Clinical Presentations and Risk Factors of Gastrointestinal Bleeding in the Emergency Department: A Multicenter Retrospective Study.

BACKGROUND AND AIMS: Gastrointestinal bleeding is a major healthcare burden and is associated with significant morbidity and mortality. This study aimed to assess the prevalence, clinical presentation, and risk factors of patients presenting with gastrointestinal bleeding in the emergency department. MATERIALS AND METHODS: This retrospective study was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia. The medical records of patients who presented to the emergency department with gastrointestinal bleeding between January 2010 and January 2020 were reviewed. Patients aged 18 years or older, with gastrointestinal bleeding (upper or lower) regardless of underlying cause, lifestyle, location of bleeding, health status, or medication use, were included. Demographic characteristics, initial vital signs, medical history, physical examination findings, comorbidities, medications, laboratory and radiological investigations, cause and stage of liver disease, management, and complications were recorded. Endoscopic findings and management of the bleeding site were collected according to the presenting symptoms. RESULTS: A total of 760 patients were included. The mean age was 62.7 ± 17.8 years, and 61.4% were males. The most common comorbidities at presentation were hypertension (54.1%), diabetes mellitus (51.2%), and ischemic heart disease (18.2%). The origins of the bleeding were lower gastrointestinal in 52% and upper gastrointestinal in 48% of patients. CONCLUSIONS: Lower gastrointestinal bleeding was found to be more common than upper gastrointestinal bleeding. Hemorrhoids, polyps, diverticular disease, and colonic ulcers were the major risk factors for lower gastrointestinal bleeding. In contrast, upper gastrointestinal bleeding was predominantly caused by esophageal varices, gastritis, and peptic ulcers.

Assessment of nursing knowledge and practice toward prevention of acquired infections in the emergency department of King Faisal Medical Complex in Taif.

Background: Hospital-acquired infections constitute a significant source of morbidity and mortality for both patients and healthcare professionals. Nursing professionals constitute an integral component of any quality-related program in a hospital, given their oversight and provision of nearly all healthcare services. Nurses' knowledge and attitudes play a significant role in healthcare delivery. Within Saudi Arabia, the prevalence of hospital-acquired infections in hospital settings has prompted a growing emphasis on evaluating nursing knowledge and adherence to practice standards aimed at hospital-acquired infection prevention. Methods: This single-center cross-sectional study was conducted at the emergency department of King Faisal Medical Complex, Taif, between October and December 2022, involving 168 nurses. The study utilized a pre-validated structured online questionnaire comprising three sections: demographics, knowledge assessment, and practice evaluation. Knowledge and practice levels were categorized as good, moderate, and poor using quartiles. Results: The study encompassed 168 nurses employed in the emergency department of the hospital, revealing their proficiency in standard practices for preventing hospital-acquired infections. Notably, 63.8% of participants demonstrated a commendable "Good" level of knowledge, while 10.6% exhibited a "Moderate" level and 25.5% manifested a "Poor" level in terms of knowledge. Similarly, concerning practice levels, 56.4% showcased a commendable "Good" practice level, 22.3% maintained a "Moderate" practice level, and 21.3% presented a "Poor" practice level. Chi-square analysis unveiled a significant association between age and knowledge levels (p = 0.000). In addition, age (p = 0.000) and years of clinical experience (p = 0.000) were significantly linked to nurses' practice levels The nurses aged 40-50 years (82%) and those with 10-15 years of clinical experience (83.3%) showed good levels of knowledge and practice, respectively. Overall, most of the nurses demonstrated effective knowledge and compliance with infection prevention practices. Conclusion: Sociodemographic factors such as age and clinical experience exert a notable impact on nurses' knowledge and practices regarding hospital-acquired infections.

Assessment of Knowledge, Attitude, and Practices of Cardiovascular Medical Emergencies Among Dental Students: An Institutional-Based Cross-Sectional Study.

BACKGROUND:  Dental health and treatment are impacted by cardiovascular disease trends, complications, and related treatments. Every dentist should be prepared to handle the most serious cardiovascular emergencies and should expect to encounter them. Colleges have liability toward students to receive sufficient instructions so that they are prepared and self-assured to handle potentially life-threatening circumstances. The aim of this study is to assess the knowledge, attitude, and practice (KAP) among dental students in the Kingdom of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was conducted from January to June 2023 on undergraduates, interns, and postgraduate students studying at the dental school. A pre-validated questionnaire with 22 close-end questions consisting of demographic data and KAP items related to cardiovascular medical emergencies was circulated through Google form links. Statistical analysis was conducted using the chi-square test and multinomial regression. RESULTS: Of the 252 participants, the students overall showed moderate to poor responses among the KAP items related to cardiac emergencies. Most of the students (85%) showed positive attitude toward basic life support (BLS) and 78% on automated external defibrillation (AED). The majority of students showed unsafe practice (86.1%) that is they have not faced a cardiac emergency in the dental clinic, while 63.1% don't update their emergency skills. Postgraduate students compared to other groups showed superior responses in all three domains of KAP with statistical significance (p<0.000). The undergraduates showed moderate levels of knowledge and attitude response, but unsafe responses to practice items were observed. CONCLUSION: This study depicts that dental students who will eventually become dental practitioners have a critical need for training in managing cardiovascular medical emergencies.

Standardized protocol for quantification of nerve bundle density as a biomarker for endometriosis.

Introduction: We propose a standardized protocol for measurement of nerve bundle density in endometriosis as a potential biomarker, including in deep endometriosis (DE), ovarian endometriomas (OMA) and superficial peritoneal endometriosis (SUP). Methods: This was a prospective cohort of surgically excised endometriosis samples from Dec 1st 2013 and Dec 31st 2017 at a tertiary referral center for endometriosis in Vancouver, BC, Canada. Surgical data were available from linked patient registry. Protein gene product 9.5 (PGP9.5) was used to identify nerve bundles on immunohistochemistry. PGP9.5 nerve bundles were counted visually. To calculate nerve bundle density, PGP9.5 nerve bundle count was divided by the tissue surface area (total on the slide). All samples were assessed using NHS Elements software for semi-automated measurement of the tissue surface area. For a subset of samples, high power fields (HPFs) were also counted as manual measurement of the tissue surface area. Intraclass correlation was used to assess intra observer and inter observer reliability. Generalized linear mixed model (GLMM) with random intercepts only was conducted to assess differences in PGP9.5 nerve bundle density by endometriosis type (DE, OMA, SUP). Results: In total, 236 tissue samples out of 121 participants were available for analysis in the current study. Semi-automated surface area measurement could be performed in 94.5% of the samples and showed good correlation with manually counted HPFs (Spearman's rho = 0.781, p < 0.001). To assess intra observer reliability, 11 samples were assessed twice by the same observer; to assess inter observer reliability, 11 random samples were blindly assessed by two observers. Intra observer reliability and inter observer reliability for nerve bundle density were excellent: 0.979 and 0.985, respectively. PGP9.5 nerve bundle density varied among samples and no nerve bundles could be found in 24.6% of the samples. GLMM showed a significant difference in PGP9.5 nerve bundle density between the different endometriosis types (X2 = 87.6, P < 0.001 after adjusting for hormonal therapy, with higher density in DE and SUP in comparison to OMA). Conclusion: A standardized protocol is presented to measure PGP9.5 nerve bundle density in endometriosis, which may serve as a biomarker reflecting local neurogenesis in the endometriosis microenvironment.

Draft Genome of Nocardia canadensis sp. nov. Isolated from Petroleum-Hydrocarbon-Contaminated Soil.

The bacterial strain WB46 was isolated from the rhizosphere of willow plants (Salix purpurea L.) growing in soil contaminated with petroleum hydrocarbons. The strain was subjected to whole-genome shotgun sequencing using Illumina HiSeq. Its draft genome is 7.15 Mb, with a 69.55% GC content, containing 6387 protein-coding genes and 51 tRNA and 15 rRNA sequences. The quality and reliability of the genome were assessed using CheckM, attaining an estimated genome completeness of 98.75% and an estimated contamination of 1.68%. These results indicate a high-quality genome (>95%) and low contamination (<5%). Many of these genes are responsible for petroleum hydrocarbon degradation, such as alkane 1-monooxygenase (alkB) and naphthalene dioxygenase (ndo). 16S rRNA gene analysis, including in silico DNA-DNA hybridization (DDH) and average nucleotide identity (ANI), showed that strain WB46 belongs to the genus Nocardia, and the most closely related species is Nocardia asteroides. The strain WB46 showed a distance of 63.4% and sequence identity of 88.63%, respectively. These values fall below the threshold levels of 70% and 95%, respectively, suggesting that the strain WB46 is a new species. We propose the name of Nocardia canadensis sp. nov. for this new species. Interestingly, the sequence divergence of the 16S rRNA gene showed that the divergence only occurred in the V2 region. Therefore, the conventional V3-V4, V5-V7, or V8-V9 targeting metabarcoding, among others, would not be able to assess the diversity related to this new species.

Olfactory dysfunction among patients with COVID-19.

OBJECTIVES: To assess the frequency of olfactory dysfunction (OD) among individuals afflicted with coronavirus disease of 2019 (COVID-19). METHODS: A comprehensive literature search was carried out across several bibliographical databases (PubMed, Scopus, Google Scholar, and Web of Science) to extract publications in the English language between January 2020 and December 2021 to report the incidence of OD alone or together with gustatory dysfunction (GD) among COVID-19 patients. RESULTS: Based on eligibility criteria, 84 articles were included from 27 countries, comprising 36,903 patients, of whom 58.1% were females. The generality rates of olfactory impairment alone was 34.60% and in conjunction with GD was 11.36%. Patients with OD were subclassified into various categories, and the prevalence of anosmia was 20.85%, 5.04% for hyposmia, 8.88% for anosmia or hyposmia, 1.84% for parosmia, 0.78% for phantosmia, and 0.02% for hyperosmia, among COVID-19 patients. CONCLUSION: Clinical features associated with OD, either isolated or in combination with GD, are common in patients with COVID-19 and consider important signs of COVID-19 that may guide clinicians in the early phase of the disease.PROSPERO Reg. No.: 417296.

Assessing the Impact of COVID-19 Vaccines on Sickle Cell Anaemia Patients: A Comparative Analysis of Biochemical and Haematological Parameters.

The coronavirus disease 2019 (COVID-19) vaccines have been developed to help prevent the spread of the virus infections. The COVID-19 vaccines, including Pfizer, Moderna, and AstraZeneca, have undergone rigorous testing and have demonstrated both safety and effectiveness. Extensive evidence supports their effectiveness in preventing severe illness, hospitalization, and mortality associated with COVID-19 infection. The administration of COVID-19 vaccines can directly affect hematological and biochemical parameters, with reported cases showing an association with thrombosis and thrombocytopenia. Therefore, it was hypothesized that COVID-19 vaccines may also influence hematological and biochemical markers in sickle cell patients. This study aimed to investigate the side effects of COVID-19 vaccines on sickle cell patients, providing a comprehensive evaluation of hematological and biochemical parameters. To our knowledge, this is the first study of its kind conducted in Saudi Arabia. The study included the evaluation of Pfizer and Oxford-AstraZeneca vaccines in sickle cell patients, measuring key parameters. Our findings revealed varying impacts of both vaccines on the ALT, AST, and CRP levels. Notably, CRP and ALT exhibited potential as indicators for renal disease, diabetes, and arthritis. However, further investigations are necessary to uncover the underlying mechanisms that drive these observed differences and comprehend their clinical implications for this vulnerable patient population. The unique nature of our study fills a crucial research gap and underscores the need for additional research in this area.

Spontaneous epiglottic abscess: pathophysiology and airway management options.

Laryngeal abscesses are rare in the modern antibiotic era. This report presents a novel case of an epiglottic abscess in a patient with diabetes who developed respiratory distress and was managed by awake intubation in the emergency room followed by transoral incision and drainage of the abscess and tracheostomy. Full recovery after 1 week of intravenous antibiotic treatment was observed. Surgical intervention is necessary for treatment and culture-directed antimicrobial therapy. Poorly controlled diabetes is a newly described risk factor for spontaneous epiglottic abscess development.

A Framework for Prediction of Oncogenomic Progression Aiding Personalized Treatment of Gastric Cancer.

Mutations in genes can alter their DNA patterns, and by recognizing these mutations, many carcinomas can be diagnosed in the progression stages. The human body contains many hidden and enigmatic features that humankind has not yet fully understood. A total of 7539 neoplasm cases were reported from 1 January 2021 to 31 December 2021. Of these, 3156 were seen in males (41.9%) and 4383 (58.1%) in female patients. Several machine learning and deep learning frameworks are already implemented to detect mutations, but these techniques lack generalized datasets and need to be optimized for better results. Deep learning-based neural networks provide the computational power to calculate the complex structures of gastric carcinoma-driven gene mutations. This study proposes deep learning approaches such as long and short-term memory, gated recurrent units and bi-LSTM to help in identifying the progression of gastric carcinoma in an optimized manner. This study includes 61 carcinogenic driver genes whose mutations can cause gastric cancer. The mutation information was downloaded from intOGen.org and normal gene sequences were downloaded from asia.ensembl.org, as explained in the data collection section. The proposed deep learning models are validated using the self-consistency test (SCT), 10-fold cross-validation test (FCVT), and independent set test (IST); the IST prediction metrics of accuracy, sensitivity, specificity, MCC and AUC of LSTM, Bi-LSTM, and GRU are 97.18%, 98.35%, 96.01%, 0.94, 0.98; 99.46%, 98.93%, 100%, 0.989, 1.00; 99.46%, 98.93%, 100%, 0.989 and 1.00, respectively.

Concurrent Killian-Jamieson and Zenker's Diverticula.

Pharyngoesophageal diverticula are rare causes of dysphagia. Zenker's diverticulum is the most common type, followed by Killian-Jamieson diverticulum. A 44-year-old male presented to our clinic with a longstanding history of dysphagia and globus sensation. Bilateral pharyngoesophageal diverticula were confirmed by imaging CT and esophagogastroscopy. He underwent transcervical resection, and a right Killian-Jamieson diverticulum was observed during surgery. The left diverticulum was found to originate above the cricopharyngeus muscle and was labeled as Zenker's diverticulum. Bilateral pharyngoesophageal diverticula are rare, and physicians should be aware of the variable clinical presentations and management options for pharyngoesophageal diverticula.

Intelligent Wireless Capsule Endoscopy for the Diagnosis of Gastrointestinal Diseases.

Through a wireless capsule endoscope (WCE) fitted with a miniature camera (about an inch), this study aims to examine the role of wireless capsule endoscopy (WCE) in the diagnosis, monitoring, and evaluation of GI (gastrointestinal) disorders. In a wearable belt recorder, a capsule travels through the digestive tract and takes pictures. It attempts to find tiny components that can be used to enhance the WCE. To accomplish this, we followed the steps below: Researching current capsule endoscopy through databases, designing and simulating the device using computers, implanting the system and finding tiny components compatible with capsule size, testing the system and eliminating noise and other problems, and analyzing the results. In the present study, it was shown that a spherical WCE shaper and a smaller WCE with a size of 13.5 diameter, a high resolution, and a high frame rate (8-32 fps) could help patients with pains due to the traditional capsules and provide more accurate pictures as well as prolong the battery life. In addition, the capsule can also be used to reconstruct 3D images. Simulation experiments showed that spherical endoscopic devices are more advantageous than commercial capsule-shaped endoscopic devices for wireless applications. We found that the sphere's velocity through the fluid was greater than the capsule's.

Safety and user experience with off-label use of a flash glucose monitor (FreeStyle Libre® 1) among very young children with type 1 diabetes mellitus.

OBJECTIVES: FreeStyle Libre 1 (FGM) has been approved by the FDA for children older than 4 years. It enables noninvasive glucose monitoring without the need for finger pricking. Parents of very young children often use the device off-label. Thus, we aimed to evaluate the safety of and user experience with FreeStyle Libre® 1 and determine its impact on sleep and glycemic control. METHODS: This was an ambi-directional cohort study. We recruited parents of very young children with type 1 diabetes mellitus (T1DM) who were less than 5 years old when they started using FGM at the King Saud University Diabetes Center. The parents filled out a survey evaluating their experience with the system. In addition, the glucose metrics of the children were also obtained from the Libre View system. RESULTS: We included 31 children with mean age of the children when they started using FGM was 3.88 ± 1.10 years (range, 1.46-5.4 years), and the mean sensor use was 2.3 ± 1.3 years. During the use of the device, the parents had increased sleep duration of 0.71 h (p-value=0.04), had earlier bedtime by 2.8 h (p-value=0.04), and were able to sleep in a separate room from their children. In addition, the time in range improved by 9.9%, the time above range decreased by 8.8%, and the HbA1c level reduced by 1.56%. CONCLUSIONS: The safety profile of FGM used for very young children with T1DM is the same for older children, which leads to improved metabolic control and sleep quality of both the parent and the child.

An AI-Inspired Spatio-Temporal Neural Network for EEG-Based Emotional Status.

The accurate identification of the human emotional status is crucial for an efficient human-robot interaction (HRI). As such, we have witnessed extensive research efforts made in developing robust and accurate brain-computer interfacing models based on diverse biosignals. In particular, previous research has shown that an Electroencephalogram (EEG) can provide deep insight into the state of emotion. Recently, various handcrafted and deep neural network (DNN) models were proposed by researchers for extracting emotion-relevant features, which offer limited robustness to noise that leads to reduced precision and increased computational complexity. The DNN models developed to date were shown to be efficient in extracting robust features relevant to emotion classification; however, their massive feature dimensionality problem leads to a high computational load. In this paper, we propose a bag-of-hybrid-deep-features (BoHDF) extraction model for classifying EEG signals into their respective emotion class. The invariance and robustness of the BoHDF is further enhanced by transforming EEG signals into 2D spectrograms before the feature extraction stage. Such a time-frequency representation fits well with the time-varying behavior of EEG patterns. Here, we propose to combine the deep features from the GoogLeNet fully connected layer (one of the simplest DNN models) together with the OMTLBP_SMC texture-based features, which we recently developed, followed by a K-nearest neighbor (KNN) clustering algorithm. The proposed model, when evaluated on the DEAP and SEED databases, achieves a 93.83 and 96.95% recognition accuracy, respectively. The experimental results using the proposed BoHDF-based algorithm show an improved performance in comparison to previously reported works with similar setups.

Converging alfalfa (Medicago sativa L.) and petroleum hydrocarbon acclimated ACC-deaminase containing bacteria for phytoremediation of petroleum hydrocarbon contaminated soil.

Plant assisted bioremediation of petroleum hydrocarbon contaminated soil is considered an effective green technology whereby accelerated degradation occurs due to converged effect of microorganisms and plants. However, survival and growth of microbes and plants under stress conditions is challenging task for success of the technology. In this study, plant growth promoting bacteria containing 1-aminocyclopropane-1-carboxylate (ACC)-deaminase activity and tolerance to petroleum hydrocarbon contamination were used in association with alfalfa for bioremediation of petroleum hydrocarbon contaminated soil. Eight pre-isolated bacterial isolates from soil having previous history of petroleum contamination were used in convergence with alfalfa on sand soil which was artificially contaminated (10 g crude oil per kg-1 of coarse textured soil). Combined effect of bacteria and plants on the degradation of petroleum hydrocarbons under controlled conditions of light and temperature was observed for a period of 60 days. The results of the study revealed that four bacterial isolates Bacillus subtilis strain PM32Y, Bacillus cereus strain WZ3S1, Bacillus sp. strain SM73 and Bacillus sp. strain WZ3S3 in association with alfalfa significantly degraded petroleum hydrocarbons. The most significant biodegradation (47%) of petroleum hydrocarbons was recorded in the experimental unit receiving PM32Y inoculation in association with alfalfa. Biodegradation of petroleum hydrocarbons was 33% with alone inoculation (without alfalfa) of PM32Y. The study revealed that combined use of bacteria and alfalfa plant is more efficient than alone application of either bacteria or plants for degradation of petroleum hydrocarbons.

This study provides the evidence for phytoremediation and significant degradation of petroleum hydrocarbons by using plant growth promoting bacteria (PGPB), containing 1-aminocyclopropane-1-carboxylate deaminase (ACC-deaminase) in association with alfalfa (Medicago sativa L.). The most significant biodegradation of petroleum hydrocarbons was recorded with a new combination of Bacillus subtilis strain PM32Y in association with alfalfa.

Interleukin-1ß and plasminogen activating system members in endometriotic stromal cell migration/invasion.

OBJECTIVE: To study the role of interleukin (IL)-1ß and the plasminogen activating (PA) system members in endometriotic stromal cell (ESC) migration/invasion. DESIGN: Primary cultures of ESCs. SETTING: Tertiary referral center for endometriosis and pelvic pain. PATIENT(S): Patients with surgically excised endometriosis. INTERVENTION(S): Interleukin-1ß stimulation of primary cultures of ESCs and knockdown of the PA system members urokinase plasminogen activator (uPA), uPA receptor, and plasminogen activator inhibitor-1 (PAI-1). MAIN OUTCOME MEASURE(S): Invasion/migration assays. RESULT(S): In primary cultures, IL-1ß-stimulated ESC production of the PA system members uPA, uPA receptor, and PAI-1. Interleukin-1ß also enhanced ESC migration and invasion, and these effects were inhibited by the IL-1 receptor-1 antagonist anakinra. Knockdown of each of the 3 PA system members also inhibited ESC migration and invasion. Knockdown of these PA system members further attenuated the impact of IL-1ß on migration and invasion, suggesting that they mediated the promigration and proinvasion effects of IL-1ß. To supplement the cell culture work, immunohistochemistry was performed on tissue sections of endometriotic epithelium/stroma: uPA, PAI-1, and IL-1ß histoscores were not found to be correlated with each other. CONCLUSION(S): In primary cultures of ESCs, IL-1ß induces migration and invasion, which is mediated by PA system members and inhibited by the drug anakinra. However, the immunohistochemistry expression of IL-1ß, urokinase plasminogen inhibitor-1, and PAI-1 were not correlated, suggesting other regulatory mechanisms for PA system members. Inhibition of IL-1ß (e.g., with anakinra) may have potential as a novel treatment approach for the migration/invasion of endometriosis.

A Pediatric Case of Spinal Intradural Epidermoid Cyst: A Rare Encounter.

Intradural epidermoid cysts of the spine are rare congenital lesions. Their etiology is thought to stem from ectodermal remnants during embryonic development. They result in a diverse clinical presentation, often marked by an insidious onset and variable neurological deficits. Timely diagnosis is crucial for optimizing patient outcomes. We present the case of a 10-year-old male child presenting a six-month history of worsening back pain, intermittent leg weakness, and urinary incontinence. The physical examination revealed tenderness over the lower thoracic and lumbar spine, lower limb weakness, hyperreflexia, and sensory deficits. The diagnostic work-up, including cerebrospinal fluid analysis and magnetic resonance imaging, confirmed the presence of an intradural epidermoid cyst in the lumbosacral region. Surgical excision resulted in complete resection, with subsequent improvement in neurological deficits. This pediatric case underscores the importance of maintaining a high index of suspicion for unexplained neurological deficits. Characteristic imaging findings played a pivotal role in the diagnosis, guiding successful surgical intervention and achieving favorable outcomes.

Assessment of the ability, perception, and readiness of nurses to manage tracheostomy-related complications in Riyadh City: a cross-sectional study.

BACKGROUND: Nursing staff play a key role in the bedside management of tracheostomized patients in both intensive care units and general floors. Effective provision of postoperative care to these patients by nurses is critical. This study aimed to assess the readiness of nursing staff to manage tracheostomy-related complications in Riyadh, Saudi Arabia. METHODS: This cross-sectional study enrolled 395 nurses in Riyadh, Saudi Arabia. A self-administered questionnaire developed by the authors was distributed to nurses via an online survey. The questionnaire assessed nurses' socio-demographic characteristics and their knowledge and practices regarding tracheostomy indications, postoperative care, and management of its complications. RESULTS: Of respondents, approximately 59% (232/395) had poor knowledge regarding tracheostomy-related complications and indications, 39% (154/395) had moderate knowledge, and only 2%(9/395) had good knowledge. Several factors were associated with increased knowledge, including having a higher education degree, working in a tertiary/quaternary hospital, being a government employee, caring for tracheostomized patients, and attending courses or lectures on managing tracheostomized patients. CONCLUSIONS: Knowledge level and practices regarding tracheostomy-related complications and indications among nurses remain limited. In-service continuous professional development programs for nurses working in all hospital settings are strongly recommended. Further research is warranted to elicit the major factors contributing to inadequate knowledge and practices among nurses in Riyadh.

Evaluate the side effect associated with COVID-19 vaccine on adolescents in Riyadh, Saudi Arabia: A cross-section study.

OBJECTIVES: To investigate the side effects of Pizer- BioNTech mRNA (BNT162b2) and Spikevax (mRNA- 1273) Coronavirus disease 2019 (COVID-19) vaccines on adolescents in Riyadh, Saudi Arabia. METHODS: A cross-sectional study using an online questionnaire was carried out among COVID-19 vaccine adolescent recipients in Riyadh, Saudi Arabia. After receiving at least one dose of each vaccine, general and demographic data were collected, and vaccine-related side effects were evaluated. RESULTS: The final sample consisted of 604 participants with a majority age group of 16-17 years old. Approximately 89.1% of the study participants were female. Most participants reported pain at the injection site (85.1% 1st dose, 79.8% 2nd dose), feeling tired, and headache (58.6% 1st dose, 64.2% 2nd dose). Moreover, we found that patients who took the first dose and had a chronic disease had 2.4 times higher odds of having menstrual disorder (females) than non-chronic disease patients (p=0.03) and 4.5 times higher odds of exhibiting breathing congestion (p=0.01). In addition, patients with chronic disease had 2.4 times higher odds of exhibiting muscle and joint pain and dizziness than non-chronic disease patients (p=0.01, p=0.02). Males were less likely to have dizziness after the first dose than females (OR=0.26, p=0.01). CONCLUSION: This study investigates the adverse effects of COVID-19 vaccines among adolescents in Riyadh. As a result, this study creates a database to inform people about the risk of experiencing side effects based on their gender, age, and the vaccine type; more investigation is needed to better understand the link between risk factors and the development of adverse effects.

Potential of plant growth promoting bacterial consortium for improving the growth and yield of wheat under saline conditions.

Owing to inconsistent results of a single bacterial strain, co-inoculation of more than one strain under salinity stress could be a more effective strategy to induce salt tolerance. Co-inoculation of more than one bacterial strain could be more effective due to the presence of several growths promoting traits. This study was conducted to evaluate the effectiveness of multi-strains bacterial consortium to promote wheat growth under salinity stress. Several plant growth promoting rhizobacteria (PGPR) had been isolated and tested for their ability to grow in increasing concentrations of sodium chloride (NaCl). Those rhizobacterial strains having tolerance against salinity were screened to evaluate their ability to promote wheat growth in the presence of salinity by conducting jar trials under axenic conditions. The rhizobacteria with promising results were tested for their compatibility with each other before developing multi-strain inoculum of PGPR. The compatible PGPR strains were characterized, and multi-strain inoculum was then evaluated for promoting wheat growth under axenic conditions at different salinity levels, i.e., 2.1 (normal soil), 6, 12, and 18 dS m-1. The most promising combination was further evaluated by conducting a pot trial in the greenhouse. The results showed that compared to a single rhizobacterial strain, better growth-promoting effect was observed when rhizobacterial strains were co-inoculated. The multi-strain consortium of PGPR caused a significant positive impact on shoot length, root length, shoot fresh weight, and root fresh weight of wheat at the highest salinity level in the jar as well as in the pot trial. Results showed that the multi-strain consortium of PGPR caused significant positive effects on the biochemical traits of wheat by decreasing electrolyte leakage and increasing chlorophyll contents, relative water contents (RWC), and K/Na ratio. It can be concluded that a multi-strain consortium of PGPR (Ensifer adhaerens strain BK-30, Pseudomonas fluorescens strain SN5, and Bacillus megaterium strain SN15) could be more effective to combat the salinity stress owing to the presence of a variety of growth-promoting traits. However, further work is going on to evaluate the efficacy of multi-strain inoculum of PGPR under salt-affected field conditions.

Deep brain stimulation in children and youth: perspectives of patients and caregivers gleaned through Twitter.

OBJECTIVE: This study aims to glean patient and caregiver perspectives surrounding deep brain stimulation (DBS) in children and youth through an analysis of patterns of social media usage. METHODS: The authors performed a comprehensive search of the Twitter Application Programming Interface (API) database for all tweets about DBS use in children and youth, with no date restriction. Data pertaining to each tweet were extracted for analysis. Results were analyzed using qualitative and quantitative methodologies. These included thematic analysis of tweets, accounts, and descriptive statistics. Sentiment analysis of extracted tweets was also performed. A multivariable regression model was used to identify predictors of higher engagement metrics (likes, retweets, and quotes). RESULTS: A comprehensive search of the Twitter database yielded 877 tweets from 816 unique accounts meeting study inclusion criteria. Most tweets were from patients or caregivers, researchers, or news media outlets. The most common themes among analyzed tweets were research discussing novel findings (45.2%) or personal experiences of patients or caregivers (27.4%). Sentiment analysis showed that 54.5% of tweets were positive, 35.1% were neutral, and 10.4% were negative. The presence of pictures or videos increased the tweet engagement count by an average of 10.5 (95% CI 7.3-13.6). Tweets about personal patient experiences (ß = 6, 95% CI 0.95-12) and tweets tagging other accounts (ß = 3.2, 95% CI 0.63-5.8) were also significantly associated with higher engagement metrics. CONCLUSIONS: The current study is the first to assess patient and caregiver perspectives surrounding pediatric DBS through a comprehensive analysis of social media usage. Given the nascent field, social media presents an opportunity to share experiences and promote patient and healthcare professional education surrounding pediatric DBS.