Search

Rheumatoid arthritis (RA) is a chronic autoimmune disease frequently treated with immunosuppressive agents such as methotrexate (MTX). Although MTX is generally well-tolerated, it can lead to adverse effects, including renal impairment. We present a case of a patient with newly diagnosed RA who developed severe renal impairment shortly after initiating MTX therapy. A 50-year-old male with recently diagnosed RA presented with vomiting, skin itching, mouth ulcers, and a pruritic rash, all occurring shortly after starting MTX treatment. These symptoms led to acute kidney injury (AKI), necessitating hemodialysis. The patient’s symptoms and laboratory findings were indicative of ANCA-associated small-vessel vasculitis with a picture of rapidly progressive glomerulonephritis (RPGN). Treatment included discontinuation of MTX, hemodialysis, immunosuppressive therapy with corticosteroids and cyclophosphamide, and patient education. This case emphasizes the need for close monitoring of RA patients initiated on MTX therapy and prompt evaluation of renal function. Clinicians should be vigilant for signs of renal impairment and be prepared to initiate appropriate interventions, including discontinuation of MTX and consideration of immunosuppressive therapy, to optimize patient outcomes. Further research is warranted to understand better the mechanisms underlying renal complications in RA patients receiving MTX treatment.

Despite the widespread use of social educational tools during the last decade in K12 education, the growth curve of utilizing these tools to enhance reading activities has remained lower than expected in learning environments. However, the rapid shift from face-to-face education to online education brought about by the pandemic has attracted educators who utilize these technologies to enhance reading scores among students. Drawing on data from Programme for International Student Assessment 2018, prediction models were conducted to investigate the effects of social reading activity tools on reading proficiency scores while controlling for other factors. The results indicate that reading emails, involvement in online chat (e.g., WhatsApp), reading online news, searching for information online to learn about particular topics and searching for practical information online (e.g., schedules) are significant predictors of higher reading proficiency scores. On the other hand, taking part in online group discussions or forums is a negatively significant predictor of reading proficiency scores. Moreover, reading proficiency scores differ depending on the types of schools students attended, their gender and their social, cultural and economic status when interaction was introduced in the model. These results should help educators as well as researchers to strategically utilize social reading activities according to the nature of the tasks they assign to students.

This study evaluated the usability of Large Language Models (LLMs), specifically ChatGPT, in assessing the completeness of reporting in orthodontic research abstracts. We focused on two key areas: randomized controlled trials (RCTs) and systematic reviews, using the CONSORT-A and PRISMA guidelines for evaluation. Twenty RCTs and twenty systematic reviews published between 2018 and 2022 in leading orthodontic journals were analyzed. The results indicated that ChatGPT achieved perfect agreement with human reviewers on several fundamental reporting items; however, significant discrepancies were noted in more complex areas, such as randomization and eligibility criteria. These findings suggest that while LLMs can enhance the efficiency of literature appraisal, they should be used in conjunction with human expertise to ensure a comprehensive evaluation. This study underscores the need for further refinement of LLMs to improve their performance in assessing research quality in orthodontics and other fields. [ABSTRACT FROM AUTHOR]

Background: Despite saving a vast number of lives through blood transfusions, transfusion-transmitted infections (TTIs) still threaten the lives of people needing blood transfusion. Hence, screening blood donors and reviewing the prevalence of TTIs amongst blood donors might show the impact of these infections among our people. The aim of this study was to evaluate the prevalence rates of transfusion-transmitted infections among blood donors in Makkah as foundation for providing harmless blood transfusion in Makkah, Saudi Arabia. Methods: A retrospective study was carried out at the Central Blood Bank in Makkah city, Saudi Arabia, from January 1, 2023, to December 31, 2023. A total of 13,706 samples were collected and screened for hepatitis B surface antigen (HBsAg), hepatitis B surface antibodies (HBsAbs), hepatitis B core antibodies (HBcAbs), antibodies to hepatitis C virus (anti-HCV), antibodies to HIV 1 and 2 (HIV I/II Ab), antibodies to HTLV 1 and 2 (HTLV I/II Ab), Malarial antibodies, and antibodies to VDRL. Results: A total of 13,706 blood units were received and tested. Out of the total, 52% were non-Saudi donors and 47.9% were Saudi donors; 28.4% were aged 18 - 28 years, 42.8% were aged 29 - 39 years, 24.4% were aged 40 - 50 years, and 4.4% were aged 51 - 60 years. The majority was O+ blood group (42.7%), followed by A+ (26.2%), B+ (18.7%), AB+ (4.6%), O- (3.8%), A- (2.1%), B- (1.5%), and AB- (0.4%). While 42.6% of the blood units donated were from voluntary donors, 57.4% were donated by replacement donors. Sixty-one samples (0.4%) tested positive for HBsAg, 824 samples (6%) for HBcAb, 43 samples (0.3%) for HCV antibodies, 754 samples (5.5%) for HBsAb, and 44 samples (0.3%) for HIV I/II Ag/Ab combinations. Further, 44 samples (0.3%) were positive for HTLV I/II antibodies, 83 samples (0.6%) for VDRL antibodies, and only 3 samples (nearly 0%) for malaria antibodies. Forty-three samples (0.3%) were positive for NAT-HBV, 7 samples (0.1%) were positive for NAT-HCV, and 6 samples (0.1%) were positive for NAT-HIV. The analysis revealed a statistically significant and strong correlation between HBsAgs and NAT-HBV (r = 0.819, p < 0.0001). In contrast, while there was a statistically significant association between HBsAgs and HBcAbs, the correlation was weak (r = 0.191, p < 0.0001). Additionally, there was an association between HBsAbs and HBsAgs, but the Spearman correlation indicated a very weak relationship (r = 0.042, p < 0.0001). Conclusions: Prevalence rates of transfusion-transmitted infections showed a steady decline in 2023, and these rates were much lower in Makkah than in other parts of the country or in neighboring countries. The importance of using NAT in the screening of blood donors was indicated in this study. These findings could contribute to improving the understanding of TTIs epidemiology and supporting health authorities in controlling blood-borne pathologies. [ABSTRACT FROM AUTHOR]

Though it is well-accepted that Task-Technology Fit theory is a useful framework for examining university student success in online courses, the effectiveness of the theory has rarely been studied with graduate-level students or with a sample representing more than a few universities or programs. The current study investigated learners' perceived performance in a national sample of students in over 400 graduate-level online learning environments through a path analysis involving five theoretically important constructs in the context of Task-Technology Fit theory. The results demonstrate that learners' perceived performance will by and large be most greatly influenced by the value of the task. "Task value" was the strongest predictor after controlling for other variables in the model, followed by "quality of content." Learner performance depends on how they perceive both the quality of the content as well as the design of the course itself. The "Ease of use," "relationships between users," and "technology satisfaction" had weaker relationships with performance, all leading to the understanding that online education organizations and information systems companies worldwide should emphasize usability when designing LMSs if the goal is to boost learners' performance and satisfaction.

This literature review will illustrate how writing could improve students' comprehension. Writing is one of the most important skills that students need to master for college level work. Therefore, students should be prepared with these skills before moving to the college level because they are required to write numerous papers that tend to be used for learning assessment. Writing not only helps professors to assess students, but it also helps students to enhance their reading comprehension; this is because students' writing is formed based on what they have read. Therefore, this means that reading comprehension is a critical skill for college level success. Reading comprehension is a complex process. In order to understand a text, the reader needs to recognize its words and access their meaning, the reader needs to activate related knowledge must be activated, and the reader needs to generate inferences as information is integrated during the time of reading. Thus, students' writing is affected by their reading, and how they understand what they have read. In this paper on the reading comprehension, the connection between reading and writing and the effects of writing on how students learn content will be discussed in light of the literature to illustrate importance in preparing students for writing they will do in their college classes.

Background: High blood pressure (BP) is a major risk factor for cardiovascular disease. The triglyceride-glucose (TyG) index is a useful tool for identifying insulin resistance at an early stage and has been proposed as a cost-effective predictor for hypertension. However, available studies are limited. This study aims to investigate the association between the TyG index and BP. Methods: Retrospective hospital data of a large cohort (n=1596) of adults aged ≥ 18 in Saudi Arabia were analyzed. The TyG index was calculated. Lipid markers, systolic BP (SBP), diastolic BP (DBP), and body mass index (BMI) were included. Results: Across quartiles of the TyG index, SBP was significantly higher in those with higher vs lower TyG (p< 0.03). No significant association was observed for DBP. A 2-SD higher SBP was significantly associated with a TyG difference of 1.7 (95% CI: 0.1, 3.3). In subgroup analysis, the relationship prevailed in females only [1.8 (95% CI: 0.3, 3.3)]. Across BMI categories (normal, overweight, obesity), the association between SBP and TyG was observed in participants with obesity only. Conclusions: The TyG index may act as a cost-effective predictive marker for high blood pressure, especially among specific subgroups. Future prospective studies are needed to confirm this relationship. [ABSTRACT FROM AUTHOR]

Background The minimal important difference (MID) is defined as the smallest difference that the patient perceives as important. Furthermore, the smallest worthwhile effect (SWE) is the important change measured with the benefit-harm trade-off method. The aim of this study was to evaluate the MID in orthodontic treatment duration to inform the decision regarding seeking procedures to accelerate orthodontic tooth movement and reduce treatment duration. Methods We constructed a survey eliciting views of the MID from adult participants from four countries undergoing orthodontic treatment. Ten questions addressed reduction in the treatment duration for both durations 12 and 24 months, and four questions were related to the reduction in treatment duration that the patients would require to undergo surgical or non-surgical adjunctive procedures. We applied a univariable random effects logistic regression model to examine the association between the participants' characteristics and the MID. Then, we fitted a multivariable logistic random effects regression including significant predictors. Results Four hundred and fifty adults, with a median age of 21 (interquartile range: 19–24), undergoing orthodontic treatment participated in the survey. Of the respondents, 60% considered 15 days as a trivial reduction from 12 months duration of therapy and 70% considered 15 days a trivial reduction from 24 months. Of the respondents, 48% considered the period of 2 months a moderate reduction from 12 months, and 60% considered 2 months a moderate reduction from 24 months. From these results, we inferred that patients considered reductions of approximately 1 month as the MID in the treatment duration for both 12 and 24 months. However, SWE was considerably more than the MID for most of the participants to decide undergoing surgical adjunctive procedures to reduce the time of therapy. The participants required smaller SWE to undergo non-surgical procedures compared to surgical procedures. Conclusion The MID in the treatment duration is one month for both treatment durations 12 and 24 months. Patients require a greater SWE than the MID to undergo adjunctive procedures to shorten the duration, particularly for surgical procedures. [ABSTRACT FROM AUTHOR]