Improved pediatric ICU mortality prediction for respiratory diseases: machine learning and data subdivision insights.

The growing concern of pediatric mortality demands heightened preparedness in clinical settings, especially within intensive care units (ICUs). As respiratory-related admissions account for a substantial portion of pediatric illnesses, there is a pressing need to predict ICU mortality in these cases. This study based on data from 1188 patients, addresses this imperative using machine learning techniques and investigating different class balancing methods for pediatric ICU mortality prediction. This study employs the publicly accessible "Paediatric Intensive Care database" to train, validate, and test a machine learning model for predicting pediatric patient mortality. Features were ranked using three machine learning feature selection techniques, namely Random Forest, Extra Trees, and XGBoost, resulting in the selection of 16 critical features from a total of 105 features. Ten machine learning models and ensemble techniques are used to make accurate mortality predictions. To tackle the inherent class imbalance in the dataset, we applied a unique data partitioning technique to enhance the model's alignment with the data distribution. The CatBoost machine learning model achieved an area under the curve (AUC) of 72.22%, while the stacking ensemble model yielded an AUC of 60.59% for mortality prediction. The proposed subdivision technique, on the other hand, provides a significant improvement in performance metrics, with an AUC of 85.2% and an accuracy of 89.32%. These findings emphasize the potential of machine learning in enhancing pediatric mortality prediction and inform strategies for improved ICU readiness.

Photobiomodulation in Orthodontics: Mechanisms and Clinical Efficacy for Faster Tooth Movement.

Accelerated orthodontics has revolutionized traditional dental practices by employing innovative techniques to expedite tooth movement and enhance treatment outcomes. Among these advancements, low-level laser therapy (LLLT) has emerged as a promising adjunctive method that offers a non-invasive and efficient approach to accelerate orthodontic tooth movement. By harnessing the power of low-level lasers, LLLT aims to stimulate cellular activity, promote bone remodeling, and reduce treatment duration, thereby revolutionizing the landscape of orthodontic care. In this review, we discuss the mechanism of action, methods, efficacy, advantages, limitations, and future scope of LLLT, uncovering its transformative impact on the field of accelerated orthodontics.

Advances in nano sensors for monitoring and optimal performance enhancement in photovoltaic cells.

Nanosensors have gained significant attention in recent years for improving energy conversion and storage performance in solar cells. These nanosensors, typically made from nanoparticles or nanowires, can be embedded within the solar cell to monitor parameters like temperature and light intensity. By monitoring these parameters, nanosensors provide real-time feedback and control to optimize the efficiency and performance of the solar cell. They also play a role in detecting potential issues, such as defects, for proactive maintenance and troubleshooting. The integration of nanosensors in solar cells enables the development of smart energy systems, leading to increased power output, improved stability, and a longer lifespan of solar cells. The deployment of nanosensors in solar cells offer promising trajectory for advancing energy conversion, utilization, and storage capabilities. This review summarizes recent advances in nanosensors in solar cells, with a focus on the role they play in enhancing energy conversion, utilization, and storage performance.

Utilization of Shock Team and Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) in the Management of Cardiogenic Shock in Northern Ontario.

Background: Despite advancements in critical care and coronary revascularization, cardiogenic shock (CS) outcomes remain poor. Implementing a shock team and use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) have been associated with improved CS outcomes, but its feasibility in remote and rural areas remains unknown. Methods: This retrospective study included patients with CS who required mechanical circulatory support (MCS) at Health Sciences North, Sudbury, Ontario. The analysis aimed to accomplish 2 objectives: first, to review the outcomes associated with use of Impella (Abiomed, Danvers, MA) and, second, to assess the feasibility of establishing a shock team to facilitate the local implementation of VA-ECMO. The primary endpoint was in-hospital mortality. Results: The outcomes of 15 patients with CS who received Impella between 2015 and 2021 were reviewed. Their average age was 65 years (standard deviation [SD]: 13), and 8 patients (53%) were female. CS was ischemic in 12 patients (80%). Transfemoral Impella CP (cardiac power) was the most frequently used (93%). Thirteen patients (87%) died during the index hospital stay post-Impella because of progressive circulatory failure. The shock team was established following consultations with several Canadian MCS centres, leading to the development of a protocol to guide use of MCS. There have been 4 cases in which percutaneous VA-ECMO using Cardiohelp (Getinge/Maquet, Wayne, NJ) has been used; 3 (75%) survived beyond the index hospitalization. Conclusions: This analysis demonstrated the feasibility of implementing a shock team in remote Northern Ontario, enabling the use of VA-ECMO with success in a centre with a sizeable rural catchment area. This initiative helps address the gap in cardiac care outcomes between rural and urban areas in Ontario.

Introduction: En dépit des avancées des soins aux patients en phase critique et de la revascularisation coronarienne, les résultats du choc cardiogénique (CC) semblent mauvais. La mise en place d'une équipe de choc et l'utilisation de l'oxygénation extracorporelle (ECMO, de l'anglais extracorporeal membrane oxygenation) par voie veino-artérielle (VA) (VA-ECMO) ont été associées à de meilleurs résultats du CC, mais on ignore sa faisabilité dans les régions éloignées et rurales. Méthodes: La présente étude rétrospective portait sur des patients en CC qui ont eu besoin d'une assistance circulatoire mécanique (ACM) à Horizon Santé-Nord, à Sudbury, en Ontario. L'analyse visait 2 objectifs : le premier objectif était de passer en revue les résultats associés à l'utilisation de Impella (Abiomed, Danvers, MA) et, le deuxième était d'évaluer la faisabilité de la mise en place d'une équipe de choc pour faciliter la mise en œuvre locale de la VA-ECMO. Le principal critère d'évaluation était la mortalité intrahospitalière. Résultats: Nous avons passé en revue les résultats cliniques de 15 patients ayant subi un CC qui avaient reçu une Impella entre 2015 et 2021. L'âge moyen était de 65 ans (écart type [ET] : 13), et 8 patients (53 %) étaient des femmes. Le CC était d'origine ischémique chez 12 patients (80 %). L'Impella CP (cardiac power, soit la pompe cardiaque) par voie transfémorale était la plus fréquemment utilisée (93 %). Treize patients (87 %) sont morts durant le séjour de référence à l'hôpital après l'utilisation de l'Impella en raison d'insuffisance circulatoire progressive. La mise en place de l'équipe de choc à la suite des consultations dans plusieurs centres canadiens d'ACM a mené à l'élaboration d'un protocole d'utilisation de l'ACM. Il y a eu 4 cas chez lesquels la VA-ECMO par voie percutanée à l'aide de Cardiohelp (Getinge/Maquet, Wayne, New Jersey, É.-U.) a été utilisée ; 3 (75 %) ont survécu après l'hospitalisation de référence. Conclusions: Cette analyse a démontré la faisabilité de la mise en place d'une équipe de choc dans les régions éloignées du nord de l'Ontario, qui a permis d'utiliser efficacement la VA-ECMO dans un centre d'une circonscription hospitalière rurale non négligeable. Cette initiative aide à remédier à l'écart des résultats en soins cardiaques entre les régions rurales et urbaines de l'Ontario.

Retraction: Urinary Bladder Hernia: A Rare Cause of Urinary Frequency.

[This retracts the article DOI: 10.7759/cureus.20993.].

A lightweight and robust authentication scheme for the healthcare system using public cloud server.

Cloud computing is vital in various applications, such as healthcare, transportation, governance, and mobile computing. When using a public cloud server, it is mandatory to be secured from all known threats because a minor attacker's disturbance severely threatens the whole system. A public cloud server is posed with numerous threats; an adversary can easily enter the server to access sensitive information, especially for the healthcare industry, which offers services to patients, researchers, labs, and hospitals in a flexible way with minimal operational costs. It is challenging to make it a reliable system and ensure the privacy and security of a cloud-enabled healthcare system. In this regard, numerous security mechanisms have been proposed in past decades. These protocols either suffer from replay attacks, are completed in three to four round trips or have maximum computation, which means the security doesn't balance with performance. Thus, this work uses a fuzzy extractor method to propose a robust security method for a cloud-enabled healthcare system based on Elliptic Curve Cryptography (ECC). The proposed scheme's security analysis has been examined formally with BAN logic, ROM and ProVerif and informally using pragmatic illustration and different attacks' discussions. The proposed security mechanism is analyzed in terms of communication and computation costs. Upon comparing the proposed protocol with prior work, it has been demonstrated that our scheme is 33.91% better in communication costs and 35.39% superior to its competitors in computation costs.

Nanomaterials Connected to Bioreceptors to Introduce Efficient Biosensing Strategy for Diagnosis of the TORCH Infections: A Critical Review.

TORCH infection is a significant risk factor for severe fetal damage, especially congenital malformations. Screening pregnant women for TORCH pathogens could reduce the incidence of adverse pregnancy outcomes and prevent birth defects. Hence, timely identification and inhibition of TORCH infections are effective ways to successfully prevent them in pregnant women. Recently, the superiority of biosensors in TORCH pathogen sensing has been emphasized due to their intrinsic benefits, such as rapid response time, portability, cost-effectiveness, much friendlier preparation and determination steps. With the introduction of advanced nanomaterials into biosensing, the diagnostic properties of biosensors have significantly improved. This study core presents and debates the current progress in biosensing systems for TORCH pathogens using various artificial and natural receptors. The incorporation of nanomaterials into various transduction systems can enhance diagnostic performance. The key performance characteristics of optical and electrochemical biosensors, such as response time, limit of detection (LOD), and linear detection range, are systematically discussed, along with the current TORCH pathogens used for constructing biosensors. Finally, the major problems that exist for converting scientific investigation into product development are also outlined.

Efficacy of intra-arterial lidocaine administration on pain and inflammatory response after uterine artery embolization for symptomatic fibroids.

BACKGROUND: There have been conflicting outcomes regarding the use of lidocaine to reduce pain after uterine artery embolization (UAE). PURPOSE: To investigate the efficacy of intra-arterial lidocaine injection for pain and inflammatory response control within 24 h of UAE for symptomatic uterine fibroids. MATERIAL AND METHODS: Of 1530 patients who underwent UAE for uterine fibroids in 2007-2021, 5 mL of 1% lidocaine was injected into each uterine artery immediately after UAE in 23 patients. A disease-matched control group (n = 23) who did not receive intra-arterial lidocaine was generated from the same registry. The pain score, white blood cell (WBC) count, C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and fentanyl consumption were compared before and after UAE. Complete infarction of the dominant fibroid was assessed using magnetic resonance imaging. RESULTS: Significantly lower WBC count, CRP level, and NLR were noted 24 h after UAE in the lidocaine group. No statistically significant difference was noted in the pain score between groups at 0-24 h. The cumulative fentanyl dose administered during the first 24 h after UAE was not significantly different. After embolization, fibroid-related symptoms resolved in all patients. No significant difference was observed in the rate of complete infarction of the dominant fibroid. CONCLUSION: Lidocaine administration immediately after UAE resulted in a significant reduction in the inflammatory response. However, such a difference in the inflammatory reaction did not contribute to significant reductions in pain scores or fentanyl consumption.

Does Gender Affect the Outcomes of Myocardial Revascularization for Left-Main Coronary Artery Disease?

Currently, gender is not considered in the choice of the revascularization strategy for patients with unprotected left main coronary artery (ULMCA) disease. This study analyzed the effect of gender on the outcomes of percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) in patients with ULMCA disease. Females who had PCI (n = 328) were compared with females who had CABG (n = 132) and PCI in males (n = 894) was compared with CABG (n = 784). Females with CABG had higher overall hospital mortality and major adverse cardiovascular events (MACE) than females with PCI. Male patients with CABG had higher MACE; however, mortality did not differ between males with CABG vs PCI. In female patients, follow-up mortality was significantly higher in CABG patients, and target lesion revascularization was higher in patients with PCI. Male patients had no difference in mortality and MACE between groups; however, MI was higher with CABG, and congestive heart failure was higher with PCI. In conclusion, women with ULMCA disease treated with PCI could have better survival with lower MACE compared with CABG. These differences were not evident in males treated with either CABG or PCI. PCI could be the preferred revascularization strategy in women with ULMCA disease.

Single Versus Dual Antiplatelet Therapy After Coronary Artery Bypass Grafting for Unprotected Left-Main Coronary Disease.

BACKGROUND: The use of dual antiplatelet therapy (DAPT) after coronary revascularization for left-main disease is still debated. The study aimed to characterize patients who received dual versus single antiplatelet therapy (SAPT) after coronary artery bypass grafting (CABG) for unprotected left-main disease and compare the outcomes of those patients. RESULTS: This multicenter retrospective cohort study included 551 patients who were grouped into 2 groups: patients who received SAPT (n = 150) and those who received DAPT (n = 401). There were no differences in age ( P = 0.451), gender ( P = 0.063), smoking ( P = 0.941), diabetes mellitus ( P = 0.773), history of myocardial infarction ( P = 0.709), chronic kidney disease ( P = 0.615), atrial fibrillation ( P = 0.306), or cerebrovascular accident ( P = 0.550) between patients who received SAPT versus DAPT. DAPTs were more commonly used in patients with acute coronary syndrome [87 (58%) vs. 273 (68.08%); P = 0.027], after off-pump CABG [12 (8%) vs. 73 (18.2%); P = 0.003] and in patients with radial artery grafts [1 (0.67%) vs. 32 (7.98%); P < 0.001]. While SAPTs were more commonly used in patients with low ejection fraction [55 (36.67%) vs. 61 (15.21%); P < 0.001] and in patients with postoperative acute kidney injury [27 (18%) vs. 37 (9.23%); P = 0.004]. The attributed treatment effect of DAPT for follow-up major adverse cerebrovascular and cardiac events was not significantly different from that of SAPT [ß, -2.08 (95% confidence interval (CI), -20.8-16.7); P = 0.828]. The attributed treatment effect of DAPT on follow-up all-cause mortality was not significantly different from that of SAPT [ß, 4.12 (CI, -11.1-19.32); P = 0.595]. There was no difference in bleeding between groups ( P = 0.666). CONCLUSIONS: DAPTs were more commonly used in patients with acute coronary syndrome, after off-pump CABG, and with radial artery grafts. SAPTs were more commonly used in patients with low ejection fraction and acute kidney injury. Patients on DAPT after CABG for left-main disease had comparable major adverse cerebrovascular and cardiac events and survival to patients on SAPT, with no difference in bleeding events.

Current status and prospects for improved targeted delivery approaches for cancer.

Millions of individuals worldwide suffer from the complicated disease known as cancer. Though they frequently have serious side effects and can harm healthy cells, the current cancer treatments, such as radiation therapy and chemotherapy, are effective in many cases. Targeted drug delivery systems have emerged as a promising new paradigm in cancer treatment because they can deliver drugs directly to cancer cells with minimal harm to healthy cells. This review aims to give a broad overview of the state of targeted drug delivery systems for cancer treatment and investigate the technology's potential in the future. We'll go through the various kinds of targeted drug delivery systems, their drawbacks, the most recent developments, and possible future paths for further study and creation. This review aims to provide an overview of the current status of targeted drug delivery systems for cancer treatment, including the different types of targeted drug delivery systems, their limitations, recent advancements, and potential future directions for research and development. By examining the field's current state and exploring prospects, this review aims to highlight the potential of targeted drug delivery systems for improving cancer treatment and ultimately enhancing patient outcomes.

Assessing Social Determinants of Health Among Patients With Depression at Primary Healthcare Centers in Riyadh City.

BACKGROUND AND PURPOSE:  Depression is a common and serious medical illness that is greatly influenced by socioeconomic, demographic, and biological factors. The recognition of social determinants of depression can help reduce the risk factors and promote mental health. The purpose of this study was to assess the social determinants of health (SDOH) of patients with depression and to classify its categories at primary healthcare centers (PHCs) in Riyadh, Saudi Arabia. METHODOLOGY:  A cross-sectional study using a self-administered questionnaire was conducted among 322 participants who were selected through a convenience sampling technique from June 2021 to August 2022. The study included Saudi and non-Saudi patients at the Ministry of Health PHCs in Riyadh, Saudi Arabia, aged 12 years and older. Independent samples of t-test and one-way ANOVA test were used to assess differences in means of numerical variables. Correlations were made by the Pearson correlation coefficient. A p-value of <0.05 was set as the level of statistical significance. Logistic regression was used to determine the main variables associated with moderate to severe depression. RESULTS: The findings showed 51% had minimal to mild depression, 27% had moderate depression, and 22% had moderately severe to severe depression. A greater proportion of females had moderate to severe depression (61%) (p=0.007). Also, moderate to severe depression was higher in those with lower monthly income(54%)(p=0.03). Saudi nationals were found to have a higher percentage of moderate to severe depression(51%)(p=0.007). Marital status was found to be associated with depression as single respondents were more likely to have moderate to severe depression (p=0.052) with 54%. CONCLUSION: SDOH including gender, income, marital status, and nationality are associated with depression. Having a comprehensive system focusing not only on mental health services but also on the social determinants of mental health is very important. Future research is needed to understand the association between depression and SDOH in Saudi Arabia. The study results can help policymakers determine the areas that require improvements.

Deep Learning Framework for Liver Segmentation from T1-Weighted MRI Images.

The human liver exhibits variable characteristics and anatomical information, which is often ambiguous in radiological images. Machine learning can be of great assistance in automatically segmenting the liver in radiological images, which can be further processed for computer-aided diagnosis. Magnetic resonance imaging (MRI) is preferred by clinicians for liver pathology diagnosis over volumetric abdominal computerized tomography (CT) scans, due to their superior representation of soft tissues. The convenience of Hounsfield unit (HoU) based preprocessing in CT scans is not available in MRI, making automatic segmentation challenging for MR images. This study investigates multiple state-of-the-art segmentation networks for liver segmentation from volumetric MRI images. Here, T1-weighted (in-phase) scans are investigated using expert-labeled liver masks from a public dataset of 20 patients (647 MR slices) from the Combined Healthy Abdominal Organ Segmentation grant challenge (CHAOS). The reason for using T1-weighted images is that it demonstrates brighter fat content, thus providing enhanced images for the segmentation task. Twenty-four different state-of-the-art segmentation networks with varying depths of dense, residual, and inception encoder and decoder backbones were investigated for the task. A novel cascaded network is proposed to segment axial liver slices. The proposed framework outperforms existing approaches reported in the literature for the liver segmentation task (on the same test set) with a dice similarity coefficient (DSC) score and intersect over union (IoU) of 95.15% and 92.10%, respectively.

Cross-Sectional Assessment of Dermatologists' Knowledge and Attitude Towards Isotretinoin-Related Ocular Side Effects in Aseer, Saudi Arabia.

BACKGROUND: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit, which includes the hair follicle, hair shaft and sebaceous gland. The only treatment that has an effect on all the main aetiological causes of acne is isotretinoin. However, it may have a variety of negative side effects. The aim of this study was to evaluate the knowledge and attitudes of dermatologists regarding ocular effects following isotretinoin prescribing in the Aseer region, Saudi Arabia. METHODOLOGY: An anonymous online cross-sectional survey was conducted in August 2022 to investigate dermatologists' knowledge and attitude regarding isotretinoin-related ocular side effects in Aseer, Saudi Arabia. Participants were recruited using convenience and snowball sampling methods. RESULTS: A total of 48 dermatologists were included in this survey. The age distribution ranged from 25 to over 60 years. Sixteen (37.5%) were aged 31-40 years, 29 (60.4%) were male and 20 (41.7%) were specialists. All dermatologists reported that it can cause dry eye, 32 (66.7%) reported that it can cause contact lens intolerance, 10 (20.8%) reported that it can cause a decrease in dark adaptation and two (4.2%) thought that it can cause ectopia lentis and retinoblastoma. Regarding attitude, 43 (87.5%) thought that a course of isotretinoin is not recommended if the patient has recently undergone refractive surgery, 30 (62.5%) always inform patients about ocular side effects, 31 (72.9%) do not consider referring patients for ophthalmic examinations before initiating isotretinoin, 12 (25.0%) always prescribe lubricant eye drops, 15 (31.3%) always ask patients about recent refractive surgery, 17 (35.4%) always warn patients about avoiding refractive surgery during isotretinoin use and 19 (39.6%) always inform patients concerning discomfort with contact lenses. CONCLUSIONS: The survey reveals that dermatologists in Aseer, Saudi Arabia, generally have good knowledge of isotretinoin related to some ocular side effects, especially dry eye and contact lens intolerance. However, there is some variation in their practices with regard to patient education, referrals for ophthalmic examinations, the use of lubricant eye drops and refractive surgery during isotretinoin treatment. Thus, dermatologists should receive educational training on the safety profile of isotretinoin while managing acne vulgaris.

Corrigendum: Enhanced biodegradation of phenanthrene and anthracene using a microalgal-bacterial consortium.

[This corrects the article DOI: 10.3389/fmicb.2023.1227210.].

Synthesis, Properties, Applications, and Future Prospective of Cellulose Nanocrystals.

The exploration of nanocellulose has been aided by rapid nanotechnology and material science breakthroughs, resulting in their emergence as desired biomaterials. Nanocellulose has been thoroughly studied in various disciplines, including renewable energy, electronics, environment, food production, biomedicine, healthcare, and so on. Cellulose nanocrystal (CNC) is a part of the organic crystallization of macromolecular compounds found in bacteria's capsular polysaccharides and plant fibers. Owing to numerous reactive chemical groups on its surface, physical adsorption, surface grating, and chemical vapor deposition can all be used to increase its performance, which is the key reason for its wide range of applications. Cellulose nanocrystals (CNCs) have much potential as suitable matrices and advanced materials, and they have been utilized so far, both in terms of modifying and inventing uses for them. This work reviews CNC's synthesis, properties and various industrial applications. This review has also discussed the widespread applications of CNC as sensor, acoustic insulator, and fire retardant material.

Advancement in total hip implant: a comprehensive review of mechanics and performance parameters across diverse novelties.

The UK's National Joint Registry (NJR) and the American Joint Replacement Registry (AJRR) of 2022 revealed that total hip replacement (THR) is the most common orthopaedic joint procedure. The NJR also noted that 10-20% of hip implants require revision within 1 to 10 years. Most of these revisions are a result of aseptic loosening, dislocation, implant wear, implant fracture, and joint incompatibility, which are all caused by implant geometry disparity. The primary purpose of this review article is to analyze and evaluate the mechanics and performance factors of advancement in hip implants with novel geometries. The existing hip implants can be categorized based on two parts: the hip stem and the joint of the implant. Insufficient stress distribution from implants to the femur can cause stress shielding, bone loss, excessive micromotion, and ultimately, implant aseptic loosening due to inflammation. Researchers are designing hip implants with a porous lattice and functionally graded material (FGM) stems, femur resurfacing, short-stem, and collared stems, all aimed at achieving uniform stress distribution and promoting adequate bone remodeling. Designing hip implants with a porous lattice FGM structure requires maintaining stiffness, strength, isotropy, and bone development potential. Mechanical stability is still an issue with hip implants, femur resurfacing, collared stems, and short stems. Hip implants are being developed with a variety of joint geometries to decrease wear, improve an angular range of motion, and strengthen mechanical stability at the joint interface. Dual mobility and reverse femoral head-liner hip implants reduce the hip joint's dislocation limits. In addition, researchers reveal that femoral headliner joints with unidirectional motion have a lower wear rate than traditional ball-and-socket joints. Based on research findings and gaps, a hypothesis is formulated by the authors proposing a hip implant with a collared stem and porous lattice FGM structure to address stress shielding and micromotion issues. A hypothesis is also formulated by the authors suggesting that the utilization of a spiral or gear-shaped thread with a matched contact point at the tapered joint of a hip implant could be a viable option for reducing wear and enhancing stability. The literature analysis underscores substantial research opportunities in developing a hip implant joint that addresses both dislocation and increased wear rates. Finally, this review explores potential solutions to existing obstacles in developing a better hip implant system.

Examining the Impact of Socioeconomic Factors and Lifestyle Habits on Obesity Prevalence Among Male and Female Adolescent Students in Asser, Saudi Arabia.

Background Understanding the relationships between obesity and lifestyle factors is essential for the effective prevention and management of obesity in youth. This study aimed to investigate the association between sociodemographic factors, lifestyle elements such as physical activity and social stress, and the prevalence of overweight and obesity among Saudi adolescents in the Aseer region. Methodology From December 2022 to March 2023, we conducted a cross-sectional study using the multi-stage stratified random sampling technique. The study included Saudi male and female adolescents aged 12-19 years attending middle and high schools. Ordinal logistic regression was used to analyze the association between the ordinal dependent variable, classified into weight groups (normal, overweight, obese), and the independent variables. Results Of the total of 512 individuals, 90.4% were aged ≥18 years, 77.5% were males, and 76.8% were urban residents. Of the studied population, 33.6% were overweight, and 20.5% were obese. The prevalence of obesity and overweight was significantly higher among males compared to females (20.9% vs. 19.1% and 36.5% vs. 23.5%, respectively). Multivariate analysis revealed the following factors to be associated with obesity and overweight: female gender (2.31, 95% CI = 1.45-3.71), age 12-17 years (0.53, 95% CI = 0.28-0.97), place of delivery (Tanoma) (2.32, 95% CI = 1.13-4.75), family size of over eight members (0.43, 95% CI = 0.24-0.74), family monthly income of over 20,000 SAR (3.79, 95% CI = 1.38-11.35), being smokers (0.26, 95% CI = 1.31-2.93), experiencing social stress (1.96, 95% CI = 1.96-2.93), engagement in physical activity less than three times a week (0.49, 95% CI = 0.32-0.75), and engagement in physical activity more than three times a week (0.36, 95% CI = 0.22-0.58). Conclusions These findings emphasize the importance of addressing demographic, socioeconomic, and lifestyle factors in combating childhood and adolescent obesity through targeted interventions.

Congenital Talipes Equinovarus Management and Outcomes: The Experiences of Pediatric Tertiary Centers in Abha, Saudi Arabia.

BACKGROUND: Congenital talipes equinovarus (CTEV), also known as clubfoot, describes a range of foot abnormalities usually present at birth (congenital) in which a baby's foot is twisted out of shape or position. In clubfoot, tendons are shorter than usual. Clubfoot is a fairly common birth defect and is usually an isolated problem for an otherwise healthy newborn. AIM: This study aimed to investigate the experiences of pediatric tertiary centers in Abha, Saudi Arabia, regarding the management, frequency, treatment options, and outcomes of CTEV. METHODS: A retrospective chart review of pediatric patients with clubfoot was conducted to evaluate the number of cases, treatment options, and outcomes at Abha Maternity and Children Hospital and Khamis Mushait Maternity and Children Hospital. Data were extracted independently using prestructured data extraction forms. The collected data included demographic and medical information, family history, clinico-epidemiological information, risk factors, management options, and complications of clubfoot. RESULTS: The study included 89 children with CTEV from the target hospitals. Their ages ranged from 20 days to six years, with a mean age of 10.5 ± 14.5 months. Of these, 57 (64%) were male. CTEV was unilateral in 53 (59.5%) cases and bilateral in 36 (40.5%) cases. The majority of the cases had isolated CTEV. Nearly all cases had Ponseti casting with a tendo-Achilles tenotomy (TAT) surgical procedure. Patient follow-up ranged from one week to three years, with an average follow-up of 3.1 months. Only three (3.4%) cases experienced recurrence of deformity after management. CONCLUSION: Ponseti casting with the tendo-Achilles tenotomy approach emerged as the most commonly employed management option, demonstrating a low rate of recurrence.

Enhanced biodegradation of phenanthrene and anthracene using a microalgal-bacterial consortium.

Polycyclic aromatic hydrocarbons (PAHs) are chemicals that are released into the environment during activities of the petroleum industry. The bioaccumulation, carcinogenic and mutagenic potential of PAHs necessitates the bioremediation of these contaminants. However, bioremediation of PAHs has a number of limitations including the inability of a single microbe to degrade all of the PAH fraction's environmental constituents. Therefore, a different paradigm, employing microalgal-bacterial consortium (MBC), may be used to effectively remove PAHs contaminants. In this type of interaction, the microalgae and bacteria species in the consortium work together in a way that enhances the overall performance of the MBC. Bacterial species in the consortium provide essential nutrients or growth factors by degrading toxic substances and provide these to microalgae, while the microalgae species provide organic carbon for the bacterial species to grow. For the first time, the ability of Gonium pectorale (G. pectorale) microalgae to break down phenanthrene (PHE) and anthracene (ANT) was investigated. Phenanthrene was shown to be more effectively degraded by G. pectorale (98%) as compared to Bacillus licheniformis (B. licheniformis) 19%. Similarly, G. pectorale has effectively degrade anthracene (98%) as compared with B. licheniformis (45%). The consortia of G. pectorale and B. licheniformis has shown a slight increase in the degradation of PHE (96%) and ANT (99%). Our findings show that B. licheniformis did not inhibit the growth of G. pectorale and in the consortia has effectively eliminated the PAHs from the media. Therefore G. pectorale has a tremendous potential to remove PAHs from the polluted environment. Future research will be conducted to assess Gonium's capacity to eliminate PAHs that exhibit high molar masses than that of PHE and ANT.