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Radiation therapy in treatment of head and neck cancer has contributed to improved survival rate of cancer patients. However, this is accompanied by a potential rise in post radiation complications including radiation induced malignancies and osteoradionecrosis.Radiation Induced Osteosarcoma (RIOS) is rarely reported. In this paper, we report an unusual case of RIOS involving the parotid gland and mandible that was initially misdiagnosed as Osteoradionecrosis (ORN) provide a comprehensive review of the literature.

BackgroundRheumatoid arthritis (RA) can cause depression and anxiety. This study evaluated the factors associated with depression and anxiety in patients with RA and examined the effect of conventional and biologic disease-modifying antirheumatic drugs (DMARDs).MethodsThis cross-sectional study was conducted in a regional hospital in Riyadh between March and November 2022 and included 213 patients with RA. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS) and data about patients’ DMARDs use was obtained from the hospital’s medical records.ResultsBased on the HADS scores, 35 (16.4%) and 49 (23%) patients with RA had depression and anxiety, respectively. There was a significant association between the level of depression and anxiety and the use of leflunomide and tocilizumab among patients with RA (p = 0.006 and p = 0.009, respectively). Patients with RA who took leflunomide had significantly higher scores for anxiety (β = 0.158, value of p = 0.037) when compared to patients who did not take leflunomide. Patients with RA who took etanercept showed a significantly lower depression score even after adjusting for confounders, including sociodemographic, clinical, and lifestyle factors (β = −0.189, p = 0.043).ConclusionThe present study highlighted the prevalence of psychiatric disorders among patients with RA and the level of depression and anxiety may differ between patients with RA depending on the type of DMARDs used. We recommend patients with RA be screened regularly for depression and anxiety to avoid further extra-articular systemic complications associated with RA.

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor that typically arises from the skin. MCC is characterized by an aggressive behavior with frequent local recurrence, regional lymph node and distant metastasis. Non-cutaneous MCC has been reported in different locations infrequently. In this paper, we report an unusal case of primary Merkel Cell Carcinoma of the parotid gland and provide a comprehensive review of the literature of this rare entity.

BackgroundCoronavirus disease 2019 (COVID-19) is a rapidly spreading global pandemic. The clinical characteristics of COVID-19 have been reported; however, there is limited research investigating the clinical characteristics of COVID-19 in the Middle East. This study aims to investigate the clinical, radiological and therapeutic characteristics of patients diagnosed with COVID19 in Saudi Arabia.MethodsThis study is a retrospective single-centre case series study. We extracted data for patients who were admitted to the Al-Noor Specialist Hospital with a PCR confirming SARS-COV-2 between 12th and 31st of March 2020. Descriptive statistics were used to describe patients' characteristics. Continuous data were reported as mean ± SD. Chi-squared test/Fisher test were used as appropriate to compare proportions for categorical variables.ResultsA total of 150 patients were hospitalised for COVID-19 during the study period. The mean age was 46.1 years (SD: 15.3 years). The most common comorbidities were hypertension (28.8%, n = 42) and diabetes mellitus (26.0%, n = 38). Regarding the severity of the hospitalised patients, 105 patients (70.0%) were mild, 29 (19.3%) were moderate, and 16 patients (10.7%) were severe or required ICU care.ConclusionThis case series provides clinical, radiological and therapeutic characteristics of hospitalised patients with confirmed COVID-19 in Saudi Arabia.

The present study aimed to investigate the degree to which science teachers in the upper basic stage practice the required roles in light of the digital age demands amidst COVID-19. To that aim, the descriptive survey approach was used in addition to a questionnaire of 30 items spread over 3 domains: technological, social and research, in a form of scale developed distinctly for gathering data. Reliability and validity of these items were verified. The sample of the study consisted of (143) male and female science teachers. The statistical treatment of data involved using the means, standard deviations, and three-way MANOVA. The results of the study showed that the degree to which science teachers in the upper basic stage practice the required roles in light of the digital age demands amidst COVID-19 pandemic was moderate. Technological domain ranked first with a mean of (3.90) and got a high degree. Social domain ranked second with a mean of (3.31) while Research domain ranked last with a mean of (2.54) and both got a moderate degree. The findings also indicated that there were no statistically significant differences in the science teachers' practice attributed to the variables of gender, experience and education sector. The study reached several recommendations, the most important of which is educating teachers about the importance of practicing the required roles in light of the digital age demands amidst COVID-19 pandemic.

Abstract Introduction Image quality reduction due to metallic artefacts is a significant challenge during vascular computed tomography (CT) imaging of the lower extremities in patients with hip prostheses. This study aims to analyse various reconstruction algorithms' ability to reduce metal artefacts due to two types of hip prostheses during lower extremity CT angiography examinations. Methods A pelvis phantom was fabricated with the insertion of a tube filled with contrast media to simulate the femoral artery, and the phantom was then CT scanned with and without hip prostheses. Multimodal images were acquired using different kilovoltage peak (kVp) settings and reconstructed with different algorithms, such as filtered back projection (FBP), iterative reconstruction (iDose4), iterative model‐based reconstruction (IMR) and orthopaedic metal artefact reduction (O‐MAR). Image quality was assessed based on image noise, signal‐to‐noise ratio (SNR) and Hounsfield unit (HU) deviation. Results The IMR approach significantly improved image quality compared to iDose4 and FBP. For the vascular region, O‐MAR improves SNR by 5 ± 1, 23 ± 5 and 42 ± 9 for FBP, iDose4 and IMR respectively, and improves HU precision towards the baseline values by 49% and 83% for FBP and IMR, respectively. The noise reduction was 71% and 89% for FBP and IMR, and 57% for iDose4. O‐MAR greatly enhances SNR corrections among the most severe artefacts, with 29 ± 1 and 43 ± 4 for FBP and IMR, compared to iDose4 by 37 ± 7. Conclusion IMR combined with O‐MAR could improve the CT angiography of the lower extremities of patients with a hip prosthesis.

Background: Rheumatoid arthritis (RA) can cause depression and anxiety. This study evaluated the factors associated with depression and anxiety in patients with RA and examined the effect of conventional and biologic disease-modifying antirheumatic drugs (DMARDs). Methods: This cross-sectional study was conducted in a regional hospital in Riyadh between March and November 2022 and included 213 patients with RA. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS) and data about patients' DMARDs use was obtained from the hospital's medical records. Results: Based on the HADS scores, 35 (16.4%) and 49 (23%) patients with RA had depression and anxiety, respectively. There was a significant association between the level of depression and anxiety and the use of leflunomide and tocilizumab among patients with RA (p = 0.006 and p = 0.009, respectively). Patients with RA who took leflunomide had significantly higher scores for anxiety (ß = 0.158, value of p = 0.037) when compared to patients who did not take leflunomide. Patients with RA who took etanercept showed a significantly lower depression score even after adjusting for confounders, including sociodemographic, clinical, and lifestyle factors (ß = -0.189, p = 0.043). Conclusion: The present study highlighted the prevalence of psychiatric disorders among patients with RA and the level of depression and anxiety may differ between patients with RA depending on the type of DMARDs used. We recommend patients with RA be screened regularly for depression and anxiety to avoid further extraarticular systemic complications associated with RA. [ABSTRACT FROM AUTHOR]

Background: Cardiac arrest remains a critical global health challenge, necessitating effective interventions to improve outcomes. Autopulse Mechanical Chest Compression has emerged as a potential adjunct to conventional manual cardiopulmonary resuscitation (CPR). This study aimed to comprehensively investigate the association between Autopulse use and various outcomes following cardiac arrest. Methods: A thorough literature review was conducted using PubMed, Embase, Scopus, Google Scholar, CINAHL, and the Cochrane Library. Articles were evaluated for eligibility according to predefined criteria. The collected data was synthesized, and the findings were subsequently presented. Results: Sixteen studies were included in the study. A synthesis of diverse studies revealed nuanced perspectives on Autopulse Mechanical Chest Compression. Enhanced CPR success and improved survival rates in out-of-hospital cardiac arrest were demonstrated, while potential drawbacks were suggested, warranting scrutiny of device design and implementation strategies. Meta-analyses on ROSC favored Autopulse, indicating a statistically significant advantage over Manual CPR (relative risk 1.43, 95% CI 1.07-1.92). Complication analyses showed no significant difference (relative risk 1.11, 95% CI 0.93-1.33), emphasizing comparable safety profiles. Patient survival rates exhibited variations, with Autopulse demonstrating higher rates in some studies, but nuances were observed in 30-day survival and hospital discharge rates. Conclusion: Autopulse Mechanical Chest Compression holds promise as a supplementary strategy in cardiac arrest resuscitation. However, complexities arose in longer-term outcomes, highlighting the need for contextual considerations. [SJEMed 2024; 5(1.000): 030-041]

Objective: The objective of this systematic review is to assess the effectiveness of digital orthodontics in utilizing implants for maxillary protraction as a treatment for skeletal class III malocclusion in children. Materials and Methods: The study was registered with PROSPERO with the number CRD42023407406 on 23/03/2023. We conducted an extensive comprehensive literature search in nine electronic databases, including PubMed, PubMed Central, Scopus, Cochrane databases, Google Scholar, MEDLINE, EMBASE, LILACS, and the Web of Sciences databases. The studies were evaluated for their methodology, the intervention technology used, the outcomes, and their quality. Publication bias assessment was conducted using the Jadad scale and the ROBINS-I assessment tool. Results: We included a total of 17 studies that comprised a total of 376 patients in this analysis. The number of patients and participants fluctuated between 1 and 71, with > 60 % being female. The patients were aged between 1.1 and 19.2 years. We included only nine studies in the meta-analysis, in which we observed a success rate between 71.4 % and 100 % with a 95 % CI of 17.4 ± 2.988 (±17.2 %) [14.412–20.388]. The failure rates, although minimal, ranged from 5.9 % to 28.6 %, with a 95 % CI of 2.3 ± 1.480 (±64.3 %) [0.820–3.780]. Conclusion: The evidence suggests that digital orthodontics is a promising approach for treating children with skeletal class III malocclusion using implants for maxillary protraction. However, further high-quality studies are required for validating our current observations and regulating the stability of treatment outcomes on a long-term basis.

Aim of the study: Fluid shear stress (FSS) plays a critical role in osteoblast proliferation via extracellular signal-regulated kinase 5 (ERK5). Kruppel-like factor 4 (KLF4) knockout robustly enhances bone formation due to increased osteoblast differentiation and mineralization. However, the effect of KLF4 on osteoblast proliferation is unresolved. Therefore, the aim of our study was to investigate the effect of KLF4 on osteogenic lineage cell proliferation and the relationship between KLF4 and ERK5. Materials and methods: MC3T3-E1 cells were treated with FSS and/or KLF4 siRNA, cell viability was accessed by Edu labeling and CCK-8 assay, and proliferative gene expression were assessed by PCR array. Bone marrow stromal cells (BMSCs) were infected with adenovirus expressing KLF4 and/or constitutively active MEK5, cell viability was evaluated using crystal violet staining, colony formation assay, and cell WST1 assay. The levels of KLF4 and ERK5 phosphorylation were identified through qRT-PCR and western blot, respectively. Results: KLF4 expression was significantly down-regulated by FSS exposure, however, this was reversed by ERK5 siRNA. KLF4 overexpression inhibited colony formation efficiency and cell viability in BMSCs. Adenoviruses expressing constitutively active MEK5 increased ERK5 phosphorylation, which inhibited KLF4 expression, and promoted BMSC proliferation. FSS-induced osteoblast proliferation also involved elevation of Cyclin B2 and Cdc14b as well as repressed expression of P27. Conclusions: KLF4 negatively regulates osteogenic lineage cell proliferation, and ERK5 negatively regulates KLF4 expression and promotes osteogenic lineage cell proliferation. [ABSTRACT FROM AUTHOR]

Let $F$ represent a digitized version of an image $f\left ({x,y }\right)$ . Assume that the image fits inside a rectangular region and this region is subdivided into $M\,\,\times \,\,N$ squares. We call these squares the shifted box functions. Thus $f\left ({x,y }\right)$ is approximated by $M\,\,\times \,\,N$ matrix $F$ . This paper proofs that $F$ can be recovered exactly and uniquely from the Radon transform of $f$ using only one selected view angle with a well selected family of $MN$ lines. The paper also proposes a precise method for computing the Radon transform of an image. The approach can be categorized as an algebraic reconstruction, but it is merely a theoretical contribution for the field of limited data tomography.

In this paper, we present methods for identifying an image from a given set of Radon projections. Given a suitably regular 2-D or 3-D function, we form a new function $g$ from $f$ using a linear transformation. We show how the Radon projections of $f$ and $g$ can be used to determine the transformation. The proposed algorithms introduce three major contributions: 1) Improvements on the 2-D setting using the moments of the Radon projections with only two orthogonal projections. 2) A natural extension of the 2-D setting to work with the 3-D setting. In particular, reducing the 3-D problem to a 2-D problem so that we can recover a translation, a scaling, or a rotation transformation of a 3-D object in the Radon domain. 3) An efficient method of recovering a rotation of a 3-D image around an arbitrary axis and an angle of rotation.

Recent studies have indicated that microRNA and VEGF are considered to be genetic modifiers and are associated with elevated levels of fetal haemoglobin HbF, and thus they reduce the clinical impact of sickle haemoglobin (HbS) patients. This cross-sectional study was performed on clinical confirmed subjects of SCD cases. miR-423-rs6505162 C>T and VEGF-2578 C>A genotyping was conducted by ARMS-PCR in SCD and healthy controls. A strong clinical significance was reported while comparing the association of miR-423 C>T genotypes between SCD patients and controls (p = 0.031). The microRNA-423 AA genotype was associated with an increased severity of SCD in codominant model with odd ratio (OR = 2.36, 95% CI, (1.15–4.84), p = 0.018) and similarly a significant association was observed in recessive inheritance model for microRNA-423 AA vs (CC+CA) genotypes (OR = 2.19, 95% CI, (1.32–3.62), p < 0.002). The A allele was associated with SCD severity (OR = 1.57, 95% CI, (1.13–2.19), p < 0.007). The distribution of VEGF-2578 C>A genotypes between SCD patients and healthy controls was significant (p < 0.013). Our results indicated that in the codominant model, the VEGF-2578-CA genotype was strongly associated with increased SCD severity with OR = 2.56, 95% CI, (1.36–4.82), p < 0.003. The higher expression of HbA1 (65.9%), HbA2 (4.40%), was reported in SCD patients carrying miR-423-AA genotype than miR-423 CA genotype in SCD patients carrying miR-423 CA genotype HbA1 (59.98%), HbA2 (3.74%) whereas SCD patients carrying miR-423 CA genotype has higher expression of HbF (0.98%) and HbS (38.1%) than in the patients carrying AA genotype HbF (0.60%), HbS (36.1%). ARMS-PCR has been proven to be rapid, inexpensive and is highly applicable to gene mutation screening in laboratories and clinical practices. This research highlights the significance of elucidating genetic determinants that play roles in the amelioration of the HbF levels that is used as an indicator of severity of clinical complications of the monogenic disease. Further well-designed studies with larger sample sizes are necessary to confirm our findings.

Characterizing heterogeneity in reservoir rocks at the pore scale is crucial to understand the flow patterns better, and estimate reservoir petrophysical properties such as porosity and permeability. This study introduces multifractals as descriptors for rock samples’ heterogeneity at the pore scale. We analyzed twenty rock samples from sandstone and carbonate reservoirs using their 3D X-ray micro-computed tomography images. In addition, we simulated porosity and permeability properties and examined their correlation with multifractal parameters. The results show that the capacity dimension $D_{0}$ and the information dimension $D_{1}$ correlate with porosity and permeability simulated from images, respectively. Finally, we calculated several multifractal parameters such as the width of the spectrum, the asymmetry degree of the spectrum in the horizontal direction and the value of the vertical difference between the two branches of the spectrum. Results illustrate the ability of multifractal parameters to classify groups of rock samples according to their degree of heterogeneity.

The research aims to highlight the position of Iraq in the American strategy during the Second World War (1939-1945) and the areas and aspects through which the United States of America sought to enter Iraq, taking advantage of the war and economic lost conditions that Iraq was going through, and the outbreak of the May 1941 uprising in it, and the need for its location The geopolitical importance in the war against the Axis powers that tried to strengthen their relations with the nationalist trend represented by Rashid Ali Al-Kilani and the Four Colonels and the role of the United States of America in supporting Britain, to abort the May 1941 uprising, and the return of the British to occupy Iraq again, and turn it into an arena for international conflict during World War II and exploitation The United States of America to establish its interests in this country, which enjoys economic capabilities and a strategic location for the richest of a great power such as the United States of America seeks to control the Middle East region, leaving it to others

Endodontic treatment of a permanent mandibular first molar is often difficult due to its related complex variations. The root cause of endodontic failure is the inability of a practitioner to recognize and manage an irregular root canal system. Knowledge of dental anatomy, thorough examination, and utilization of recent diagnostic tools are required for an effective root canal treatment. A 31-year-old Saudi male patient presented to the endodontic clinic for endodontic treatment of the mandibular left first molar (#36). Clinical examination using a dental operating microscope (DOM) followed by radiographic examination including cone-beam computed tomography (CBCT) revealed the diagnosis of asymptomatic apical periodontitis in a previously attempted root canal therapy which was incomplete. The periapical disease involved middle mesial canal (MMC) intermingling with the mesiobuccal (MB) in the mesial root. The root canal treatment was successfully carried out with no symptoms during 6 months of follow-up period. This case reports the presence of unusual presentation of MMC and MB canal in the mandibular first molar, which had resulted in postendodontic complications, which was diagnosed using CBCT and successfully managed with good prognosis. Dentists can use technical and imaging advancements including the DOM and CBCT to recognize anatomical variations in the root canal system, especially in cases of postendodontic failures or complications.

يهتم علم المورفوتكتونيك بالتفسير التكويني لأشكال سطح الأرض، حيث تتم دراسة أصل تلك المظاهر وعلاقتها بالعملية التكتونية الناجمة من الضغط والشد وطبيعة التكوينات الصخرية للأحواض. تعد تلك العملية من العمليات الأساسية في تشكيل العديد من المظاهر الأرضية، حيث تؤثر العمليات الداخلية تأثيرا كبيرا في توليد الضغط الشديد والتحكم بطبيعة التكوينات الصخرية في حوض منطقة الدراسة، فضلا عن تباين عمليات الارتفاع والانخفاض التي كانت السبب في تكوين اشكال أرضية مختلفة، وأسهمت في حدوث العديد من الشقوق والفواصل والصدوع في التكوينات الصخرية التي تتأثر بالعمليات الجيومورفولوجية. إن المنطقة نشطة من الناحية الزلزالية إذ تتوزع في حوض الدراسة مجموعة من البؤر الزلزالية تتراوح اعماقها بين (5.1-20) كم والبعض منها تتوافق مع مواقع حفر الإذابة المتطورة وفي طور النمو وبعضها موازيا للصدع الإقليمي، إذ يبلغ عدد حفر الإذابة المتطورة (16)، وفي طور النمو (85) متمركزة في الأجزاء العليا والوسطى للحوض غير مستقرة والتي تطابق مناطق الضعف كون هذه الأجزاء نشطة تكتونيا وتكون في تغير مستمر. اعتمدت الدراسة على تحليل العمليات المورفوتكتونية للأحواض الثانوية لحوض وادي بادوش بالاعتماد على نموذج الارتفاعات الرقمية للمنطقة (DEM) وباستخدام برنامج (Arc GIS V.10.8)، بتطبيق خمس مؤشرات جومورفولوجية للنشاط التكتوني الحديث وبيان العمليات التحت السطحية بشكل تطبيقي معتمدا على قياسات دقيقة للأحواض وبذلك تم تحديد وقوع الحوض ضمن النشاط التكتوني الحديث في الأجزاء العليا والوسطى مما كان له الأثر على جيومورفولوجية الحوض بينما في اجزاءه الدنيا تكون منخفضة وحدوث تشوه وشذوذ على مسارات الشبكة المائية.

The oil policy of the Iraqi government after 1921 was characterized by confusion, confusion, and lack of clarity. The foreign oil company controlled Iraqi oil through the sharing of Iraqi oil between the governments of Western countries through what was given to it by the San Remo conference in 1920.Where the Turkish Oil Company got a percentage ranging from (23.75%), the French Oil Company (23.75%), Shell (British-Dutch), a percentage of (23.75%), and Aramco Company (23.25%), and each entity got a percentage (5%) .Thus, the Western countries and their oil companies, whose name was changed in 1929, shared to the Iraq Petroleum Company, and thus Iraq lost control of its oil imports and its resources became in the hands of foreign companies. And it continued to serve the interests of Western countries, forgetting the right of the Iraqi people, who were in dire need of oil imports at the time when the Iraqis only received cheap prices that did not meet their national economy and their cables with heavy restrictions for long periods that extended to less than seventy-five years