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This study was conducted to investigate the impact of climate change disclosure on the cost of debt and gain deep insight into the usefulness of political connections and ESG disclosure for reducing the cost of debt. A sample of 83 listed firms in the Egyptian context, spanning 498 observations over 6 years from 2018 to 2023, was used. A quantitative approach was adopted to examine the key hypotheses. This research reveals that climate change disclosure decreases the cost of debt. Furthermore, political connections and ESG disclosure moderate the main nexus. Multiple robustness checks were conducted to confirm these findings. Crucial policy implications for regulators, investors, and sustainability experts were developed by highlighting the latest practices of corporations aligned with achieving Sustainable Development Goals. The significance of this study lies in filling several gaps in the literature regarding climate change disclosure, political connections, and ESG disclosure and how a company’s strategic approach can impact the cost of capital.

Background In COVID-19 patients, undetected co-infections may have severe clinical implications associated with increased hospitalization, varied treatment approaches and mortality. Therefore, we investigated the implications of viral and bacterial co-infection in COVID-19 clinical outcomes. Methods Nasopharyngeal samples were obtained from 48 COVID-19 patients (29% ICU and 71% non-ICU) and screened for the presence of 24 respiratory pathogens using six multiplex PCR panels. Results We found evidence of co-infection in 34 COVID-19 patients (71%). Influenza A H1N1 (n = 17), Chlamydia pneumoniae (n = 13) and human adenovirus (n = 10) were the most commonly detected pathogens. Viral co-infection was associated with increased ICU admission (r = 0.1) and higher mortality (OR 1.78, CI = 0.38–8.28) compared to bacterial co-infections (OR 0.44, CI = 0.08–2.45). Two thirds of COVID-19 critically ill patients who died, had a co-infection; and Influenza A H1N1 was the only pathogen for which a direct relationship with mortality was seen (r = 0.2). Conclusions Our study highlights the importance of screening for co-infecting viruses in COVID-19 patients, that could be the leading cause of disease severity and death. Given the high prevalence of Influenza co-infection in our study, increased coverage of flu vaccination is encouraged to mitigate the transmission of influenza virus during the on-going COVID-19 pandemic and reduce the risk of severe outcome and mortality.

COVID-19 severity due to innate immunity dysregulation accounts for prolonged hospitalization, critical complications, and mortality. Severe SARS-CoV-2 infections involve the complement pathway activation for cytokine storm development. Nevertheless, the role of complement in COVID-19 immunopathology, complement‐modulating treatment strategies against COVID-19, and the complement and SARS‐CoV‐2 interaction with clinical disease outcomes remain elusive. This study investigated the potential changes in complement signaling, and the associated inflammatory mediators, in mild-to-critical COVID-19 patients and their clinical outcomes. A total of 53 patients infected with SARS-CoV-2 were enrolled in the study (26 critical and 27 mild cases), and additional 18 healthy control patients were also included. Complement proteins and inflammatory cytokines and chemokines were measured in the sera of patients with COVID-19 as well as healthy controls by specific enzyme-linked immunosorbent assay. C3a, C5a, and factor P (properdin), as well as interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, and IgM antibody levels, were higher in critical COVID-19 patients compared to mild COVID-19 patients. Additionally, compared to the mild COVID-19 patients, factor I and C4-BP levels were significantly decreased in the critical COVID-19 patients. Meanwhile, RANTES levels were significantly higher in the mild patients compared to critical patients. Furthermore, the critical COVID-19 intra-group analysis showed significantly higher C5a, C3a, and factor P levels in the critical COVID-19 non-survival group than in the survival group. Additionally, IL-1β, IL-6, and IL-8 were significantly upregulated in the critical COVID-19 non-survival group compared to the survival group. Finally, C5a, C3a, factor P, and serum IL-1β, IL-6, and IL-8 levels positively correlated with critical COVID-19 in-hospital deaths. These findings highlight the potential prognostic utility of the complement system for predicting COVID-19 severity and mortality while suggesting that complement anaphylatoxins and inflammatory cytokines are potential treatment targets against COVID-19.

Asthma is a common chronic respiratory disease that affects children and adults and can have a serious impact on their quality of life. Factors contributing to the development of asthma and related exacerbations are multifactorial, with microbial communities colonizing the airways possibly playing a key role. The study included asthmatic (79) and healthy children (57) aged 5-16 years. Nasal and throat swabs were collected, and bacterial (16s rRNA) and fungal (18s rRNA) amplicon sequence analysis was performed. Diversity indices and the most abundant microbial genera were estimated accordingly. At the level of the bacteriome in the nasal samples, the asthma group had significantly lower diversity than the control group (p = 0.02). However, the microbiota of the asthma cohort was more evenly distributed, and were enriched in the control group. Throat samples collected from the asthma cohort revealed significantly lower diversity (p < 0.0001), with a significant difference in species composition between the two groups (p = 0.005). Enriched bacterial species were different within the asthma subgroups (controlled vs uncontrolled asthma). The fungal microbiome of the nasal and throat samples showed no difference in species richness between the two groups, however, a significant difference in beta diversity (species composition) was detected. The nasal samples from the control group were enriched with species, while the asthma cases were enriched with species. On the other hand, throat specimens of the asthma group were found to be enriched with and Our findings suggest that asthmatic samples were less diverse than the control samples with certain microbial genera enriching some study groups. Addressing the biomarkers that influence the progression of asthma could lead to improved care for children suffering from severe asthmatic episodes, possibly by including targeted therapies and prevention strategies.

This meta-analysis aims to synthesize evidence on the association between key risk factors and the development of diabetic retinopathy (DR), a major complication of diabetes mellitus. We systematically reviewed and analyzed data from 11 studies published up to April 2023, focusing on the impact of poor glycemic control, triglyceride levels, duration of diabetes exceeding 10 years, and hypertension on DR risk. Odds ratios (ORs) were calculated using a random-effects model to account for heterogeneity among studies. Elevated fasting blood glucose and glycated hemoglobin levels were significantly associated with an increased risk of DR (OR: 2.41, 95% CI: 1.63-3.57), highlighting the importance of glycemic control. Triglyceride levels and the duration of diabetes over 10 years also showed positive associations with DR risk, albeit with weaker effect sizes. Hypertension was identified as a potential risk factor, although the association was not statistically significant across all studies. Moderate-to-high heterogeneity was observed across the analyses, underscoring the multifactorial nature of DR. This meta-analysis confirms the critical role of glycemic control in preventing DR and identifies other important risk factors, including triglyceride levels and prolonged diabetes duration. The findings emphasize the need for comprehensive diabetes management strategies to mitigate the risk of DR. Future research should explore the mechanisms underlying these associations and develop targeted interventions.

Alveolar ridge deformities can be caused by several factors. Managing alveolar deformities prior to implant placement is essential to increase bone width, height or both. Several techniques and materials are now available to perform ridge augmentation procedures. The postoperative exposure of the membrane is the most frequent postoperative complications of ridge augmentation procedures. The present case describes the horizontal ridge augmentation procedure and the outcome of surgical attempt to manage post-operative membrane exposure, and shows the unpredictability of managing postoperative membrane exposure surgically.

Newspaper digitization has gained wide interest around the world. Archives of digitized newspapers and magazines contain a wealth of information that spans decades. To extract this abundance of information, optical character recognition (OCR) techniques with extensive manual page annotation have been employed. The OCR techniques extract the text from the raw image of the page, while page annotation adds meta-data about the content of the page such as the category of the page and the location of articles and other elements. To automate this process, I propose a framework for detecting newspaper pages elements and categorizing newspaper pages. The framework will use visual features of the digitized newspaper to classify the printed media type and decompose the newspaper page into its main elements (news articles, advertisements, and page headers) using object detection. Then, it will use both visual and textual features to categorize the newspaper page into its main sections (first page, politics, economy, sports, and advertisement). The element detection stage is leveraged by using only news articles for categorizing the pages, since other elements, such as advertisements, may contain visual and textual features that are not related to the page section. This framework will prepare the newspaper page for the OCR methods to extract meaningful information. The page elements detection phase of the framework is language-agnostic, which allows it to extract the articles from newspapers in different languages (e.g., Arabic, English, French, German, etc). The framework will use two deep neural networks architectures, Faster R-CNN which is based on the convolutional neural network (CNN) architecture and Transformers to classify and detect elements in the printed media.

[Please see PDF for full article text] [Please see PDF for full article text] Objectives: To investigate epidemiological changes in respiratory fungal infections (RFI), including fungal isolation and colonization, at one of the main centers in Medina. The incidence of RFI is rising due to an increase in the number of immunocompromised individuals, a higher prevalence of respiratory viral infections, and an aging population. Methods: A retrospective cross-sectional study was conducted by extracting data of patients with fungal-positive respiratory cultures from King Fahad Hospital (KFH), Al Madinah Al Munawwarah from 2013 to 2023. Results: A total of 352 episodes of fungal-positive cultures were identified in 79 patients, reflecting a 12-fold increase in RFI prevalence. The most frequent fungus was Candida albicans 43% (n=150), followed by C. tropicalis at 34% (n=119), C. glabrata at 7% (n=25), C. parapsilosis at 5% (n=18), C. dubliniensis at 3.4% (n=12), and Aspergillus fumigatus at 3.4% (n=12). Bronchoalveolar lavage was performed 52 times, with 19 cultures growing C. albicans and 8 cultures positive for A. fumigatus. None of the 58 lung biopsy samples grew mold. Only one patient had 2 C. glabrata isolates resistant to voriconazole and fluconazole. The most prevalent comorbidities were respiratory diseases (30%) and lower limb injuries and diabetes (16%). Conclusion: Candida albicans was the leading cause of RFI. Continuous monitoring, improved diagnostics, and targeted interventions are crucial to address existing challenges and emerging threats. The growing recognition of fungal infections necessitates increased research and education for healthcare professionals. Keywords: Saudi Arabia, Aspergillus, Candida, candidiasis, respiratory, fungal, infections

The current study investigated how students at King Saud University’s College of Pharmacy perceive the effectiveness of the Academic Advising Unit and their experiences with academic advisors. Our study examined responses gathered from 164 participants, including 97 female and 67 male students, representing various academic years (2 nd to 6 th ). The survey assessed several key aspects, including the availability of advisors, their knowledge and expertise, communication effectiveness, level of support and encouragement, ability to assist with goal setting, integration of feedback, accessibility of resources, and overall student satisfaction. The results of our study revealed that while the majority of students in the College of Pharmacy expressed satisfaction with and support for academic advising, a notable proportion of students exhibited ambivalence or dissatisfaction with the advising services. Regarding advisor availability, 57% of students expressed satisfaction, while 32% were indifferent, reflecting unmet needs. Similarly, in terms of communication, 62% were satisfied, but 28% were neutral, again suggesting an inconsistency in advisor responses. A similar trend was observed concerning advisor knowledge and expertise, with 58% satisfied and 31% neutral. Specifically, when questioned about guidance on research and extracurricular activities, only 48% expressed satisfaction. Overall, 61% felt that communication was beneficial in resolving their issues. Students were below-average in their satisfaction with the support provided during challenging times. Findings suggest that an average level of academic advising functioning and emphasized the need for more individualized and consistent academic advising to better meet student expectations.