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Abstract Understanding root canal morphology is essential for successful endodontic treatment. This study aimed to investigate morphological variations in root and canal systems of anterior and premolar teeth across different age groups and genders in a Saudi Arabian subpopulation using a novel classification system. A total of 3573 maxillary and mandibular anterior and premolar teeth in 209 patients were examined using cone-beam computed tomography (CBCT) in a Saudi subpopulation. The number of roots was identified, and root canal configurations were classified according to Ahmed et al. coding system (Int Endod J 50(8):761–770, 2017). Demographic data including gender (male and female) and age (divided into 6 groups—10–20, > 20–30, > 30–40, > 40–50, > 50–60, > 60–70) were recorded. The Chi-square test was used for statistical analysis, and the significance level was set at 0.05 (P = 0.05). Results showed that maxillary and mandibular central incisors, lateral incisors, and canines predominantly exhibited the 1TN1 configuration. Maxillary first premolars had a higher prevalence of double-rooted variants with code 2TN B1 P1. Maxillary second premolars more frequently displayed the 1TN1–2−1 configuration. No significant gender and age differences were observed in maxillary anterior and premolar teeth (p > 0.05). A number of supplemental configurations such as 2TNB1–2P1, 3TN MB1 DB1 P1, and 3TN 1(MB1 DB1) P1 were noted in maxillary premolars. For mandibular anteriors, results showed no significant difference by gender, but for age, mandibular incisors showed more prevalence of complex canal configurations up to 40 years. However, the difference with other age groups (> 40–70 years) was not statistically significant (p 0.05). Several supplemental configurations such as 1TN1–2−3, 1TN1–2−3−2, 2TN B1/L1, and 2TN 1B1/L1) were noted in mandibular first premolars. This study identified a wide range of root and canal anatomical variations in anterior and premolar teeth within a Saudi subpopulation. The findings revealed that while age influenced the complexity of root canal systems in mandibular incisors, no significant association between gender and canal complexity was observed. The Ahmed et al. classification system offered a detailed analysis of these complex variations, providing a clear understanding of the root canal morphology in this population.

BACKGROUND: ICU and other patients hospitalized with corona-virus disease 2019 (COVID-19) are more susceptible to secondary infections. Undetected secondary infections tend to have a severe clinical impact, associated with prolonged hospitalization and higher rates of inpatient mortality. OBJECTIVES: Estimate the prevalence of secondary infections, determine the frequency of microbial species detected at different body sites, and measure the association between secondary infections and outcomes among hospitalized COVID-19 patients. DESIGN: Cross-sectional analytical study. SETTING: Tertiary care center in Riyadh PATIENTS AND METHODS: Data were collected through retrospective chart review of hospitalized COVID-19 patients >18 years old from March 2020 until May 2022 at King Saud University Medical City (27 months). Rates of secondary infections among hospitalized COVID-19 patients were described and data on clinical outcomes (intensive care admission, invasive management procedures and mortality) was collected. MAIN OUTCOME MEASURES: Features and rates of infection and mortality. SAMPLE SIZE: 260 RESULTS: In total, 24.2% of the study population had secondary infections. However, only 68.8% of patients had secondary infection testing, from which 35.2% had a confirmed secondary infection. These patients had a significantly higher prevalence of diabetes mellitus (P

Background: The suboptimal implementation of guideline-directed medical therapy (GDMT) for heart failure (HF) patients has been linked with poor clinical outcomes. Little is known about the potential role of cardiology residency training programs in improving trainees’ (ie, future cardiologists’) ability to utilize GDMT. Methods: In this survey-based study, we examined the degree of exposure to ambulatory HF patient management among cardiology trainees in Canada. All cardiology residency program directors (n = 15; 100% response rate) completed our survey. Results: Although 9 programs (60%) mandated ≥ 3 ambulatory cardiology rotations, only 3 (20%) required ≥ 2 ambulatory HF rotations. When HF rotations were provided, only 7 programs (47%) offered moderate or higher exposure to ambulatory nontransplant HF patients (defined as ≥ 5 clinics/rotations). This element was independent of program- and institution-specific characteristics. All institutions had a multidisciplinary HF clinic, and the majority (13 [87%]) had access to an inpatient HF service, a consultative HF service, and/or a specialist pharmacist. Furthermore, 13 program directors (87%) agreed on the importance of adopting HF training curriculum and their program’s readiness to implement such a module. Conclusions: The current state of HF training among cardiology residencies is suboptimal and in need of improvement. Most programs have access to a HF clinic, a specialist pharmacist, or an inpatient consultative service, which would facilitate adoption of a HF management curriculum that focuses on practical and experiential aspects of GDMT optimization. This program, which is under development, will be offered to training programs nationwide, to enable trainees to manage this growing and increasingly complex patient population. Résumé: Contexte: Une mise en application sous-optimale des traitements médicaux recommandés dans les lignes directrices (TMRLD) dans les cas de patients atteints d’insuffisance cardiaque (IC) a été associée à des issues cliniques défavorables. On en sait peu sur le rôle éventuel des programmes de résidence en cardiologie sur l’amélioration des capacités des stagiaires (c.-à-d. des futurs cardiologues) à mettre en œuvre les TMRLD. Méthodologie: Notre étude s’appuyant sur un sondage a permis d’examiner le niveau d’exposition des stagiaires en cardiologie au Canada à la prise en charge des patients ambulatoires atteints d’IC. La direction de tous les programmes de résidence en cardiologie (n = 15; taux de réponse de 100 %) a participé à notre sondage. Résultats: Alors que neuf programmes (60 %) exigeaient ≥ trois stages en cardiologie ambulatoire, seulement trois d’entre eux (20 %) exigeaient ≥ deux stages en IC ambulatoire. Parmi les programmes offrant des stages en IC, seulement sept (47 %) offraient une exposition modérée à élevée à des patients ambulatoires atteints d’IC et n’ayant pas reçu de greffe (cette exposition était établie à cinq cliniques par stage ou plus); le niveau d’exposition à ces patients ne dépendait pas des caractéristiques du programme ou de l’établissement. Dans tous les établissements, une clinique multidisciplinaire spécialisée en IC était présente, et la majorité d’entre eux (13 [87 %]) bénéficiaient également d’un service pour les patients hospitalisés atteints d’IC, d’un service de consultation en IC et/ou de la présence d’un pharmacien spécialisé. De plus, la direction de 13 programmes (87 %) se disait en accord avec l’importance d’adopter un curriculum de formation portant sur l’IC et considérait que leur programme était prêt à intégrer un tel module. Conclusions: L’état actuel de la formation en IC dans les programmes de résidence en cardiologie n’est pas optimal, et des améliorations sont nécessaires. La plupart des programmes ont accès à une clinique en IC, un pharmacien spécialisé ou un service de consultation pour les patients hospitalisés, ce qui pourrait faciliter l’adoption d’un curriculum de prise en charge de l’IC portant sur l’expérience concrète de l’optimisation des TMRLD. Ce module, qui est en cours d’élaboration, sera offert à tous les programmes de formation à travers le Canada, pour permettre aux stagiaires de mieux prendre en charge cette population de patients qui gagne en nombre et en complexité.

Understanding root canal morphology is essential for successful endodontic treatment. This study aimed to investigate morphological variations in root and canal systems of anterior and premolar teeth across different age groups and genders in a Saudi Arabian subpopulation using a novel classification system. A total of 3573 maxillary and mandibular anterior and premolar teeth in 209 patients were examined using cone-beam computed tomography (CBCT) in a Saudi subpopulation. The number of roots was identified, and root canal configurations were classified according to Ahmed et al. coding system (Int Endod J 50(8):761–770, 2017). Demographic data including gender (male and female) and age (divided into 6 groups—10–20, > 20–30, > 30–40, > 40–50, > 50–60, > 60–70) were recorded. The Chi-square test was used for statistical analysis, and the significance level was set at 0.05 (P = 0.05). Results showed that maxillary and mandibular central incisors, lateral incisors, and canines predominantly exhibited the 1TN1 configuration. Maxillary first premolars had a higher prevalence of double-rooted variants with code 2TN B1 P1. Maxillary second premolars more frequently displayed the 1TN1–2−1 configuration. No significant gender and age differences were observed in maxillary anterior and premolar teeth (p > 0.05). A number of supplemental configurations such as 2TNB1–2P1, 3TN MB1 DB1 P1, and 3TN 1(MB1 DB1) P1 were noted in maxillary premolars. For mandibular anteriors, results showed no significant difference by gender, but for age, mandibular incisors showed more prevalence of complex canal configurations up to 40 years. However, the difference with other age groups (> 40–70 years) was not statistically significant (p < 0.05). For mandibular premolars, the code 1TN1 was observed in more than 90% of the teeth with no significant differences in gender and age groups (p > 0.05). Several supplemental configurations such as 1TN1–2−3, 1TN1–2−3−2, 2TN B1/L1, and 2TN 1B1/L1) were noted in mandibular first premolars. This study identified a wide range of root and canal anatomical variations in anterior and premolar teeth within a Saudi subpopulation. The findings revealed that while age influenced the complexity of root canal systems in mandibular incisors, no significant association between gender and canal complexity was observed. The Ahmed et al. classification system offered a detailed analysis of these complex variations, providing a clear understanding of the root canal morphology in this population. [ABSTRACT FROM AUTHOR]

Implantable bioelectrodes have the potential to advance neural sensing and muscle stimulation, mainly in patients with peripheral nerve injuries. They function as the transducer at the interface between the damaged nerve and the muscle which is controlled by that nerve. This work reports the fabrication and characterization of novel, low-cost, flexible bioelectrodes based on polyaniline (PANI) and supported with silicone polymer. The fabricated electrodes were evaluated for their electrical and mechanical characteristics. PANI was used as the main transducer component in this fabrication. The characterization methods included electrical conductivity, capacitive behavior, long-term electrical impedance, and mechanical evaluation. The results of the fabricated PANI-silicone-based samples displayed a bulk impedance of 0.6 kΩ with an impedance of 1.6 kΩ at the frequency of 1 kHz. Furthermore, the bioelectrodes showed a charge storage capacity range from 0.0730 to 4.3124 C/cm2. The samples were stable when subjected to cyclic voltammetry tests. The bioelectrodes revealed very flexible mechanical properties as observed from the value of Young’s modulus (in the order of MPa) which was less than that of skin. Hence, the PANI-based bioelectrodes reported herein showed promising electrochemical characteristics with high flexibility.

Abstract Along with its heavy toll of morbidity and mortality, the coronavirus disease 2019 (COVID-19) pandemic exposed several limitations of the current global research response. The slow and inefficient process of carrying out traditional randomized clinical trials led regulatory authorities to hastily approve treatments and tests without sufficient evidence of safety and efficacy. We here outline issues with the current research platform, summarize shortcomings of traditional randomized clinical trials particularly apparent at the time of pandemics, and highlight the advantages of pragmatic clinical trials as an alternative to rapidly generate the needed clinical evidence. We further discuss barriers and challenges to pragmatic clinical trials implementation and explore opportunities for research institutions and regulatory authorities to facilitate widespread adoption of this vital research tool. As a subsequent wave of COVID-19, and/or another epidemic, are all but inevitable in our lifetime, we must ensure that our research infrastructure is conducive to carrying out pragmatic clinical trials to expeditiously generate the needed evidence and blunt the epidemic’s toll on human lives and livelihoods.

Purpose: This review aimed to summarize the evidence on patient‐reported outcomes and clinical performance of digitally fabricated removable partial dentures (RPDs) compared to traditionally fabricated dentures. Methods: Three databases were systematically searched (PubMed, CENTRAL, and Wiley online library) for clinical studies comparing digitally and conventionally fabricated RPDs regardless of data acquisition methods used for fabrication. The Cochrane Collaboration risk of bias assessment tool 2 and the Oxford Center for Evidence‐based Medicine tool were used to assess risk of bias, and level of evidence, respectively. Descriptive narrative analysis was used to summarize data on patient‐reported outcomes, as there were inadequate studies to pool data in a meta‐analysis. A random‐effects model was used to analyze the data of framework fit accuracy. Results: Ten randomized controlled trials were included in the systematic review, and 4 were included in the meta‐analysis. Two studies showed that digitally fabricated RPDs are associated with higher patient satisfaction than conventionally fabricated RPDs (with a mean difference of 12.5 mm on a 100‐satisfaction scale, p =.008). The pooled standardized mean difference for framework fit accuracy was 0.49 (p = 0.02) in favor of conventionally fabricated RPDs, which showed that conventionally fabricated RPDs have a quantitatively better fit compared to digitally fabricated RPDs. However, clinical evaluation studies showed that both frameworks have clinically acceptable fit. Conclusions: Current evidence shows that digitally fabricated RPDs are associated with higher patient satisfaction compared to conventionally fabricated RPDs. However, the scarcity of literature here warrants the generalization of this conclusion. Both digitally and conventionally fabricated metal RPD frameworks showed acceptable fit clinically. [ABSTRACT FROM AUTHOR]

Introduction: Organ donation is widely contentious among the Saudi population though remains largely understudied. In the aim to understand the public perception of organ donation, willingness to donate, and the reasons for donation refusal, we carried out this study. Methodology: A cross-sectional questionnaire-based study was conducted on a stratified-by-region random sample of 2596 Saudi residents in Riyadh area between 15 and 70 years of age in March 2010. The main outcomes were rates of organ donation awareness, willingness to donate, and awareness of Islamic opinion permitting organ donation. Secondary exploratory analysis was performed to determine reasons for organ donation refusal. Results: Seventy-six percentage of the sample had some background knowledge of organ donation; however, 41% were unwilling to donate their organs, with only 30.1% of our sample having had a prior knowledge about Islamic opinion about organ donation. Overall, of those who had background knowledge of organ donation, 79.5% thought that organ donation was important or very important. Respondents who are women, older, more educated, and in higher income group were more likely to be aware of organ donation (P < 0.05) and those younger than 35 years old were more likely to be unaware of the Islamic opinion (P < 0.001). The most cited reasons for donation refusal included the desire to be buried with complete parts (43.8%) (i.e., not disfigured), having an incomplete idea about brain death (24%), and because they thought that it was forbidden in Islam (15.1%). Conclusion: The level of organ donation awareness was comparatively high, but knowledge of the Islamic views of organ donation lacked among high portion of our sample, which partially explains the high organ donation refusal rate. There remains a large need to promote public awareness about the importance of organ donation and to clear the confusion of the Islamic view.

Fusion is known as a developmental anomaly described by the union of two neighbouring teeth. The worldwide prevalence of bilaterally fused teeth in the primary dentition is about 0.02% which is considered very rare. Only few cases of bilateral fusion have been reported in Indian population. This paper presents a rare case of three-year-old boy with bilateral fusion of primary mandibular lateral incisors and canine teeth. Treatment consisted of pit and fissure sealants and topical fluoride application. To conclude, fused primary teeth are considered as harmless asymptomatic abnormality.

BACKGROUND AND OBJECTIVES: Despite the known benefits of support during chilbirth, most hospitals in Saudi Arabia do not allow a companion during labor. This can be due to cultural beliefs among pregnant Saudi women. The aims of this study are to describe Saudi women's preferences towards supportive companions during labor and to explore their attitudes and knowledge about the importance of support during childbirth. DESIGN AND SETTING: Prospective cohort study conducted in three governmental tertiary hospitals within Riyadh. SUBJECTS AND METHODS: Women who consented were interviewed during their postpartum hospital stay using a validated standardized Arabic questionnaire. Participants were asked about their preferences and attitudes towards companions during childbirth, as well as about their knowledge on the importance of such support. RESULTS: Of 402 women who participated in the study, 182 women (45.3%) preferred the presence of a companion during childbirth and only 57 of all interviewed women (14.2%) had ever had a supportive companion during any of their previous childbirths. The mother (58%) or husband (51%) was the most preferred person as a childbirth companion. Age, level of educational, or antenatal, intrapartum or postpartum status had no impact on their decision. However, women who had some sort of antenatal educational classes and/or read educational material about childbirth were more likely to prefer support during labor. More than one-third of participants (35.9%) thought that having a companion as support during labor would not help, but the most common reason for not preferring to have a companion was their fear of being exposed most of the time to their companion (64.1%). CONCLUSIONS: A significant percentage of surveyed Saudi women preferred not to have a supportive companion during childbirth. The reason might be a lack of understanding of the positive role of a companion during childbirth or because of cultural beliefs. Education of women during their antenatal care about the importance and the implementation of such a practice are warranted.