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Knee osteoarthritis is often treated surgically (knee joint replacement) or non-surgically (physiotherapy, pharmacological treatment). However, interventional radiologists can also offer a number of image-guided percutaneous therapies, including pharmacological treatments (intra-articular steroid, local anesthetic, and hyaluronic acid injections), biological options (platelet-rich plasma or mesenchymal stem cell injections), and newer nonpharmacological therapies (neuroablation, neuromodulation, and genicular artery embolization). Intra-articular steroid injection is the most widely used radiologically guided therapy; it provides pain relief and can help confirm the joint as the source of pain. However, platelet-rich plasma injection may provide greater pain relief and functional improvement compared with other intra-articular injections. Mesenchymal stem cell injections may improve pain, function, and cartilage volume, but the therapy is still under clinical investigation. Neuroablation and neuromodulation achieve pain reduction by targeting the sensory nerves of the knee joint. Radiofrequency ablation has been shown to be more effective than intraarticular steroid injections at treating knee osteoarthritis pain and function. Potential advantages of neuromodulation over conventional radiofrequency ablation include less intraprocedural pain and lower risk of thermal damage to adjacent structures. Genicular artery embolization aims to downregulate inflammation and its downstream effects by altering synovial blood flow; it is considered a promising therapy for osteoarthritis-associated knee pain. [ABSTRACT FROM AUTHOR]

The aim of the study is to identify the most commonly used personalized learning strategies in higher education in Saudi Arabia and explore the conditions for effective implementation of these strategies. In this study, a mixed-methods approach was employed, which involved conducting a survey of 390 students and conducting interviews with 18 students across three universities in Saudi Arabia. The findings reveal that the most commonly used personalized learning strategies are tailoring instruction to individual needs and preferences, providing one-on-one support and guidance, and allowing for student choice and autonomy. Flexible pacing and learner agency were also identified as important strategies, while adaptive assessment was found to be the least commonly used strategy. The study suggests that adequate resources, training and support, collaboration and communication, flexibility and adaptability, assessment and feedback, and clear goals and expectations are necessary for effective implementation of personalized learning strategies. These findings provide insights into the prerequisites for the successful execution of personalized learning approaches in tertiary education in Saudi Arabia and can serve as a blueprint for formulating impactful policies and practices that improve student-learning results. [ABSTRACT FROM AUTHOR]

This paper examines the effectiveness of using augmented reality (AR) with the ARCS (Attention, Relevance, Confidence, and Satisfaction) framework to improve student performance and motivation in primary schools in Saudi Arabia. A sample of 100 randomly selected primary school pupils from grades 4 to 6 were used in the study, and two motivational and learning use scales were used to collect data. The results of the study indicated that AR implementation using the ARCS framework significantly improved knowledge and motivation among the primary school students. The paper recommends that AR should be adopted in primary schools in Saudi Arabia, specifically for grades 4 to 6, as an effective method of enhancing student learning and motivation. [ABSTRACT FROM AUTHOR]

Cardiogenic shock (CS) associated with biventricular failure (BiVF) carries significant in-hospital morbidity and mortality. We describe here the successful use of percutaneous biventricular Impella (Bi-Pella) for cardiogenic shock secondary to acute biventricular myocardial infarctions (AMI-CS), as guided by parameters such as mixed venous oxygen saturation (SvO2), pulmonary artery pulsatility index (PAPi), central venous pressure (CVP), and cardiac power output (CPO). We aim to highlight the promising outcomes of timely implanted biventricular Impella in (AMI-CS). [ABSTRACT FROM AUTHOR]

This study serves as a follow-up on a 2020 study by Wang and Lund that examined the policy changes and announcement information provided by American public libraries during the early weeks of the coronavirus (COVID-19) pandemic, using the same list of libraries as the 2020 study to examine how the COVID response evolved over the past two years. Seven types of information were collected from the public libraries' websites, with the help of the Internet Archive to collect specific dates: frequency of announcement updates, date of start curbside/pickup services, date of reopening libraries, dates of posting vaccine-related information, dates of removal of COVID-19 related information, and dates of reopening face-to-face programs. The findings indicate that the timing of COVID response updates varied based on factors including the size of the municipality in which the public library is located and the political leaning of the municipality's voters. [ABSTRACT FROM AUTHOR]

Introduction. Middle East respiratory syndrome (MERS) outbreaks have had a considerable negative impact on health systems in Saudi Arabia. We aimed to study the psychological impact of a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak on emergency room resident physicians (ERRPs). Methods. We assessed the MERS-related psychological impact and concerns of ERRPs using a self-report questionnaire. Results. The majority (91%) of the ERRPs agreed that their work put them at risk of infection, but most (65%) did not agree that they should not be looking after patients infected with MERS. Despite that, 54% of ERRPs reported being afraid of contracting the infection from infected patients and only 4.2% of them were willing to change their current job. The majority of the ERRPs (85%) felt that their job would expose their families to risk of infection. Conclusions. Our study demonstrated the considerable psychological impact of MERS outbreaks on ERRPs. The ERRPs’ concerns and the psychological impact of MERS outbreaks should be considered in greater detail by hospital policymakers. [ABSTRACT FROM AUTHOR]

This study investigated the impact of crude oil pollution on different types of soils in Kuwait. For this purpose the oil trench, which consisted of diversity of soils was studied. Several boreholes were made to determine the extent of oil contamination in the soil matrix and its effects on soil chemical properties. The highest depth of oil pollution was measured in the Typic Torripsamments and Typic Petrogypsids and the highest width was at the Typic Aquisalids. This variation is due to physical and chemical characteristics of soil and the depth of the hardpan. Soil samples were collected from the different soil type layers in the oil trenches and also from reference (control) sites to compare the total petroleum hydrocarbon (TPH), total extractable matters (TEM) levels, soil pH, CaCO 3 and electrical conductivity (ECe). The Typic Calcigypsids soils showed the highest concentration of TPH and TEM, which were signi fi cantly higher in the oil trench by 99% than control. The soil pH and CaCo 3 were reduced in presence of oil and the soil ECe was signi fi cantly altered at the 95% level of con fi dence. The study showed that soil types behaved differently with crude oil pollution. [ABSTRACT FROM AUTHOR]

Background: The use of transcatheter aortic valve replacement (TAVR) is steadily increasing with TAVR procedures offered to patients across the entire spectrum of surgical risks. The Gulf TAVR registry captures the demographics of patients undergoing TAVR in the Gulf region, comorbidities that drive outcomes, procedural success, complications, and one-year outcomes of death or rehospitalization.Methods: This is a retrospective cohort study for adult patients aged at least 18 years undergoing TAVR at eight centers in the Gulf region. The primary outcome was a composite of death or re-hospitalization at one-year. Secondary outcomes included the individual components of the composite, stroke, and myocardial infarction (MI). We used multivariable Cox regression to determine factors associated with the composite endpoint.Results: A total of 795 patients (56% male) were included in the final analysis with a mean age of 74.6 (standard deviation (SD) 8.9) years, Society of Thoracic Surgeons Score (STS) Score 4.9 (4.2), ejection fraction of 53% (12.7%). Transfemoral approach was employed in over 95% (762/795). The primary outcomes rate was 12.8% (95% confidence interval [CI]: 10.6-15.4); secondary endpoints were death 5.4% (95% CI 4.0-7.2); stroke 0.8% (95% CI 0.3, 1.7), MI 0.8% (95% CI 0.4-1.9), rehospitalization: 9.3% (95% CI 7.5-11.5) of whom 71.6% were related to cardiovascular causes. 77% of the cardiovascular admissions were attributable to heart failure or the need for pacemaker implantation. Stage IV or V chronic kidney disease was significantly associated with the primary composite endpoint (Hazard Ratio: 2.49, [95% CI: 1.31, 4.73], p = 0.005). Although not significant, paravalvular leak and severe left ventricular dysfunction showed a 2-fold and 3-fold increased risk for the composite endpoint, respectively.Conclusions: The Gulf TAVR registry is the first of its kind in the region. It profiles an elderly population with a high procedural success rate and a low rate of complications. One-year outcomes were primarily driven by repeat hospitalization for heart failure and pacemaker implantation indicating a need to optimize heart failure management and improve algorithms for the detection of conduction abnormalities. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this article is to review the embryology of the lower limb arterial anatomy along with common variants and their clinical relevance. Design: Embryologic variations of the lower limb arterial system may be explained by i.) persistence of primordial arterial segments, ii.) abnormal fusion, iii.) segmental hypoplasia/absence, or a combination of both. Persistent sciatic artery, corona mortis, and popliteal entrapment syndrome will also be discussed with associated symptoms, and potential complications. Conclusion: Knowledge of these variations is essential for surgical and endovascular management as failure to recognize them can result in complications. [ABSTRACT FROM AUTHOR]