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Funding Acknowledgements Type of funding sources: None. Background Meditation can induce changes in autonomic balance, which can benefit cardiovascular health. The present meta-analysis evaluated changes in heart rate variability (HRV) in meditators. Methods PubMed and Embase were searched for primary prospective studies using the search terms ‘heart rate variability’ and ‘meditation’ until January 18th, 2019. The statistical significance of the difference between subgroups is evaluated by the standardized mean difference (SMD), 95% confidence interval (CI), and P-value. I2 value was used to assess the statistical heterogeneity between the included studies. Results Twenty-one studies involving 538 meditators (experienced= 209, beginners= 329) and 334 controls (mean age= 40.61, 35% male) were included. Regarding time-domain indices, no statistically significant differences were observed when assessing HRV between i) meditators versus controls (SMD= -0.17; 95% CI: [-0.50, 0.17]; p= 0.30; I2= 0%), ii) pre- versus post-meditation (SMD= -0.41; 95% CI: [-1.10, 0.28]; p= 0.25; I2= 80%) or iii) at baseline versus during meditation (SMD= -0.40; 95% CI: [-0.94, 0.14]; p= 0.14; I2= 72%). Pertaining to frequency-domain indices, analysis of low frequency (LF), normalized low frequency (LFnu) and high frequency (HF) between i) meditators versus controls, ii) at baseline versus post-meditation and iii) at baseline versus during meditation yet again did not show any variations. Seven studies assessed normalized high frequency (HFnu) at baseline versus during meditation collectively demonstrated a significantly higher HFnu during meditation in beginners with notable heterogeneity (SMD= 1.29; 95% CI: [0.09, 2.49]; p= 0.04; I2= 95). Moreover, LF/HF was evaluated by seven studies at baseline versus during meditation. Both meta-analysis (SMD= 0.76; 95% CI: [-0.17, 1.69]; p= 0.11; I2= 94%) as well as subset analysis of experienced meditators (SMD= -0.46; 95% CI: [-0.88, -0.03]; p= 0.03; I2= 0%) revealed a significantly lower LF/HF at baseline. Conclusions Short-term changes in HRV indices were observed during meditation, but there is limited evidence for significant long-term effects.

Funding Acknowledgements Type of funding sources: None. Background Platelets play a crucial role in thrombotic mechanism. Mean platelet volume (MPV) is primarily indicator of platelet activation and its measurement is easy and time-effective. The MPV is associated with adverse cardiac events in coronary artery disease. However, limited data are available to assess the relationship of MPV to severity of coronary atherosclerosis through multiple indicators including SYNTAX and GENSINI scores and multivessel disease (MVD) in non-ST-segment elevation myocardial infarction (NSTEMI). Objective We tested the association of MPV to severity of coronary atherosclerosis via multiple indicators in NSTEMI. Methods Ninety-three newly diagnosed NSTEMI patients (male 80.6% male and mean age 60.1 ± 12.3) were prospectively enrolled those who underwent first-time coronary angiography. The MVD defined as having stenosis >70% in >1 coronary vessels and clinical risk scores including SYNTAX and GENSINI were calculated to stratify coronary atherosclerosis severity. These indicators were sub-categorized into low risk (score Results Patients with intermediate-high risk SYNTAX (P = 0.001) and GENSINI (P = 0.002) scores had higher MPV values as compared to low risk. The higher MPV was also observed in in MPV than single vessel disease (P = 0 .017). The MPV was positively correlated with SYNTAX score (r = 0.281, P = 0.006, Spearmen’s Correlation), GENSINI (r = 0.219, P = 0.035, Spearmen’s Correlation), and MVD (r = 0.243, P = 0.019, Spearmen’s Correlation). Using logistic regression analysis after adjustment of traditional risk factors, we observed MPV remained independently associated with intermediate-high risk SYNTAX [odds ratio (OR): 0.881(95% confidence interval (Cl): 0.247-1.516), P = 0.006) and GENSINI scores [OR: 0.782(95%Cl: 0.131-1.434), P = 0.019) and MVD [OR: 0.718(95%Cl: 0.027-1.409), P = 0.042]. Operating characteristic curves (AUC) for MPV also evaluated intermediate-high SYNTAX score [AUC: 0.696(95%Cl: 0.587-0.804), P = 0.001) and GENSINI score [AUC: 0.694(95%Cl: 0.062-0.851), P = 0.003] and MVD [AUC: 0.660(95% Cl: 0.541-0.779), P = 0.020]. Conclusions We studied a positive relationship of MPV with high coronary severity through multiple indicators including SYNTAX, GENSINI and MVD in NSTEMI patients.

Funding Acknowledgements Type of funding sources: None. Background Trimethylamine N-oxide (TMAO) is reported to accelerate atherosclerosis and adverse cardiac outcomes. Relationship between coronary atherosclerotic burden and TMAO has linked in stable coronary artery disease and ST-segment elevation myocardial infarction, but not in non-ST-segment elevation myocardial infarction (NSTEMI). Objective We examined an association of TMAO with coronary atherosclerosis burden in NSTEMI. Methods In this prospective cohort, two groups including NSTEMI (n = 73) and age-sex matched Healthy (n = 35) individuals were enrolled between 2019 and 2020. The number of diseased coronary vessels and clinical risk scores including SYNTAX and GENSINI were used to stratify coronary atherosclerotic burden. Fasting plasma TMAO was measured by isotope dilution high-performance liquid chromatography. Results The median plasma TMAO levels (0.59 mM; [interquartile range [IQR]: 0.43-0.78) versus (0.42 mM; IQR: 0.33-0.64) were significantly higher in NSTEMI group versus Healthy group, respectively (P = 0.006). Among the patients with NSTEMI group, the plasma TMAO levels were significantly higher in the multivessel disease (MVD) versus single vessel disease (P = 0.002), and intermediate-high risk (score³23) versus low risk (score Conclusions TMAO levels are independently associated with high coronary atherosclerotic burden in NSTEMI. Abstract Figure. Abstract

ObjectiveTo investigate the associations of alkaline phosphatase (ALP) variability measures with new onset heart failure, cardiovascular mortality, and all-cause mortality in type 2 diabetes mellitus patients with a populational-cohort study.MethodThis study included patients with type 2 diabetes mellitus who presented to ambulatory, outpatient and inpatient facilities managed by the public sector in Hong Kong between January 1st, 2000 to December 31st, 2019. Comprehensive clinical and medical data including demographics, past comorbidities, medications, and laboratory examinations of complete blood, lipid/glycemic profile and their variability were collected. ALP and its variability measures were extracted. Univariable and multiple multivariable Cox regression were used to identify the associations of alkaline phosphatase variability with new onset heart failure and mortality risks. Patients were stratified into three subgroups based on the tertiles of baseline ALP level.ResultsThe study cohort consisted of 14289 patients (52.52% males, mean age at initial drug exposure: 74.55 years old [standard deviation (SD): 12.7]). Over a mean follow up of 2513 days [interquartile range (IQR): 1151-4173]), 10182 patients suffered from all-cause mortality (incidence rate [IR]: 71.25%), 1966 patients (IR: 13.75%) died from cardiovascular causes, and 1171 patients (IR: 8.19%) developed with new onset heart failure. Higher cumulative incidences of all three outcomes were observed for the highest tertile of ALP compared to medium/low tertiles. ALP baseline and variability level predicted new onset heart failure, cardiovascular and all-cause mortality before adjusting for subclinical biomarkers (p < 0.01). Amongst the measures of ALP variability, the hazard ratio (HR) of coefficient of variation (CV) was markedly raised in particular (new onset heart failure: HR=2.73, 95% confidence interval [CI]= [1.71-4.37], p ConclusionsRaised ALP level and variability are associated with increased risks of all-cause mortality, cardiovascular mortality and new onset heart failure amongst patients with type 2 diabetes mellitus.

Background Students and faculty members should work together as partners in the present era of modern medical education. Many medical schools across the globe are seeking excellence in medical education, including excellence in student engagement. Objective The current study aimed to explore Saudi medical students' perceptions regarding the Association for Medical Education in Europe's (AMEE) ASPIRE criteria for excellence in student engagement. Design A cross-sectional study targeting Saudi medical students from the five main universities in Saudi Arabia. A questionnaire was designed based on the AMEE's ASPIRE criteria for recognition of excellence in student engagement. Data were collected via SurveyMonkesy and analyzed using SPSS (Version 20). Twenty-three randomly selected medical students from Imam University were interviewed as well. Results Seventy-six percent (n=759) of students completed the survey. In general, Saudi medical students supported the ASPIRE criteria for student engagement. Students with the highest GPA (4.5-5) constituted 44% of students supporting excellence in student engagement. Students in medical schools using problem-based learning (PBL) agreed more than did those who did not follow a PBL curriculum. Most of the students at Imam Mohammad Ibn Saud University (87.8%) agreed that students should be formally and informally involved in peer-assisted teaching. The highest percentage of students who agreed was from Imam University as compared to the other four universities (P = 0.0001). Conclusion Saudi medical students support student engagement criteria as stated in the ASPIRE Awards criteria for excellence in student engagement. A significant proportional relationship was observed between increments in GPA and support of student engagement activities. The current study may encourage all colleagues around the world to implement the concept of "student engagement" in their universities. Additional studies should be conducted worldwide to seek international medical students' perceptions regarding student engagement.

Background: The SaudiMEDs framework was founded and adopted by the Saudi Deans’ Committee in 2011 to ensure that Saudi medical graduates learned core competencies. Meanwhile, CanMEDs was established by the Canadian Royal College of Physicians and Surgeons in 1996 and aimed to establish the abilities and skills of all aspects of medical practice, as well as to ensure the acquisition of basic knowledge related to medical education. The main purpose of this study was to explore the similarities and differences between both frameworks. Methods: In March and April 2017, 15 researchers conducted an extensive review of both the SaudiMEDs and CanMEDs frameworks using a semi-quantitative evaluation with color codes to determine the following: the exact similarities in both frameworks, the close similarities, and the unique differences. Results: According to the coloring system, most of the frameworks were similar. For example, Leadership, Communication and Professionalism were almost identical in both frameworks. There was some degree of similarity between both frameworks in “Collaborator”. Furthermore, the SaudiMEDs framework had a unique input which involved the most essential skills that undergraduate medical students must acquire. Conclusion: SaudiMEDs has great potential to improve the quality of Saudi medical graduates in a manner that fits our current and future needs. CanMEDs focuses mainly on outcomes and processes, while SaudiMEDs focuses more on outcomes. SaudiMEDs was not created to provide a copy-and-paste curriculum. The ultimate goal was to create an outcome-based curriculum that ensures the quality of Saudi medical school graduates.

Background Most of the medical schools in Saudi Arabia are currently evolving their curricula in accordance with the most recognized medical education trends worldwide. Undergraduate medical school’s curriculum should be compatible with community health needs. Therefore, the study aims to explore the current contents of Saudi undergraduate medical curricula and to check if the core topics that were internationally recognized were implemented in their curriculum. Methodology An online questionnaire was designed and sent to 37 deans of medical schools in Saudi Arabia. The deans or the vice-deans in charge of the curriculum were asked to complete the pre-designed questionnaire, which assessed the status of inclusion of the core topics in the curriculum of their affiliated schools. Each listed core topic was evaluated according to five options for each subject: not included, separate required course, part of the required course, separate elective course, and part of an elective course. Results Twenty four out of 37 (65%) Saudi medical schools completed the survey questionnaire. Almost all core topics, such as communication skills, evidence-based medicine, patient safety, professionalism were included in the curricula of Saudi medical schools as separate required courses or as part of required courses or elective courses. Complementary and alternative medicine and the history of medicine were the topics least taught in Saudi medical colleges, as 25% of the schools did not include them in their curricula. Conclusion The majority (65%) of the internationally recognized core topics were included in the Saudi undergraduate medical curricula. Evidence-based medicine, complementary medicine, the Saudi healthcare system, patient safety, and professionalism/medical ethics should be part of compulsory credited courses in all Saudi undergraduate medical curricula.

This work illustrates the improvement in ultra-trace Hg(II) determination in water based on a novel flexible extraction and preconcentration technique (FEPT). This method focuses on the covalent functionalisation of carbon fibre (CF) based on (3-mercaptopropyl)trimethoxysilane. The functionalisation of CF is carried out in two steps: functionalising the surface of CF using acid treatment to obtain hydroxy and carboxyl groups on the surface, followed by a condensation reaction between the carboxyl or hydroxy groups on the carbon (CF-OH) and (3-mercaptopropyl)trimethoxysilane to form mercapto-CF (CF-SH). FTIR, EDX, SEM, XRD and UV-Vis were utilised to confirm the modification. ICP-MS is utilised to determine the Hg(II) and to assess the influence of the memory effect on the results using Au3+ solution and suspended Au nanoparticles (Au-NPs). The result shows that the Au-NPs improve Hg(II) detection and eliminate the memory effect. This study also includes appropriate parameters for contact time, eluent solution, pH, and the foreign metal and ions preconcentration factor. As a result, thiol-CF shows high Hg(II) uptake, flexibility, and stability during the analysis process, with a recovery of 98.96% ± 0.41% for 10 preconcentration factors. These features make FEPT a valuable method for extracting pollutants and overcoming the problems associated with the analysis of such samples.

Dental implant is on rise in today’s time and era due to its importance in improving quality of life of patients. However, the success of the dental implant is significantly associated with individuals’ medical condition. Immunocompromised patients due to their weak immunity are considered sensitive for any type of surgery as it can result in various complications. Similarly in case of placing dental implants in immunocompromised patients’ supreme care and attention is needed in order to avoid risk and hazardous consequences. Oral and maxillofacial surgeons see an increasing number of patients with immunocompromised conditions in their daily practice due to better long-term health care and new indications for immunosuppressive therapy. The aim of this research is to review the available information about the dental implants in immunocompromised patients. Despite the fact that certain diseases are still considered risk factors in the effectiveness of dental implants in immunocompromised patients, there are few definite contradictions in this treatment option. As a result, disease control of risk factors, as well as personal risk assessment prior to dental implant treatment, may be considered more important than the disease or risk factor itself. Presence of various diseases can raise the risk of treatment failure or side effects in case of dental implant. Majority of the studies support dental implants as reliable and safe option under utmost care in immunocompromised patients however, the literature is quite divided and scarce in this regard and future research can be beneficial to yield better outcome and treatment strategies.

Computer-Aided Detection (CAD) systems are one of the most effected tools nowadays in aiding physicians in the detection of liver tumors at early stage. In this paper, the CADe system will be built which has the ability to detect the abnormal tumor inside the liver. In order to create that system, different types of classifiers must be implemented. In our CADe system, a support vector machine (SVM) and K-Nearest Neighbor (KNN) will be used as classifiers. A total number of 120 images including the normal and abnormal cases were collected. Initially, the features will be extracted from database images in order to distinguish between the classes of those liver tumors. Then, by using SVM and KNN the images will be classified into two classes normal and abnormal cases. The paper reveals that SVM and KNN, which demonstrated 100 percent precision, 100 percent sensitivity, and 100 percent specificity, were the best classifiers.

Nano letters 212(13), 5516–5521 (2021). doi:10.1021/acs.nanolett.1c00677, We present the discovery of a charge density wave (CDW) ground state in heavily electron-doped molybdenum disulfide (MoS$_2$). This is the first observation of a CDW in any d$^2$ (column 6) transition metal dichalcogenide (TMD). The band structure of MoS$_2$ is distinct from the d$^0$ and d$^1$ TMDs in which CDWs have been previously observed, facilitating new insight into CDW formation. We demonstrate a metal–insulator transition at 85 K, a 25 meV gap at the Fermi level, and two distinct CDW modulations, (2√3 × 2√3) R30° and 2 × 2, attributable to Fermi surface nesting (FSN) and electron–phonon coupling (EPC), respectively. This simultaneous exhibition of FSN and EPC CDW modulations is unique among observations of CDW ground states, and we discuss this in the context of band folding. Our observations provide a route toward the resolution of controversies surrounding the origin of CDW modulations in TMDs., Published by ACS Publ., Washington, DC

Resume Nous rapportons un cas rare de granulome eosinophile isole de localisation vertebrale L3 chez un adolescent de 15 ans. Une progression de l’osteolyse avec instabilite vertebrale sans signe neurologique a ete observee sous corset. Le traitement chirurgical a permis de corriger la deformation et de stabiliser le rachis. Une chimiotherapie postoperatoire par vinblastine et corticoide a ete prescrite selon le protocole de prise en charge des histiocytoses langheransiennes (HL2010). Aucune recidive n’a ete observee a 5 ans de recul.

Primary cardiac lymphoma is a rare tumour especially in immunocompetent person. It is invariably fatal unless diagnosed and treated early. Our patient was a 76 year old Chinese gentlemen, known case diabetes mellitus and hypertension, who presented with 3 months history of failure symptoms. He also had loss of appetite. His vital signs were stable. There was bibasal crepitation, raised JVP with normal heart sounds and bilateral pedal edema. Chest X-ray showed bilateral pleural effusion.He was admitted for stabilization of heart failure and started on diuretics. Echocardiography showed the LV ejection fraction was 50% with grade 1 diastolic dysfunction. There was a global pericardial effusion with effusion size 2.52cm maximum at posterior to LV. There was partial RA collapse .Patient was otherwise hemodynamically stable. Patient was observed closely and diuretics continued. Echocardiography on the third day of admission showed a suspicious looking mass in the right atrial (RA) and right ventricular (RV) wall near the AV groove. It become apparent after pericardial effusion became less. Patient was counselled and agreed for pericardial tapping but procedure had to be abandoned as effusion has reduced compared to before ( MRI cardiac showed an infiltrating mass around the right atrio-ventricular groove extending to the right ventricular free wall and around the pericardial lining around the ascending aorta and pulmonary trunks. There is inhomogenous signal in STIR with iso-intensity on T1 weighted images. First pass metabolism revealed some vascularity. There was a patchy myocardial enhancement on late gadolinium enhancement. pericardium was thickened with global pericardial effusion- 16mm. Large right pleural effusion seen and minimal left pleural effusion. Mediastinal lymphadenopathy was seen. The finding were suggestive of cardiac lymphoma with differential sarcoma. Subsequent day, patient develop acute ischemic stroke which was complicated by aspiration pneumonia and septic shock. Fortunately he recovered after 1 week of antibiotics and non-invasive ventilatory support. FDG PET- CT scan showed FDG-avid primary cardiac lymphoma with pericardial involvement and conglomerate of multiple group of mediastinal and supra clavicular lymph nodes . Bilateral hypermetabolic adrenal nodule were seen but unable to determine its relevance to the primary pathology(lymphoma). No marrow or other organ involvement. Stage is likely IIE. We were unable to harvest the lymph node because they were too deep. Patient"s family was counselled for cardiac biopsy but family did not want to take the risk as patient was bedridden and fragile. They were also not keen for any chemotherapy or invasive procedure. Once patient was out of infection, they requested to bring back patient to home. He was sent to nursing home for full time care but succumbed to another bout of aspiration pneumonia one week after discharge. Abstract P884 Figure. Echo, MRI, Pet CT scan

Background There is increasing evidence that inflammatory biomarkers growth differentiation factor 15 (GDF-15) and neutrophil-lymphocyte ratio (NLR) appear to be associated with stroke and adverse cardiovascular events in patients with atrial fibrillation (AF). However, long-term impact of catheter ablation (CA) on GDF-15 and NLR is still unknown. Objective To evaluate the long-term change in GDF-15 and NLR after CA in paroxysmal AF patients. Methods A total of 58 paroxysmal AF patients were consecutively enrolled to perform CA. The inflammatory biomarkers GDF-15 and NLR were measured at baseline and 6-months postablation. Results All patients except one could complete 6-Months follow up. Fifty (87.7%) patients maintained sinus rhythm (SR group) and seven (12.3%) patients sustained AF recurrence (AFR group). No significant difference was noted in clinical and procedural characteristics between two groups (p>0.05), except mean fluoroscopy time (minutes 22±11.7 vs. 13±5.3, p=0.001) significantly longer in AFR than SR group. The GDF-15 (pg/ml 195±57 vs. 216±88, p=0.398), and NLR (% 1.8 (1.3–3) vs. 2.6 (1.4–3.4), p=0.395) were comparable at baseline in both SR and AFR groups respectively. At 6-months postablation, GDF-15 (pg/ml 133±41 vs. 195±57, p0.05) Conclusion Inflammatory biomarkers; GDF-15 and NLR significantly decreased at long-term on successful maintenance of sinus rhythm by CA in paroxysmal AF patients. Acknowledgement/Funding None

Background Several studies have reported an association between improvements in hand hygiene and the reductions in rates of intestinal parasitic diseases. However, only a some have addressed its link to the frequency of influenza-like illness. The current study aimed to find the correlation between personal hygiene habits and the frequency of influenza-like illness. Methods A cross-sectional study targeting 3000 participants conducted in Riyadh city, Saudi Arabia. A systematic random sampling methodology was applied for participant from different part of Riyadh city using a computer generating system. The researcher first started by calling each participant. A full explanation was given to each participant in details (from the purpose of the research, consent to answer the questionnaire, to the explanation of the outcome definition). Each point of the questionnaire was explained to them to make sure they had excellent comprehension, and therefore, respond accurately. Descriptive statistics and Odds Ratio and its 95% confidence intervals were used to determine the association between frequency of influenza-like illness and the studied variables. Results Two thousand eighty-two (69.4%) completed the questionnaire. The participants who spent 5–10 s in handwashing with soap and rubbing were at increased risk of more frequent influenza-like illness (odds ratio = 1.37, 1.08–1.75). Handwashing with soap and rubbing after handshaking is an independent protective habit against frequent influenza-like illness (adjusted OR = 0.59, 0.37–0.94). Conclusion The decrease of the frequency of influenza-like illness could be done through the following: getting the influenza vaccine annually, washing hands with soap and hand rubbing not less than 15 s after getting out of the bathroom, before and after handshaking and before eating. Soap companies should invent soaps that take less rubbing time to kill bacteria, and subsequently may maximize compliance in the community.

Objectives The current study aims to find the differences between glioblastoma multiforme (GBM) and giant cell glioblastoma (GCG) regarding mortality and prognosis among adults and elderly patients in the U.S. Methods and Materials This study is a historical cohort type of study and is conducted on adults and elderly individuals with GBM or GCG from the years 1985–2014 in the U.S. Data were collected from the Surveillance, Epidemiology, and End Results Program (SEER) database. The study exposure was GBM or GCG and the outcome was mortality. The potential confounders were age, sex, race, ethnicity, year of diagnosis, primary site, brain overlap, and surgery. A chi‐square test was used for categorical data. A univariate analysis was used for variables having a p‐value, When comparing glioblastoma multiforme (GBM) and giant cell glioblastoma (GCG) using SEER database, the researches have found the following: GCG was not statistically significant in association with reduced mortality. Non‐Spanish–Hispanics with GBM or GCG had a higher mortality rate than did Spanish–Hispanics. Factors such as being female, being age 59–65, and having a year of diagnosis before 2010 were independently associated with increased mortality.

Brain cancer is the tenth leading cause of death in the U.S. Glioblastoma multiforme (GBM) is the most lethal primary malignant central nervous system tumor in adults. The present study employed samples from 1985-2014 to discover the difference in prognosis among glioblastoma subtypes after the evolution of treatment modalities over the past few years. The current study aims to find the differences between Glioblastoma multiforme (GBM) and giant cell glioblastoma (GCG) in terms of prognosis among adults and elderly patients in the U.S. This study is a historical cohort type of study and is conducted on adults and elderly individuals with GBM or GCG from the years 1985-2014 in the U.S. Data were collected from the Surveillance, Epidemiology, and End Results Program (SEER) database. The study exposure was GBM or GCG and the outcome was mortality. The potential confounders were age, sex, race, ethnicity, year of diagnosis, primary site, and surgery. A chi-square test was used for categorical data. A univariate analysis was used for variables having a p-value < 0.05. Potential confounders were selected and evaluated using multivariate logistic regression models to calculate the odds ratio with stepwise selection. The study sample was 25,117. The incidences of GBM and GCG were not similar in relation to age group. Also, Spanish-Hispanic ethnicity was independently protective of GBM and GCG as compared to Non-Spanish-Hispanic ethnicity patients with GBM have a higher mortality rate than do GCG patients. The mortality rate was higher among patients diagnosed before 2010. In conclusion, GCG was not statistically significant in association to reduced mortality. Non-Spanish-Hispanics with GBM or GCG had a higher mortality rate than did Spanish-Hispanics. Factors such as being female, being age >59, and having a year of diagnosis before 2010 were independently associated with increased mortality.

Background Students and faculty members should work together as partners in the present era of modern medical education. Many medical schools across the globe are seeking excellence in medical education, including excellence in student engagement. Objective The current study aimed to explore Saudi medical students’ perceptions regarding the Association for Medical Education in Europe’s (AMEE) ASPIRE criteria for excellence in student engagement. Design A cross-sectional study targeting Saudi medical students from the five main universities in Saudi Arabia. A questionnaire was designed based on the AMEE’s ASPIRE criteria for recognition of excellence in student engagement. Data were collected via SurveyMonkesy and analyzed using SPSS (Version 20). Twenty-three randomly selected medical students from Imam University were interviewed as well. Results Seventy-six percent (n=759) of students completed the survey. In general, Saudi medical students supported the ASPIRE criteria for student engagement. Students with the highest GPA (4.5–5) constituted 44% of students supporting excellence in student engagement. Students in medical schools using problem-based learning (PBL) agreed more than did those who did not follow a PBL curriculum. Most of the students at Imam Mohammad Ibn Saud University (87.8%) agreed that students should be formally and informally involved in peer-assisted teaching. The highest percentage of students who agreed was from Imam University as compared to the other four universities (P = 0.0001). Conclusion Saudi medical students support student engagement criteria as stated in the ASPIRE Awards criteria for excellence in student engagement. A significant proportional relationship was observed between increments in GPA and support of student engagement activities. The current study may encourage all colleagues around the world to implement the concept of “student engagement” in their universities. Additional studies should be conducted worldwide to seek international medical students’ perceptions regarding student engagement.

ASEAN Entrepreneurship Profiling is one of the initial efforts to bring together profiles among ASEAN countries and to find the most powerful determining factor for entrepreneurs in ASEAN, developed using the Neuroresearch and Waterfall Model research methods. This research aims to identify the design of ASEAN Entrepreneurship Profiling website design to collect data online by using Neuroresearch and Waterfall Model research methods. The result shows that this profiling is expected to be able to contribute to novice entrepreneurs to explore gaps, take advantage of opportunities, prepare for their capacity, and build their potential. It is also easier for business actors when visiting the website as it displays self-profiling and recommendations for themselves.

The treatment objectives in congenital pseudarthrosis of the tibia are bone consolidation and a restored lower-limb axis. They are difficult to achieve, and various surgical techniques have been described, with varying results in terms of bone consolidation and complications. The present study reports clinical and radiographic results in 3 patients managed by the same original technique of transplantar intramedullary nailing using a custom-made proximal locking nail, without surgical approach or resection of the pseudarthrosis site. Good assembly stability allowed immediate weight-bearing. The technique is relatively noninvasive, offering a first-line alternative in under-3 year-olds.

Resume L’objectif du traitement de la pseudarthrose congenitale est l’obtention d’une consolidation osseuse associee a la restitution de l’axe du membre inferieur. Ces objectifs sont difficiles a obtenir et de nombreuses techniques chirurgicales ont ete decrites offrant des resultats heterogenes en termes de consolidation osseuse et de survenue de complications. Le but de ce travail est de presenter les resultats cliniques et radiographiques de trois patients pris en charge selon une technique originale d’enclouage centromedullaire par voie transplantaire utilisant un clou sur mesure a verrouillage proximal sans abord ni resection du foyer de pseudarthrose. La bonne stabilite du montage autorise un appui immediat. Il s’agit d’une technique peu invasive constituant une approche chirurgicale supplementaire de premiere intention chez l’enfant de moins de 3 ans.

Resume Introduction A ce jour, il n’existe pas de solution therapeutique consensuelle pour les scolioses idiopathiques de l’adolescent (SIA) dont la courbure est comprise entre 30 et 60° en fin de croissance. Objectif L’objectif de cette etude etait d’effectuer une evaluation du devenir a long terme des patients porteurs d’une SIA d’amplitude moderee. Materiel et methodes Il s’agit d’une etude retrospective multicentrique. Les criteres d’inclusion etaient un angle de Cobb en fin de croissance compris entre 30 et 60° et un recul superieur a 20 ans. Les donnees recueillies etaient les valeurs angulaires a l’adolescence et au dernier recul et des scores de qualite de vie au dernier recul. Resultats Au total, 258 patients ont ete inclus, dont 100 patients operes a l’adolescence, 116 n’ayant jamais ete operes et 42 operes a l’âge adulte. Le recul moyen etait de 27,8 ans. L’augmentation de l’angle de Cobb au recul etait significativement differente dans les 3 groupes (respectivement 3,2° vs 8,8° vs 23,6°, p p = 0,002). Les scores de qualite de vie ne montraient pas de difference significative. Discussion Les patients operes a l’adolescence avaient une faible progression radiologique, demontrant l’efficacite du traitement chirurgical pour des courbures superieures a 50°. Les courbures superieures a 40° sont evolutives et necessitent parfois un traitement chirurgical a l’âge adulte. Les scolioses lombaires ont montre un potentiel evolutif plus important que les scolioses thoraciques a l’âge adulte et justifient une arthrodese des que l’angulation atteint 35°. Niveau de preuve 4.

IntroductionTo date there is no consensus on therapeutic indications in adolescent idiopathic scoliosis (AIS) with curvature between 30° and 60° at the end of growth.ObjectiveThe objective of this study was to assess outcome in patients with moderate AIS.Material and methodsA multicenter retrospective study was conducted. Inclusion criteria were: Cobb angle, 30–60° at end of growth; and follow-up > 20 years. The data collected were angular values in adolescence and at last follow-up, and quality of life scores at follow-up.ResultsA total of 258 patients were enrolled: 100 operated on in adolescence, 116 never operated on, and 42 operated on in adulthood. Mean follow-up was 27.8 years. Cobb angle progression significantly differed between the 3 groups: 3.2° versus 8.8° versus 23.6°, respectively; P 35° (OR=4.278, P=0.002). There were no significant differences in quality of life scores.DiscussionPatients operated on in adolescence showed little radiological progression, demonstrating the efficacy of surgical treatment for curvature greater than 50°. Curvature greater than 40° was progressive and may require surgery in adulthood. Lumbar scoliosis showed greater potential progression than thoracic scoliosis in adulthood, requiring fusion as of 35° angulation.Level of evidenceIV, retrospective study.

Estimating the wing structural weight of an extremely manoeuvrable Unmanned Aerial Vehicle (UAV) during conceptual design has proven to be a significant challenge due to its high load factor (the ratio of an aircraft lift to its weight). The traditional empirical method relies on existing statistical data of previously built aircraft, then is inadequate for the innovative UAV structure design which can endure extremely manoeuvrable load (load factor is greater than 9g). In this paper, the finite element model for wing structure of an extremely manoeuvrable UAV with foreplane was built, and the structural weight was estimated by static aeroelastic optimisation considering structural strength and buckling constraints. The methodology developed here is only consisted of three components, which is much less than that for existing method, thus the procedure developed here sacrificed some accuracy, but it’s faster and more suitable for aircraft conceptual design. It was validated by the overlap between the weights given by the methodology, and the results from empirical equations when the load factors are less than 9g. Through the analysis procedure developed, the wing structural weights of the extremely manoeuvrable UAV were given under different load cases (load factor changes from 5g to 12g).