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Background: The development of heart failure is a turning point in the natural course of aortic stenosis (AS). Pulmonary oedema and elevated left ventricular pressure (LVP) are cardinal features of heart failure. Evaluating pulmonary oedema by lung ultrasound involves taking the upper hand with a bedside noninvasive tool that may reflect LVP. Aim: We sought to assess the correlation between sonographic pulmonary congestion, invasive LV pre-A pressure, and echocardiographic LV end-diastolic pressure (LVEDP) in symptomatic AS patients receiving transcatheter aortic valve replacement. Methods: Forty-eight consecutive patients with severe AS and planned transcatheter aortic valve implantation (TAVI) were enrolled. LVEDP was estimated to be normal or elevated using the ASE/EACVI algorithm and transmitral Doppler indices, the E/A ratio, the E/e′, and the left atrial volume index. Invasive LV pre-A pressure was used as a reference, with > 12 mm Hg defined as elevated. Results: Forty-eight patients (25 women (52%), mean age 75 years, standard deviation (SD) ± 7.7 years) were enrolled in the study. We detected severe B-lines (≥ 30) in 13 (27%) patients and moderate B-lines (15–30) in 33 (68.6%) patients. The number of B-lines increased significantly with the severity of New York Heart Association (NYHA) functional classes (Fig. 1). The B-line count was 14 ± 13 in NYHA class I patients, 20 ± 20 in class II patients, and 44 ± 35 in class III patients (p < 0.05, rho = 0.384). The number of B-lines was correlated with the E/E' ratio (R = 0.664, p < 0.0001) and the proBNP level (R = 0. 882, p < 0.008). We found no significant correlation with the LVEDP or LVEF. The LVEDP correlated well with the E/E' ratio (R = 0.491, p < 0.001) but not at all with E/A, DT, or LAVI. All patients had an elevated LVEDP > 12, with a mean pressure of 26 mmHg, a minimum of 13 mmHg, and a maximum of 45 mmHg, with an SD of 7.85. Conclusion: Assessing lung ultrasonic B-lines is a straightforward and practical approach to identifying pulmonary oedema in AS patients. The number of B-lines correlated with the E/E' ratio and the functional status of patients but did not correlate with invasive LVEDP or LVEF. All patients had elevated LVEDP that correlated with E/E'. [ABSTRACT FROM AUTHOR]

This study aimed to examine the factors influencing the behavioral intent of faculty members to use augmented reality (AR) technologies to support student learning. The Technology Acceptance Model (TAM), the Unified Theory of Acceptance and Use of Technology (UTAUT), and the Theory of Planned Behavior (TPB) were adopted as the theoretical framework for the study. The study involved 326 faculty members from four universities in Saudi Arabia. Data were collected through an online survey that included measurements of the constructs of interest. Results indicated that teachers' perceived usefulness, perceived ease of use, attitudes toward technology, perceived behavioral control, social norms, and resource availability had significant positive effects on their behavioral intent to use AR technologies. Additionally, mediation analyses revealed that teachers' perceived benefits and confidence in using AR technologies, as well as support from the teaching community and institution, mediated the relationship between the independent variables and their behavioral intention to use AR technologies. These findings have important implications for the implementation of AR technologies in educational institutions and underscore the need to provide teachers with training and resources to increase their confidence and perceived benefits of using AR technologies. [ABSTRACT FROM AUTHOR]

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]

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]

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]

Summary: Transcatheter aortic valve replacement (TAVR) is an alternative treatment for selected patients with severe aortic valve stenosis who are at high risk for conventional surgery. Critical stenosis of left main coronary artery as a late complication after TAVR is quite rare. [ABSTRACT FROM AUTHOR]

Introduction: C-shaped root canal anatomical variations cause challenges in endodontics treatment. This study investigated the prevalence of C-shaped root canals in mandibular second molars in the Kuwaiti population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images of sound mature mandibular second molars of 247 Kuwaiti patients were collected from government dental centers. An endodontist and radiologist examined the images to determine the presence of C-shaped canals. They were evaluated at four levels (canal orifice, coronal, middle, and apical thirds of root). Data were collected and statistically analyzed. Results: One hundred and forty-nine scans and 199 teeth belonging to 62 males and 87 females aged 16–56 years were included. C-shaped canals were found in 26 (13.07%) cases and were more common in females. Females were more likely to have bilateral C-shaped canals (P < 0.05). C2 was the most frequent morphology type at the orifice and coronal levels (53.9%) and apical levels (38.5%). An uninterrupted "C" shape was seen in 4 teeth (15.39%). A lingual longitudinal groove with the buccal notch (groove Type II) was seen in 14 teeth (53.85%). Conclusion: The prevalence of C-shaped canals in the mandibular second molars of a Kuwaiti population was higher than studies performed in the Middle-East population. The morphology type of C-shaped canal in mandibular second molars varied between the root levels. Radicular groove with buccal notches was most frequently located on the lingual side. [ABSTRACT FROM AUTHOR]

Limited data exist regarding knowledge and perceptions of surgeons and patients about robotic-assisted surgery (RAS) in the Middle East. This study aimed to explore perceptions of surgeons and patients about RAS. A questionnaire-based survey was distributed among surgeons of different specialties and patients. Between March and September 2019, 278 and 256 surveys were completed by surgeons and patients, respectively (95.2% and 94.8% response rate, respectively). The surgeons' self-reported experience with technology was related to the level of comfort with computers and computer literacy. Most surgeons have heard of RAS availability, and the majority agreed to its introduction into the healthcare system. However, only 75 (27%) of the surgeons thought that the surgeon has complete control over the robot, and 69 (25%) surgeons were not sure of the level of control the surgeon has over the robot reflecting poor knowledge about this technology. Less than a third of patient respondents have heard of RAS. However, half of them would consider it should they need to undergo surgery. When compared to open surgery, 23 (9%), 26 (10%), and 94 (37%) patient respondents thought that RAS caused less pain, had fewer complications, and was faster than conventional surgery, respectively. Knowledge and perceptions about RAS are limited among surgeons and patients in Kuwait. Efforts should focus on increasing awareness. [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]

Nowadays, data hiding techniques are one of the most growing researching areas. This paper introduces a quadruple histogram shifting-based reversible data embedding approach for digital images. Pixel differences distribution is utilized for maximizing the hiding payload capacity while preserving minimum degradations for stego-images. The improved histogram-based reversible data embedding algorithm is designed with the potential of maximizing the hiding payload capacity while keeping a perfect stego-image quality with data lossless. The proposed algorithm utilizes a 3 × 3 -box predictive filter and can hide 2-bits per pixel to increase the payload capacity. Firstly, an embedding phase has been performed by applying a numerical ordering strategy of the pixels to be predicted by the 3-by-3 box filter. The proposed algorithm is performing this ordering strategy in four stages to avoid affecting the follow-up prediction of all other pixels. In the other side, an extracting phase has been performed by reversing the four stages to generate the embedded data. The comparison with state-of-the-art schemes is performed to validate and guarantee the prevalence of the improved histogram-based reversible data embedding approach. The obtained test results demonstrated and confirmed that the proposed improved histogram-based reversible data embedding approach not only can improve the payload capacity but also can save the stego-image quality. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether low total psoas muscle area (tPMA), as a surrogate for sarcopaenia, is a predictor of adverse outcomes in patients undergoing advanced EVAR. Materials and Methods: A retrospective review of medical records was performed for 257 patients who underwent advanced EVAR (fenestrated or branched technique) in a single tertiary centre from 1 January 2008 to 1 September 2019. The study cohort was divided into tertiles based on tPMA measurement performed independently by two observers from a peri-procedural CT scan at the level of mid-L3 vertebral body. The low tertile was considered sarcopaenic. Logistic regression analysis was used to assess the association of tPMA with 30-day mortality and post-procedural complications. Univariable analysis and adjusted multivariable Cox regression were used to assess the association of tPMA with all-cause mortality. Results: A total of 257 patients comprised 193 males and 64 females with the mean age of 75.4 years (± 6.8) were included. Adjusted multivariable Cox regression revealed an 8% reduction in all-cause mortality for every 1 cm2 increase in tPMA, P < 0.05. TPMA was associated with 30-day mortality (OR 0.85, 95% CI 0.75–0.96, P < 0.05) and spinal cord ischaemia (SCI) (OR 0.89, 95% CI 0.82–0.97, P < 0.05). For remaining post-procedural complications, tPMA was not a useful predictive tool. TPMA correlated negatively with hospital stay length (rs-0.26, P < 0.001). Patients with lower tPMA were more likely to be discharged to a rehabilitation center (OR 0.93, 95% CI 0.87–0.98 , P < 0.05). Conclusion: Measurement of tPMA can be a useful predictive tool for adverse outcomes after advanced EVAR. Level of Evidence: Level 3, Retrospective cohort study. [ABSTRACT FROM AUTHOR]

The integration of technology tools into classrooms is a growing trend worldwide. Research studies indicate that technological tools are crucial in creating an environment in which students play an active role in the learning process. The Saudi Arabia government has heavily invested in the Information and Communication Technology (ICT) field, but is yet to fully benefit from the investment. There are a myriad of enablers and hindrances affecting the successful implementation of ICT in Saudi schools. Successful implementation of ICT can be realised through the promotion of constructivist learning environment. This study utilised mixed methodology approach in collecting data from teachers to evaluate the factors affecting effective ICT implementation in Saudi secondary schools. The factors affecting the practical use of educational technology include lack of management and technical support, time limitations, lack of ICT and pedagogical training, negative attitudes and beliefs towards educational technology, lack of clear policies and strategies on ICT adoption in learning institutions and resistance to change and inadequate technological resources. No single factor is capable of guaranteeing the successful ICT implementation in schools; therefore, a multifaceted approach is needed. [ABSTRACT FROM AUTHOR]

This study was designed to identify various barriers that have hindered the adoption of LMSs in Saudi Arabian universities. Learning management systems (LMSs) have been adopted in many learning institutions because of their functionalities and applications to improve pedagogy. Universities have been encouraged to use LMSs to enhance the collaborative working environment among students and between the students and their instructors. This study was done by administering 150 questionnaires to students in three universities in Saudi Arabia. Findings from the study revealed that the main barriers to the use of LMSs were inadequate technical support by the universities, negative attitude toward technology, and inadequate training on the LMS platforms. Minor barriers identified include poor Internet access and networking, limited infrastructure to support the LMS, lack of hardware and software to run the LMS, and challenges in English language proficiency. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper covers type one and two educational obstacles in using technology in the classrooms, and considering those obstacles tries to find the answer to the following overarching research question which can help to gauge some obstacles for the educational technology integration for elementary and high school education: What obstacles do teachers identify when integrating technology with instruction? This paper examines the educational obstacles like time to prepare materials and lessons for quality technology-rich lessons, policies and security restrictions, access to resources, and the level of comfort to use technology. Based on examining the type one and two obstacles, the goal is to gain a greater understanding as to why there is a disconnect between the seemingly common educational belief, that technology can and must be used in the twenty-first century classrooms, and actual classroom practices through evaluating the mentioned obstacles. [ABSTRACT FROM AUTHOR]

This paper demonstrates the potential of Saudi schools for technology leadership provided by Learning Resource Centres (LRCs) to enhance the formation of a technology-motivated educational environment. Using the grounded theory methodology and the CBAM stages of concern and levels of use this study sheds light on Saudi LRCs and their leadership role within the framework of the ongoing ICT-related education reform. From the interviews of the participants in the training programme at Northern Borders University, Saudi Arabia, it is found that Saudi schools require standardized technology leadership to implement standardized uses of technology via networked LRCs. The Saudi teachers with little knowledge of technology can use LRCs. [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]

Copyright of Kuwait Journal of Science is the property of Kuwait University, Academic Publication Council and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)