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The prevalence of nutritional disorders in Saudi children with inflammatory bowel diseases (IBDs) has been reported using the World Health Organization (WHO) reference. Our aim was to provide more accurate definition of the prevalence of nutritional impairment in Saudi children with IBDs based on the national growth reference and to demonstrate the effect of using a reference from other populations on the prevalence rates.

Weight, height, and body mass index data, from the multicenter study of IBDs in Saudi children and adolescents, were plotted on the new Saudi national growth reference. Statistical analyses included frequency calculations and z-test for proportions to investigate the significance of the difference in prevalence. A p-value of<0.05 was considered significant.

Among a total of 374 patients, 119 (32%) had ulcerative colitis (UC) and 255 (68%) had Crohn's disease (CD). Compared with the WHO reference, the Saudi national reference produced a significantly lower prevalence of thinness in patients with UC (24% vs. 8%, p=0.001), CD (35% vs. 20%, p=0.002), and of short stature in patients with CD (28% vs. 11%, p<0.001). The difference in the prevalence of overweight was not significant.

We provide more accurate prevalence estimate of nutritional disorders in Saudi children with IBDs based on national reference. The use of the WHO reference overestimated the prevalence of thinness and short stature in Saudi children. Prevalence estimates based on references from other populations should be interpreted with caution.

We provide more accurate prevalence estimate of nutritional disorders in Saudi children with IBDs based on national reference. The use of the WHO reference overestimated the prevalence of thinness and short stature in Saudi children. Prevalence estimates based on references from other populations should be interpreted with caution.

Endoscopic submucosal dissection (ESD) is widely used as a treatment modality for gastric mucosal neoplasia. While proton pump inhibitors (PPIs) have been used for the control of artificial ulcers created by ESD (ESD-ulcers), complete healing of the ulcers is not always achieved in all the cases. The purpose of this study was to identify the clinical factors that are predictive of refractory ESD-ulcers.

We recruited 90 patients with 102 artificial ulcers that formed after the patients underwent ESD for gastric tumours. All the patients received a 20-mg capsule of esomeprazole daily until the 56th day after ESD, and underwent endoscopy at 1, 4, 6 and 8weeks after the ESD. We analyzed the clinical factors that were associated with the complete healing at 8weeks after the ESD (CH-8w). The ulcers in the scar stage were defined as the complete healing in this study.

Of the 102 ESD-ulcers, 16.7% failed to show complete healing after the 8weeks of PPI therapy. Univariate analysis identified the percent reduction of the ulcer size at 4weeks after ESD (PR-4w) as being significantly associated with CH-8w. Multivariate analysis identified ulcer location in the lower-third of the stomach and PR-4w>95% as being independently correlated with the CH-8w (odds ratio=4.86 and 7.89, respectively). Analysis of the area under the receiver operating characteristic (AUROC) curve demonstrated that the AUROC curve of PR-4w for predicting the CH-8w was 0.78.

Based on the results of our study, endoscopic observation at 4weeks after ESD would help in the early identification of refractory ESD-ulcers.

Based on the results of our study, endoscopic observation at 4 weeks after ESD would help in the early identification of refractory ESD-ulcers.

To determine the reliability of subjective and objective quantification of mitral annular calcification (MAC) in elderly patients with severe aortic stenosis, to define quantitative sex- and age-related reference values of MAC, and to correlate quantitative MAC with mitral valve disease.

In this retrospective, IRB-approved study, we included 559 patients (268 females, median age 81 years, inter-quartile range 77-85 years) with severe aortic stenosis undergoing CT. Four independent readers performed subjective MAC categorization as follows no, mild, moderate, and severe MAC. Two independent readers performed quantitative evaluation of MAC using the Agatston score method (Agatston

). Mitral valve disease was determined by echocardiography.

Subjective MAC categorization showed high inter-reader agreement for no (k=0.88) and severe MAC (k=0.75), whereas agreement for moderate (k=0.59) and mild (k=0.45) MAC was moderate. Intra-reader agreement for subjective MAC categorization was substantial (k=0.69 and 0.subjective MAC assessment. Women show higher AgatstonMAC scores than men, particularly in the elderly population. AgatstonMAC shows high accuracy to diagnose mitral stenosis.An objective law was observed that naive case fatality rates (CFRs) of a disease will decrease early and then gradually increase infinitely near the true CFR as time went on during an outbreak. The normal growth of naive CFR was an inherent character rather than indicating the disease was becoming more severe. According to the law, by monitoring real-time naive CFRs, it can help outbreak-controllers know if there were many cases left unconfirmed or undiscovered in the outbreak. We reflected on the use of the naive CFR in the context of COVID-19 outbreaks. The results showed that Hubei Province of China, France and South Korea had cases that were not confirmed in a timely manner during the initial stages of the outbreak. Delayed case confirmations existed for long periods of time in France, Italy, the United Kingdom, the Netherlands and Spain. Monitoring of real-time naive CFRs could be helpful for decision-makers to identify under-reporting of cases during pandemics.The outbreak of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is thought to have occurred first in Wuhan, China in December 2019, before spreading to over 120 countries in the months that followed. It was declared a "public health emergency of international concern" by the World Health Organization on January 31, 2020 and recognized as a pandemic on March 11, 2020. The primary route of SARS-CoV-2 transmission from human to human is through inhalation of respiratory droplets. Devising protective technologies for stopping the spread of the droplets of aerosol containing the viral particles is a vital requirement to curb the ongoing outbreak. However, the current generations of protective respirator masks in use are noted for their imperfect design and there is a need to develop their more advanced analogues, with higher blockage efficiency and the ability to deactivate the trapped bacteria and viruses. It is likely that one such design will be inspired by nanotechnologies. Here we describe a new design from Egypt, utilizing a reusable, recyclable, customizable, antimicrobial and antiviral respirator facial mask feasible for mass production. The novel design is based on the filtration system composed of a nanofibrous matrix of polylactic acid and cellulose acetate containing copper oxide nanoparticles and graphene oxide nanosheets and produced using the electrospinning technique. Simultaneously, the flat pattern fabricated from a thermoplastic composite material is used to provide a solid fit with the facial anatomy. This design illustrates an effort made in a developing setting to provide innovative solutions for combating the SARS-CoV-2 pandemic of potentially global significance.

The purpose of this study is to compare the micromotion of various tibial reconstruction strategies including short cemented and long cementless stems with or without metaphyseal augmentation.

A moderate tibial bone defect was milled into dual density polyurethane test blocks. Mechanical testing was performed on 4 test constructs (1) short cemented stem (75-mm total length) alone; (2) short cemented stem with a symmetric metaphyseal cone; (3) a press-fit (175-mm total length) diaphyseal engaging tibial construct without a cone, and (4) the same press-fit tibial construct with a metaphyseal cone augment. Micromotion of the baseplate/cone construct with respect to the tibia block was measured during a stair descent loading profile for 10,000 cycles. The peak-to-peak micromotion of these various tibial constructs was compared. Unpaired t-tests were used to evaluate differences in peak-to-peak micromotion among the various tibial constructs tested. An analysis of variance was performed for final validation.

The cemented short stem demonstrated similar varus/valgus displacement, internal/external rotation, compression, and lift-off micromotion values under loading compared to a cementless long stem. A tibial cone improved compression and lift-off micromotion for both cemented and cementless constructs. A short 50-mm cemented stem with a cone demonstrated a lower micromotion at the anterior SI location compared to a press-fit 150-mm cementless stem without a tibial cone.

A short cemented tibial component with a cone achieved similar micromotion during simulated stair descent compared to a cementless diaphyseal press-fit implant in cases of moderate tibial defects.

A short cemented tibial component with a cone achieved similar micromotion during simulated stair descent compared to a cementless diaphyseal press-fit implant in cases of moderate tibial defects.

Approximately 15%-20% of total knee arthroplasty (TKA) patients do not experience clinically meaningful improvements. Selleck Ridaforolimus We sought to compare the accuracy and parsimony of several machine learning strategies for developing predictive models of failing to experience minimal clinically important differences in patient-reported outcome measures (PROMs) 1 year after TKA.

Patients (N= 587) in 3 large Veteran Health Administration facilities completed PROMs before and 1 year after TKA (92% follow-up). Preoperative PROMs and electronic health record data were used to develop and validate models to predict failing to experience at least a minimal clinically important difference in Knee Injury and Osteoarthritis Outcome Score (KOOS) Total, KOOS JR, and KOOS subscales (Pain, Symptoms, Activities of Daily Living, Quality of Life, and recreation). Several machine learning strategies were used for model development. Ten-fold cross-validation and bootstrapping were used to produce measures of overall accuracy (C-statistic, Brier Score). The sensitivity and specificity of various predicted probability cut-points were examined.

The most accurate models produced were for the Activities of Daily Living, Pain, Symptoms, and Quality of Life subscales of the KOOS (C-statistics 0.76, 0.72, 0.72, and 0.71, respectively). Strategies varied substantially in terms of the numbers of inputs required to achieve similar accuracy, with none being superior for all outcomes.

Models produced in this project provide estimates of patient-specific improvements in major outcomes 1 year after TKA. Integrating these models into clinical decision support, informed consent and shared decision making could improve patient selection, education, and satisfaction.

Level III, diagnostic study.

Level III, diagnostic study.