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ABSTRACT: Teaching practice holds paramount significance within the domain of teacher education and training, providing student teachers with a tangible opportunity to acquire practical knowledge and firsthand experience in the dynamics of schooling and classroom pedagogy. This study set out to investigate the perceptions of EFL student teachers regarding the school-based teaching practice course in four colleges of education and basic education in Duhok province of the Kurdistan Region-Iraq. A combined qualitative and quantitative methodological approach was used to gather the research data. A paper and online questionnaire provided quantitative data from 132 participants, complemented by conducting semi-structured interviews with 16 student teachers. The results showed that the teaching practice experience was deemed ineffective and inadequate in preparing to become qualified EFL teachers. The results further revealed that the majority of the elements involved in the topic being studied were deemed unsatisfactory and there were multiple areas for improvement in the phenomenon. The implications of these findings extend our understanding of the process and procedures of the teaching practice course in this specific context. The findings presented add to our understanding of the various aspects of the subject. The research has the potential to inform policy decisions and practical interventions, thereby positively influencing the field and leading to tangible improvements. This study holds significant importance as it addresses a critical gap in existing research, shedding light on an area that has thus far been underexplored. A significant limitation of the current study is its exclusive focus on student teachers as the primary data collection subjects. Therefore, future research should consider investigating the perspectives of other stakeholders involved in the teaching practice, including university supervisors, school principals, representatives of English departments, the course developers, and focal persons.

Whilst risk prediction for individual prostate cancer (PCa) cases is of a high priority, the current risk stratification indices for PCa management have severe limitations. This study aimed to identify gene copy number alterations (CNAs) with prognostic values and to determine if any combination of gene CNAs could have risk stratification potentials. Clinical and genomic data of 500 PCa cases from the Cancer Genome Atlas stable were retrieved from the Genomic Data Commons and cBioPortal databases. The CNA statuses of a total of 52 genetic markers, including 21 novel markers and 31 previously identified potential prognostic markers, were tested for prognostic significance. The CNA statuses of a total of 51/52 genetic markers were significantly associated with advanced disease at an odds ratio threshold of ≥1.5 or ≤0.667. Moreover, a Kaplan–Meier test identified 27/52 marker CNAs which correlated with disease progression. A Cox Regression analysis showed that the amplification of MIR602 and deletions of MIR602, ZNF267, MROH1, PARP8, and HCN1 correlated with a progression-free survival independent of the disease stage and Gleason prognostic group grade. Furthermore, a binary logistic regression analysis identified twenty-two panels of markers with risk stratification potentials. The best model of 7/52 genetic CNAs, which included the SPOP alteration, SPP1 alteration, CCND1 amplification, PTEN deletion, CDKN1B deletion, PARP8 deletion, and NKX3.1 deletion, stratified the PCa cases into a localised and advanced disease with an accuracy of 70.0%, sensitivity of 85.4%, specificity of 44.9%, positive predictive value of 71.67%, and negative predictive value of 65.35%. This study validated prognostic gene level CNAs identified in previous studies, as well as identified new genetic markers with CNAs that could potentially impact risk stratification in PCa.

Objectives: To assess patients' awareness of the indications and complications of sleeve gastrectomy in King Khalid University Hospital, Riyadh, Saudi Arabia. Methods: The cross-sectional study conducted from December 2017 to May 2018 in KKUH, Riyadh, Saudi Arabia included all patients aged 18 years and older. Data collection was conducted through self-administered questionnaires. Chi-square test was performed to determine the significant differences between variables. A P value of < 0.05 was considered statistically significant. Result: Of 480 participants, 247 (51.5%) of them were male. The educational level of most was bachelor's degree (253; 52.7%). Most of the participants (326; 67.9%) are not aware about BMI. However, 80 (16.7%) participants knew the true answer to obese BMI. Of the total participants, 283 (59.0%) did not knew about sleeve gastrectomy indications; however, 311 (64.8%) of the participants had heard about the complications of sleeve gastrectomy. All these results are correlated with the educational level of the participants. Conclusion: Our study shows a lack of awareness of sleeve gastrectomy indications and complications among study population. We need to increase public awareness about sleeve gastrectomy indications and complication by proper scientific health education in the community.

Lung cancer is the second most commonly diagnosed cancer in the world. In terms of the diagnosis of lung cancer, combination carcinoembryonic antigen (CEA) and cancer antigen 125 (CA125) detection had higher sensitivity, specificity, and diagnostic odds ratios than CEA detection alone. Most individuals with elevated serum CA125 levels had lung cancer that was either in stage 3 or stage 4. Serum CA125 levels were similarly elevated in lung cancer patients who also had pleural effusions or ascites. Furthermore, there is strong evidence that human lung cancer produces CA125 in vitro, which suggests that other clinical illnesses outside of ovarian cancer could also be responsible for the rise of CA125. MUC16 (CA125) is a natural killer cell inhibitor. As a screening test for lung and ovarian cancer diagnosis and prognosis in the early stages, CA125 has been widely used as a marker in three different clinical settings. MUC16 mRNA levels in lung cancer are increased regardless of gender. As well, increased expression of mutated MUC16 enhances lung cancer cells proliferation and growth. Additionally, the CA125 serum level is thought to be a key indicator for lung cancer metastasis to the liver. Further, CA125 could be a useful biomarker in other cancer types diagnoses like ovarian, breast, and pancreatic cancers. One of the important limitations of CA125 as a first step in such a screening technique is that up to 20% of ovarian tumors lack antigen expression. Each of the 10 possible serum markers was expressed in 29–100% of ovarian tumors with minimal or no CA125 expression. Therefore, there is a controversy regarding CA125 in the diagnosis and prognosis of lung cancer and other cancer types. In this state, preclinical and clinical studies are warranted to elucidate the clinical benefit of CA125 in the diagnosis and prognosis of lung cancer.

Whilst risk prediction for individual prostate cancer (PCa) cases is of a high priority, the current risk stratification indices for PCa management have severe limitations. This study aimed to identify gene copy number alterations (CNAs) with prognostic values and to determine if any combination of gene CNAs could have risk stratification potentials. Clinical and genomic data of 500 PCa cases from the Cancer Genome Atlas stable were retrieved from the Genomic Data Commons and cBioPortal databases. The CNA statuses of a total of 52 genetic markers, including 21 novel markers and 31 previously identified potential prognostic markers, were tested for prognostic significance. The CNA statuses of a total of 51/52 genetic markers were significantly associated with advanced disease at an odds ratio threshold of ≥1.5 or ≤0.667. Moreover, a Kaplan–Meier test identified 27/52 marker CNAs which correlated with disease progression. A Cox Regression analysis showed that the amplification of MIR602 and deletions of MIR602, ZNF267, MROH1, PARP8, and HCN1 correlated with a progression-free survival independent of the disease stage and Gleason prognostic group grade. Furthermore, a binary logistic regression analysis identified twenty-two panels of markers with risk stratification potentials. The best model of 7/52 genetic CNAs, which included the SPOP alteration, SPP1 alteration, CCND1 amplification, PTEN deletion, CDKN1B deletion, PARP8 deletion, and NKX3.1 deletion, stratified the PCa cases into a localised and advanced disease with an accuracy of 70.0%, sensitivity of 85.4%, specificity of 44.9%, positive predictive value of 71.67%, and negative predictive value of 65.35%. This study validated prognostic gene level CNAs identified in previous studies, as well as identified new genetic markers with CNAs that could potentially impact risk stratification in PCa. [ABSTRACT FROM AUTHOR]

Introduction: Increased smartphone accessibility has enhanced the speed and diversity of the dissemination of data, ideas, and thoughts. Notably, patients often turn to social media platforms to gather information on treatment options, share personal experiences, offer opinions, and choose the best health-care providers. Social media has been employed to distribute health information. Aims: This study aimed to analyze the content regarding orthodontic functional appliances posted on various social media platforms. Materials and Methods: The study analyzed content posted in August 2020 on four social media sites, namely, Instagram, YouTube, Twitter, and Reddit, focusing on terms related to orthodontic functional appliances. Data from the first 100 posts per keyword were collected and then recorded and coded in spreadsheets. Descriptive and statistical analyses were performed to elucidate the nature of the posted content. Results and Discussion: A total of 1204 posts were included in the study. Of these, 29.8.2% were photos and 51.8% were videos. Majority of the posts (65.3%) were about information sharing and uploaded by doctors (51.2%). The type of malocclusion was described as Class II in 18.4% of the posts but not specified in 72.8%. The overall usefulness of the posts was low. Posts of photos, posts on Instagram, and posts by doctors were found to be more significantly useful (P < 0.001). Conclusion: Patients, doctors, and academics extensively use social media platforms to disseminate orthodontic information. However, more useful posts on orthodontic functional appliances should be uploaded, including those on treatment effectiveness, patient experience, and patient–clinician relationships, which have been widely disregarded.

Lung cancer is the second most commonly diagnosed cancer in the world. In terms of the diagnosis of lung cancer, combination carcinoembryonic antigen (CEA) and cancer antigen 125 (CA125) detection had higher sensitivity, specificity, and diagnostic odds ratios than CEA detection alone. Most individuals with elevated serum CA125 levels had lung cancer that was either in stage 3 or stage 4. Serum CA125 levels were similarly elevated in lung cancer patients who also had pleural effusions or ascites. Furthermore, there is strong evidence that human lung cancer produces CA125 in vitro, which suggests that other clinical illnesses outside of ovarian cancer could also be responsible for the rise of CA125. MUC16 (CA125) is a natural killer cell inhibitor. As a screening test for lung and ovarian cancer diagnosis and prognosis in the early stages, CA125 has been widely used as a marker in three different clinical settings. MUC16 mRNA levels in lung cancer are increased regardless of gender. As well, increased expression of mutated MUC16 enhances lung cancer cells proliferation and growth. Additionally, the CA125 serum level is thought to be a key indicator for lung cancer metastasis to the liver. Further, CA125 could be a useful biomarker in other cancer types diagnoses like ovarian, breast, and pancreatic cancers. One of the important limitations of CA125 as a first step in such a screening technique is that up to 20% of ovarian tumors lack antigen expression. Each of the 10 possible serum markers was expressed in 29–100% of ovarian tumors with minimal or no CA125 expression. Therefore, there is a controversy regarding CA125 in the diagnosis and prognosis of lung cancer and other cancer types. In this state, preclinical and clinical studies are warranted to elucidate the clinical benefit of CA125 in the diagnosis and prognosis of lung cancer. [ABSTRACT FROM AUTHOR]

Objectives: To determine the efficacy of open versus closed negative pressure wound therapy for contaminated and dirty surgical wounds in terms of time duration to full wound healing. Study Design: Quasi-experimental study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Quetta Pakistan, from Oct 2021 to Apr 2022. Methodology: A total of 96 patients with surgical wounds requiring repair were included for study. All patients underwent their respective surgery followed by grouping. Patients in Group-A received closed negative pressure wound therapy while those in Group-B received open negative pressure wound therapy. All patients were followed up till complete healing of the wound or till the occurrence of complications. Results: Our study sample had a mean age of 44.16±12.66 years, with a slight female preponderance of 51(53.1%) participants. The mean total healing time for closed negative pressure wound therapy was 17.35±6.95 days, while it was 42.00±16.21 days with open negative pressure wound therapy, (p0.05). Conclusion: Closed negative pressure wound therapy results in faster wound healing, with a similar complication rate as open negative pressure wound therapy.

AIM: To analyze the prevalence of peripapillary intra-choroidal cavitation (PICC) in eyes with gamma peripapillary atrophy (γPPA), in eyes with peripapillary staphyloma (PPS) and in those combining γPPA and PPS and to analyze border tissue discontinuity in PICC. METHODS: This prospective cross-sectional non interventional study included highly myopic eyes. Non-highly myopic eyes were used as control. Radial and linear scans centered on the optic nerve head were performed using spectral-domain optical coherence tomography. Variables were analyzed along the twelve hourly optical coherence tomography sections in both eyes of each subject. RESULTS: A total of 667 eyes of 334 subjects were included: 229 (34.3%) highly myopic eyes and 438 (65.7%) non highly myopic eyes. The mean age of the highly myopic group was 48.99±17.81y. PICC was found in a total of 40 eyes and in 13.2% (29/220) of highly myopic eyes. PICC was found in 10.4% (40/386) of eyes with γPPA, in 20.5% (40/195) of eyes with PPS and in 22.7% (40/176) of those combining γPPA and PPS. All the eyes with PICC showed the co-existence of γPPA and PPS whereas none of the eyes presenting only one of these entities exhibited PICC. A border tissue discontinuity in the γPPA area was found in all eyes with PICC. CONCLUSION: We confirm the presence of a border tissue discontinuity in the γPPA area of all eyes with PICC. These findings suggest the involvement of mechanical factors in the pathogenesis of PICC which may contribute to PICC-related visual field defects.

This study examines the impacts of recreation activities on Mount Tahan (2187 m a.s.l); the highest mountain in Peninsular Malaysia by assessing tree diameter, height, leaf area, sapwood area, and chlorophyll fluorescence (CF) of selected species. Vegetation cover was also determined by counting the number of species. Two most dominant tree species in the study plots, i.e., Tristaniopsis fruticosa and Baeckea frutescens were selected as representative to assess the impacts on the vegetation growth. Both tree species dominated over 50% of total vegetation in both areas. Meanwhile, CF was determined on T. fruticosa since this species was the only broadleaf species found in both areas. Four plots sized 20 m X 20 m representing each disturbed and undisturbed were established in camping and trampling areas. The total number of plant species recorded was 29 in both camping and trampling areas but was found less in disturbed plots. Impacts of trampling and camping on all the parameters at higher altitude in disturbed plots were significantly different from those in the undisturbed plots. For trampling, all growth parameters taken in disturbed plots were found lower than in undisturbed plots. For camping, however, the mean values of vegetation cover were found lower in disturbed plots compared to undisturbed plots but the mean values of tree diameter, height, leaf area and sapwood area were found greater in disturbed than in undisturbed plots. In contrast, all CF parameters were found higher in disturbed plots for both trampling and camping areas. Keywords: Recreation activities, Physiological characteristic, Chlorophyll fluorescence, Upper mountain, 1. Introduction Recreation ecology is in a sense a redefining of an age-old activity. Doubtless, human moving through the wilderness or bush have always observed the impacts of others who [...]

Objectives: Infective endocarditis of the aortic valve complicated by annular abscess is a challenging problem and often requires patch reconstruction after surgical debridement of the abscess cavity. Filling the remaining cavity with antibiotics is advocated to prevent recurrent endocarditis. This study aimed at evaluating the role of local antibiotics in patients with aortic valve infective endocarditis complicated by annular abscess. Methods: Between January 2012 and December 2021, all consecutive patients with aortic valve infective endocarditis complicated by annular abscess undergoing cardiac surgery and annular patch reconstruction were included. Patients receiving local antibiotics were compared with patients without local antibiotics. The primary endpoints were the incidence of recurrent endocarditis, re-operation, and mortality during two-year follow-up. Results: A total of 41 patients with aortic valve infective endocarditis complicated by annular abscess underwent surgical patch reconstruction after radical debridement. In total, 20 patients received local antibiotics in the abscess cavity and 21 patients were treated without local antibiotics. The most common causative microorganisms were the staphylococci species and the most common location of the abscess was the non-coronary annulus. During two-year follow-up, one patient in each group developed recurrent endocarditis (p > 0.99) and both patients were reoperated (p > 0.99). Two-year mortality was 30% in the local antibiotic group and 24% in the control group (p = 0.65). Conclusions: Radical debridement and patch reconstruction of the aortic annulus in patients with aortic valve infective endocarditis complicated by annular abscess is an effective surgical strategy. Filling of the remaining abscess cavity with antibiotic seems not to affect the rate of recurrent endocarditis, reoperation, and mortality during two-year follow-up.

Desde inicios del siglo XX, el sociólogo Immanuel Wallerstein (2000) venía pronosticando que el sistema mundial capitalista estaba en decadencia y se comenzaba a transformar en otro tipo de sistema, pero sin especificar cuál sería. Ahora, varios economistas le han puesto nombre al nuevo sistema económico: el tecnofeudalismo. Sin embargo, tal y como señalaba el mismo Wallerstein y uno de sus discípulos Ramón Grosfoguel, un análisis puramente económico del sistema mundial sería reduccionista, economicista e incluso eurocéntrico. Por tanto, en este artículo se pretende describir las distintas heterarquías del nuevo sistema y detallar una dialéctica marxista decolonial acerca de cómo está construido este sistema.

The Staphylococcus aureus enterotoxin A (SEA) is the toxin mostly involved in Staphylococcus aureus (S. aureus) food poisoning. In this study, the effect of different lactic acid (LA) concentrations (LA 1% and 2%) and temperatures (4°C, 25°C, and 37 °C) on S. aureus growth and relative sea expression in fresh meat cuts were studied. Real-Time RT-PCR used to determine the relative sea expression. Fresh meat cuts were inoculated with 105 CFU/g of S. aureus producing enterotoxin A. S. aureus growth and relative sea expression were regularly tested for 48 hours. The growth of S. aureus was decreased by one log CFU/g than control sample using 1% LA and 2% LA 2% (5.32 ± 3.76 log CFU/g, 4.38 ± 3.00 log CFU/g and 4.54 ± 3.18 log CFU/g respectively) at zero time. Relative expression of the sea gene in both LA concentrations was lower than control. Moreover, both lactic acid concentrations had effect on relative sea gene expression at all examined hours, especially at 4°C compared to control samples. The higher the lactic acid concentration, the lower the S. aureus entero- toxin A relative expression was. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Plant Production is the property of Egyptian National Agricultural Library (ENAL) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To assess patients’ awareness of the indications and complications of sleeve gastrectomy in King Khalid University Hospital, Riyadh, Saudi Arabia. Methods: The cross‑sectional study conducted from December 2017 to May 2018 in KKUH, Riyadh, Saudi Arabia included all patients aged 18 years and older. Data collection was conducted through self‑administered questionnaires. Chi‑square test was performed to determine the significant differences between variables. A P value of < 0.05 was considered statistically significant. Result: Of 480 participants, 247 (51.5%) of them were male. The educational level of most was bachelor’s degree (253; 52.7%). Most of the participants (326; 67.9%) are not aware about BMI. However, 80 (16.7%) participants knew the true answer to obese BMI. Of the total participants, 283 (59.0%) did not knew about sleeve gastrectomy indications; however, 311 (64.8%) of the participants had heard about the complications of sleeve gastrectomy. All these results are correlated with the educational level of the participants. Conclusion: Our study shows a lack of awareness of sleeve gastrectomy indications and complications among study population. We need to increase public awareness about sleeve gastrectomy indications and complication by proper scientific health education in the community [ABSTRACT FROM AUTHOR]

This article focuses on the everyday responses of the local creatives in dealing with the problematic single narrative of creative cities. Aiming to understand the everyday creative and media practices of individuals in the creative collectives that are situated in emerging creative cities in Southeast Asia, the research specifically addresses key contemporary debates within the field of urban media and communication studies. The article gives priority to the voices of the city dwellers from a bottom-up approach, looking at the material and embodied practices in their everyday life. Empirically, this article seeks the alternative voices raised by the members of selected creative collectives - four collectives in Bandung, Indonesia, and four others in George Town, Malaysia - in articulating the meaning of creativity, the media practices involved within, and the organic ways of organizing urban collectives. Drawing insights from the notion of articulation and media practice, and by employing both ethnographic and visual methodology approaches, in particular the use of the photo-documentation method, there are three key thematic findings elaborated here. These themes are (1) social settings in media-related practices, (2) material objects and sensitive affection, and (3) the labor of love. The ways in which these are discussed, using a combination of ethnographic vignettes and photo collages, foreground the importance of cultural identity articulation practiced by the creative collectives in both cities. Thus, the interlinkage between mediated experiences, spatial practices, and visual contexts is also a key significant aspect in the analysis of these bottom-up, organic urban creativities.

Objective: To compare our experience with the LigaSure small jaw device and Harmonic scalpel in total thyroidectomy regarding operative time and major complications associated with surgery. Study Design: Prospective comparative study. Place and Study Duration: General Surgery Department, Pak Emirates Military Hospital, Rawalpindi and Combined Military Hospital, Kohat Pakistan, from Oct 2017 to Apr 2020. Methodology: This study included 150 patients diagnosed with simple/toxic multinodular goitre, thyroid carcinoma, and diffuse thyroid enlargement. Eighty-one patients were randomly assigned to the LigaSure Group and 69 to the Harmonic Group who underwent total thyroidectomy. Mean operative time and major complications like blood loss, hematoma, hypocalcemia, recurrent laryngeal injury, and surgical site infection were compared. Results: Median (IQR) operative time of the LigaSure small jaw device was 55.00(11) minutes, and that of the Harmonic scalpel was 60.00 (11) (p

BackgroundFrailty and sarcopenia are common in older people and are associated with adverse outcomes including increased mortality and morbidity. It is unclear whether screening for frailty and sarcopenia would identify specific populations most at risk of poor outcomes during unplanned hospital admissions, which screening tools should be used and what the trajectory of both conditions are over the course of an admission. The TYSON study is an observational cohort study aiming to determine the prevalence, trajectory and outcomes associated with frailty and sarcopenia in different patient cohorts. This protocol tests the feasibility and acceptability of TYSON processes.ObjectivesTo determine in acutely admitted medical patients who are older adults: Primary: The feasibility and acceptability of frailty and sarcopenia assessments; Secondary: (1) Differences in community and hospital frailty assessments, as assessed by the medical team, the patient and elderly care physicians, (2) The dynamic changes in frailty and sarcopenia during a hospital admission, and patient outcomes; Exploratory: Inflammatory and metabolic mediators associated with frailty and sarcopenia.MethodsA single centre, prospective observational study including patients aged ≥ 65 years admitted to an acute medical unit. Frailty assessments include the Rockwood clinical frailty and e-frailty index. Sarcopenia assessments include the Bilateral Anterior Thigh Thickness (BATT) measurement. Each participant will be asked to complete 5 visits, at day 0, day 3, day 7, month 3 and month 6. Blood samples will be collected to explore inflammatory and metabolic markers associated with frailty and sarcopenia. The study and protocol have been ethically approved by the Health Research Authority (REC 20/WA/0263).DiscussionThe study will determine the feasibility and acceptability of frailty and sarcopenia assessments in an acute hospital setting, and inform on the prevalence, trajectory and associated outcomes of frailty and sarcopenia in this group of patients. An inflammatory and metabolic profile will be explored in frailty and sarcopenia.

The three-dimensional finite element stress analysis method was used to determine the pattern and concentration of stresses within the Screw-Vent⇔ endosseous implant and its supporting tissues. For this commercially pure titanium implant, maximum stresses were located within the implant collar immediately below the bony crest. These stresses were at least 18 times less than the endurance limit of commercially pure titanium (259.90 MPa). Maximum stresses (19.57 MPa) in the bone were lingual to the superior portion of the collar. Previous longitudinal radiographic studies of a similar implant have revealed bone loss mesial and distal to the implant. For the Screw-Vent, mesial and distal stresses (maximum 0.38 MPa) were much lower than those buccal and lingual to the implant. The clinical significance of the stress transfer to the bone buccal and lingual to the implant has yet to be determined. [ABSTRACT FROM AUTHOR]

A considerable number of infective endocarditis (IE) patients require cardiac surgery with an increased risk for postoperative sepsis. Intraoperative hemoadsorption may diminish the risk of postoperative hyperinflammation with potential economic implications for intensive care unit (ICU) occupation. The present study aimed to theoretically investigate the budget impact of a reduced length of ICU stay in IE patients treated with intraoperative hemoadsorption in the German healthcare system. Data on ICU occupation were extrapolated from a retrospective study on IE patients treated with hemoadsorption. An Excel-based budget impact model was developed to simulate the patient course over the ICU stay. A base-case scenario without therapy reimbursement and a scenario with full therapy reimbursement were explored. The annual eligible German IE patient population was derived from official German Diagnostic-Related Group (DRG) volume data. One-way deterministic sensitivity analysis and multivariate analysis were performed to evaluate the uncertainty over the model results. The use of intraoperative hemoadsorption resulted in EUR 2298 being saved per patient in the base-case scenario without therapy reimbursement. The savings increased to EUR 3804 per patient in the case of full device-specific reimbursement. Deterministic and probabilistic sensitivity analyses confirmed the robustness of savings, with a probability of savings of 87% and 99% in the base-case and full reimbursement scenario, respectively. Intraoperative hemoadsorption in IE patients might have relevant economic benefits related to reduced ICU stays, resulting in improved resource use. Further evaluations in larger prospective cohorts are warranted.

This research aims to investigate the relationship between orthodontic treatment (OT) and altered passive eruption (APE). Materials and Methods: A case–control study was carried out among the dentistry students at Jazan University. A total of 21 students were recruited for the case group and 20 others for the control group. Variables were measured on the maxillary incisor teeth. They included an image analysis of the teeth width-to-height (W/H) ratio, a cone beam computed tomography (CBCT) analysis of buccal bone thickness (BCT), and the distance from the cementoenamel junction (CEJ) to the bone crest (BC) (CEJ–BC). In addition, a systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Prominent literature databases, including Medline/PubMed, the Cochrane Library, Embase, Scopus, Saudi Digital Library, and Google Scholar, were searched for articles published before November 2022 on two main concepts (APE and orthodontics). Quality of evidence was assessed using the Newcastle–Ottawa scale (NOS), and the certainty of evidence was assessed using the grading of recommendations assessment development and evaluation (GRADE) approach. Results: A total of 164 teeth were evaluated. No statistical differences were observed in the W/H ratio and BCT between the two groups. A significant increase in the CEJ–BC distance in the right and left maxillary lateral incisors was observed for people who had undergone OT (p ≤ 0.002 and 0.001, respectively). In the systematic review, two articles were included for qualitative synthesis. One of the included studies showed an increase in the post-orthodontics clinical crown length of the maxillary anterior teeth. Another study reported no difference in the prevalence of APE between orthodontically treated and untreated people. Conclusion: This research concludes that OT might not be an etiological factor for APE. However, more clinical and radiological studies must be conducted to arrive at decisive conclusions.

Background: Bladder cancer (BCa), the sixth commonest cancer in the USA, is highly lethal when metastatic. Spatial and temporal patterns of patient-specific metastatic spread are deemed random and unpredictable. Whether BCa metastatic patterns can be quantified and predicted more accurately is unknown. Objective: To develop a web-based calculator for forecasting metastatic progression in individual BCa patients. Design, setting, and participants: We used a prospectively collected longitudinal dataset of 3503 BCa patients who underwent a radical cystectomy following diagnosis and were enrolled continuously. We subdivided patients by their pathologic subgroup stages of organ confined (OC), extravesical (EV), and node positive (N+). We illustrated metastatic pathway progression using color-coded, circular, tree ring diagrams. We created a dynamical, data-visualization, web-based platform that displays temporal, spatial, and Markov modeling figures with predictive capability. Outcome measurements and statistical analysis: Patients underwent history and physical examination, serum studies, and liver function tests. Surveillance follow-up included computed tomography scans, chest x-rays, and radiographic evaluation of the reservoir and upper tracts, with bone scans performed only if clinically indicated. Outcomes were measured by time to clinical recurrence and overall or progression-free survival. Results and limitations: Metastases developed in 29% of patients (n = 812; median follow-up 15.3 yr), with 5-yr overall survival of 20.2%, compared with 78.6% in those without metastases (n = 1983; median follow-up 10.9 yr). The three commonest sites of spread at the time of first progression were bone (n = 214; 26.4%), pelvis (n = 194; 23.9%), and lung (n = 194; 23.9%). The order and frequency of these sites vary when divided by pathologic subgroup stages of OC (lung [n = 65; 25.1%], urethra [n = 45; 17.4%], and bone [n = 29; 11.2%]), EV (pelvis [n = 63; 33.0%], bone [n = 45; 23.6%], and lung [n = 29; 15.2%]), and N+ (bone [n = 111; 30.7%], retroperitoneum [n = 70; 19.3%], and pelvis [n = 60; 16.6%]). Markov chain modeling indicated a higher probability of spread from bladder to bone (15.5%), pelvis (14.7%), and lung (14.2%). Conclusions: Our web-based calculator allows real-time analyses in the clinic based on individual patient-specific demographic and cancer data elements. For contrasting subgroups, the models indicated differences in Markov transition probabilities. Spatiotemporal patterns of BCa metastasis and sites of spread indicated underlying organotropic mechanisms in the prediction of response. This recognition opens the possibility of organ site–specific therapeutic targeting in the oligometastatic BCa setting. In the precision medicine era, visualization of complex, time-resolved clinical data will enhance management of postoperative metastatic BCa patients. Patient summary: We developed a web-based calculator to forecast metastatic progression for individual bladder cancer (BCa) patients, based on the clinical and demographic information obtained at diagnosis. This can help in predicting disease status and survival, and improving management in postoperative metastatic BCa patients. Take Home Message: Future pathways of metastatic progression for individual bladder cancer patients can be determined based on currently available clinical and demographic information obtained at diagnosis. In focused subgroups of patients, these metastatic spread patterns can also portend disease status and survival.

Objective: To determine the diagnostic accuracy of Alvarado score and the RIPASA score for acute appendicitis using histopathology as a gold standard. Study Design: Cross sectional validation study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Mar to Sep 2018. Methodology: A total number of 270 patients were included in the study presenting with pain right iliac fossa to the Accident and Emergency department. Surgeons and Seniors Residents in Surgery on call in the Accident and Emergency Department. Combined Military Hospital, Rawalpindi, scored the patients with suspicion of acute appendicitis with Alvarado Score and RIPASA score simultaneously. After appendectomy of these patients, the removed appendix was sent for histopathology to confirm whether it was normal or inflamed. A 2x2 table was used for calculating sensitivity, specificity and diagnostic accuracy of the RIPASA score and Alvarado Score. The two scoring systems were then compared for diagnostic accuracy. Results: In our study, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of RIPASA score and Alvarado score for diagnosing acute appendicitis were 92.1%, 62.1%, 95.2%, 48.6%, 88.9% and 72.6%, 68.9%, 95.1%, 23.2%, 72.2% respectively. Conclusion: The diagnostic accuracy of RIPASA score was more than that of Alvarado score in diagnosing acute appendicitis.