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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]

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 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]

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]

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: 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]

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]

Abstract: Background: There is a paucity of data regarding acute myocardial infarction (MI) complicated by cardiogenic shock (AMI-CS) in the Gulf region. This study addressed this knowledge gap by examining patients experiencing AMI-CS in the Gulf region and analyzing hospital and short-term follow-up mortality. Methods: The Gulf-Cardiogenic Shock registry included 1,513 patients with AMI-CS diagnosed between January 2020 and December 2022. Results: The incidence of AMI-CS was 4.1% (1,513/37,379). The median age was 60 years. The most common presentation was ST-elevation MI (73.83%). In-hospital mortality was 45.5%. Majority of patients were in SCAI (Society for Cardiovascular Angiography and Interventions shock classification) stage D and E (68.94%). Factors associated with hospital mortality were previous coronary artery bypass graft (odds ratio [OR]: 2.49; 95% confidence interval [CI]: 1.321-4.693), cerebrovascular accident (OR: 1.621; 95% CI: 1.032-2.547), chronic kidney disease (OR: 1.572; 95% CI: 1.158-2.136), non-ST-elevation MI (OR: 1.744; 95% CI: 1.058-2.873), cardiac arrest (OR: 5.702; 95% CI: 3.640-8.933), SCAI stage D and E (OR: 19.146; 95% CI: 9.902-37.017), prolonged QRS (OR: 10.012; 95% CI: 1.006-1.019), right ventricular dysfunction (OR: 1.679; 95% CI: 1.267-2.226), and ventricular septal rupture (OR: 6.008; 95% CI: 2.256-15.998). Forty percent had invasive hemodynamic monitoring, 90.02% underwent revascularization, and 45.80% received mechanical circulatory support (41.31% had intra-aortic balloon pump and 14.21% had extracorporeal membrane oxygenation/Impella devices). Survival at 12 months was 51.49% (95% CI: 46.44%-56.29%). Conclusions: The study highlighted the significant burden of AMI-CS in this region, with high in-hospital mortality. The study identified several key risk factors associated with increased hospital mortality. Despite the utilization of invasive hemodynamic monitoring, revascularization, and mechanical circulatory support in a substantial proportion of patients, the 12-month survival rate remained relatively low., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by the Shock Society.)