactive thyroid eye disease and compare them with the values reported in the literature. METHODS: This case series evaluated consecutive patients with inactive thyroid eye disease treated at a tertiary eye hospital from 2015 to 2020. The patients' baseline demographics and clinical characteristics were obtained. The axial and coronal length, width, and volume of the lacrimal gland were measured on computed tomography scan images, and the results were statistically analyzed. RESULTS: A total of 21 patients (42 orbits) with inactive thyroid eye disease were evaluated. Their mean age was 49.0 ± 14.6 years, and 12 (57.1%) of them were men. The main complaint was dryness, and the majority of the patients had good vision and mild proptosis. The mean axial length and width of the lacrimal gland were 19.3 ± 3.9 mm and 7.5 ± 2.1 mm, respectively; coronal length and width, 20.4 ± 4.5 mm and 7.5 ± 2.1 mm, respectively; and lacrimal gland volume, 0.825 ± 0.326 mm3. Age, sex, or laterality were not found to be determinants of lacrimal gland enlargement. CONCLUSION: Patients with thyroid eye disease have enlarged lacrimal gland even in the nonactive phase of the disease multifactorial aspects influence the lacrimal gland in thyroid eye disease, making it difficult to establish a clear correlation with predisposing factors. Further studies are warranted to better understand the association between thyroid eye disease and the lacrimal gland.