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Hind M AlOsaimi,1 Mohammed K Alshammari,2 Ghadah K Almijlad,3 Nawaf M Alotaibi,3 Dhafer A Alqahtani,4 Mohammed M Alshamrani,5 Tariq A Shutur,6 Mansior F Alhazmi,6 Mohammed A Hurubi,6 Kutayd S ALShammari,6 Khalid M Alzahrani,7 Hadeel M Aldaghriri,7 Anood A Alshammari,8 Oudah S Alatawi,8 Reema A Alharbi9 1Department of Pharmacy Services Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia; 2Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia; 3Department of Clinical Pharmacy, Northern Border University, Rafha, Kingdom of Saudi Arabia; 4Department of Pharmacy, Security Forces Hospital, Riyadh, Kingdom of Saudi Arabia; 5Department of Respiratory Care, Northern Armed Area Forced Hospital, Hafar al Batin, Kingdom of Saudi Arabia; 6Department of Supply and Logistics, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia; 7Department of Radiology, Northern Armed Area Forced Hospital, Hafar Al Batin, Kingdom of Saudi Arabia; 8Pharmaceutical Services Department, Northern Area Armed Forces Hospital, King Khalid Military, Hafr Al Batin, Kingdom of Saudi Arabia; 9Department of Medicine, University of Tabuk, Tabuk, Saudi ArabiaCorrespondence: Mohammed K Alshammari, Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia, Email Mkaalshammari@kfmc.med.saPurpose: Despite the existence of effective medications, pulmonary tuberculosis (PTB) remains a significant global public health concern, The evaluation and feedback of national TB control programs are crucial, requiring diligent monitoring of TB treatment outcomes and analysis of the factors influencing these outcomes. This study aims to provide valuable insights into the challenges faced by TB patients, which can inform better strategies for treatment and management in the future.Patients and Methods: We conducted a study in King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia (KSA), from January 1, 2018 to December 31, 2023. The study was a registry-based retrospective cohort study. Patients’ data were sourced from the National Tuberculosis Registry database of Saudi Arabia. Treatment outcomes were determined as either success or failure, considering clinical evaluation, changes in chest X-rays, and the results of subsequent sputum examinations during follow-up. To evaluate the data, SPSS version 28.0 was used.Results: A total of 427 PTB patients participated in the study. The results show successful treatment outcomes among 88.5% of patients. Among the patients, males exhibited a higher likelihood of treatment failure as compared to females (aOR 1.3; 95%Cl 1.2– 1.5, p < 0.001). Patients with positive sputum smear (aOR 1.3; 95%Cl 1.1– 1.3 p < 0.00) and the presence of cough were associated with an increased risk of treatment failure (aOR1.5; 95%Cl 1.1– 1.4, p < 0.001).Conclusion: This study shows that the percentage of unsuccessful treatment outcomes is high, ie, 11.5%, due to patients’ deaths and loss to follow-up. Enhanced supervision and treatment monitoring for tuberculosis patients at high risk of treatment failure can lead to improved treatment success rates in Saudi Arabia.Keywords: tuberculosis, treatment outcomes, retrospective study, Saudi Arabia

Adnan A Mubaraki,1,&ast; Naif M Alotaibi,2,&ast; Ahmed Abdulrahan Alshaer,2,&ast; Mohammed H Alhamayani,2,&ast; Meshal F Althobaiti,2,&ast; Alsharif M Alqurashi,2,&ast; Asrar Alqaedi,3,&ast; Huda Abdullah Aljehafy4,&ast; 1Department of Medicine, Faculty of Medicine, Taif University, Taif, Saudi Arabia; 2Intern Medical Student, Faculty of Medicine, Taif University, Taif, Saudi Arabia; 3Department of Pediatric Nephrology, Taif Children Hospital, Taif, Saudi Arabia; 4Department of Pediatrics, Taif Children Hospital, Taif, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Naif M Alotaibi, Email legend.otibah@gmail.comBackground: Diabetes mellitus (DM) has become one of the most prevalent medical conditions worldwide. Despite the fact that DM affects a substantial proportion of the Saudi population over the age of 30, the general level of awareness of diabetic neuropathy has been reported to be poor in Saudi Arabia.Objective: To determine the level of awareness of diabetic neuropathy and its complications among the population of Taif City.Methods: This cross-sectional study evaluated the level of awareness of diabetic neuropathy among the population of Taif City using an online pre-designed self-administered questionnaire.Results: Of 486 participants enrolled in the study, 57.2% were females and 42.8% were males. In addition, 88.1% of the participants were Saudis. Our study showed that awareness of diabetic neuropathy and its complications among the population of Taif was almost non-existent, with 83.9% of the participants having never heard of diabetic neuropathy in their life. The level of awareness of this disorder was scored as 7.65 1.01 out of a total of 18, even though the educational level of the participants was excellent, and 61.3% of them had a university degree and above.Conclusion: This is the first report demonstrating the knowledge of diabetic neuropathy among residents of Taif City. Regardless of educational level, the knowledge of diabetic neuropathy was poor, necessitating greater efforts to increase public awareness using different approaches and campaigns. This will help in the early detection of such complications and impact the response to different treatment modalities.Keywords: diabetes mellitus, diabetic neuropathy, diabetic complications, level of awareness, taif

Nawaf M Alotaibi,1,2 Virginia Chen,1,3,4 Zsuzsanna Hollander,1,3,4 Jonathon A Leipsic,5 Cameron J Hague,5 Darra T Murphy,5 Mari L DeMarco,1,6 JM FitzGerald,3,7,8 Bruce M McManus,1,3,4,6 Raymond T Ng,4,9 Don D Sin1,3,7 1Centre for Heart Lung Innovation, James Hogg Research Centre, St Paul’s Hospital, Vancouver, BC, Canada; 2Department of Medicine, Division of Pulmonary Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Institute for Heart and Lung Health, Vancouver, BC, Canada; 4PROOF Centre of Excellence, Vancouver, BC, Canada; 5Department of Radiology, St Paul’s Hospital, Vancouver, BC, Canada; 6Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; 7Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; 8The Lung Centre, Vancouver General Hospital, Vancouver, BC, Canada; 9Department of Computer Sciences, University of British Columbia, Vancouver, BC, Canada Background: Etiologies of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are heterogeneous. We phenotyped severe AECOPD based on molecular pathogen detection of sputum samples collected at hospitalization of COPD patients and determined their outcomes.Methods: We phenotyped 72 sputum samples of COPD patients who were hospitalized with a primary diagnosis of AECOPD using a molecular array that detected common bacterial and viral respiratory pathogens. Based on these results, the patients were classified into positive or negative pathogen groups. The pathogen-positive group was further divided into virus or bacteria subgroups. Admission day 1 blood samples were assayed for N-terminal prohormone brain natriuretic peptide, CRP, and complete blood counts.Results: A total of 52 patients had a positive result on the array, while 20 patients had no pathogens detected. The most common bacterial pathogen detected was Haemophilus influenzae and the most common virus was rhinovirus. The pathogen-negative group had the worse outcomes with longer hospital stays (median 6.5 vs 5 days for bacteria-positive group, P=0.02) and a trend toward increased 1-year mortality (P=0.052). The bacteria-positive group had the best prognosis, whereas the virus-positive group had outcomes somewhere in between the bacteria-positive and pathogen-negative groups.Conclusion: Molecular diagnostics on sputum can rapidly phenotype serious AECOPD into bacteria-, virus-, or pathogen-negative groups. The bacteria-positive group appears to have the best prognosis, while pathogen-negative group has the worst. These data suggest that AECOPD is a heterogeneous event and that accurate phenotyping of AECOPD may lead to novel management strategies that are personalized and more precise. Keywords: COPD, molecular pathogen detection, exacerbation phenotypes

Nawaf M Alotaibi,1,2 Virginia Chen,1,3,4 Zsuzsanna Hollander,1,3,4 Cameron J Hague,5 Darra T Murphy,5 Jonathon A Leipsic,5 Mari L DeMarco,1,6 J Mark FitzGerald,7,8 Bruce M McManus,1,3,4,6 Raymond T Ng,4,9 Don D Sin1,3,7 1Centre for Heart Lung Innovation, James Hogg Research Centre, St Paul’s Hospital, Vancouver, BC, Canada; 2Division of Pulmonary Medicine, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Institute for Heart Lung Health, 4PROOF Centre of Excellence, 5Department of Radiology, St Paul’s Hospital, 6Department of Pathology and Laboratory Medicine, 7Division of Respiratory Medicine, Department of Medicine, University of British Columbia, 8The Lung Centre, Vancouver General Hospital, 9Department of Computer Sciences, University of British Columbia, Vancouver, BC, Canada Rationale: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are caused by a variety of different etiologic agents. Our aim was to phenotype COPD exacerbations using imaging (chest X-ray [CXR] and computed tomography [CT]) and to determine the possible role of the blood tests (C-reactive protein [CRP], the N-terminal prohormone brain natriuretic peptide [NT-proBNP]) as diagnostic biomarkers. Materials and methods: Subjects who were hospitalized with a primary diagnosis of AECOPD and who had had CXRs, CT scans, and blood collection for CRP and NT-proBNP were assessed in this study. Radiologist blinded to the clinical and laboratory characteristics of the subjects interpreted their CXRs and CT images. ANOVA and Spearman’s correlation were performed to test for associations between these imaging parameters and the blood-based biomarkers NT-proBNP and CRP; logistic regression models were used to assess the performance of these biomarkers in predicting the radiological parameters. Results: A total of 309 subjects were examined for this study. Subjects had a mean age of 65.6±11.1 years, 66.7% of them were males, and 62.4% were current smokers, with a mean FEV1 54.4%±21.5% of predicted. Blood NT-proBNP concentrations were associated with cardiac enlargement (area under the curve [AUC] =0.72, P

Vegetables are an essential component of a balanced diet. The consumption of ready-to-eat foods may lead to the risk of infections and illnesses due to microbial contamination. To mitigate the potential of microbial contamination risks, it is critical to promote safe handling practices among consumers. In this study, our research evaluated the efficacy of different vegetable washing methods, specifically with lettuce, tomato, and cucumber, to establish optimal practices for reducing microbial contamination. This study consisted of two phases. Initially, a survey was distributed to 150 volunteers using snowball sampling to assess everyday vegetable handling and washing methods. The survey's results identified four predominant methods: washing with a 5% vinegar solution for 3 min followed by tap water rinse (37.3% of participants), rinsing with tap water for 1 min (29.3%), washing with a 5% salt solution (vegetable soap) for 3 min followed by a tap water rinse (16.6%), and a 3 min tap water rinse (14%). A minor segment (3.33%) reported not washing their vegetables at all. The survey's findings guided the second phase, which tested the aforementioned washing protocols' effectiveness in reducing Escherichia coli ( E. coli ) levels on spiked contaminated salad vegetables. The tested vegetables were sterilized using UV light, inoculated with 0.5 McFarland E. coli , and then washed using the four identified methods. After that, E. coli enumeration after washing was performed using 3M™ Petrifilm and the comparison was analyzed via one-way ANOVA. During this study, it was revealed that the cucumbers had the highest E. coli contamination levels in comparison to the lettuce and tomato after washing. Interestingly, by comparing the three washing methods, it was found that washing the vegetables with vinegar proved to be the most effective solution for reducing microbial presence on both lettuce and cucumbers. Notably, the natural smoothness of tomato skin led to no significant differences in contamination levels across washing methods. In summary, vinegar washing effectively reduces microbial contamination from salad vegetables, highlighting the need for informed consumer practices to prevent foodborne outbreaks. This study emphasizes the importance of monitoring contamination sources and using safe washing techniques.

Background: Schwannomas are well-encapsulated, solitary tumors that grow slowly from the nerve sheath. Sellar schwannomas tend to be mistaken for other sellar/parasellar lesions due to similar clinical and radiological findings. The present article describes the clinical presentation, radiological findings, histopathological features, and outcome of a patient with sellar schwannoma. Case Description: A 23-year-old female, known to have hypothyroidism secondary to Hashimoto's thyroiditis, presented with multiple episodes of galactorrhea, weight gain, and irregular menstrual cycle for 8 months. It was associated with decreased visual acuity and episodic headaches. Neurological examination revealed no focal deficits. Brain magnetic resonance imaging (MRI) showed a well-defined lobulated lesion in the sellar region, compressing the right optic nerve and optic chiasm. The patient underwent craniotomy and tumor resection. The histopathological sections were diagnostic of schwannoma. Postoperatively, the patient noted a subjective improvement in her visual acuity. She was discharged in stable condition with regular follow-ups at neurosurgery, endocrine, and ophthalmology clinics. Conclusion: Schwannoma of the sellar region is rare and can be misdiagnosed as pituitary adenomas. Preoperative hormonal profile and meticulous neuroradiological assessment narrow down the differential diagnosis for patients with sellar lesions. The diagnosis of sellar schwannomas is established with histopathology and immunohistochemistry results., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Ali Alkhaibary et al.)

Turbinaria ornata, Polycladia myrica, and Padina pavonica is a perennial Mediterranean-native seaweed that is commonly used for mass display. The principal aims of this reconnaissance were the isolation of various compounds from methanolic seaweeds extraction and screening the potential effect as antibacterial, and antioxidant. The micro-dilution method was used to measure antibacterial activity. Gas chromatography-mass spectrophotometry (GC. Mass) abused to analyze the chemical components of the methanolic seaweed extract. The existence of 19 secondary metabolites was discovered using GC-MS analysis: 8 different compounds for each seaweed's species. Among these bioactive compounds, 4 compounds from P. pavonica extract showed the binding affinity and ability to react with Beta-ketoacyl synthase (PDB ID 1EK4) of Escherichia coli. The phytocompounds' drug-like and poisonous characteristics were predicted. Auto Dock was used to examine the ligand receptor complexes' binding strength. T. ornate and P. pavonica had the highest activity against K. pneumonia, with 22.50 mm (0.78 µg/ml) and 22.23 mm (5.10 µg/ml) obtained, respectively. In a concentration-dependent manner, the extract components demonstrated substantial antioxidant activity. P. pavonica had the highest scavenging activity (78.00%, IC50 = 6.35 µg/ml), while ascorbic acid had a 96.45% scavenging impact. Because the chemicals bind to the Lipinski Ro5, they have drug-like characteristics. The compounds had no hepatotoxic effects. P. pavonica extract has the prospect of being used as a source of medicinal drug-like chemicals. The docking investigation found a strong correlation between the experimental results and the docking results. Finally, brown seaweed extract, particularly P. pavonica extract, demonstrated strong antibacterial, antioxidant, and free radical scavenging properties., (© 2024. The Author(s).)

Wheat, a staple cereal crop, faces challenges due to climate change and increasing global population. Maintaining genetic diversity is vital for developing drought-tolerant cultivars. This study evaluated the genetic diversity and drought response of five wheat cultivars and their corresponding F1 hybrids under well-watered and drought stress conditions. Molecular profiling using ISSR and SCoT-PCR markers revealed 28 polymorphic loci out of 76 amplified. A statistically significant impact of parental genotypes and their crosses was observed on all investigated agro-morphological traits, including root length, root weight, shoot length, shoot weight, proline content, spikelet number/spike, spike length, grain number/spike, and grain weight/spike. The parental genotypes P1 and P3 had desirable positive and significant general combining ability (GCA) effects for shoot fresh weight, shoot dry weight, root fresh weight, root dry weight, shoot length, and root length under well-watered conditions, while P3 and P5 recorded the highest GCA estimates under drought stress. P3 and P4 showed the highest GCA effects for number of spikelets per spike, the number of grains per spike, and grain weight per spike under normal conditions. P5 presented the maximum GCA effects and proved to be the best combiner under drought stress conditions. The cross P1× P3 showed the highest positive specific combining ability (SCA) effects for shoot fresh weight under normal conditions, while P2×P3 excelled under water deficit conditions. P1× P2, P1 × P3, and P4× P5 were most effective for shoot dry weight under normal conditions, whereas P1×P3 and P3×P5 showed significant SCA effects under drought stress. Positive SCA effects for root fresh weight and shoot length were observed for P3×P5 under stressed conditions. Additionally, P4×P5 consistently recorded the highest SCA for root length in both environments, and P3×P5 excelled in the number of spikelets, grains per spike, and grain weight per spike under drought conditions. The evaluated genotypes were categorized based on their agronomic performance under drought stress into distinct groups ranging from drought-tolerant genotypes (group A) to drought-sensitive ones (group C). The genotypes P5, P2×P5, and P3×P5 were identified as promising genotypes to improve agronomic performance under water deficit conditions. The results demonstrated genetic variations for drought tolerance and highlighted the potential of ISSR and SCoT markers in wheat breeding programs for developing drought-tolerant cultivars., Competing Interests: Diaa Abd El-Moneim and Elsayed Mansour are Academic Editors for PeerJ., (©2024 Ezzat et al.)

Hepatocellular carcinoma (HCC) is a common critical type of hepatic cancer worldwide. Recent guidelines have considered ablative therapeutic approaches as the primary option for managing early-stage surgically untreatable HCC. Among these therapies, radiofrequency ablation (RFA) and microwave ablation (MWA) have attained a significant role due to their efficacy and theoretical advantages. This review aims to compare and analyze the efficacy and safety of two common modalities, i.e., MWA and RFA, in the management of HCC. The literature search included PubMed, Cochrane Central Register of Controlled Trials, Medline, and Ovid for articles published until 2024. The outcomes included the local tumor progression (LTP), complete ablation (CA), the overall survival (OS) rate, or major complications. A meta-analysis was performed using Review Manager 5.3. The systematic review included six randomized controlled trials, including 826 patients. The findings revealed that MWA resulted in lower LTP and higher CA rates compared to RFA. However, the effect of complications was higher in the MWA therapy group. Despite that, the differences between all parameters were not significant. Statistical significance was not evident in the OS rates between the two modalities. Three studies found comparable survival rates between the two modalities, while one study reported similar local tumor recurrence-free survival rates between the two approaches. Both techniques appear to be effective and safe for the management of liver tumors, providing clinicians with valuable options for personalized patient care. Further high-quality research is needed to confirm these findings and guide clinical decision-making., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Shaqran et al.)

Background and Objectives: Dual antiplatelet therapy (DAPT) is necessary to minimize the risk of periprocedural thromboembolic complications associated with aneurysm embolization using pipeline embolization device (PED). We aimed to assess the impact of platelet function testing (PFT) on reducing periprocedural thromboembolic complications associated with PED flow diversion in patients receiving aspirin and clopidogrel., Methods: Patients with unruptured intracranial aneurysms requiring PED flow diversion were identified from 13 centers for retrospective evaluation. Clinical variables including the results of PFT before treatment, periprocedural DAPT regimen, and intracranial complications occurring within 72 h of embolization were identified. Complication rates were compared between PFT and non-PFT groups. Differences between groups were tested for statistical significance using the Wilcoxon rank sum, Fisher exact, or χ 2 tests. A P -value <.05 was statistically significant., Results: 580 patients underwent PED embolization with 262 patients dichotomized to the PFT group and 318 patients to the non-PFT group. 13.7% of PFT group patients were clopidogrel nonresponders requiring changes in their pre-embolization DAPT regimen. Five percentage of PFT group [2.8%, 8.5%] patients experienced thromboembolic complications vs 1.6% of patients in the non-PFT group [0.6%, 3.8%] ( P = .019). Two (15.4%) PFT group patients with thromboembolic complications experienced permanent neurological disability vs 4 (80%) non-PFT group patients. 3.7% of PFT group patients [1.5%, 8.2%] and 3.5% [1.8%, 6.3%] of non-PFT group patients experienced hemorrhagic intracranial complications ( P > .9)., Conclusion: Preprocedural PFT before PED treatment of intracranial aneurysms in patients premedicated with an aspirin and clopidogrel DAPT regimen may not be necessary to significantly reduce the risk of procedure-related intracranial complications., (Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)

Objectives: To shed some light on a potential therapeutic modality that may facilitate resolution of botulism symptoms, namely 3,4-diaminopyridine (3,4-DAP)., Methods: In Riyadh, Saudi Arabia, we recently encountered a foodborne botulism outbreak that, luckily, was discovered early. In Prince Sultan Military Medical city, we admitted, during a period of approximately 3 weeks, 15 probable cases, 2 of which were excluded due to more likely alternative diagnoses. We report in this case series 13 highly suspected cases of botulism that we encountered during the outbreak., Results: A total of 12 out of 13 patients required intensive care unit (ICU) admission, one of which required intubation. Symptoms included cranial nerve palsies, gastrointestinal symptoms, limb and respiratory muscle weakness. Patients showed clinical improvement when received botulinum antitoxin and 3,4-DAP if given early in the course of the disease., Conclusion: Early admisntration of 3,4-DAP may facilitate recovery and prevent disease progression. Larger prospective trials should be carried out to confirm that., (Copyright: © Saudi Medical Journal.)

Experiments have assessed various polymer composites for radiation shielding in diverse applications. These composites are lighter and non-toxic when compared to lead (Pb), making them particularly effective in diagnostic imaging for shielding against low-energy photons. This study demonstrates the fabrication of four composites by combining a base material, specifically a high-density polyethylene (HDPE) polymer, with 10% and 20% silicon (Si) and silicon carbide (SiC), respectively. Additionally, 5% molybdenum (Mo) was incorporated into the composites as a heavy metal element. The composites obtained were fabricated into 20 disks with a uniform thickness of 2 mm each. Discs were exposed to radiation from a low-energy X-ray source (32.5-64.5 keV). The chemical and physical properties of composites were assessed. The shielding ability of samples was evaluated by determining the linear and mass attenuation coefficients (μ and μ m ), radiation protection efficiency (RPE), half-value layer (HVL), and mean free path (MFP). According to our findings, supplementing HDPE with additives improved the attenuation of beams. The μ m values showed that composite X-ray shielding characteristics were enhanced with filler concentration for both Si and SiC. Polymer composites with micro-molecule fillers shelter X-rays better than polymers, especially at low energy. The HVL and MFB values of the filler are lower than those of the pure HDPE sample, indicating that less thickness is needed to shield at the appropriate energy. HC-20 blocked 92% of the incident beam at 32.5 keV. This study found that increasing the composite sample thickness or polymer filler percentage could shield against low-energy radiation.

Background: Vaccine hesitancy is a growing concern in Saudi Arabia, impacting even well-educated parents. The decision-making process involves various factors such as accessibility, trustworthy information, and the influence of social networks, reflecting a complex interplay of emotional, cultural, social, spiritual, and political dimensions., Objective: This review seeks to evaluate the prevalence and trends of vaccine hesitancy, identify contributing factors, and explore potential solutions to enhance immunization rates. This review aligns with global concerns, as the World Health Organization has identified vaccine hesitancy as a top global health threat., Methods: Our systematic review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and PICOS (Population, Intervention, Comparison, Outcomes, and Study) criteria for comprehensive assessment. We will conduct a thorough search across various databases, encompassing a wide range of vaccines, and pay special attention to vaccination campaigns and refusals. Inclusion criteria involve descriptive, observational, and analytical studies focusing on factors influencing vaccine acceptance or hesitancy. The study will use the Crowe Critical Appraisal Tool for quality assessment and perform a narrative synthesis to summarize findings thematically., Results: This systematic review is expected to unveil the prevalence and trends of vaccine hesitancy in diverse populations in Saudi Arabia, shedding light on cultural, religious, and social factors contributing to hesitancy. It aims to assess the effectiveness of implemented strategies, enable regional and global comparisons, and provide implications for tailored vaccination policies. Additionally, the review may pinpoint research gaps, guiding future investigations to address and mitigate vaccine hesitancy effectively., Conclusions: The findings are expected to have direct policy implications and guide interventions to strengthen vaccination programs and improve public health outcomes., International Registered Report Identifier (irrid): PRR1-10.2196/54680., (©Mohammed Kanan, Samar Abdulrahman, Abdulaziz Alshehri, Renad AlSuhaibani, Nawaf M Alotaibi, Azhar Alsaleh, Bushra Nasser, Rana Baowaydhan, Ibrahim Alredaini, Taif Khalid, Fatima Almukhtar, Nourah Altoaimi, Almaha Alhneshel, Shouq Alanazi, Shahad Algmaizi. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 22.03.2024.)

Purpose of Review: Spirometry is a validated tool in the diagnosis of obstructive airways disease. However, it may be insufficiently sensitive in detecting airflow limitation in the small airways. This review highlights common clinical scenarios wherein airflow limitation may be missed or overlooked., Recent Findings: This article covers recent literature on the interpretation of lung function test, focusing on detection of mild obstructive airways disease. It also sheds light on the contextual difficulties of defining mild airflow limitation on spirometry., Summary: We highlight the consensus definition of mild obstructive airways disease and emphasize that this definition does not necessarily mean mild in certain disease-specific contexts. Several spirometric findings outside of a reduced forced expiratory volume in one second/forced vital capacity ratio should raise suspicion of mild obstruction., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

The operative mechanisms and advantageous synergies existing between the rhizobiome and the wild plant species Abutilon fruticosum were studied. Within the purview of this scientific study, the reservoir of genes in the rhizobiome, encoding the most highly enriched enzymes, was dominantly constituted by members of phylum Thaumarchaeota within the archaeal kingdom, phylum Proteobacteria within the bacterial kingdom, and the phylum Streptophyta within the eukaryotic kingdom. The ensemble of enzymes encoded through plant exudation exhibited affiliations with 15 crosstalking KEGG (Kyoto Encyclopaedia of Genes and Genomes) pathways. The ultimate goal underlying root exudation, as surmised from the present investigation, was the biosynthesis of saccharides, amino acids, and nucleic acids, which are imperative for the sustenance, propagation, or reproduction of microbial consortia. The symbiotic companionship existing between the wild plant and its associated rhizobiome amplifies the resilience of the microbial community against adverse abiotic stresses, achieved through the orchestration of ABA (abscisic acid) signaling and its cascading downstream effects. Emergent from the process of exudation are pivotal bioactive compounds including ATP, D-ribose, pyruvate, glucose, glutamine, and thiamine diphosphate. In conclusion, we hypothesize that future efforts to enhance the growth and productivity of commercially important crop plants under both favorable and unfavorable environmental conditions may focus on manipulating plant rhizobiomes., (© 2024. The Author(s).)

Objectives: The objectives of the current study are twofold. First, it aimed to explore the prevalence of depression, anxiety and stress symptoms (i.e., psychological disorders) among Kuwait University students. Second, it sought to identify and quantify the associated risk factors as well as the students' coping strategies utilized to address these psychological disorders. Methods: We used a cross-sectional study at Kuwait University and selected students using a multistage stratified cluster sampling design among the 15 faculties of Kuwait University. To serve the study purposes, two cross-cultural and validated instruments were used, including the Depression, Anxiety and Stress Scale 21 (DASS-21) and the Brief-COPE scale. Descriptive statistics, as well as logistic regression analysis, were used to analyze the study findings. Results: A sample of 1142 students from various faculties participated in this study. We found that 681 (59.6%), 791 (69.3%) and 588 (51.5%) of the participants had depression, anxiety and stress symptoms, respectively. The highest coping strategies for stressors and challenges faced were moderate and high emotion-based coping strategies ( n = 1063, 93.1%). Students from the Faculty of Allied Health Sciences as well as students from the Faculty of Engineering had significantly higher stress levels compared with students from other faculties ( p < 0.05). Our results demonstrated that family problems were consistently a significant predictor of depression, anxiety and stress symptoms among Kuwait University students ( p < 0.05). We further found that students who presented with stress and anxiety symptoms and those who practiced avoidant-focused coping strategies were substantially more likely to experience depression (ORs ≥ 2.7, p < 0.01). Conclusions: Our findings inferred that the majority of Kuwait University students have a remarkably high prevalence of mental health problems, mainly anxiety, depression, and stress symptoms along with inconsistent coping strategies toward the faced challenges during their studies. Therefore, the most important recommendation of the current study is the establishment of counselling centers in all faculties at Kuwait University. In turn, doing so facilitates the integration of wellness programs and the provision of comprehensive educational seminars, specialized training sessions and self-management techniques for Kuwait University students, leading to desired academic outcomes.

BACKGROUND Material selection is crucial in restorative dentistry, influenced by aesthetics, material properties, and tooth location. This understanding is key for advancing dental practices and patient outcomes. The present study aimed to assess dentists' preferences for restorative materials in single-tooth crowns (SC) and how abutment tooth location and preparation margins influence these choices. MATERIAL AND METHODS A web-based pre-validated questionnaire survey was conducted among 811 actively practicing dentists in Saudi Arabia. RESULTS In posterior teeth, we found that ceramic was the most preferred material for SC regardless of the abutment tooth location and location of margins, followed by porcelain fused to metal (PFMs). In anterior teeth, ceramics were preferred, followed by CAD/CAM-based resin SC. Among the choice of ceramics in teeth for both supra-gingival margins, monolith zirconia was the most-preferred material for SC fabrication in posterior teeth, followed by zirconia-reinforced lithium silicate ceramic. Similarly, for sub-gingival margins, monolith zirconia crowns were the most popular option in posterior teeth among the respondents, with the highest in the mandibular molar region. In the anterior region, layered zirconia was the least preferred, and lithium disilicate ceramics was the most-favored option. A statistically significant difference existed between supra- and subgingival preparation for teeth 11 (P=0.01), 16 (P=0.03), and 34 (P=0.02). CONCLUSIONS Ceramic was the material of choice among Saudi dentists for replacement of SC, irrespective of the location and preparation margin. Monolith zirconia was usually selected for posterior teeth and lithium disilicate ceramics was the top choice in anterior teeth.

The global challenge posed by Dengue virus (DENV) infection persists, exacerbated by the absence of specific antiviral therapies. The viral methyltransferase (MTase) enzyme, crucial for viral RNA methylation and immune system evasion, has emerged as a promising drug target for combating Dengue fever. In this study, a comprehensive exploration of natural compounds derived from the COCONUT database was conducted, selecting 224 compounds based on their structural similarity to the native substrate of the MTase enzyme, S-adenosyl-L-methionine (SAM). Employing virtual screening techniques, four natural compounds (CNP0307160, CNP0082902, CNP0449158, and CNP0296775) with acceptable docking scores were selected for further re-docking after geometry optimization by the DFT method. Re-docking analyses unveiled significant interactions, including hydrogen bonds and hydrophobic interactions, between these selected ligands and the MTase protein. To gain deeper insights into the dynamic stability of these complexes, we conducted molecular dynamics simulations which showed lower RMSD values for CNP0307160, CNP0082902, and CNP0296775 when compared to the reference molecule. Furthermore, we assessed the structural and dynamic stability of the protein-ligand complexes through free binding energy calculations and Principal Component Analysis (PCA) of the simulation trajectories. In these analyses, the CNP0296775 compound exhibited promising results compared to the other three compounds. The cumulative findings of these investigations underscore the potential of CNP0296775 as a strong inhibitor of DENV MTase, thus offering a promising starting point for its further experimental validation and optimization.Communicated by Ramaswamy H. Sarma.

Aquaporins (AQPs) are membrane proteins that facilitate the transport of water and other small molecules across biological membranes. AQPs are involved in various physiological processes and pathological conditions, including cancer, making them as potential targets for anticancer therapy. However, the development of selective and effective inhibitors of AQPs remains a challenge. In this study, we explored the possibility of using natural sapogenins, a class of plant-derived aglycones of saponins with diverse biological activities, as potential inhibitors of AQPs. We performed molecular docking, dynamics simulation and binding energy calculation to investigate the binding and inhibition mechanism of 19 sapogenins against 13 AQPs (AQP0-AQP13) that are overexpressed in various cancers. Our results showed that out of 19 sapogenins, 8 (Diosgenin, Gitogenin, Tigogenin, Ruscogenin, Yamogenin, Hecogenin, Sarsasapogenin and Smilagenin) exhibited acceptable drug-like characteristics. These sapogenin also exhibited favourable binding affinities in the range of -7.6 to -13.4 kcal/mol, and interactions within the AQP binding sites. Furthermore, MD simulations provided insights into stability and dynamics of the sapogenin-AQP complexes. Most of the fluctuations in binding pocket were observed for AQP0-Gitogenin and AQP4-Diosgenin. However, remaining protein-ligand complex showed stable root mean square deviation (RMSD) plots, strong hydrogen bonding interactions, stable solvent-accessible surface area (SASA) values and minimum distance to the receptor. These observations suggest that natural sapogenin hold promise as novel inhibitors of AQPs, offering a basis for the development of innovative therapeutic agents for cancer treatment. However, further validation of the identified compounds through experiments is essential for translating these findings into therapeutic applications.Communicated by Ramaswamy H. Sarma.

Breast cancer is a major global health issue for women. Thyme oil, extracted from Thymus vulgaris L., has shown promising anticancer effects. In the present study, we investigated how Thyme oil can influence breast cancer treatment using a multimethod approach. We used network pharmacology to identify the active compounds of Thyme oil, their molecular targets, and the pathways involved in breast cancer. We found that Thyme oil can modulate several key proteins (EGFR, AKT1, ESR1, HSP90AA1, STAT-3, SRC, IL-6, HIF1A, JUN, and BCL2) and pathways (EGFR tyrosine kinase inhibitor resistance, prolactin signaling pathway, HIF-1 signaling pathway, estrogen signaling pathway, ERBB signaling pathway, AGE-RAGE signaling pathway, JAK-STAT signaling pathway, FoxO signaling pathway, and PI3K-AKT signaling pathway) related to breast cancer progression. We then used molecular docking and dynamics to study the interactions and stability of the Thyme oil-compound complexes. We discovered three potent compounds (aromadendrene, α-humulene, and viridiflorene) that can bind strongly to important breast cancer proteins. We also performed in vitro experiments on MCF-7 cells to confirm the cytotoxicity and antiproliferative effects of Thyme oil. We observed that Thyme oil can inhibit cancer cell growth and proliferation at a concentration of 365.37 μg/mL. Overall, our results provide a comprehensive understanding of the pharmacological mechanism of Thyme oil in breast cancer treatment and suggest its potential as a new or adjuvant therapy. Further studies are needed to validate and optimize the therapeutic efficacy of Thyme oil and its active compounds., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Facial appearance significantly affects psychosocial wellbeing, and an improvement in facial aesthetics is considered an essential outcome of orthognathic treatment. The surgery-first approach (SFA) has emerged as a promising alternative to the conventional orthodontics-first approach (OFA) due to its potential advantages in reducing treatment duration and cost, delivering early aesthetic improvement, and increasing patient satisfaction. However, its impact on final facial aesthetics and how it compares with the OFA has, to our knowledge, not yet been investigated. This retrospective study aimed to compare the improvement in facial aesthetics after orthognathic surgery in an SFA and an OFA group. Preoperative and postoperative 3-dimensional stereophotogrammetry facial images of 40 patients were evaluated by five professional assessors using the Global Aesthetic Improvement Scale (GAIS). Similar aesthetic improvement outcomes were found in both the SFA and OFA groups. The GAIS score significantly correlated with the following facial variables: upper lip projection, chin prominence, facial proportions, paranasal hollowing, lip competence, mandibular projection, and facial profile. No significant correlation was found between a change in aesthetic score and the surgical variables. There was a positive association between overall GAIS score and the gender and experience level of the individual assessors. This study suggests that aesthetic facial improvement achieved with the SFA is satisfactory and comparable to that of the OFA., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: There is little data on patient and caregiver perceptions of spine surgery in children and youth. This study aims to characterize the personal experiences of patients, caregivers, and family members surrounding pediatric spine surgery through a qualitative and quantitative social media analysis., Methods: The Twitter application programming interface was searched for keywords related to pediatric spine surgery from inception to March 2022. Relevant tweets and accounts were extracted and subsequently classified using thematic labels. Tweet metadata was collected to measure user engagement via multivariable regression. Sentiment analysis using Natural Language Processing was performed on all tweets with a focus on tweets discussing the personal experiences of patients and caregivers., Results: 2424 tweets from 1847 individual accounts were retrieved for analysis. Patients and caregivers represented 1459 (79.0%) of all accounts. Posts discussed the personal experiences of patients and caregivers in 83.5% of tweets. Pediatric spine surgery research was discussed in few posts (n=90, 3.7%). Within the personal experience category, 975 (48.17%) tweets were positive, 516 (25.49%) were negative, and 533 (26.34%) were neutral. Presence of a tag (beta: -6.1, 95% CI -9.7 to -2.5) and baseline follower count (beta<0.001, 95% CI <0.001 to <0.001) significantly affected tweet engagement negatively and positively, respectively., Conclusions: Patients and caregivers actively discuss topics related to pediatric spine surgery on Twitter. Posts discussing personal experience are most prevalent, while posts on research are scarce, unlike previous social media studies. Pediatric spine surgeons can leverage this dialogue to better understand the worries and needs of patients and their families., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Microvascular decompression (MVD) as a treatment for trigeminal neuralgia (TGN) has high success rate but is associated with risks of complication. This study analyzes Twitter to provide insights into discussions surrounding MVD for patients with TGN., Methods: A Twitter search performed in April 2022 yielded 491 tweets from 426 accounts. Tweets and accounts were classified thematically, and descriptive statistics were used for various social media metrics. Using a natural language processing machine learning algorithm, sentiment analysis (SA) was performed to evaluate patient perspectives before and after surgery, and a multivariate regression model was used to identify predictors of higher engagement metrics (likes, retweets, quote tweets, replies)., Results: Most accounts were patients, caregivers, and other members of the public (70%). The most encountered themes were research (47%) and personal experiences (33.4%). SA of tweets about patient experiences showed that 40.2% of tweets were positive, 31.1% were neutral and 28.7% were negative. Negative tweets decreased significantly in postoperative tweets and mostly discussed complications or failure of surgery (63%). On multivariate analysis, only inclusion of media (photo or video) in a Tweet was associated with higher engagement metrics., Conclusions: This study provides a comprehensive review of Twitter use discussing MVD in TGN and is the first to assess patient satisfaction after treatment using SA. The data presented on patient perspectives on social media could help physicians establish direct lines of communication with patients, fostering a more patient-focused care., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: The number of articles retracted by peer-reviewed journals has increased in recent years. This study systematically reviews retracted publications in the spine surgery literature., Methods: A search of PubMed MEDLINE, Ovid EMBASE, Retraction Watch, and the independent websites of 15 spine surgery-related journals from inception to September of 2022 was performed without language restrictions. PRISMA guidelines were followed with title/abstract screening, and full-text screening was conducted independently and in duplicate by two reviewers. Study characteristics and bibliometric information for each publication was extracted., Results: Of 250 studies collected from the search, 65 met the inclusion criteria. The most common reason for retraction was data error (n = 15, 21.13%), followed by plagiarism (n = 14, 19.72%) and submission to another journal (n = 14, 19.72%). Most studies pertained to degenerative pathologies of the spine (n = 32, 80.00%). Most articles had no indication of retraction in their manuscript (n = 24, 36.92%), while others had a watermark or notice at the beginning of the article. The median number of citations per retracted publication was 10.0 (IQR 3-29), and the median 4-year impact factor of the journals was 5.05 (IQR 3.20-6.50). On multivariable linear regression, the difference in years from publication to retraction (p = 0.0343, β = 6.56, 95% CI 0.50-12.62) and the journal 4-year impact factor (p = 0.0029, β = 7.47, 95% CI 2.66-12.28) were positively associated with the total number of citations per retracted publication. Most articles originated from China (n = 30, 46.15%) followed by the United States (n = 12, 18.46%) and Germany (n = 3, 4.62%). The most common study design was retrospective cohort studies (n = 14, 21.54%)., Conclusions: The retraction of publications has increased in recent years in spine surgery. Researchers consulting this body of literature should remain vigilant. Institutions and journals should collaborate to increase publication transparency and scientific integrity., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Three-dimensional (3D) printing refers to a wide range of additive manufacturing processes that enable the construction of structures and models. It has been rapidly adopted for a variety of surgical applications, including the printing of patient-specific anatomical models, implants and prostheses, external fixators and splints, as well as surgical instrumentation and cutting guides. In comparison to traditional methods, 3D-printed models and surgical guides offer a deeper understanding of intricate maxillofacial structures and spatial relationships. This review article examines the utilization of 3D printing in orthognathic surgery, particularly in the context of treatment planning. It discusses how 3D printing has revolutionized this sector by providing enhanced visualization, precise surgical planning, reduction in operating time, and improved patient communication. Various databases, including PubMed, Google Scholar, ScienceDirect, and Medline, were searched with relevant keywords. A total of 410 articles were retrieved, of which 71 were included in this study. This article concludes that the utilization of 3D printing in the treatment planning of orthognathic surgery offers a wide range of advantages, such as increased patient satisfaction and improved functional and aesthetic outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alhabshi et al.)

Objective: The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for wide-necked bifurcation aneurysms. These aneurysms may require the use of a concomitant stent. The objective of this study was to determine the clinical and radiological outcomes of patients undergoing stent-assisted WEB treatment. In addition, the authors also sought to determine the predictors of a concomitant stent in aneurysms treated with the WEB device., Methods: The data for this study were taken from the WorldWideWEB Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups based on treatment: stent-assisted WEB and WEB device alone. The authors compared clinical and radiological outcomes of both groups. Univariable and multivariable binary logistic regression analyses were performed to determine factors that predispose to stent use., Results: The study included 691 intracranial aneurysms (31 with stents and 660 without stents) treated with the WEB device. The adequate occlusion status did not differ between the two groups at the latest follow-up (83.3% vs 85.6%, p = 0.915). Patients who underwent stenting had more thromboembolic (32.3% vs 6.5%, p < 0.001) and procedural (16.1% vs 3.0%, p < 0.001) complications. Aneurysms treated with a concomitant stent had wider necks, greater heights, and lower dome-to-neck ratios. Increasing neck size was the only significant predictor for stent use., Conclusions: This study demonstrates that there is no difference in the degree of aneurysm occlusion between the two groups; however, complications were more frequent in the stent group. In addition, a wider aneurysm neck predisposes to stent assistance in WEB-treated aneurysms.

Recently, there has been considerable attention towards the production of environmentally friendly nanoparticles (NPs). In this investigation, the successful synthesis of cerium oxide nanoparticles (CeO 2 NPs) was achieved by employing an eco-friendly technique that utilized an extract from the leaves of local plant quinoa (Chenopodium quinoa L.). The synthesized CeO 2 NPs were subjected to characterization using state-of-the-art methods. The prepared CeO 2 NPs contained a round shape with clusters and have a size of 7-10 nm. To assess how effective CeO 2 NPs derived from C. quinoa were against Ustilago tritici, a fungal disease that negatively affects wheat crop globally, a study was performed on two varieties of wheat crop comprised of Arooj (V1) and Akber (V2), cultivated under field conditions. CeO 2 NPs were applied foliarly twice to the wheat crop at four different concentrations: T0 (0 mg/L), T1 (50 mg/L), T2 (75 mg/L), and T3 (100 mg/L). The results revealed that the control group (T0) exhibited the highest disease severity index (DSI) with a value of 75% compared to the other concentrations of CeO 2 NPs on both varieties. At a concentration of 100 mg/L of CeO 2 NPs, the DSI dropped to a minimum of 35% and 37% on both V1 and V2 respectively. These findings indicated that an increase in the concentration of CeO 2 NPs has a beneficial impact on disease severity. Similar patterns have also been observed with disease incidence (DI), with the greatest efficacy observed at a concentration of 100 mg/L of CeO 2 NPs. Our investigation has shown that CeO 2 NPs exhibitd significant antifungal potential against U. tritici which may be a promising strategy to mitigate fungal disease and crop losses globally., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background Burn injuries can be highly traumatic and harmful, leading to significant mortality rates, extended hospital stays, deformity, and incapacity. In the long term, they may also result in rejection, social stigma, and psychiatric issues. This study aimed to estimate the awareness and practices related to burn injury first aid among the general public in Taif, Saudi Arabia. Methods This is an online cross-sectional survey in Taif, Saudi Arabia. An online self-administered questionnaire was distributed to the adult population, comprising individuals aged 18 years and older, of both genders, from June 2023 to August 2023. The questionnaire consisted of 24 questions divided into demographics and first aid for burns. The Scientific Research Ethics Committee at Taif University, Taif, Saudi Arabia, obtained the ethical approval for the study. Results A total of 531 individuals were included in the study. About half were male (58.4%) and in the age group of 22-29 years (52%). Out of that number, 24.1% were medical field students. About one-third of the respondents had participated in a burn training course (33.7%), and 73.8% reported experiencing a burn injury before, either to themselves or their family. Most respondents chose to treat the burn area using honey, and only 15.6% knew that they should administer water to a burn injury for 10 to 15 or >15 minutes. Most of the participants reported an excellent knowledge level (62.9%). Only 8.7% had an excellent practice level. The total knowledge and practice score was significantly associated with participation in the burn training course (P-value < 0.001 and 0.015, respectively). The work nature and prior experience with a burn injury were significantly associated with the knowledge scores (P-value=0.003, for both). Monthly income and the work nature also correlated with the practice total score (P-value=0.023 and <0.001, respectively). Conclusion Most participants had an excellent knowledge level, however, most of them reported poor or acceptable practice scores. It highlights the need for training sessions, awareness campaigns, and dissemination of evidence-based information to bridge the gap between knowledge and practice., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alhusayni et al.)

Background: The Woven EndoBridge (WEB) device is a novel intrasaccular flow disruptor tailored for bifurcation aneurysms. We aim to describe the degree of aneurysm occlusion at the latest follow-up, and the rate of complications of aneurysms treated with the WEB device stratified according to rupture status., Methods: Our data were taken from the WorldWideWeb Consortium, an international multicenter cohort including patients treated with the WEB device. Aneurysms were classified into two groups: ruptured and unruptured. We compared clinical and radiologic outcomes of both groups. Propensity score matching (PSM) was done to match according to age, gender, bifurcation, location, prior treatment, neck, height, dome width, daughter sac, incorporated branch, pretreatment antiplatelets, and last imaging follow-up., Results: The study included 676 patients with 691 intracranial aneurysms (529 unruptured and 162 ruptured) treated with the WEB device. The PSM analysis had 55 pairs. In both the unmatched (85.8% vs 84.3%, p=0.692) and matched (94.4% vs 83.3%, p=0.066) cohorts there was no significant difference in the adequate occlusion rate at the last follow-up. Likewise, there were no significant differences in both ischemic and hemorrhagic complications between the two groups. There was no documented aneurysm rebleeding after WEB device implantation., Conclusion: There was no significant difference in both the radiologic outcomes and complications between unruptured and ruptured aneurysms. Our findings support the feasibility of treatment of ruptured aneurysms with the WEB device., Competing Interests: Competing interests: JDBD: Honoraria from Medtronic. Travel grant from Microvention. MD: No relevant relationships NA: No relevant relationships RWR: Grants from National Institutes of Health, Heitman foundation, Society of vascular and interventional neurology; Advisory board participation for Rapid medical; Site PI for Microvention and Penumbra JEV: No relevant relationships AG : No relevant relationships SVL: No relevant relationships LR: No relevant relationships AAB: No relevant relationships ES: No relevant relationships KP: No relevant relationships KEL: No relevant relationships GS : No relevant relationships MAM: No relevant relationships IL: No relevant relationships PMR: No relevant relationships JAV: Fees from MicroVention for proctoring cases for new physician users of the Woven EndoBridge device; Medtronic travel expense VŽ: Participation on the data safety monitoring board or advisory board for KBC Sestre Milosrdnice, Zagreb / OB Nova Gradiška MUH: No relevant relationships CR: No relevant relationships HR: No relevant relationships VMT: No relevant relationships SM: No relevant relationships SG: No relevant relationships PH: No relevant relationships NA: No relevant relationships JDR: No relevant relationships YR: No relevant relationships CMS: No relevant relationships OG: No relevant relationships MP: No relevant relationships ALK: No relevant relationships CM: No relevant relationships SE: No relevant relationships RMS: Supported by the NREF, Joe Niekro Foundation, Brain Aneurysm Foundation, Bee Foundation, and the National Institutes of Health (R01NS111119-01A1, UL1TR002736, and KL2TR002737) through the Miami Clinical and Translational Science Institute, from the National Center for Advancing Translational Sciences and the National Institute on Minority Health and Health Disparities. AH: Consulting or speaker fees from Medtronic, MicroVention, Stryker, Penumbra, Cerenovus, Genentech, GE Healthcare, Scientia, Balt, Viz.ai, Insera Therapeutics, Proximie, NeuroVasc, NovaSignal, Vesalio, and Galaxy Therapeutics. AS: No relevant relationships AN: No relevant relationships JJ: Consulting and speaker fees from Cerenovus MP: No relevant relationships JS: No relevant relationships CPF: No relevant relationships MBB: No relevant relationships MM: Grants from Balt, Medtronic, MicroVention, and Stryker. MMS: No relevant relationships JB: No relevant relationships BTJ: No relevant relationships RAD: No relevant relationships TH: No relevant relationships RT: Medtronic Stocks CU: No relevant relationships BL : No relevant relationships PP: No relevant relationships ASP: Grants from NIH, Microvention, Cerenovus, Medtronic and Stryker; Consulting fees from Neurovascular, Stryker NeurovascularBalt, Q’Apel Medical, Cerenovus, Microvention, Imperative Care, Agile, Merit, CereVasc and Arsenal Medical; stock options from InNeuroCo, Agile, Perfuze, Galaxy and NTI GP: No relevant relationships CJG: Grants to institution from Medtronic and Penumbra; consulting fees from Stryker and MicroVention. HA: Proctoring fees from MicroVention. Grants to institution from the National Institutes of Health; consulting fees from Amnis Therapeutics, Apellis Pharmaceuticals, Boston Scientific, Canon Medical Systems, Cardinal Health 200, Cerebrotech Medical Systems, Cerenovus, Cerevatech Medical, Cordis, Corindus, EndoStream Medical, Imperative Care, Integra, IRRAS, Medtronic, MicroVention, Minnetronix Neuro, Penumbra, Q’Apel Medical, Rapid Medical, Serenity Medical, Silk Road Medical, StimMed, Stryker Neurovascular, Three Rivers Medical, VasSol, Viz.ai, and W.L. Gore & Associates; payment for participation on the steering committees for the Cerenovus EXCELLENT and ARISE II Trial; Medtronic SWIFT PRIME, VANTAGE, EMBOLISE, and SWIFT DIRECT Trials; MicroVention FRED Trial and CONFIDENCE Study; MUSC POSITIVE Trial; Penumbra 3D Separator Trial, COMPASS Trial, INVEST Trial, MIVI Neuroscience EVAQ Trial; Rapid Medical SUCCESS Trial; InspireMD C-GUARDIANS IDE Pivotal Trial; stock or stock options in Adona Medical, Amnis Therapeutics, Bend IT Technologies, BlinkTBI, Buffalo Technology Partners, Cardinal Consultants, Cerebrotech Medical Systems, Cerevatech Medical, Cognition Medical, CVAID, E8, EndoStream Medical, Imperative Care, Instylla, International Medical Distribution Partners, Launch NY, NeuroRadial Technologies, Neurotechnology Investors, Neurovascular Diagnostics, Perflow Medical, Q’Apel Medical, QAS.ai, Radical Catheter Technologies, Rebound Therapeutics (purchased in 2019 by Integra Lifesciences), Rist Neurovascular (purchased in 2020 by Medtronic), Sense Diagnostics, Serenity Medical, Silk Road Medical, Songbird Therapy, Spinnaker Medical, StimMed, Synchron, Three Rivers Medical, Truvic Medical, Tulavi Therapeutics, Vastrax, VICIS, and Viseon AFD: Consulting fees from Cerenovus, Penumbra, Medtronic, Stryker, Oculus, and Koswire. No relevant relationships RD: No relevant relationships PK: No relevant relationships. VK: No relevant relationships. PL: No relevant relationships SB: No relevant relationships CJS: Participation on the data safety monitoring board or advisory board for Zoll Circulation JK: No relevant relationships PJ: No relevant relationships ST: No relevant relationships FC: No relevant relationships NL: Honoraria for lectures from Cerenovus, Stryker, and CrossMed. MAA: Funding to institution from MicroVention for WEBIT trial; proctoring fees from MicroVention. HHC: No relevant relationships CC: Consulting fees from MicroVention, Stryker, Medtronic, MIVI, and Cerenovus. ABP: Grant to institution from Medtronic; consulting fees from MicroVention, Medtronic, and Q’Apel; workstation for research from Siemens AAD: No relevant relationships, (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Endoluminal flow diversion reduces blood flow into intracranial aneurysms, promoting thrombosis. Postprocedural dual antiplatelet therapy (DAPT) is necessary for the prevention of thromboembolic complications. The purpose of this study is to therefore assess the impact that the type and duration of DAPT has on aneurysm occlusion rates and iatrogenic complications after flow diversion., Methods: A retrospective review of a multicenter aneurysm database was performed from 2012 to 2020 to identify unruptured intracranial aneurysms treated with single device flow diversion and ≥12-month follow-up. Clinical and radiologic data were analyzed with aneurysm occlusion as a function of DAPT duration serving as a primary outcome measure., Results: Two hundred five patients underwent flow diversion with a single pipeline embolization device with 12.7% of treated aneurysms remaining nonoccluded during the study period. There were no significant differences in aneurysm morphology or type of DAPT used between occluded and nonoccluded groups. Nonoccluded aneurysms received a longer mean duration of DAPT (9.4 vs 7.1 months, P = 0.016) with a significant effect of DAPT duration on the observed aneurysm occlusion rate (F(2, 202) = 4.2, P = 0.016). There was no significant difference in the rate of complications, including delayed ischemic strokes, observed between patients receiving short (≤6 months) and prolonged duration (>6 months) DAPT (7.9% vs 9.3%, P = 0.76)., Conclusions: After flow diversion, an abbreviated duration of DAPT lasting 6 months may be most appropriate before transitioning to low-dose aspirin monotherapy to promote timely aneurysm occlusion while minimizing thromboembolic complications., Competing Interests: J.R.M. has received consulting compensation for Stryker and Penumbra. A.B.P. has received consulting, proctoring, and lecturing compensation from Medtronic, Microvention, and Penumbra. J.S. has received consulting compensation from Medtronic. The remaining authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

A metagenomic whole genome shotgun sequencing approach was used for rhizospheric soil micribiome of the wild plant Abutilon fruticosum in order to detect antibiotic resistance genes (ARGs) along with their antibiotic resistance mechanisms and to detect potential risk of these ARGs to human health upon transfer to clinical isolates. The study emphasized the potential risk to human health of such human pathogenic or commensal bacteria, being transferred via food chain or horizontally transferred to human clinical isolates. The top highly abundant rhizospheric soil non-redundant ARGs that are prevalent in bacterial human pathogens or colonizers (commensal) included mtrA, soxR, vanRO, golS, rbpA, kdpE, rpoB2, arr-1, efrA and ileS genes. Human pathogenic/colonizer bacteria existing in this soil rhizosphere included members of genera Mycobacterium, Vibrio, Klebsiella, Stenotrophomonas, Pseudomonas, Nocardia, Salmonella, Escherichia, Citrobacter, Serratia, Shigella, Cronobacter and Bifidobacterium. These bacteria belong to phyla Actinobacteria and Proteobacteria. The most highly abundant resistance mechanisms included antibiotic efflux pump, antibiotic target alteration, antibiotic target protection and antibiotic inactivation. antimicrobial resistance (AMR) families of the resistance mechanism of antibiotic efflux pump included resistance-nodulation-cell division (RND) antibiotic efflux pump (for mtrA, soxR and golS genes), major facilitator superfamily (MFS) antibiotic efflux pump (for soxR gene), the two-component regulatory kdpDE system (for kdpE gene) and ATP-binding cassette (ABC) antibiotic efflux pump (for efrA gene). AMR families of the resistance mechanism of antibiotic target alteration included glycopeptide resistance gene cluster (for vanRO gene), rifamycin-resistant beta-subunit of RNA polymerase (for rpoB2 gene) and antibiotic-resistant isoleucyl-tRNA synthetase (for ileS gene). AMR families of the resistance mechanism of antibiotic target protection included bacterial RNA polymerase-binding protein (for RbpA gene), while those of the resistance mechanism of antibiotic inactivation included rifampin ADP-ribosyltransferase (for arr-1 gene). Better agricultural and food transport practices are required especially for edible plant parts or those used in folkloric medicine., (© 2023. Springer-Verlag GmbH Germany, part of Springer Nature.)

Mangiferin (MGF), a xanthone derived from Mangifera indica L., initially employed as a nutraceutical, is now being explored extensively for its anticancer potential. Scientists across the globe have explored this bioactive for managing a variety of cancers using validated in vitro and in vivo models. The in vitro anticancer potential of this biomolecule on well-established breast cancer cell lines such as MDA-MB-23, BEAS-2B cells and MCF-7 is closer to many approved synthetic anticancer agents. However, the solubility and bioavailability of this xanthone are the main challenges, and its oral bioavailability is reported to be less than 2%, and its aqueous solubility is also 0.111 mg/mL. Nano-drug delivery systems have attempted to deliver the drugs at the desired site at a desired rate in desired amounts. Many researchers have explored various nanotechnology-based approaches to provide effective and safe delivery of mangiferin for cancer therapy. Nanoparticles were used as carriers to encapsulate mangiferin, protecting it from degradation and facilitating its delivery to cancer cells. They have attempted to enhance the bioavailability, safety and efficacy of this very bioactive using drug delivery approaches. The present review focuses on the origin and structure elucidation of mangiferin and its derivatives and the benefits of this bioactive. The review also offers insight into the delivery-related challenges of mangiferin and its applications in nanosized forms against cancer. The use of a relatively new deep-learning approach to solve the pharmacokinetic issues of this bioactive has also been discussed. The review also critically analyzes the future hope for mangiferin as a therapeutic agent for cancer management.

Background Vitiligo, the most common pigment disorder, impacts 0.5-2% of the global population, often causing psychological distress due to appearance changes and potential discrimination. Existing data on depressive symptoms and quality of life (QoL) effects in Saudi Arabian vitiligo patients are limited and inconsistent. Hence, this multi-center investigation was conducted in Saudi Arabia to determine the prevalence of depressive symptoms and quality of life (QoL) impairment in patients with vitiligo and to identify factors linked to increased psychological distress in this population. Methods We conducted a multi-center cross-sectional study in Saudi Arabia, employing two validated Arabic questionnaires, the Dermatology Life Quality Index (DLQI) and the Patient Health Questionnaire-9 items (PHQ-9), along with demographic information. Appropriate statistical analyses were performed. Results In total, 204 patients completed the survey. The median DLQI was 4 (range: 25), while the median PHQ-9 was 5 (range: 27). Factors associated with worse QoL included an early age of onset (under 18 years) and a disease duration exceeding five years. Conversely, only disease duration correlated with worse PHQ-9 scores. Vitiligo lesions on the lower extremities, feet, and genitalia were linked to poorer DLQI scores, while only genitalia were associated with worse PHQ-9 scores. We recommend further social awareness campaigns emphasizing the role of supportive families to improve the well-being of vitiligo patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Alkhowailed et al.)

Stigmatizing attitudes of psychiatry professionals toward patients with various mental disorders may negatively impact treatment-seeking behaviors. However, in Saudi Arabia, little is known about psychiatry residents' attitudes toward individuals with a specific disease/disorder. Therefore, the purpose of this study was to assess psychiatry residents' attitudes toward patients with substance use disorder (SUD), bipolar disorder and schizophrenia in Saudi Arabia. Data for this cross-sectional study were collected from psychiatry residents (N = 79) in Saudi Arabia with a structured questionnaire containing sociodemographic and attitude-related variables. The 11-item Medical Condition Regard Scale (MCRS) for individuals with three conditions was used to assess participants' attitudes. A linear regression model was fitted to investigate the association. Based on the MCRS (on a scale of 11 to 66), participants' mean attitude scores were 41.59 (SD: 8.09), 54.53 (SD: 5.90) and 54.20 (SD: 6.60) for SUD, bipolar disorder and schizophrenia, respectively. Adjusted regression analysis demonstrated that senior residents, an age ≥ 27 years and a high confidence level were significantly associated with psychiatry residents' positive attitudes toward patients with the three conditions. Psychiatry residents' attitude scores were relatively lower (i.e., negative attitudes) for patients with SUD than for those with bipolar disorder and schizophrenia. Future longitudinal studies are recommended to explore the factors behind psychiatry residents' negative attitudes toward patients with addictive behaviors and mental illnesses.

The monkeypox virus (MPXV) is an enveloped, double-stranded DNA virus belonging to the genus Orthopox viruses. In recent years, the virus has spread to countries where it was previously unknown, turning it into a worldwide emergency for public health. This study employs a structural-based drug design approach to identify potential inhibitors for the core cysteine proteinase of MPXV. During the simulations, the study identified two potential inhibitors, compound CHEMBL32926 and compound CHEMBL4861364, demonstrating strong binding affinities and drug-like properties. Their docking scores with the target protein were -10.7 and -10.9 kcal/mol, respectively. This study used ensemble-based protein-ligand docking to account for the binding site conformation variability. By examining how the identified inhibitors interact with the protein, this research sheds light on the workings of the inhibitors' mechanisms of action. Molecular dynamic simulations of protein-ligand complexes showed fluctuations from the initial docked pose, but they confirmed their binding throughout the simulation. The MMGBSA binding free energy calculations for CHEMBL32926 showed a binding free energy range of (-9.25 to -9.65) kcal/mol, while CHEMBL4861364 exhibited a range of (-41.66 to -31.47) kcal/mol. Later, analogues were searched for these compounds with 70% similarity criteria, and their IC 50 was predicted using pre-trained machine learning models. This resulted in identifying two similar compounds for each hit with comparable binding affinity for cysteine proteinase. This study's structure-based drug design approach provides a promising strategy for identifying new drugs for treating MPXV infections.

Background and Objectives : Group B streptococcus (GBS) is the leading cause of infections in neonates with high fatality rates. GBS is caused by the streptococcus bacterium known as streptococcus agalactiae, which is highly contagious and can be transmitted from pregnant women to infants. GBS infection can occur as an early onset or late-onset infection and has different treatment strategies. Antibiotics are effective in treating GBS infections at early stages. The aim of this systematic review was to summarize the clinical characteristics and treatment strategies for GBS, with a focus on antibiotics. Material and Methods : The findings of this review were reported in accordance with the PRISMA 2020 guidelines and a flow diagram of the study selection process, a summary of the included studies, a description of the study characteristics, a summary of the results, a discussion of the implications of the findings, and a conclusion are included. Overall, the authors followed a rigorous methodology to ensure that this review is comprehensive and inclusive of relevant studies on GBS infection and its treatment. Results : Overall, 940 studies were reviewed and only the most relevant 22 studies were included in the systematic review. This review describes the characteristics of patients in different studies related to early onset GBS disease and presents various treatment strategies and outcomes for GBS infection in pediatrics. The studies suggest that preventive measures, risk-based intrapartum antibiotic prophylaxis, and maternal vaccination can significantly reduce the burden of GBS disease, but late-onset GBS disease remains a concern, and more strategies are required to decrease its rate. Improvement is needed in the management of the risk factors of GBS. A conjugate vaccine with a serotype (Ia, Ib, II, III, and V) has been proven effective in the prevention of GBS in neonates. Moreover, penicillin is an important core antibiotic for treating early onset GBS (EOD). Conclusions : This systematic review summarizes the treatment comparison for GBS infections in neonates, with a primary focus on antibiotics. IAP (intrapartum antibiotic prophylaxis) according to guidelines, antenatal screening, and the development of a conjugate vaccine may be effective and could lower the incidence of the disease.

Objective: Delayed cerebral ischemia (DCI) associated with vasospasm is well described in the setting of aneurysmal subarachnoid hemorrhage (SAH). In addition, DCI is very infrequently encountered in patients who have undergone resection of a brain tumor with unclear pathophysiology. The occurrence of DCI in the pediatric population is exceedingly rare, and outcomes in this population have, to the authors' knowledge, never been systematically reviewed. Therefore, the authors present what is to their knowledge the largest series of pediatric patients with this complication and systematically reviewed the literature for individual participant data., Methods: The authors conducted a retrospective review of 172 sellar and suprasellar tumors in pediatric patients who underwent surgery at the Montreal Children's Hospital between 1999 and 2017 to identify cases of vasospasm occurring after tumor resection. Descriptive statistics, including patient characteristics, intraoperative and postoperative findings, and outcome status, were collected. A systematic review was also conducted using three databases (PubMed, Web of Science, Embase) to identify reported cases available in the literature of vasospasm after tumor resection in children and collect individual participant data on these patients for further analysis., Results: Six patients treated at Montreal Children's Hospital were identified, with an average age of 9.5 years (range 6-15 years). The prevalence of vasospasm after tumor resection was 3.5% (6/172). Vasospasm in all 6 patients occurred after craniotomy was performed to treat a suprasellar tumor. The average interval from surgery to symptoms was 3.25 days (range 12 hours-10 days). The most common tumor etiology was craniopharyngioma, seen in 4 cases. Extensive tumor encasement of blood vessels requiring significant operative manipulation was described in all 6 patients. A rapid decrease in serum sodium (exceeding 12 mEq/L/24 hrs or below 135 mEq/L) was seen in 4 patients. On final follow-up, 3 patients were left with significant disability, and all patients had persistent deficits. A systematic review of the literature revealed a total of 10 other patients whose characteristics and treatment were compared with those of the 6 patients treated at Montreal Children's Hospital., Conclusions: Vasospasm after tumor resection in children and youth is likely a rare entity, with a prevalence of 3.5% in this case series. Suprasellar tumor location (particularly craniopharyngioma tumor etiology), significant encasement of blood vessels by the tumor, and postoperative hyponatremia may be predictive factors. Outcome is poor, with most patients having significant persistent neurological deficits.

In this study, we evaluated the occurrence, relative abundance (RA), and density (RD) of simple sequence repeats (SSRs) in the complete genome and transcriptomic sequences of the plant pathogenic species of Pythium to acquire a better knowledge of their genome structure and evolution. Among the species, P. ultimum had the highest RA and RD of SSRs in the genomic sequences, whereas P. vexans had the highest RA and RD in the transcriptomic sequences. The genomic and transcriptomic sequences of P. aphanidermatum showed the lowest RA and RD of SSRs. Trinucleotide SSRs were the most prevalent class in both genomic and transcriptomic sequences, while dinucleotide SSRs were the least prevalent. The G + C content of the transcriptomic sequences was found to be positively correlated with the number (r = 0.601) and RA (r = 0.710) of SSRs. A motif conservation study revealed the highest number of unique motifs in P. vexans (9.9%). Overall, a low conservation of motifs was observed among the species (25.9%). A gene enrichment study revealed P. vexans and P. ultimum carry SSRs in their genes that are directly connected to virulence, whereas the remaining two species, P. aphanidermatum and P. arrhenomanes, harbour SSRs in genes involved in transcription, translation, and ATP binding. In an effort to enhance the genomic resources, a total of 11,002 primers from the transcribed regions were designed for the pathogenic Pythium species. Furthermore, the unique motifs identified in this work could be employed as molecular probes for species identification., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The unmet medical need for drug-resistant tuberculosis (DRTB) is a significant concern. Accordingly, identifying new drug targets for tuberculosis (TB) treatment and developing new therapies based on these drug targets is one of the strategies to tackle DRTB. QcrB is an innovative drug target to create treatments for DRTB. This article highlights QcrB inhibitors and their therapeutic compositions for treating TB. The literature for this article was gathered from PubMed and free patent databases utilizing different keywords related to QcrB inhibitor-based inventions. The data was collected from the conceptualization of telacebec (2010) QcrB to December 2022. A little interesting and encouraging research has been performed on QcrB inhibitors. Telacebec and TB47 are established QcrB inhibitors in the clinical trial. The inventive QcrB inhibitor-based drug combinations can potentially handle DRTB and reduce the TB therapy duration. The authors anticipate great opportunities in fostering QcrB inhibitor-based patentable pharmaceutical inventions against TB. Drug repurposing can be a promising strategy to get safe and effective QcrB inhibitors. However, developing drug resistance, drug tolerance, and selectivity of QcrB inhibitors for Mtb will be the main challenges in developing effective QcrB inhibitors. In conclusion, QcrB is a promising drug target for developing effective treatments for active, latent, and drug-resistant TB. Many inventive and patentable combinations and compositions of QcrB inhibitors with other anti-TB drugs are anticipated as future treatments for TB., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Given the potential for social media to allow widespread public engagement, its role in healthcare, including in cancer care as a support network, is garnering interest. To date, the use of social media in neuro-oncology has not been systematically explored. In the current manuscript, we sought to review Twitter use on glioblastoma among patients, caregivers, providers, researchers, and other stakeholders., Methods: The Twitter application programming interface (API) database was surveyed from inception to May 2022 to identify tweets about glioblastoma. Number of tweet likes, retweets, quotes, and total engagement were noted for each tweet. Geographic location, number of followers, and number of Tweets were noted for users. We also categorized Tweets based on their underlying themes. A natural language processing (NLP) algorithm was used to assign a polarity score, subjectivity score, and analysis label to each Tweet for sentiment analysis., Results: A total of 1690 unique tweets from 1000 accounts were included in our analyses. The frequency of tweets increased from 2013 and peaked in 2018. The most common category among users was MD/researchers (21.6%, n  = 216), followed by Media/News (20%, n  = 200) and Business (10.7%); patients or caregivers accounted for only 4.7% ( n  = 47) while medical centers, journals, and foundations accounted for 5.4%, 3.7%, and 2.1%. The most common subjects that Tweets covered included research (54%), followed by personal experience (18.2%) and raising awareness (14%). In terms of sentiment, 43.6% of Tweets were classified as positive, 41.6% as neutral, and 14.9% as negative; a subset analysis of "personal experience" tweets revealed a higher proportion of negative Tweets (31.5%) and less neutral tweets (25%). Only media (β = 8.4; 95% CI [4.4, 12.4]) and follower count (minimally) predicted higher levels of Tweet engagement., Conclusion: This comprehensive analysis of tweets on glioblastoma found that the academic community are the most common user group on Twitter. Sentiment analysis revealed that most negative tweets are related to personal experience. These analyses provide the basis for further work into supporting and developing the care of patients with glioblastoma., Competing Interests: The authors have no conflicts of interest relevant to this article to disclose., (© The Author(s) 2023. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)

Background: Degenerative cervical myelopathy (DCM) is a progressive neurologic condition caused by age-related degeneration of the cervical spine. Social media has become a crucial part of many patients' lives; however, little is known about social media use pertaining to DCM., Objective: This manuscript describes the landscape of social media use and DCM in patients, caretakers, clinicians, and researchers., Methods: A comprehensive search of the entire Twitter application programing interface database from inception to March 2022 was performed to identify all tweets about cervical myelopathy. Data on Twitter users included geographic location, number of followers, and number of tweets. The number of tweet likes, retweets, quotes, and total engagement were collected. Tweets were also categorized based on their underlying themes. Mentions pertaining to past or upcoming surgical procedures were recorded. A natural language processing algorithm was used to assign a polarity score, subjectivity score, and analysis label to each tweet for sentiment analysis., Results: Overall, 1859 unique tweets from 1769 accounts met the inclusion criteria. The highest frequency of tweets was seen in 2018 and 2019, and tweets decreased significantly in 2020 and 2021. Most (888/1769, 50.2%) of the tweets' authors were from the United States, United Kingdom, or Canada. Account categorization showed that 668 of 1769 (37.8%) users discussing DCM on Twitter were medical doctors or researchers, 415 of 1769 (23.5%) were patients or caregivers, and 201 of 1769 (11.4%) were news media outlets. The 1859 tweets most often discussed research (n=761, 40.9%), followed by spreading awareness or informing the public on DCM (n=559, 30.1%). Tweets describing personal patient perspectives on living with DCM were seen in 296 (15.9%) posts, with 65 (24%) of these discussing upcoming or past surgical experiences. Few tweets were related to advertising (n=31, 1.7%) or fundraising (n=7, 0.4%). A total of 930 (50%) tweets included a link, 260 (14%) included media (ie, photos or videos), and 595 (32%) included a hashtag. Overall, 847 of the 1859 tweets (45.6%) were classified as neutral, 717 (38.6%) as positive, and 295 (15.9%) as negative., Conclusions: When categorized thematically, most tweets were related to research, followed by spreading awareness or informing the public on DCM. Almost 25% (65/296) of tweets describing patients' personal experiences with DCM discussed past or upcoming surgical interventions. Few posts pertained to advertising or fundraising. These data can help identify areas for improvement of public awareness online, particularly regarding education, support, and fundraising., (©Lior M Elkaim, Jordan J Levett, Farbod Niazi, Mohammed A Alvi, Nathan A Shlobin, Joseph R Linzey, Faith Robertson, Rakan Bokhari, Naif M Alotaibi, Oliver Lasry. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 22.05.2023.)

The symptoms of psychiatric infirmities have variability, and selected drug regimens for mental illness are comparatively complex and individualized; therefore, pharmacy services vary with respect to patients, diseases, healthcare settings, community structures, and countries. Clinical pharmacy services for mental health (MH) are continuously being upgraded. A structured search of the literature was performed in the Cochrane, PubMed (Medline), PsycINFO, Google scholar, Scopus, Science Direct, and Springer Links databases. The title and abstract of each retrieved article were evaluated for relevance. To remove uncertainty and ambiguity, the full-text articles were retrieved and examined for relevance. The articles were further assessed on the basis of inclusion and exclusion criteria. Narrative synthesis was performed, creating new categories and relevant subcategories and further subsections. The articles and the results were assessed for quality and bias. Pharmacists have a range of expertise in psychiatric care. The services can be classified as conventional, extended, and advanced pharmacy services. Conventional services include the quality use of medicines in healthcare settings and medication support services in communities that ensure medication adherence. Pharmacists perform extended roles in collaborative medication therapy management, multidisciplinary community mental health teams, collaborative care, patient education, home medication review, hospital-to-home transit, and screening services. In the USA, the role of pharmacists was advanced by prescribing as collaborative and interim prescribers. Australia launched an accredited program for psychiatric first-aid pharmacists. Pharmacists can provide mental care to rural populations using health technology. The role of pharmacists in MH is appreciated either independently or as a team member. Patients and healthcare providers rank the services of pharmacists in MH highly. Still, there is a margin for improvement in the training of pharmacists. Pharmacists cannot provide sufficient time to their patients. Public awareness about the role of pharmacists in MH needs more attention. Moreover, the training of psychiatric pharmacists should be standardized around the world.