The Transcriptional Response of Trametes versicolor to Growth on Maple Chips and Miscanthus Straw

This thesis research explored the transcriptional response of Trametes versicolor, a white-rot fungus, in response to fundamentally different types of lignocellulosic biomass (miscanthus and maple) and rich medium (malt extract agar). After five weeks of growth by the fungus on the biomass, the fungal RNA was extracted from three biological replicates per biomass type and mRNA was sequenced (approximately 30 million reads per sample). The reads were processed using ArrayStar to covert to RPKM and annotated using JGI\u27s T. versicolor GO annotation file along with NCBI\u27s BLAST. Comparisons were made between average gene expression of the fungus grown on maple, miscanthus, and the malt extract plate. A cut-off of 20X or greater expression was used for comparing fungi grown on either miscanthus or maple to the plate, with 45 and 61 transcripts meeting this threshold, respectively. The majority of the genes were known to be involved with biomass deconstruction by fungi (e.g. peroxidases, glycosyl hydrolases) with some unexpected genes appearing (e.g. MAPKKK). When comparing miscanthus with maple, a cut-off of 3X or greater expression was used giving 55 transcripts that were higher in maple and 46 transcripts that were higher in miscanthus. As with the previous comparisons with the rich media, most of the differentially expressed genes belonged to expected categories of enzymes involved in lignocellulose breakdown; however, it is notable that the majority of transcripts more highly expressed in miscanthus when compared to maple (at a 3X threshold) had unknown functions. Overall, this research provided insight into the biochemical mechanisms used by T. versicolor to deconstruct lignocellulosic biomass, and identified a plethora of uncharacterized genes encoding enzymes that may be critically important in lignocellulosic degradation

Generic orphan drug substitution: a critical analysis of global practices and Saudi Arabia’s perspective

In an era of cost pressure, substituting generic drugs represents one of the main cost-containment strategies of healthcare systems. Despite the obvious financial benefits, in a minority of cases, substitution may require caution or even be contraindicated. In most jurisdictions, to obtain approval, the bioequivalence of generic products with the brand-name equivalent needs to be shown via bioavailability studies in healthy subjects. Rare diseases, defined as medical conditions with a low prevalence, are a group of heterogenous diseases that are typically severe, disabling, progressive, degenerative, and life-threatening or chronically debilitating, and disproportionally affect the very young and elderly. Despite these unique features of rare diseases, generic bioequivalence studies are typically carried out with single doses and exclude children or the elderly. Furthermore, the excipients and manufacturing processes for generic/biosimilar products can differ from the brand products which may affect the shelf-life of the product, its appearance, smell, taste, bioavailability, safety and potency. This may result in approval of generics/biosimilars which are not bioequivalent/comparable in their target population or that meet bioequivalence but not therapeutic equivalence criteria. Another concern relates to the interchangeability of generics and biosimilars which cannot be guaranteed due to the phenomenon of biocreep. This review summarizes potential concerns with generic substitution of orphan drugs and discusses potentially problematic cases including narrow therapeutic index drugs or critical conditions where therapeutic failure could lead to serious complications or even death. Finally, we put forward the need for refining regulatory frameworks, with emphasis on Saudi Arabia, for generic substitution and recent efforts toward this direction

Types of Errors Involved in the English-Arabic Translation of Research Abstracts

This study seeks to shed light on the analysis of translation errors occurring in the abstracts of research papers by MA students in the College of Languages and Translation at Imam Mohamed Ben Saud Islamic University, Riyadh, Saudi Arabia. The papers were translated from English into Arabic. A sample consisting of forty abstracts has been collected for this end. Liao’s (2010) model of analysis has been used to classify and analyze the errors made in the translations. The final results of this study show that the most occurring errors made by students when translating their abstracts from English into Arabic are mainly language ones. The study puts forward a number of suggestions, which may be very helpful to future students to avoid making translation errors in such abstracts

The Transcriptional Response of Trametes versicolor to Growth on Maple Chips and Miscanthus Straw

This thesis research explored the transcriptional response of Trametes versicolor, a white-rot fungus, in response to fundamentally different types of lignocellulosic biomass (miscanthus and maple) and rich medium (malt extract agar). After five weeks of growth by the fungus on the biomass, the fungal RNA was extracted from three biological replicates per biomass type and mRNA was sequenced (approximately 30 million reads per sample). The reads were processed using ArrayStar to covert to RPKM and annotated using JGI\u27s T. versicolor GO annotation file along with NCBI\u27s BLAST. Comparisons were made between average gene expression of the fungus grown on maple, miscanthus, and the malt extract plate. A cut-off of 20X or greater expression was used for comparing fungi grown on either miscanthus or maple to the plate, with 45 and 61 transcripts meeting this threshold, respectively. The majority of the genes were known to be involved with biomass deconstruction by fungi (e.g. peroxidases, glycosyl hydrolases) with some unexpected genes appearing (e.g. MAPKKK). When comparing miscanthus with maple, a cut-off of 3X or greater expression was used giving 55 transcripts that were higher in maple and 46 transcripts that were higher in miscanthus. As with the previous comparisons with the rich media, most of the differentially expressed genes belonged to expected categories of enzymes involved in lignocellulose breakdown; however, it is notable that the majority of transcripts more highly expressed in miscanthus when compared to maple (at a 3X threshold) had unknown functions. Overall, this research provided insight into the biochemical mechanisms used by T. versicolor to deconstruct lignocellulosic biomass, and identified a plethora of uncharacterized genes encoding enzymes that may be critically important in lignocellulosic degradation

Quality Perceptions, Expectations, and Individual Characteristics among Adult Patients Visiting Primary Healthcare Centers in Saudi Arabia: A Cross-Sectional Study

Quality is a main concern of primary healthcare centers, and pursuing quality can lead to service improvement as well as affordable healthcare. The purpose of this cross-sectional study was to describe patients’ healthcare quality perceptions and expectations and determine the relationships between them and associated factors. The study was conducted on a convenience sample of 470 patients visiting primary healthcare centers. Data were collected between April and July 2022 using an anonymous questionnaire. Bivariate and multivariate analyses were conducted. Most participants reported high levels of quality perceptions and expectations. Bivariate analyses showed a significant correlation between quality perceptions and expectations. Both being single and having a higher level of education were statistically different in terms of quality perception and expectations, respectively. Further, being single, highly educated, and employed had significant differences in terms of expectations. In regression, primary education and expectations influenced quality perceptions. Marital status, profession, and perception were the only variables that significantly influenced participants’ expectations. Patients’ healthcare quality perceptions and expectations are important for ensuring the efficiency of healthcare services. Primary healthcare centers are the key avenue for disease prevention and early detection. The optimization of primary healthcare centers’ quality and addressing its potential issues should be performed through interdisciplinary teamwork

The impact of antimicrobial stewardship program implementation at four tertiary private hospitals: results of a five-years pre-post analysis

BACKGROUND: Antimicrobial stewardship (AMS) programs have shown to reduce the emergence of antimicrobial resistance (AMR) and health-care-associated infections (HAIs), and save health-care costs associated with an inappropriate antimicrobial use. The primary objective of this study was to compare the consumption and cost of antimicrobial agents using defined daily dose (DDD) and direct cost of antibiotics before and after the AMS program implementation. Secondary objective was to determine the rate of HAIs [Clostridium difficile (C. difficile), ventilator-associated pneumonia (VAP), and central line-associated bloodstream infection (CLABSI) before and after the AMS program implementation. METHODS: This is a pre-post quasi-experimental study. Adult inpatients were enrolled in a prospective fashion under the active AMS arm and compared with historical inpatients who were admitted to the same units before the AMS implementation. Study was conducted at four tertiary private hospitals located in two cities in Saudi Arabia. Adult inpatients were enrolled under the pre- AMS arm and post- AMS arm if they were on any of the ten selected restricted broad-spectrum antibiotics (imipenem/cilastatin, piperacillin/tazobactam, colistin, tigecycline, cefepime, meropenem, ciprofloxacin, moxifloxacin, teicoplanin and linezolid). RESULTS: A total of 409,403 subjects were recruited, 79,369 in the pre- AMS control and 330,034 in the post- AMS arm. Average DDDs consumption of all targeted broad-spectrum antimicrobials from January 2016 to June 2019 post- AMS launch was lower than the DDDs use of these agents pre- AMS (233 vs 320 DDDs per 1000 patient-days, p = 0.689). Antimicrobial expenditures decreased by 28.45% in the first year of the program and remained relatively stable in subsequent years, with overall cumulative cost savings estimated at S.R. 6,286,929 and negligible expenses of S.R. 505,115 (p = 0.648). Rates of healthcare associated infections involving C. difficile, VAP, and CLABSI all decreased significantly after AMS implementation (incidence of HAIs in 2015 compared to 2019: for C. difficile, 94 vs 13, p = 0.024; for VAP, 24 vs 6, p = 0.001; for CLABSI, 17 vs 1, p = 0.000; respectively). CONCLUSION: Implementation of AMS program at HMG healthcare facilities resulted in reduced antimicrobials use and cost, and lowered incidence of healthcare associated infections

Disability of Neck and Shoulder among Female Dental Students: A Pilot Study

Background: The dentistry profession may lead to musculoskeletal pain. Although the literature highlights the high rates of neck-shoulder pain in dentists, clear evidence about the prevalence of musculoskeletal disability among female dental students is lacking. This study aimed to assess the disability level of neck and shoulder pain among dentistry students, to compare the disability level between clinical and pre-clinical dentistry students, and to assess the association between neck-shoulder pain, the Neck Disability Index (NDI), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH). Methods: This pilot study included 46 female dentistry students aged 19–26 years. Participant’s demographics were recorded. Pain intensity was obtained using the Numerical Pain Rating Scale. Neck and shoulder disability were measured by the NDI and the QuickDASH score, respectively. Results: 46 female dentistry students aged (21.3 ± 1.58) were included. Neck and shoulder pain occurrence were higher in clinical students compared to pre-clinical students. Pain and related disability were significantly and positively correlated. Conclusion: This study demonstrates high rates of neck-shoulder pain in female dentistry students and a significant difference in the prevalence rate between clinical and pre-clinical students

Use of YouTube as a Learning Modality for Clinical Procedures among Dental Students in Riyadh, Saudi Arabia—A Cross-Sectional Study

Social media like YouTube are increasingly used by students as a learning tool. The aim of this study was to examine the use of YouTube videos as a means of learning clinical procedures among dental students in Riyadh, Saudi Arabia. A cross-sectional observational study was conducted among dental students from six dental colleges in Riyadh, Saudi Arabia. Among the total of 331 dental students who responded to this survey, 93.9% (n = 308) reported that they had used YouTube for dental learning. A total of 65.30% (n = 201) of the respondents strongly agreed that they find videos of clinical procedures on YouTube helpful as a learning tool. A total of 54.40% (n = 180) agreed that they always refer to YouTube videos to prepare for a clinical procedure that they have never done before. A total of 75.3% (n = 232) reported that they most commonly watched clinical procedures related to restorative dentistry, 67.2% (n = 207) for fixed prosthodontics procedures, 65.3% (n = 201) for endodontic clinical procedures, and 62.3% (n = 192) for removable prosthodontics videos. A total of 50.60% (n = 156) strongly agreed that YouTube videos are helpful in relating theoretical knowledge with clinical knowledge. A total of 50.30% (n = 155) reported that it is important to have faculty guidance regarding useful YouTube videos on dental procedures. A total of 91.90% (n = 283) participants would like their dental school to post tutorials or videos for clinical procedures on YouTube. Even after increased availability of online videos, a majority of dental students felt that YouTube videos suggested by faculty were more valuable than videos identified through normal searching

Epidemiology and clinical characteristics of Morganella morganii infections: A multicenter retrospective study

Background: Morganella morganii is a Gram-negative, opportunistic pathogen that can cause a variety of infections, including bloodstream infections, especially in those with compromised immune systems. It is often resistant to antibiotics, making it a difficult organism to treat. Limited studies have addressed M. morganii, but the organism is becoming increasingly recognized as a public health threat. More research is needed to understand the epidemiology and virulence factors of M. morganii in Saudi Arabia, as well as to develop effective treatment strategies. Methods: This retrospective study included all M. morganii bloodstream infections patients admitted to five tertiary care hospitals in Saudi Arabia between 2015 and 2022. Results: The study population included 75 patients (45 males and 30 females) between the age of 53–72 with a 54% ICU admission rate. The most comorbidities were hypertension followed by diabetes. The most common symptoms were fever, cough, shortness of breath, vomiting, and fatigue. The study also found that M. morganii was often resistant to multiple antibiotics, including ciprofloxacin, trimethoprim/sulfamethoxazole, gentamicin, amoxicillin, nitrofurantoin, and colistin. The most common treatment for M. morganii bacteremia was carbapenems, followed by aminoglycosides, ciprofloxacin, and colistin. Source control measures, such as surgery, line removal, drainage, and tissue removal, were also used in some cases. The study found that the in-hospital mortality rate for M. morganii bacteremia was 41%. The risk of mortality was increased in patients who were admitted to the ICU, who were older than 65 years, and who had Klebsiella pneumoniae co-infection. Conclusion: M. morganii bacteremia is a serious infection that is often resistant to antibiotics. Elderly patients and patients with comorbidities are at increased risk of mortality. Source control measures and appropriate antibiotic therapy are important for improving outcomes