Digital technology integration in business model innovation for carbon neutrality: An evolutionary process model for SMEs.

This study delves into the strategies employed by small and medium-sized enterprises (SMEs) to embed digital technology into their business models, aiming to reach carbon neutrality. We offer a comprehensive analysis of five high technology SMEs, unveiling an evolutionary process model that highlights their journey toward integrating technology. The integration process is delineated into three progressive stages. Initially, digital technology is seen as an 'enabler' that promotes the birth of an innovative business model, essentially transforming the mechanisms of value creation, delivery, and capture. As SMEs evolve to an intermediate stage, digital technology becomes a 'disruptor', reshaping and reinventing the business model in terms of how value is created, delivered, and captured. Entering the maturity stage, digital technology is elevated to the role of 'expertise', leading to a sophisticated business model that refines and optimizes these aspects of value. The influence of these business model innovations on carbon neutrality is complex and varies distinctly with each stage, reflecting the dynamic interplay between digital technology and business model evolution.

The Incidence of Acute Peritonitis Secondary to Different Sites of Viscus Perforation.

Objective The incidence of peritonitis secondary to viscus perforation will be examined to determine the most common sites of perforation and associated comorbidities. Methods This is a retrospective observational study based on data collected from the King Fahad Hospital of the University (KFUH). This research targeted patients who had viscus organ perforation and the relation of peritonitis secondary to it. The sample was taken from patients under the care of the General Surgery Department from the first of Feb 2016 to the 12th of Sep 2022. The final sample consisted of 450 patients. The method of diagnosis of peritonitis was mainly clinical, and the surgical approach was either through an exploratory laparotomy or a diagnostic laparoscopy. Incidental findings of viscus organ perforation were noted in addition to certain postoperative complications (e.g., adhesions) and hospital stay. Results Analysis of the results showed a significant relation (p<0.001) between viscus organ perforation and peritonitis. The most common comorbidities associated with secondary peritonitis were hypertension (12, 24.5%), diabetes mellitus (10, 20.4%), any abdominal mass (3, 6.1%), and inflammatory bowel disease (1, 2%). However, a chi-square analysis has shown no significant association between peritonitis and the targeted associated comorbidities. Conclusion Perforation of the small intestine carries the biggest association with peritonitis incidence, in addition to comorbidities such as hypertension and diabetes mellitus. Further study to establish the value of these factors might contribute to decreasing the morbidity and mortality of secondary peritonitis.

In crystallo lattice adaptivity triggered by solid-gas reactions of cationic group 7 pincer complexes.

The group 7 complexes [M(κ3-2,6-(R2PO)2C5H3N)(CO)2L][BArF4] [M = Mn, R = iPr, L = THF; M = Re, R = tBu, L = vacant site] undergo in crystallo solid-gas reactivity with CO to form the products of THF substitution or CO addition respectively. There is a large, local, adaptive change of [BArF4] anions for M = Mn, whereas for M = Re the changes are smaller and also remote to the site of reactivity.

A comparison of non-covalent interactions in the crystal structures of two σ-alkane complexes of Rh exhibiting contrasting stabilities in the solid state.

Non-covalent interactions surrounding the cationic Rh σ-alkane complexes within the crystal structures of [(Cy2PCH2CH2PCy2)Rh(NBA)][BArF4], [1-NBA][BArF4] (NBA = norbornane, C7H12; ArF = 3,5-(CF3)2C6H3), and [1-propane][BArF4] are analysed using Quantum Theory of Atoms in Molecules (QTAIM) and Independent Gradient Model approaches, the latter under a Hirshfeld partitioning scheme (IGMH). In both structures the cations reside in an octahedral array of [BArF4]- anions within which the [1-NBA]+ cation system exhibits a greater number of C-H⋯F contacts to the anions. QTAIM and IGMH analyses indicate these include the strongest individual atom-atom non-covalent interactions between the cation and the anion in these systems. The IGMH approach highlights the directionality of these C-H⋯F contacts that contrasts with the more diffuse C-H⋯π interactions. The accumulative effects of the latter lead to a more significant stabilizing contribution. IGMH %δGatom plots provide a particularly useful visual tool to identify key interactions and highlight the importance of a -{C3H6}- propylene moiety that is present within both the propane and NBA ligands (the latter as a truncated -{C3H4}- unit) and the cyclohexyl rings of the phosphine substituents. The potential for this to act as a privileged motif that confers stability on the crystal structures of σ-alkane complexes in the solid-state is discussed. The greater number of C-H⋯F inter-ion interactions in the [1-NBA][BArF4] system, coupled with more significant C-H⋯π interactions are all consistent with greater non-covalent stabilisation around the [1-NBA]+ cation. This is also supported by larger computed δGatom indices as a measure of cation-anion non-covalent interaction energy.

Foreign Body Ingestion: A Common Presentation Among Pediatric Age Group in the City of AlAhsa Eastern Province, Saudi Arabia.

Background Foreign body ingestion is a prevalent issue among children and presents considerable morbidity and mortality rates. Due to children's increased accessibility to electronic toys and equipment, foreign body ingestion has become a common reason for presenting to pediatric emergency departments worldwide. In this context, this research aims to determine the prevalence of foreign body ingestion among children in AlAhsa, Saudi Arabia. Methodology This observational retrospective descriptive study was conducted at Maternity and Children Hospital, AlAhsa, Saudi Arabia, from 2017 to 2021. The study included children (less than 14 years old) who presented to the emergency department with a history of foreign body ingestion. The biographical data, clinical presentation, type of foreign body, and X-ray findings were documented. Results A total of 91 cases of foreign body ingestion or aspiration in children under 14 years of age were included. Approximately half of the patients were under the age of three, and 62.2% of them were male, while 37.8% were female. The clinical presentation revealed that only 24% were symptomatic. Coins were the most commonly ingested foreign bodies (28.9%), followed by metallic objects (20%), and batteries were the least frequently ingested foreign bodies, recorded in eight cases. Conclusion Early detection and treatment of foreign body ingestion is crucial to prevent consequences. In this study, the most frequent foreign bodies detected were coins among children up to three years old. Raising parents' awareness about the prevention of foreign body ingestion is an important step toward reducing its incidence.

Cross-influence of information and risk effects on the IPO market: exploring risk disclosure with a machine learning approach.

The paper examines whether the structure of the risk factor disclosure in an IPO prospectus helps explain the cross-section of first-day returns in a sample of Chinese initial public offerings. This paper analyzes the semantics and content of risk disclosure based on an unsupervised machine learning algorithm. From both long-term and short-term perspectives, this paper explores how the information effect and risk effect of risk disclosure play their respective roles. The results show that risk disclosure has a stronger risk effect at the semantic novelty level and a more substantial information effect at the risk content level. A novel aspect of the paper lies in the use of text analysis (semantic novelty and content richness) to characterize the structure of the risk factor disclosure. The study shows that initial IPO returns negatively correlate with semantic novelty and content richness. We show the interaction between risk effect and information effect on risk disclosure under the nature of the same stock plate. When enterprise information transparency is low, the impact of semantic novelty and content richness on the IPO market is respectively enhanced.

Creating a Culture to Avoid Knowledge Hiding Within an Organization: The Role of Management Support.

Knowledge hiding is known to have negative consequences on organizational performance. The existing literature mainly focuses on the identification of antecedents and consequences of knowledge hiding. The studies pertaining to the top management role in creating a culture that stops concealing knowledge within an organization are limited. To fill that gap, the paper empirically address the knowledge sharing culture and to explore the management support to avoid knowledge hiding culture in an organization. This study based on an empirical study carried out in a United Kingdom-based laboratory within a high-tech global corporation, in which the atmosphere appeared conducive to knowledge sharing, and knowledge transfer appeared voluntary and spontaneous. The paper seeks to address why members of the case organization is reluctant about knowledge hiding among themselves. The study reveals that the management role is important in creating a culture that help discourage employees to withhold knowledge. The paper identifies the actions that top management takes to stop concealing knowledge within an organization. This study has provided several contributions. The findings of the study may be useful to managers and practitioners. For managers, this paper presents some important organizational factors that can be nurtured to avoid a knowledge-hiding culture in the organization. They can also take the management actions of the case organization as lessons to create a culture that encourage their employees to avoid knowledge hiding behavior.

Kikuchi-Fujimoto Disease Following COVID-19.

Kikuchi-Fujimoto Disease (KFD) is a rare self-limiting condition of unknown etiology. It is characterized by fever, and lymphadenopathy most commonly involving posterior cervical lymph nodes. Although it is of uncertain etiology, it is associated with viral infections and autoimmune diseases. Distinction from lymphadenopathy-associated alternate disorders is crucial to avoid unneeded diagnostic procedures and treatment. KFD is diagnosed based on histopathologic examination of the excised lymph node. The management is supportive with favorable outcomes within a few weeks or months. In this case, we describe a 13-year-old boy who complained of painful cervical lymphadenopathy and fever for more than three weeks following COVID-19. Diagnostic workup has been established and KFD diagnosis made based on the histopathologic features of the involved lymph node. The patient showed complete recovery with no recurrence during follow-up. So, this case highlights the possible association between COVID-19 and KFD during this pandemic and keeping it in the differential diagnosis.

Functional signaling test identifies HER2 negative breast cancer patients who may benefit from c-Met and pan-HER combination therapy.

BACKGROUND: Research is revealing the complex coordination between cell signaling systems as they adapt to genetic and epigenetic changes. Tools to uncover these highly complex functional linkages will play an important role in advancing more efficacious disease treatments. Current tumor cell signal transduction research is identifying coordination between receptor types, receptor families, and transduction pathways to maintain tumor cell viability despite challenging tumor microenvironment conditions. METHODS: In this report, coactivated abnormal levels of signaling activity for c-Met and HER family receptors in live tumor cells were measured by a new clinical test to identify a subpopulation of breast cancer patients that could be responsive to combined targeted therapies. The CELsignia Multi-Pathway Signaling Function (CELsignia) Test uses an impedance biosensor to quantify an individual patient's ex vivo live tumor cell signaling response in real-time to specific HER family and c-Met co-stimulation and targeted therapies. RESULTS: The test identified breast tumors with hyperactive HER1, HER2, HER3/4, and c-Met coordinated signaling that express otherwise normal amounts of these receptors. The supporting data of the pre-clinical verification of this test included analyses of 79 breast cancer patients' cell response to HER and c-Met agonists. The signaling results were confirmed using clinically approved matching targeted drugs, and combinations of targeted drugs in addition to correlative mouse xenograft tumor response to HER and c-Met targeted therapies. CONCLUSIONS: The results of this study demonstrated the potential benefit of a functional test for identifying a subpopulation of breast cancer patients with coordinated abnormal HER and c-Met signaling for a clinical trial testing combination targeted therapy. Video Abstract.

Escherichia coli expression and characterization of alfa-amylase from Geobacillus thermodenitrificans DSM-465 / Expressão e caracterização de Escherichia coli de alfa-amilase de Geobacillus thermodenitrificans DSM-465

Alpha amylase, catalyzing the hydrolysis of starch is a ubiquitous enzyme with tremendous industrial applications. A 1698 bp gene coding for 565 amino acid amylase was PCR amplified from Geobacillus thermodenitrificans DSM-465, cloned in pET21a (+) plasmid, expressed in BL21 (DE3) strain of E. coli and characterized. The recombinant enzyme exhibited molecular weight of 63 kDa, optimum pH 8, optimum temperature 70°C, and KM value of 157.7µM. On pilot scale, the purified enzyme efficiently removed up to 95% starch from the cotton fabric indicating its desizing ability at high temperature. 3D model of enzyme built by Raptor-X and validated by Ramachandran plot appeared as a monomer having 31% α-helices, 15% β-sheets, and 52% loops. Docking studies have shown the best binding affinity of enzyme with amylopectin (∆G -10.59). According to our results, Asp 232, Glu274, Arg448, Glu385, Asp34, Asn276, and Arg175 constitute the potential active site of enzyme.

A alfa-amilase, que catalisa a hidrólise do amido, é uma enzima ubíqua com imensas aplicações industriais. Um gene de 1698 pb que codifica a amilase de 565 aminoácidos foi amplificado por PCR, a partir de Geobacillus thermodenitrificans DSM-465, clonado no plasmídeo pET21a (+), expresso na cepa BL21 (DE3) de E. coli e caracterizado. A enzima recombinante exibiu peso molecular de 63 kDa, pH ótimo igual a 8, temperatura ótima de 70° C e valor KM de 157,7 µM. Em escala piloto, a enzima purificada removeu com eficiência até 95% de amido do tecido de algodão, indicando sua capacidade de desengomagem em alta temperatura. O modelo 3D da enzima construída por Raptor-X e validada por Ramachandran plot apareceu como um monômero com 31% de hélices alfa, 15% de folhas beta e 52% de loops. Os estudos de docking mostraram melhor afinidade de ligação da enzima com amilopectina (∆G: - 10,59). De acordo com nossos resultados, Asp 232, Glu274, Arg448, Glu385, Asp34, Asn276 e Arg175 constituem o sítio ativo potencial da enzima.

Escherichia coli expression and characterization of -amylase from Geobacillus thermodenitrificans DSM-465

Abstract Alpha amylase, catalyzing the hydrolysis of starch is a ubiquitous enzyme with tremendous industrial applications. A 1698 bp gene coding for 565 amino acid amylase was PCR amplified from Geobacillus thermodenitrificans DSM-465, cloned in pET21a (+) plasmid, expressed in BL21 (DE3) strain of E. coli and characterized. The recombinant enzyme exhibited molecular weight of 63 kDa, optimum pH 8, optimum temperature 70°C, and KM value of 157.7µM. On pilot scale, the purified enzyme efficiently removed up to 95% starch from the cotton fabric indicating its desizing ability at high temperature. 3D model of enzyme built by Raptor-X and validated by Ramachandran plot appeared as a monomer having 31% -helices, 15% -sheets, and 52% loops. Docking studies have shown the best binding affinity of enzyme with amylopectin (G -10.59). According to our results, Asp 232, Glu274, Arg448, Glu385, Asp34, Asn276, and Arg175 constitute the potential active site of enzyme.

Resumo A alfa-amilase, que catalisa a hidrólise do amido, é uma enzima ubíqua com imensas aplicações industriais. Um gene de 1698 pb que codifica a amilase de 565 aminoácidos foi amplificado por PCR, a partir de Geobacillus thermodenitrificans DSM-465, clonado no plasmídeo pET21a (+), expresso na cepa BL21 (DE3) de E. coli e caracterizado. A enzima recombinante exibiu peso molecular de 63 kDa, pH ótimo igual a 8, temperatura ótima de 70° C e valor KM de 157,7 µM. Em escala piloto, a enzima purificada removeu com eficiência até 95% de amido do tecido de algodão, indicando sua capacidade de desengomagem em alta temperatura. O modelo 3D da enzima construída por Raptor-X e validada por Ramachandran plot apareceu como um monômero com 31% de hélices alfa, 15% de folhas beta e 52% de loops. Os estudos de docking mostraram melhor afinidade de ligação da enzima com amilopectina (G: - 10,59). De acordo com nossos resultados, Asp 232, Glu274, Arg448, Glu385, Asp34, Asn276 e Arg175 constituem o sítio ativo potencial da enzima.

Escherichia coli expression and characterization of α-amylase from Geobacillus thermodenitrificans DSM-465 / Expressão e caracterização de Escherichia coli de alfa-amilase de Geobacillus thermodenitrificans DSM-465

Alpha amylase, catalyzing the hydrolysis of starch is a ubiquitous enzyme with tremendous industrial applications. A 1698 bp gene coding for 565 amino acid amylase was PCR amplified from Geobacillus thermodenitrificans DSM465, cloned in pET21a (+) plasmid, expressed in BL21 (DE3) strain of E. coli and characterized. The recombinant enzyme exhibited molecular weight of 63 kDa, optimum pH 8, optimum temperature 70°C, and KM value of 157.7µM. On pilot scale, the purified enzyme efficiently removed up to 95% starch from the cotton fabric indicating its desizing ability at high temperature. 3D model of enzyme built by Raptor-X and validated by Ramachandran plot appeared as a monomer having 31% α-helices, 15% ß-sheets, and 52% loops. Docking studies have shown the best binding affinity of enzyme with amylopectin (∆G -10.59). According to our results, Asp 232, Glu274, Arg448, Glu385, Asp34, Asn276, and Arg175 constitute the potential active site of enzyme.

A alfa-amilase, que catalisa a hidrólise do amido, é uma enzima ubíqua com imensas aplicações industriais. Um gene de 1698 pb que codifica a amilase de 565 aminoácidos foi amplificado por PCR, a partir de Geobacillus thermodenitrificans DSM-465, clonado no plasmídeo pET21a (+), expresso na cepa BL21 (DE3) de E. coli e caracterizado. A enzima recombinante exibiu peso molecular de 63 kDa, pH ótimo igual a 8, temperatura ótima de 70° C e valor KM de 157,7 µM. Em escala piloto, a enzima purificada removeu com eficiência até 95% de amido do tecido de algodão, indicando sua capacidade de desengomagem em alta temperatura. O modelo 3D da enzima construída por Raptor-X e validada por Ramachandran plot apareceu como um monômero com 31% de hélices alfa, 15% de folhas beta e 52% de loops. Os estudos de docking mostraram melhor afinidade de ligação da enzima com amilopectina (∆G: - 10,59). De acordo com nossos resultados, Asp 232, Glu274, Arg448, Glu385, Asp34, Asn276 e Arg175 constituem o sítio ativo potencial da enzima.

Kawasaki Disease Shock Syndrome in the Eastern Region of Saudi Arabia: Case Series.

Kawasaki disease (KD) is a treatable medium-sized vasculitis in the pediatric population consisting of a myriad of specific signs and symptoms. A new entity of the disease, Kawasaki disease shock syndrome (KDSS), is defined as a KD patient presenting with signs of hypoperfusion. Our aim is to describe the signs and symptoms of KDSS and how it is treated and its consequences. Out of 37 patients diagnosed with KD in the period between January 2018 and December 2019 in hospitalized patients younger than 14 years of age at Maternity and Children's Hospital in Al-Hassa, Eastern Province, Saudi Arabia, 3 (8.10%) patients fulfilled the diagnostic criteria for KDSS: 2 (66%) were male and 1 (33%) was female. The cardinal feature in all of them was peripheral cardiovascular collapse. Two patients (66%) were found to have aseptic meningitis. All patients were treated with immunomodulatory agents (intravenous immunoglobulin) and all responded well to anti-inflammatory doses of aspirin. KDSS is the shock state of KD presenting with hypoperfusion symptoms, mainly irritability and changes in the level of consciousness and peripheral cardiovascular collapse. Awareness of such presentation and management by immunomodulatory medications helps in recovery and prevention of tragic consequences of such disease.

Escherichia coli expression and characterization of α-amylase from Geobacillus thermodenitrificans DSM-465.

Alpha amylase, catalyzing the hydrolysis of starch is a ubiquitous enzyme with tremendous industrial applications. A 1698 bp gene coding for 565 amino acid amylase was PCR amplified from Geobacillus thermodenitrificans DSM-465, cloned in pET21a (+) plasmid, expressed in BL21 (DE3) strain of E. coli and characterized. The recombinant enzyme exhibited molecular weight of 63 kDa, optimum pH 8, optimum temperature 70°C, and KM value of 157.7µM. On pilot scale, the purified enzyme efficiently removed up to 95% starch from the cotton fabric indicating its desizing ability at high temperature. 3D model of enzyme built by Raptor-X and validated by Ramachandran plot appeared as a monomer having 31% α-helices, 15% ß-sheets, and 52% loops. Docking studies have shown the best binding affinity of enzyme with amylopectin (∆G -10.59). According to our results, Asp 232, Glu274, Arg448, Glu385, Asp34, Asn276, and Arg175 constitute the potential active site of enzyme.

The Association Between Admission Sources and Outcomes at a Pediatric Intensive Care Unit in Al-Ahsa, Saudi Arabia: A Retrospective Cohort Study.

Objectives In this study, we aimed to examine the association between sources of admission (either intra-hospital transfers or ED admissions) in pediatric intensive care units (PICUs) and the discharge rate, mortality rate, and referral over a period of three years. We also sought to identify the independent predictors of discharge and mortality rate in the study population. Patients and methods This was a retrospective cohort study involving the analysis of 2,547 patients' data collected from the Pediatric Intensive Care Registry of a secondary care community hospital. We included patients admitted to the PICU from January 1, 2016, till December 31, 2018, who were aged 0-14 years with a specific diagnosis, recorded source of admission, and clear outcome. Data were collected, coded, and analyzed using the SPSS Statistics software (IBM, Armonk, NY) and STATA software (StataCorp, College Station, TX). Results Of the included patients, 1,356 (53.2%) were males, and 1,191 (46.8%) were females. Infants were associated with an increased risk of a long stay in the hospital [relative risk ratio (RRR)=5.34, 95% CI: (1.28, 22.27)] and mortality [RRR=3.56, 95% CI: (1.41, 8.95)] compared to older children. Similarly, neonates were associated with a higher risk of mortality [RRR=2.83, 95% CI: (1.05, 7.65)]. Patients who were admitted through ED were associated with a lower risk of a long-stay [RRR=0.56, 95% CI: (10.36, 0.87)] and mortality [RRR=0.68, 95% CI: (0.49, 0.95)] compared to intra-hospital transfers. Concerning the admission date, all time periods were associated with a lower risk of mortality compared to the period of October-December. Conclusion Our findings showed that the age of patients, source of admission, and date of admission might be used as independent predictors for determining the outcome of admissions, including discharge and mortality rates. Further studies are required to confirm these findings.

Multisystem Inflammatory Syndrome in Children, the Real Disease of COVID-19 in Pediatrics - A Multicenter Case Series From Al-Ahsa, Saudi Arabia.

Fortunately, coronavirus disease 2019 (COVID-19) infection in pediatric populations exhibits a mild course of disease. However, a small number have recently been identified who develop a significant systemic inflammatory response, a new disease entity called multisystem inflammatory syndrome in children (MIS-C), especially after the peak of the wave in Al-Ahsa, Saudi Arabia, in early June to mid-July. In MIS-C children usually present a few days to a few weeks after recovery from COVID-19 with high grade fever, GI symptoms, Kawasaki-like picture or even toxic shock-like syndrome. Raising awareness about this disease entity is very fundamental to enable pediatricians and other health care providers to identify and manage these patients before it is too late. We describe 10 different cases of MIS-C with different risk factors and presentations.

Multisystem Inflammatory Syndrome in Children Temporally Related to COVID-19: A Case Report From Saudi Arabia.

The World Health Organization is still revising the epidemiology of multi-system inflammatory syndrome in children (MIS-C) and the preliminary case definition, although there is a dearth of robust evidence regarding the clinical presentations, severity, and outcomes. Researchers, epidemiologists, and clinicians are struggling to characterize and describe the disease phenomenon while taking care of the diseased persons at the forefronts. This report tackles the first case of a 13-year-old Saudi female with the MIS-C mimicking Kawasaki disease. Her main manifestations were fever, gastrointestinal symptoms, evidence of organ failure with an increase in inflammatory markers, and a history of coronavirus disease (COVID-19) infection. She had glucose-6-phosphate dehydrogenase (G6PD) deficiency and no significant previous history of any disease. She presented with signs of acute illness: high-grade fever (39.6°C) for five days accompanied by sore throat, malaise, reduced oral intake, abdominal pain, diarrhea, skin rash, bilateral non-suppurative conjunctivitis, and erythematous, cracked lips. Eventually, she died despite aggressive management based on the Centers for Disease Control and Prevention and the Saudi Ministry of Health guidelines for COVID-19 management. Based on this case, we suggest that pediatricians need to be aware of such atypical presentations and early referral to tertiary care is imperative for further early diagnosis and management. MIS-C is a rare yet severe and highly critical complication of COVID-19 infection in pediatrics, leading to serious and life-threatening illnesses. Knowledge about the wide spectrum of presenting signs and symptoms and disease severity, including early detection and treatment, is pivotal to prevent a tragic outcome.

A Novel Case of Severe Respiratory Symptoms and Persistent Pulmonary Hypertension in a Saudi Neonate With SARS-CoV-2 Infection.

Coronavirus disease 2019 (COVID-19) is an emergent disease that has spread rapidly to infect more than 210 countries across the world. With the increasing number of infected pregnant women, many physicians hypothesized the perinatal transmission as a potential route of transmission. Some cases of perinatal transmission have been described, but it is unclear if these occurred via the transplacental or the transcervical routes or through environmental exposure. In this report, we described a case of a female infant who was delivered by caesarean section at 34 weeks' gestation to an infected mother. The neonate was transferred into the Neonatal Intensive Care Unit (NICU) Level 3, with the precaution of airborne and contact isolation. All required investigations were performed, including blood gases, nasopharyngeal swab, chest x-ray, and echocardiogram. On the fifth day of delivery, her investigations demonstrated a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Despite applying all recommended guidelines and following the treatment protocol, she developed severe respiratory symptoms with persistent pulmonary hypertension, which progressed significantly to her death.

Congenital Nephrotic Syndrome With a Novel Presentation in Saudi Arabia.

Congenital nephrotic syndrome (CNS) is a rare and serious entity of renal diseases diagnosed in infants younger than three months. The triad of this syndrome is proteinuria, hypoalbuminemia, and edema. Without renal transplantation, these patients rarely live beyond the age of three years. Infections and sepsis are the most common causes of this condition among children. The majority of patients progress to end-stage renal disease early in life, even with aggressive supportive therapy. In this study, we present a case of a 10-year-old Saudi boy who had been diagnosed with CNS since he was two months old and has improved without renal transplantation.