Development of a core domain set for ankle osteoarthritis: An international consensus study of patients and health professionals.

OBJECTIVES: To develop an internationally agreed-upon core domain set for ankle osteoarthritis (OA). METHODS: In a three-part Delphi process, a group of multidisciplinary health professionals with expertise in ankle OA and people with ankle OA responded to online questionnaires. The questionnaires proposed a list of 29 candidate domains derived from a systematic review of ankle OA research, and interviews with people with ankle OA and health professionals. Consensus was defined a priori as ≥70% agreement in people with ankle OA and health professionals whether a domain should or should not be included in a core domain set. An online consensus meeting was held to discuss and resolve undecided candidate domains. RESULTS: A total of 100 people (75 health professionals and 25 people with ankle OA) from 18 countries (4 continents) participated in this study. Five domains reached consensus for inclusion in a core domain set for ankle OA - pain severity, health-related quality of life, function, disability and ankle range of motion. Twenty-one candidate domains reached agreement not to be included in the core domain set, and three domains remained undecided (ankle instability, physical capacity, and mental health). CONCLUSION: This international consensus study, which included people with ankle OA and health professionals, has established a core domain set for ankle OA with five domains that should be measured and reported in all ankle OA trials - pain severity, health-related quality of life, function, disability and ankle range of motion. This core domain set will guide the reporting of outcomes in clinical trials on ankle OA. Future research should determine which outcome measurement instruments should be used to measure each of the core domains.

Interventions for great saphenous vein insufficiency: A systematic review and network meta-analysis.

BACKGROUND: Great saphenous vein insufficiency (GSVI) adversely affects the quality of life of affected individuals. Minimally invasive endo-venous ablation techniques have emerged as effective and safe treatments, despite the longstanding use of surgical interventions. We aim in our study to evaluate all the available interventions in the literature, either endo-venous or conventional approaches for the treatment of GSVI. METHODS: A thorough search was performed across four electronic databases to identify relevant studies. A frequentist network meta-analysis (NWM) was executed on the combined data to derive network estimates pertaining to the outcomes of concern. Risk ratios (RRs) were employed as the effect size metric for binary outcomes, while mean differences (MDs) were utilized for continuous outcomes, each reported with a 95% confidence interval. The qualitative review was conducted employing the Cochrane risk of bias assessment tool 1. RESULTS: Our NWM included 75 studies encompassing 12,196 patients. Regarding technical success rate within the first 5 years after treatment, Endo-venous Laser Ablation (EVLA) with High Ligation and Stripping (HL/S), EVLA alone, Cyanoacrylate Adhesive Injection, cryostripping, HL/S and Radiofrequency Ablation (RFA) were significantly better than Ultrasound-Guided Foam Sclerotherapy and F-care. Also, invagination stripping was inferior to all interventions. Conservative Hemodynamic Cure for Venous Insufficiency and Varicose Veins (CHIVA) demonstrated a significantly lower recurrence rate with a RR of 0.35 [0.15; 0.79] compared to RFA, but RFA was more effective in recurrence prevention than HL/S and Mechanochemical Ablation (MOCA), with a RR of 0.63 [0.41; 0.97] and 0.18 [0.03; 0.95], respectively. Endo-venous Steam Ablation (EVSA) emerged as the most effective in reducing post-intervention pain, showing a MD of -2.73 [-3.72; -1.74] compared to HL/S. In Aberdeen Varicose Vein Questionnaire outcome, our analysis favored MOCA over most studied interventions, with an MD of -6.88 [-12.43; -1.32] compared to HL/S. Safety outcomes did not significantly differ among interventions. CONCLUSION: Our findings revealed significant variations in the technical success rates, recurrence rates, and post-intervention pain levels among different interventions. CHIVA exhibited enhanced performance in terms of lower recurrence rates, while EVSA emerged as a promising choice for mitigating post-intervention pain. Additionally, our analysis underscored the significance of patient-reported outcomes, with MOCA consistently yielding favorable results in terms of enhancing quality of life and expediting the return to regular activities.

Exploring sex disparities in cardiovascular disease risk factors using principal component analysis and latent class analysis techniques.

BACKGROUND: This study used machine learning techniques to evaluate cardiovascular disease risk factors (CVD) and the relationship between sex and these risk factors. The objective was pursued in the context of CVD being a major global cause of death and the need for accurate identification of risk factors for timely diagnosis and improved patient outcomes. The researchers conducted a literature review to address previous studies' limitations in using machine learning to assess CVD risk factors. METHODS: This study analyzed data from 1024 patients to identify the significant CVD risk factors based on sex. The data comprising 13 features, such as demographic, lifestyle, and clinical factors, were obtained from the UCI repository and preprocessed to eliminate missing information. The analysis was performed using principal component analysis (PCA) and latent class analysis (LCA) to determine the major CVD risk factors and to identify any homogeneous subgroups between male and female patients. Data analysis was performed using XLSTAT Software. This software provides a comprehensive suite of tools for Data Analysis, Machine Learning, and Statistical Solutions for MS Excel. RESULTS: This study showed significant sex differences in CVD risk factors. 8 out of 13 risk factors affecting male and female patients found that males and females share 4 of the eight risk factors. Identified latent profiles of CVD patients, suggesting the presence of subgroups among CVD patients. These findings provide valuable insights into the impact of sex differences on CVD risk factors. Moreover, they have important implications for healthcare professionals, who can use this information to develop individualized prevention and treatment plans. The results highlight the need for further research to elucidate these disparities better and develop more effective CVD prevention measures. CONCLUSIONS: The study explored the sex differences in the CVD risk factors and the presence of subgroups among CVD patients using ML techniques. The results revealed sex-specific differences in risk factors and the existence of subgroups among CVD patients, thus providing essential insights for personalized prevention and treatment plans. Hence, further research is necessary to understand these disparities better and improve CVD prevention.

Mast Cell ß-Tryptase Is Enzymatically Stabilized by DNA.

Tryptase is a tetrameric serine protease located within the secretory granules of mast cells. In the secretory granules, tryptase is stored in complex with negatively charged heparin proteoglycans and it is known that heparin is essential for stabilizing the enzymatic activity of tryptase. However, recent findings suggest that enzymatically active tryptase also can be found in the nucleus of murine mast cells, but it is not known how the enzmatic activity of tryptase is maintained in the nuclear milieu. Here we hypothesized that tryptase, as well as being stabilized by heparin, can be stabilized by DNA, the rationale being that the anionic charge of DNA could potentially substitute for that of heparin to execute this function. Indeed, we showed that double-stranded DNA preserved the enzymatic activity of human ß-tryptase with a similar efficiency as heparin. In contrast, single-stranded DNA did not have this capacity. We also demonstrated that DNA fragments down to 400 base pairs have tryptase-stabilizing effects equal to that of intact DNA. Further, we showed that DNA-stabilized tryptase was more efficient in degrading nuclear core histones than heparin-stabilized enzyme. Finally, we demonstrated that tryptase, similar to its nuclear localization in murine mast cells, is found within the nucleus of primary human skin mast cells. Altogether, these finding reveal a hitherto unknown mechanism for the stabilization of mast cell tryptase, and these findings can have an important impact on our understanding of how tryptase regulates nuclear events.

Pathogenic features of Streptococcus mutans isolated from dental prosthesis patients and diagnosed cancer patients with dental prosthesis.

Though S. mutans, virulence, and pathogenesis are characterized, reports are limited to the status of its carriage and virulence in patients with oral cancer and prosthesis. In this present study, we investigated the pathogenic characteristics of twenty strains of S. mutans of healthy subjects, fifteen of prosthesis patients, and eleven from oral cancer. The putative virulence gene and other factors, such as the ability to adhere to the oral epithelial cells, production of glycan and lactic acid of these strains were examined. Few of representative isolates of each group were used to see their activity on oral cancer cell line using cell cytotoxicity assay. The isolation rate of S. mutans was significantly more in carcinoma than prosthesis patients and control health group. The production of glycan and latic acid was together high in those isolates derived from prosthesis patients and patients with cancer. Adherence ability of strains isolated from prosthesis patients and cancer patients with oral prosthesis were significantly higher, compared to one isolated from a healthy individual. From our study results, we conclude that prosthesis patients and cancer patients with prosthesis carried a high number of S. mutans in their oral cavities. SIGNIFICANCE AND IMPACT OF STUDY: This study report that prosthesis patients and cancer patients with prosthesis carried a high number of S. mutans in their oral cavities. However, the S mutans are commensals still they have the capability to raise the severity of disease condition due to their ability to produce glycan and lactic acid. In our study, we proved that the adherence to buccal epithelial cells was significantly increased in S. mutans isolates of prosthesis patients and cancer patients. These indicate that in prosthesis patients as well as in cancerous patient's microbes had more potential to cause infection and increase the severity.

Aesthetic problems related to dental implants in the aesthetic zone: A systematic review.

Background: Patient satisfaction is a crucial indicator of a successful dental implant treatment. Attainment of an aesthetically acceptable final result is central to this success. Hence, the primary objective of this systematic review was to identify aesthetic concerns linked to dental implants within the aesthetic zone. Methods: An electronic search was conducted on different databases such as PubMed, Medline, and Google Scholar using the key terms "tooth implant," "anterior implant," "dental implantation in the aesthetic zone," and "aesthetic area implant. Following the elimination of duplicate articles and adherence to the inclusion criteria, 14 articles (five randomized clinical trials, four prospective clinical trials, four case series, and one pilot study) published between 2007 and 2020 were deemed suitable for this review. Results: The selected studies highlighted several aesthetic issues, such as recession, marginal bone loss, gingival loss, and pink aesthetic scores related to dental implants placed in the aesthetic zone. Conclusion: Addressing these challenges necessitates meticulous treatment planning, effective soft tissue management, regular follow-ups, patient education, expectation management, and collaborative efforts among specialists. A limitation of this systematic review is that it focused solely on studies conducted within a relatively short timeframe (2007-2020). However, it is essential to recognize that significant changes occurred in the treatment procedures and materials within the field during this period. These changes have resulted in notable variances in the treatment protocols utilized across studies, potentially affecting the generalizability of the findings.

Evaluation of alveolar bone loss among diabetic patients with class II amalgam restorations.

The relationship between Class II amalgam restorations and alveolar bone loss among diabetic and non-diabetic patients is evaluated at the Faculty of Dentistry, Najran University, KSA. Hence, we compared type 2 diabetic (n = 32) and non-diabetic patients (n=32) using clinical assessments and imaging techniques. Parameters such as bone loss rate, extent, age, and periodontal condition (plaque index and Gingival Index) were analyzed. Analysis of data shows that diabetic patients on average have higher bone loss.

Concerns beyond ankle symptoms predominate healthcare professionals' views of patients with ankle osteoarthritis: A qualitative study.

OBJECTIVES: Explore healthcare professionals' perspectives on the main problems that their patients with ankle osteoarthritis experience and to propose health-related domains. METHODS: A qualitative study using semi-structured interviews was conducted with an international multidisciplinary group of healthcare professionals identified as ankle experts. Eligibility criteria were aged ≥18 years, and a certified healthcare professional with ≥ 5-year experience post-qualification in working with ankle osteoarthritis and/or chronic ankle pain. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS: Twenty-one healthcare professionals (20 males; mean (range) age 49 (34-72) years) from four professions (orthopaedic surgeons (n = 9), athletic trainers (n = 5), physiotherapists (n = 4) and podiatrists (n = 3)) were interviewed. Four main themes were identified: 1) people with ankle osteoarthritis have difficulty with weight-bearing activities; 2) symptoms of pain and stiffness predominate, alongside swelling, instability, weakness and poor balance; 3) chronic pain in ankle osteoarthritis has psychosocial consequences; and 4) the loss of activities of daily living and independence compromises quality of life. We proposed 15 health-related domains that emerge from the interview data. CONCLUSION: Healthcare professionals recognise that ankle osteoarthritis patients have difficulty in physical, sporting, and occupational weight-bearing activities, and they live with persistent ankle pain, stiffness and other symptoms that have physical and psychosocial consequences. The health-related domains derived from interviews with expert healthcare professionals will contribute to the development of a core domain set for ankle osteoarthritis.

Evaluation of Periodontal Clinicoradiographic Status and Whol Salivary Prostaglandin E2 Levels among Users of Water Pipe and Cigarettes.

PURPOSE: The objective was to evaluate the periodontal clinicoradiographic status and whole salivary prostaglandin E2 (PgE2) levels among users of water pipe and cigarettes. MATERIALS AND METHODS: Demographic data, duration of smoking (pack years), and familial history of smoking were recorded using a questionnaire. Participants were allocated into three groups based on their smoking status: group 1: self-reported cigarette smokers (CS); group 2: self-reported water-pipe-users; and group 3: non-smokers. The assessment included measurements of full-mouth plaque and gingival indices (PI and GI), as well as probing depth (PD), clinical attachment loss (CAL), and marginal bone loss (MBL). Unstimulated whole saliva samples were collected and PgE2 levels were measured. Group comparisons were done and p<0.05 was considered statistically significant. RESULTS: Thirty-three, 34 and 33 individuals were included in groups 1, 2 and 3, respectively. Full mouth PI (p<0.05), GI (p<0.05), PD (p<0.05) and mesial (p<0.05) and distal (p<0.05) MBL were statistically significantly higher among patients in groups 1 and 2 than group 3. The scores of CAL in groups 1 and 2 were 3.45 ± 0.97 and 3.62 ± 1.2 mm, respectively. None of the individuals in the control group displayed CAL. PgE2 levels were statistically significantly higher among patients in groups 1 (231.5 ± 66.3 pg/ml) (p<0.05) and 2 (231.5 ± 66.3 pg/ml) (p<0.05) compared with group 3 (76.6 ± 10.6 pg/ml). In groups 1 and 2, a statistically significant relationship was observed between pack-years, the duration of water-pipe smoking, and the levels of PgE2 and PD. CONCLUSION: There is no difference in periodontal clinicoradiographic status and whole salivary PgE2 levels between CS and waterpipe-users; however, these parameters are worse in CS and water-pipe users than in non-smokers.

Structure-Property Relationships in PVDF/SrTiO3/CNT Nanocomposites for Optoelectronic and Solar Cell Applications.

The optical properties of polyvinylidene fluoride (PVDF) polymer nanocomposite films incorporating SrTiO3/carbon nanotubes (CNTs) as nanofillers are investigated. PVDF/SrTiO3/CNTs films were prepared by the solution casting technique. X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM) analyses confirmed the incorporation of SrTiO3/CNTs into the PVDF matrix. The addition of nanofillers influenced the crystalline structure, morphology, and optical properties of the films. SEM images showed spherulite morphology, which is a spherical aggregate of crystalline polymer chains. The addition of a SrTiO3/CNTs nanofiller modified the polymer's electronic structure, causing a variation in the energy gap. The addition of SrTiO3/CNTs at 0.1 wt% increased the band gap, refractive index, and nonlinear optical properties of the PVDF films. These improvements indicate the potential of these nanocomposite films in optoelectronic applications such as solar cells, image sensors, and organic light-emitting diodes.

Awareness About Osteoporosis Among the General Population Based on the Osteoporosis Knowledge Assessment Tool (OKAT): A Cross-Sectional Study in the Northern Border Region of Saudi Arabia.

OBJECTIVE: Osteoporosis is a progressive systemic skeletal disease characterized by increasing susceptibility to fractures. The current study was conducted to assess the awareness about osteoporosis among the general population in the Northern Border region of Saudi Arabia to improve awareness and proper planning for public awareness about osteoporosis. METHODS: The study was conducted as a cross-sectional survey study, based on the online distribution of the Arabic-translated Osteoporosis Knowledge Assessment Tool (OKAT). The questionnaire questions cover the demographic characteristics of the participants, as well as symptoms, risk factors, prevention, and knowledge of treatment centers for osteoporosis in Saudi Arabia. RESULTS: 395 participants were enrolled in the study after their informed consenting. After scoring all correct answers for each participant, the mean score of all participants' answers was 12.5±3.4 (range 0-19). Participants with poor knowledge (0-7 scores), moderate knowledge (8-13 scores), and good knowledge (13-20 scores) represent 61 (15.4%), 213 (53.9%), and 121 (30.6%), respectively. The mean percentage of right answers to all the questions is 44.1%. The highest awareness level was shown in the area of osteoporosis symptoms and risk of fractures, while the lowest was recorded in the questions covering the risk factors. Ages, genders, jobs, and levels of education significantly affected the participants' levels of awareness. CONCLUSION: The public awareness among the population in the Northern Border region about osteoporosis is less than satisfactory. More awareness activities targeting the risky groups should be planned especially in the area of risk factors and preventive measures for osteoporosis.

Incidence, Prevalence, Risk Factors, and Clinical Treatment for Children with Developmental Dysplasia of the Hip in Saudi Arabia. A Systematic Review.

BACKGROUND: Developmental dysplasia of the hip (DDH) leads to pain, joint instability, and early degenerative joint disease. Incidence, prevalence, and management strategies of DDH have been well-documented in several countries, but not in Saudi Arabia. OBJECTIVE: We synthesized the current evidence regarding incidence, prevalence, risk factors, and clinical treatment for children with DDH in Saudi Arabia. METHODS: We searched 3 databases to locate studies. Studies that included children with DDH in Saudi Arabia; reported either incidence rate, prevalence, risk factors, and/or clinical practice; and were available in English or Arabic were included. We excluded reviews, case studies, or animal studies. Two independent authors reviewed potential studies and assessed study's quality. RESULTS: Our search yielded 67 potential studies, of which 16 studies were included (total DDH sample = 3,127; age range = 2.5 to 86.4 months). Three studies reported incidence rates ranging from 3.1 to 4.9 per 1000 births, and 3 studies reported prevalence ranging from 6 to 78%. Nine studies reported that female sex, breech position, family history, and age less than 3 years were risk factors associated with DDH. Four studies reported that brace applications and closed reduction were conservative treatments, and 9 studies reported that open hip reduction, adductor tenotomy, and/or pelvic osteotomy were surgical approaches to treat DDH. CONCLUSIONS: In Saudi Arabia, the Incidence and prevalence rates of DDH are 3.1 to 4.9 per 1,000 births, and 6-78%, respectively (differ from what has been reported in other countries), but the risk factors of DDH in Saudi Arabia appear to be similar in comparison to other countries (female, breech presentation, family history of DDH).

Awareness and Perception of Telemedicine Among the General Population in the Central, Northern, and Western Regions of Saudi Arabia.

BACKGROUND:  Telemedicine is a paradigm shift that utilizes technology for remote healthcare delivery, improving the quality of care. OBJECTIVES: This study aims to assess the general population's awareness and perception regarding telemedicine in the central, northern, and western regions of Saudi Arabia. METHODS:  A web-based cross-sectional study was conducted in the central, northern, and western regions of Saudi Arabia from January 2024 to May 2024. A structured questionnaire was used to collect data, including sociodemographic information and questions to assess participants' awareness and perception of telemedicine. Data were analyzed using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York, United States), with significance at p < 0.05. RESULTS:  Out of 414 adult participants in the study, 264 (63.8%) were female, and 205 (49.5%) were below the age of 25. Approximately a quarter of the participants reported being very or moderately familiar with telemedicine. Furthermore, most participants (80.5%, 243) expressed their willingness to try telemedicine. The most common barriers to telemedicine practice were concerns about diagnostic reliability, resistance from physicians, and patient resistance. The study found no significant associations between participants' sociodemographic variables, their familiarity with telemedicine, and their readiness to adopt it. CONCLUSION: While there is a low level of awareness and knowledge regarding telemedicine among general populations in Saudi Arabia, there is generally a positive perception and willingness to adopt telemedicine for improved healthcare delivery. Addressing barriers to adopting such technology is crucial to ensure the country's successful implementation and widespread acceptance of telemedicine.

Sensing the invisible: Ultrasensitive and selective colorimetric detection of E. coli O157:H7 based on masking the peroxidase-mimetic activity of aptamer-modified Au/Fe3O4.

Escherichia coli O157:H7 (E. coli O157:H7) emerges as a significantly worrisome pathogen associated with foodborne illnesses, emphasizing the imperative for creating precise detection tools. In this investigation, we developed a sensitive colorimetric biosensor for detecting E. coli O157:H7. It was constructed using a nanozyme comprised of Au@Fe3O4 NPs, which was fabricated and subsequently modified with an aptamer (Apt). The nanozyme harnesses its inherent peroxidase-like activity to facilitate the transformation of reduced TMB into its oxidized form in the presence of H2O2, resulting in a noticeable shift to a blue color. However, the presence of E. coli O157:H7 effectively diminished the absorbance of oxidized TMB. Consequently, the normalized absorbance at 652 nm demonstrates a linear decrease corresponding to concentrations of E. coli O157:H7 within the range of 101 to 108 CFU mL-1 with a low limit of detection (LOD, S/N = 3) of 3 CFU mL-1.

Outcome measures in clinical studies of ankle osteoarthritis: a systematic review.

OBJECTIVE: To explore and describe the outcome measures reported in primary research of ankle osteoarthritis (OA) and to propose aligned health-related domains. METHODS: Six databases were searched, and studies were screened by two independent reviewers. Studies of participants with ankle OA who were> 18 years of age and reported outcome measure data were included. Non-English, animal, cadaveric, reviews, and studies with< 5 participants were excluded. Outcome measures were examined for content and mapped to health-related domains. RESULTS: 1386 studies were identified, of which 547 met selection criteria - reporting 250 outcome measures. Most commonly reported measures were the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (n = 257 studies), plain radiographs to measure ankle alignment (n = 211), numerical rating scale for pain severity (n = 177) and goniometry to measure ankle range of motion (n = 148). Outcome measures were organised into 19 domains. The most common domains were pain severity (315 (58%) studies), ankle alignment (254 (46%)), ankle motion (181 (33%)), disability (169 (31%)) and health-related quality of life (128 (23%)). These domains fell into the Outcome Measures in Rheumatology (OMERACT) core areas of life impact and pathophysiological manifestations. CONCLUSION: Many outcome measures are used in ankle OA research, most of which assess joint alignment, pain, and motion. Based on the outcome measures identified, we proposed 19 possible health-related domains, predominantly in the OMERACT core areas of life impact and pathophysiological manifestations of ankle OA. Clinicians and researchers can use this review in guiding selection of outcome measures.

"It's like a nail being driven in the ankle": A qualitative study of individuals' lived experiences to inform a core domain set for ankle osteoarthritis.

OBJECTIVES: Explore individuals' lived experience with ankle osteoarthritis and to identify health-related domains for ankle osteoarthritis based on the perspectives of people living with the condition, as an initial step to address the International Foot and Ankle Osteoarthritis Consortium's recommendation to develop a core domain set for ankle osteoarthritis. METHODS: A qualitative study using semi-structured interviews was conducted. Interviews were undertaken with individuals with symptomatic ankle osteoarthritis who were aged ≥35 years. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS: Twenty-three individuals (16 females; mean (range) age 62 (42-80) years) were interviewed. Five themes were identified: pain, often severe, is a central feature of living with ankle osteoarthritis; stiffness and swelling are key symptoms; ankle osteoarthritis induced mobility impairments compromise enjoyment in life; ankle osteoarthritis instability and balance impairments lead to concerns about falling; there are financial implications of living with ankle osteoarthritis. We propose 17 domains based on individuals' experiences. CONCLUSION: Study findings indicate that individuals with ankle osteoarthritis live with chronic ankle pain, stiffness and swelling which affect their ability to participate in physical, and social activities, maintain an active lifestyle, and work in physical occupations. From the data, we propose 17 domains that are important to people with ankle osteoarthritis. These domains require further evaluation to ascertain their inclusion in a core domain set for ankle osteoarthritis.

Estimation of serum C-reactive protein activity in periodontal health and disease and response to treatment: a clinico-biochemical study.

Background: Periodontitis is a chronic infectious disease affecting periodontium having multifactorial etiology, can cause significant systemic challengein addition to localized inflammation, tissue damage, and bone resorption. A serological marker of systemic inflammation known as C-reactive protein has been linked to an increased risk for a number of pathological conditions, including cardiovascular diseases. Aim: To estimate levels of serum C-reactive protein in healthy individuals and subjects with periodontal diseases and to compare serum C-reactive protein levels in subjects having periodontal disease pre-operatively & post-operatively. Materials and methods: The study was conducted on 60 subjects age ranging from 35 to 60 years. 30 individuals with healthy periodontium were in group 1 (control group) and the remaining 30 were diagnosed as adult periodontitis were in group 2 (experimental group). Periodontal examination done using gingival index, plaque index, periodontal pocket depth, and Russel's index. CRP levels were examined between group 1 and group 2 and in group 2 between baseline visit before treatment and 2 months after treatment. Results: The findings of this study show a significant connection between periodontal disease and the inflammatory marker CRP in the body, as well as a tendency for a significant decrease in serumCRP levels following periodontitis therapy. At baseline, there was a positive correlation among C-reactive protein, probing pocket depth, and Russell's index. Conclusion: As CRP is a key mediator for cardiovascular disease, an increase in C- reactive protein levels in periodontal diseases suggests a significant connection between periodontitis and cardiovascular diseases. Early periodontal treatment might decrease the severity of cardiovascular disease that already exists. This suggests that periodontal examination should be part of routine practicealong with cardiovascular examination.

A Cross-Sectional Evaluation of Parents' Awareness Towards Testicular Torsion and Their Response to a Potential Torsion: A Northern Saudi Study.

Background: Assessment of parents' awareness of testicular torsion (TT) is essential to plan for necessary awareness-raising campaigns by policymakers. Hence, the preventable loss of testis due to inadequate awareness can be avoided. We aimed to evaluate the awareness of TT amongst parents from the Aljouf region, KSA, and to assess their response to a potential torsion. Methods: We conducted a cross-sectional study among parents from the Aljouf region. The sample population was obtained using a consecutive sampling method. The present study used a pretested Arabic questionnaire. We used a statistical package for social science software for data analysis. Results: There were 320 parents who participated in different public places for the present study. Of the respondents, 10.6% of their children had sudden pain in the scrotum. More than half (52.2%) had never heard of testicular torsion, and 72.5% of parents agreed that they would seek immediate medical attention for severe testicular pain, but a low (42.5%) proportion of parents responded that they would seek help immediately. Nearly one-fourth of them responded that less than 6 hours is the critical time for repair. Parents who were knowledgeable at the critical time had more odds of presenting to a healthcare facility immediately for both mild (OR = 2.77, CI = 1.55-4.03, p = 0.001) and severe (OR = 1.92, CI = 1.03-3.63, p = 0.032). Conclusion: We found a lack of awareness of TT among Saudi parents. It is suggested to improve the knowledge among them through awareness-raising campaigns by the concerned health authorities through feasible methods. Furthermore, we recommend conducting a futuristic multicenter and exploratory study to find province-specific awareness.

Effect of Rice Husk and Wood Flour on the Structural, Mechanical, and Fire-Retardant Characteristics of Recycled High-Density Polyethylene.

Given the rising consumption of plastic products, it is becoming imperative to prioritize the recycling of plastic items as a solution to reducing plastic waste and environmental pollution. In this context, this research focuses on assessing the impact of incorporating rice husk and wood flour into recycled high-density polyethylene (rec-HDPE) to analyze its mechanical properties, flammability, and thermal stability. The combined rec-HDPE content of wood flour and rice husk varied between 0% and 20%. The rec-HDPE content of maleic anhydride grafted polyethylene (MAPE) was fixed at 3%. Mechanical characteristics such as flexural, tensile, and impact strengths were assessed. Cone calorimetry (CC) tests, limited oxygen index (LOI) tests, and horizontal and vertical burning tests were performed to determine the flammability or fire retardancy of these composites. On the other hand, to characterize the thermal characteristics of these composites, thermogravimetric analysis (TGA) was used. To further characterize the fluctuation in these characteristics, scanning electron microscopy (SEM) and infrared spectroscopy (FTIR) studies were carried out. The mechanical characteristics were found to be increased in response to adding rice husk or wood flour. An 8% increase in tensile strength and a 20% increase in elastic modulus enhancement were recorded for a 20% rice husk-added composite. SEM revealed the reason for the variation in tensile properties, based on the extent of agglomeration and the extent of uniform distribution of fillers in rec-HDPE. Following these lines, the 20% rice husk-added composite also showed a maximum increase of around 6% in its flexural strength and a maximum increase of 50% in its flexural modulus. A decrease in impact strength was recorded for rice husk and wood flour-reinforced composites, compared with unreinforced rec-HDPE. Hybrid composites displayed a lack of mechanical strength due to changes in their nature. FTIR tests were performed for a much more elaborate analysis to confirm these results. Twenty percent of rice husk-added rec-HDPE displayed the best thermal properties that were tested, based on TGA and derivative thermogravimetric (DTG) analysis. This 20% composite also displayed the best fire-retardancy characteristics according to UL 94 tests, cone calorimetry tests, and limited oxygen index tests, due to the barrier created by the silica protective layer. These tests demonstrated that the incorporation of both fillers-rice husk and wood flour-effectively enhanced the thermal, mechanical, and fire-retardant attributes of recycled HDPE.

Deciphering key genes involved in cisplatin resistance in kidney renal clear cell carcinoma through a combined in silico and in vitro approach.

The low survival rate of Kidney renal clear cell carcinoma (KIRC) patients is largely attributed to cisplatin resistance. Rather than focusing solely on individual proteins, exploring protein-protein interactions could offer greater insight into drug resistance. To this end, a series of in silico and in vitro experiments were conducted to identify hub genes in the intricate network of cisplatin resistance-related genes in KIRC chemotherapy. The genes involved in cisplatin resistance across KIRC were retrieved from the National Center for Biotechnology Information (NCBI) database using search terms as "Kidney renal clear cell carcinoma" and "Cisplatin resistance". The genes retrieved were analyzed for hub gene identification using the STRING database and Cytoscape tool. Expression and promoter methylation profiling of the hub genes was done using UALCAN, GEPIA, OncoDB, and HPA databases. Mutational, survival, functional enrichment, immune cell infiltration, and drug prediction analyses of the hub genes were performed using the cBioPortal, GEPIA, GSEA, TIMER, and DrugBank databases. Lastly, expression and methylation levels of the hub genes were validated on two cisplatin-resistant RCC cell lines (786-O and A-498) and a normal renal tubular epithelial cell line (HK-2) using two high throughput techniques, including targeted bisulfite sequencing (bisulfite-seq) and RT-qPCR. A total of 124 genes were identified as being associated with cisplatin resistance in KIRC. Out of these genes, MCL1, IGF1R, CCND1, and PTEN were identified as hub genes and were found to have significant (p < 0.05) variations in their mRNA and protein expressions and effects on the overall survival (OS) of the KIRC patients. Moreover, an aberrant promoter methylation pattern was found to be associated with the dysregulation of the hub genes. In addition to this, hub genes were also linked with different cisplatin resistance-causing pathways. Thus, hub genes can be targeted with Alvocidib, Estradiol, Tretinoin, Capsaicin, Dronabinol, Metribolone, Calcitriol, Acetaminophen, Acitretin, Cyclosporine, Azacitidine, Genistein, and Resveratrol drugs. As the pathogenesis of KIRC is complex, targeting hub genes and associated pathways involved in cisplatin resistance could bring a milestone change in the drug discovery and management of drug resistance, which might uplift overall survival among KIRC patients.