A robust optimal control framework for controlling aberrant RTK signaling pathways in esophageal cancer.

This study presents a new framework for obtaining personalized optimal treatment strategies targeting aberrant signaling pathways in esophageal cancer, such as the epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) signaling pathways. A new pharmacokinetic model is developed taking into account specific heterogeneities of these signaling mechanisms. The optimal therapies are designed to be obtained using a three step process. First, a finite-dimensional constrained optimization problem is solved to obtain the parameters of the pharmacokinetic model, using discrete patient data measurements. Next, a sensitivity analysis is carried out to determine which of the parameters are sensitive to the evolution of the variants of EGF receptors and VEGF receptors. Finally, a second optimal control problem is solved based on the sensitivity analysis results, using a modified pharmacokinetic model that incorporates two representative drugs Trastuzumab and Bevacizumab, targeting EGF and VEGF, respectively. Numerical results with the combination of the two drugs demonstrate the efficiency of the proposed framework.

Prevalence of Digital Eye Strain Among University Students and Its Association with Virtual Learning During the COVID-19 Pandemic.

Introduction: The prolonged use of digital devices is a major risk factor for digital eye strain (DES) syndrome. Aim: To estimate the prevalence of DES symptoms among students at Imam Abdulrahman University who use digital devices for virtual learning and leisure activities. Methods: This was a retrospective cross-sectional study conducted by asking medical students of Imam Abdulrahman bin Faisal University to complete a self-administered online questionnaire. The questionnaire was used to determine the effect of the hours spent on digital devices and other factors, such as screen distance and not using artificial tears, on the development of DES. The severity (moderate or severe) and frequency (occasionally, always, or never) of 16 eye strain-related symptoms, including eye pain, headache, and itching, were evaluated by using the Computer Vision Syndrome Questionnaire. Results: The overall prevalence of DES in the sample was found to be 68.53%. The largest proportion of students were found to have mild DES (43.20%), and only 11% had severe DES. The most common symptoms reported in our sample were headache, dryness, and burning. Female gender, using smartphones for online classes, and not using eye lubricants were significantly associated with increased severity of DES. Conclusion: In the wake of the COVID-19 pandemic, virtual learning has become an integral part of education, leading to increased use of digital technology. The aim of this study was to investigate the impact of virtual learning on eye strain and to determine the prevalence and effects of DES. A questionnaire was administered to participants, and the findings revealed a DES prevalence of 68.53%. The use of eye drops for lubrication and smartphones for classes was significantly associated with DES. Furthermore, females were found to be more susceptible to severe DES symptoms than males. The development of a tool such as the Computer Vision Syndrome Questionnaire to predict DES prevalence could reduce clinic time and resources by minimizing unnecessary follow-up and ophthalmology referrals.

Role of Serum Amyloid A as a Biomarker for Predicting the Severity and Prognosis of COVID-19.

Objective: To detect biomarkers that can be used to predict COVID-19 severity to identify patients with high probability of disease progression and poor prognosis. Methods: Of the 102 patients with confirmed COVID-19 who were admitted to King Fahd General Hospital, Jeddah City, Saudi Arabia, from July 1, 2021 to August 5, 2021, 50 were included in this cross-sectional study to investigate the influence of serum amyloid A (SAA) on disease severity and survival outcomes of COVID-19 patients. Dynamic shifts in SAA, C-reactive protein (CRP), white blood cell (WBC), lymphocytes, neutrophils, biochemical markers, and disease progression were examined. At admission, and at three, five, and seven days after treatment, at least four data samples were collected from all patients, and they underwent clinical status assessments. Results: Critically ill patients showed higher SAA and CRP levels and WBC and neutrophil counts and significantly lower lymphocyte and eosinophil counts compared to the moderately/severely ill patients, especially with regard to disease progression. Similarly, nonsurvivors had higher SAA levels than survivors. The moderately/severely ill patients and the survivors had significantly higher dynamic changes in SAA compared to the critically ill patients and nonsurvivors, respectively, with differences clearly noticed on the fifth and seventh day of treatment. ROC curve analysis revealed that the combination of SAA and CRP was valuable in evaluating the disease progression and prognosis of COVID-19 patients at different time points; however, a combination of SAA and lymphocyte counts was more sensitive for disease severity prediction on admission. The most sensitive parameters for predicting survival on admission were the combination of SAA/WBC and SAA/neutrophil count. Conclusions: The study findings indicate that SAA can be used as a sensitive indicator to assess the degree of disease severity and survival outcomes of COVID-19 patients.

The Epidemiology, Associated Factors and Bacterial Profile of Asymptomatic Bacteriuria in Pregnant Women: A Retrospective Chart Review Study in Saudi Arabia.

Purpose: Asymptomatic bacteriuria (ASB) is the presence of significant amounts of bacteria within the urinary tract in the absence of urinary tract infection (UTI) symptoms, resulting in negative neonatal and pregnancy consequences. This study determined the prevalence, bacteriology patterns, and associated factors with ASB among pregnant women in both primary and hospital levels of care in the Eastern Province of Saudi Arabia. Methods: This retrospective chart review study included pregnant women between 18 and 50 years who performed the screening urine culture test during their first antenatal visit between 2017 and 2021, without UTI symptoms. The collected data involved the demographic, medical, and obstetric characteristics, and urine culture results. T-tests and chi-squared tests were used for bivariate associations followed by binary logistic regression models. Results: ASB was positive among 03.42% of the 6471 pregnant women included in the study. Logistic regression revealed that the risk of positive ASB increased in pregnant women in the first and second trimesters (OR = 2.04, 95% CI = 1.41-2.93 and OR= 1.50, 95% CI = 1.03-2.19, respectively), as well as pregnant women with a history of previous UTI (OR = 2.98, 95% CI = 2.14-4.15). The predominant organism isolates were E. coli, followed by GBS, Klebsiella pneumoniae, and Enterococcus faecalis. Conclusion: With limited data on ASB among pregnant women in Saudi Arabia, findings from the current study could help decision-makers in the country assess the epidemiological characteristics of the condition. Further study is recommended to investigate the susceptibility patterns of commonly prescribed antibiotics with different uropathogens to guide the clinicians who deal with these cases. Additionally, a large national study across the other regions in the kingdom is suggested to calculate the prevalence of ASB in Saudi Arabia.

The Effect of Various Patterns of Personal Listening Devices on Hearing Among University Students in Saudi Arabia.

Background: The long-term use of earphones at high volume levels is a major risk factor for noise-induced hearing loss. Aim: To compare the hearing of university students who use personal listening devices (PLDs) at extremes (upper & lower quartiles) with respect to a) Duration of use/day b) The number of years since use c) Volume level. Methods: This cross-sectional study was conducted in the Department of Physiology, College of Medicine, at Imam Abdulrahman bin Faisal University (IAU), from September 2021 to April 2022. An online survey was distributed among IAU medical students on the subjects' patterns of earphone use. Forty participants volunteered to participate in the hearing tests: Pure Tone Audiometry (PTA), Tympanometry, and Transient Evoked Otoacoustic Emission (TEOAEs) at the ENT clinic of the King Fahd Hospital of the University (KFHU). Results: The pure tone audiometry and TEOAE showed no significant differences in the hearing thresholds/levels of participants in upper quartiles vs lower quartiles of both ears, in any of the PLD use pattern categories. However, in the TEOAE two observation were detected: a) Significantly lower amplitude in the upper quartile of the category "duration of PLD use/day" at a frequency of 1.0 kHz in the left ear (p-value 0.04) b) Significantly lower amplitude in the upper quartile of the category "volume of PLD use" at a frequency of 1.0 kHz in the left ear (p-value 0.03). Conclusion: The present findings suggest that hearing threshold/level and cochlear outer hair cells' functions do not differ significantly in the participants belonging to the upper and lower quartiles of PLD use pattern (volume level, duration of use/day, and the number of years since use).

Purple urine bag syndrome.

Purple urine bag syndrome is very rare in which urine color changes, and it becomes purple. This occurs when patients with a urinary catheter are bedridden, and suffer from urinary tract infection caused by specific organisms.

Untargeted Metabolomics Identifies Key Metabolic Pathways Altered by Thymoquinone in Leukemic Cancer Cells.

Thymoquinone (TQ), a naturally occurring anticancer compound extracted from Nigella sativa oil, has been extensively reported to possess potent anti-cancer properties. Experimental studies showed the anti-proliferative, pro-apoptotic, and anti-metastatic effects of TQ on different cancer cells. One of the possible mechanisms underlying these effects includes alteration in key metabolic pathways that are critical for cancer cell survival. However, an extensive landscape of the metabolites altered by TQ in cancer cells remains elusive. Here, we performed an untargeted metabolomics study using leukemic cancer cell lines during treatment with TQ and found alteration in approximately 335 metabolites. Pathway analysis showed alteration in key metabolic pathways like TCA cycle, amino acid metabolism, sphingolipid metabolism and nucleotide metabolism, which are critical for leukemic cell survival and death. We found a dramatic increase in metabolites like thymine glycol in TQ-treated cancer cells, a metabolite known to induce DNA damage and apoptosis. Similarly, we observed a sharp decline in cellular guanine levels, important for leukemic cancer cell survival. Overall, we provided an extensive metabolic landscape of leukemic cancer cells and identified the key metabolites and pathways altered, which could be critical and responsible for the anti-proliferative function of TQ.

Patients concerns about spinal surgery in Hafr Al Batin, Saudi Arabia.

BACKGROUND: The aim of the research to study the concerns about spine surgery in patients who attending to neurosurgery clinic in Central Hospital and King Khalid General Hospital in hafar Al-Batin. OBJECTIVE: The objective is to determine the concern of patients about spine surgery and to detect the reasons of rejection of the surgery with tying to compare the concerns with the social factors and to know the source of their knowledge. MATERIAL AND METHOD: A cross-sectional study on sample of 91 from the patients who attending neurosurgery clinic who could be suffering from any spinal diseases such as tumors, degenerative, and trauma. A standardized survey questionnaire distributed manually and responses were collected and analyzed. RESULTS: The majority of the survey respondents were suffering from trauma (48.4%). The satisfaction rate among persons undergone spine surgery was 20.9%. A negative correlation between age and level of education; rejection of spine surgery or exploring for alternative treatment because of risk of surgery was observed. The patient feedback revealed that if advised for spine operation was 46.2% will accept, 29.7% will delay surgery and looking to alternatives, while 23.1% will reject because of concerns. CONCLUSION: It is recommended that awareness campaigns are required about the importance of spine surgery and to provide the correct information about the complications of spine surgery and finally give more attention to the correct diagnosis.

Zika Virus Targeting by Screening Inhibitors against NS2B/NS3 Protease.

Zika flavivirus is suspected to cause Guillain-Barre syndrome in adults and microcephaly, along with other congenital abnormalities in infants. Presently, no vaccines or therapeutics are available. Here, we report novel compounds identified by high-throughput virtual screening of Maybridge chemical database and molecular docking studies. We selected viral enzyme NS2B/NS3 serine protease as the therapeutic target because of its important role in viral replication. We selected seven potential compounds as antiviral drug candidates because of their high GOLD fitness score, high AutoDock Vina score, or X-Score binding energy and analyzed the strength of molecular interactions between the active site amino acids and selected compounds. Our study also provides a foundation for similar studies for the search of novel therapeutics against Zika virus.