The co-existence of NAFLD and CHB is associated with suboptimal viral and biochemical response to CHB antiviral therapy: a systematic review and meta-analysis

Background and aimsChronic hepatitis B (CHB) and non-alcoholic fatty liver disease (NAFLD) are leading causes of liver-related morbidity and mortality. The interaction between these two disease processes is poorly defined and the impact of NAFLD on HBV-related cirrhosis and HCC remains unclear. The aim of this study was to evaluate the impact of NAFLD on response to antiviral CHB therapy to inform the debate on changing CHB treatment thresholds for these comorbid patients.MethodsStudies with a minimum of 50 adult CHB patients on nucleoside analogue therapy with or without concurrent NAFLD were identified from PubMed/Medline and EMBASE to February 21, 2023. Data extraction from each study included HBeAg and treatment status, diagnostic method of NAFLD, frequency of monitoring intervals, patient age, gender, grade of hepatic steatosis, BMI and metabolic comorbidities. The outcomes of interest, complete virological response (CVR), biochemical response (BR) and HBeAg loss/seroconversion, were recorded at each available monitoring interval. Comparing CHB-NAFLD and CHB-only groups, pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using random- or fixed-effects models depending on heterogeneity.ResultsFrom a search of 470 citations, we identified 32 potentially relevant papers. Overall, 11 studies, comprising 2580 unique patients, met the inclusion criteria of the meta-analysis. CHB-NAFLD patients exhibited significantly lower rates of CVR compared to CHB-only patients. This was demonstrated by an OR of 0.59 (0.38-0.93, p=0.001, I2 = 72%) at 12 months, which tapered off to an OR of 0.67 (0.48-0.95, p=0.02) at 60 months. CHB-NAFLD patients also exhibited significantly lower rates of BR compared to CHB-only patients, as demonstrated by ORs of 0.39 (0.24-0.62, p<0.0001, I2 = 53%) at 12 months and 0.33 (0.17-0.63, p=0.0008) at 24 months.ConclusionPatients with concurrent CHB and NAFLD experience delayed CVR to antiviral therapy and more persistent biochemical abnormalities in comparison to patients with CHB only. This supports the argument for earlier antiviral therapy in order to avert CHB complications in these multi-morbid patients, as the global disease burden of NAFLD continues to increase

Prevalence of overweight and obesity among saudi children: A comparison of two widely used international standards and the national growth references

ObjectiveTo compare three body mass index (BMI) classifications that are used to assess the prevalence of overweight and obesity among Saudi children aged 6–13 years: the International Obesity Task Force (IOTF) age and gender cutoffs, the World Health Organization (WHO) growth references for school-aged children, and the Saudi (KSA) national growth references.MethodsThe sample comprised 2,169 children (52.5% girls) derived from two cross-sectional studies conducted in Riyadh and Jeddah during the 2017 and 2019 school years, respectively. Body weight and height were measured, and BMI was calculated.ResultsThe proportions (%) of the participants who were classified as underweight, overweight, and obese varied according to the reference used: IOTF reference (13.8, 18.4, and 12.7), WHO reference (17.2, 19.1, and 18.9), and KSA reference (7.0, 22.4, and 9.3), respectively, indicating higher values for overweight and obesity prevalence when the WHO references were used. Kappa agreement measures between the three references were found to be high, with the coefficients ranging from 0.936 (between the IOTF and KSA references) to 0.849 (between the IOTF and WHO references). In all three classifications, girls exhibited lower overweight or obesity prevalence than boys. Family income, but not paternal or maternal education, was significantly (p = 0.015) associated with overweight/obesity when using the IOTF standards. In addition, having a small family in the house was significantly (p < 0.05) associated with obesity, irrespective of the classification system.ConclusionInconsistency was observed when estimating the prevalence of underweight, overweight, and obesity among Saudi children. However, when defining the overall prevalence of overweight plus obesity among Saudi children, the IOTF classification system performed in a similar way to the KSA references (31.1% versus 31.7%) compared to the WHO references (38.0%)

Arabic translation, cultural adaptation, and pre-testing of neighborhood environment walkability scale for adults-abbreviated (NEWS-A): Arabic NEWS-A

BackgroundImproving neighborhood walkability is critical for sustainable and livable urban development and is associated with increased physical activity. The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) is a tool for assessing neighborhood walkability among adults. Currently, no Arabic version is available for this important walkability scale.ObjectiveTo translate the NEWS-A to Arabic, culturally adapt, and pre-test it for adults.MethodsThe NEWS-A was translated and culturally adapted using Cross-cultural Survey Guidelines and then pre-tested using 65 households selected randomly from the neighborhoods of three districts in Riyadh. After answering the survey, 55 participants took part in a semi-structured cognitive interview, which sought their understanding of the words in the Arabic questionnaire, the clarity of each item, and their suggestions for improvement.ResultsTranslation and adaptation of NEWS-A to Arabic resulted in adding two items (mosque and healthcare center) to section B of the scale (stores, facilities, and other things in your neighborhood) and one related item to section C (access to services). The total individual items became 57 instead of the original 54 items in the English version. Also, we added “ATM machine” to item 14 (Bank/credit union) in section B. In addition, the overall results of the cognitive interview showed that most of the participants understood the intended meaning of the questionnaire (99.5%). Further, 99.8% of the respondents stated that the items were not difficult to comprehend, while 100% of the sample indicated that the sentences were comfortable and not sensitive to them.ConclusionTranslating, adapting, and pre-testing the NEWS-A resulted in retaining all the original items and adding three additional items. The Arabic NEWS-A provides an important tool for future research on neighborhood environment walkability among adults

Artificial intelligence-assisted tools for redefining the communication landscape of the scholarly world

The flood of research output and increasing demands for peer reviewers have necessitated the intervention of artificial intelligence (AI) in scholarly publishing. Although human input is seen as essential for writing publications, the contribution of AI slowly and steadily moves ahead. AI may redefine the role of science communication experts in the future and transform the scholarly publishing industry into a technology-driven one. It can prospectively improve the quality of publishable content and identify errors in published content. In this article, we review various AI and other associated tools currently in use or development for a range of publishing obligations and functions that have brought about or can soon leverage much-demanded advances in scholarly communications. Several AI-assisted tools, with diverse scope and scale, have emerged in the scholarly market. AI algorithms develop summaries of scientific publications and convert them into plain-language texts, press statements, and news stories. Retrieval of accurate and sufficient information is prominent in evidence-based science publications. Semantic tools may empower transparent and proficient data extraction tactics. From detecting simple plagiarism errors to predicting the projected citation impact of an unpublished article, AI’s role in scholarly publishing is expected to be multidimensional. AI, natural language processing, and machine learning in scholarly publishing have arrived for writers, editors, authors, and publishers. They should leverage these technologies to enable the fast and accurate dissemination of scientific information to contribute to the betterment of humankind

Virtopsy Controversies and Knowledge Gaps in the Middle-East and the Role of Virtopsy During the Present COVID-19 Pandemic

The present review will discuss gaps in the current state of knowledge about virtopsy in the Middle East and its practical application during the covid-19 Pandemic. Published literature in different journals with strict inclusion and exclusion criteria was extensively reviewed using PubMed search engine to elucidate applications and implications of the virtual autopsy. The present review is based upon literature survey covering a period of 17 months (June 2019 – October 2021) using the key words “Forensic Science, Virtopsy, Middle East, Radiology, Post-Mortem, Covid-19, Covid-19 pandemic”. Studies using virtopsy in the Middle East are minimal and confined to four countries: Israel (56%) followed by Turkey (27%), Iran (9%) and UAE (5%). In terms of radiological modalities applied in virtopsy in the Middle East, computerized tomography (CT) was used the most (52%), followed by X-ray (38%), ultrasound (5%) and MRI (5%). The application of virtopsy in the postmortem investigations during the current Covid-19 pandemic was documented in four reports originating from a total of 32 corona-associated deaths. Of these 32 deceased, virtopsy alone was used in 19 deceased, while 13 deceased cases were examined by traditional autopsy combined with virtopsy. The mean age of the deceased was 68 (33-94) years. There were 69% males and 31% females. In combination with traditional autopsy, virtopsy can be very effective in identifying the cause, mode, and the state of health a person was in before he died. However, virtopsy alone is shown to be less sensitive than traditional autopsy and, therefore, requires further research to replace traditional autopsy. It is hoped that the present paper will elucidate further the practical significance of virtopsy in the Middle East

Case report: Restrictive cardiomyopathy presenting with complete thromboembolism occlusion of the terminal part of the abdominal aorta in a preadolescent Saudi girl

Restrictive cardiomyopathy (RCM) is a rare disease in children, accounting for <5% of all pediatric cardiomyopathies. It may be idiopathic or may be a secondary to a systemic disease. The disease is characterized by normal systolic function with impaired ventricular filling caused by stiff ventricular walls. Children with RCM often present with symptoms of exercise intolerance, shortness of breath, weakness, and chest discomfort. Thromboembolism events are an unusual presentation of RCM. We are reporting a preadolescent female from the eastern province of Saudi Arabia who presented with sudden right lower limb swelling, paresthesia, and pain caused by a complete occlusion of the terminal part of the abdominal aorta and both common iliac arteries. Echocardiography revealed dilated atria, normal ventricle dimensions and two floating thrombi in the left atrium. The patient was successfully managed with an anticoagulant, surgical thrombectomy and cardiac transplantation

Factors Associated with Patient Visits to the Emergency Department for Asthma Therapy in Jordan

This study aimed at analyzing the factors associated with patient visits to the emergency department for asthma therapy in Jordan, by attempting to answer the study questions: What are the factors associated with patient visits to the emergency department for asthma therapy in Jordan University Hospital, and king Abdullah Hospital in Jordan? And how to reduce the use of the emergency departments for asthma treatment as a major goal of asthma management? This cross-sectional study was conducted from January 2016 to June 2016 on 400 patients reporting to the ED of two hospitals (Jordan University Hospital and King Abdullah Hospital. The researchers adopted the descriptive methodology by adopting the questionnaires as the study tool and data collection