Children and carer's experience and satisfaction of two local anaesthetic techniques; for treatment of carious mandibular primary molars in children

Background: Local anaesthesia (LA) forms the backbone of pain control techniques in dentistry and has a major role in dentistry for children. Inferior Dental Nerve Block (IDNB) has been the LA technique of choice for treatment of carious mandibular primary molars in children. However, several disadvantages have been associated with the IDNB. Buccal Infiltration (BI) with 4% Articaine have been proposed as more comfortable and pleasant alternative LA techniques to IDNB which became widely used in paediatric dentistry especially for the treatment of carious mandibular primary molars in children above the age of 4 years. Aim: To explore children and carer`s experience and satisfaction of their child’s dental treatment under LA and compare their acceptance of two LA techniques; BI with 4% Articaine and IDNB with 2% lidocaine for the treatment of mandibular carious primary molars in children under ten years of age. Method: A prospective study design was used to explore patient and carer`s acceptance of the two local anaesthetic techniques. 96 patients aged 5-9 years and their carer`s completed two questionnaires on treatment acceptance. Result: A total of 49 (50%) participants received BI with 4% Articaine and 49 (50%) had IDNB with 2% lidocaine. Two patients had IDNB but no dental treatment was performed as patients could not cope with dental treatment, thus these participants did not complete the questionnaires. The majority of the children (84.7%) and their carers (91%) were happy with their experience at the dentist including the administration of the LA (61.5% for BI and 64% for IDNB), delivery of the dental treatment (87.8% for BI and 81.6% for IDNB) and dentist management including dental teamwork (over 90%). Conclusion: Both local anaesthetic techniques; BI with 4% articaine and IDNB with 2% lignocaine were accepted among patients and carers. Dental team attitude can significantly impact the treatment outcome in children. Establishing a clear communication between the dentist, the child patient and his/her carer as well as implementing good behaviour management techniques contribute significantly to treatment acceptance among children and carers

Developing an ESP-Based Language Learning Environment to Help Students Improve Critical Thinking Skills in Written Output

In recent years, as a result of both research discoveries in the fields of foreign language acquisition and learning, the concept of teaching and learning has undergone a significant transformation. English for Specific Purposes (ESP) is a learner-centered approach to teaching English as a foreign language that emphasizes developing communicative proficiency in niche industries such agronomy, commerce, academia, accountancy, education, engineering, and information technology. This concept of English-for-Teaching as a restricted form of ESP for the classroom builds on the knowledge that instructors already have about teaching while also introducing and validating specific classroom terminology. When students interact and cooperate with one another, ESP practice emerges naturally in a language learning setting. Two major aspects that ESP highlights are the growth of dialogical interaction and the establishment of ecologically complete learning environments. In this essay, we create an ESP to aid students in the development of their critical thinking (CT) abilities in written output. We combine the Synergy model, Brain-based learning, and the Flipped Classroom models to create an ESP environment. Students CT abilities and academic success served as the studys criteria. The Course Satisfaction Questionnaire and placement exams were used to obtain the statistical data. Using the Cronbach Alpha coefficient (CAC) and Spearman correlation coefficient, the test on CT data was interpreted, and the combined data was examined using SPSS (V 26.0). By immersing students in problem-solving- based learning (PBL), this paradigm helps students develop their CT skills. It also helps students achieve academically by elevating their sense of accountability for learning outcomes and promoting the use of a variety of learning strategies

Cloud computing fitness for e-government implementation: importance-performance analysis

The means through which governments deliver services and the way they operate may be considerably enhanced through cloud computing. It can help to address e-government implementation challenges and revolutionize e-government systems in terms of cost savings and the professional use of resources. The aim of this paper is to analyze the importance and performance of the factors that influence the fitness of cloud computing for e-government implementation. This paper integrates the task technology fit model with the diffusion of innovation theory to address this issue. Yemeni public institutions were identified as sources for data collection and 292 information technology employees participated as sample respondents for a structured questionnaire. Security, compatibility, relative advantage, and tasks were the variables found to affect the fitness of cloud computing for e-government activities. However, no impact was seen from the standpoints of trialability and complexity of the technology. In terms of assessing the fitness of cloud computing for e-government services, a greater understanding among policy formulators was sought through the importance-performance matrix analysis (IPMA). The results of IPMA can help identifying areas for strategic focus to assess cloud computing as an alternative technology to implement e-government services

Biomathematical model for gyrotactic free-forced bioconvection with oxygen diffusion in near-wall transport within a porous medium fuel cell

Bioconvection has shown significant promise for environmentally friendly, sustainable “green” fuel cell technologies. The improved design of such systems requires continuous refinements in biomathematical modelling in conjunction with laboratory and field testing. Motivated by exploring deeper the near-wall transport phenomena involved in bioinspired fuel cells, in the present article, we examine analytically and numerically the combined free-forced convective steady boundary layer flow from a solid vertical flat plate embedded in a Darcian porous medium containing gyrotactic microorganisms. Gyrotaxis is one of many taxes exhibited in biological microscale transport, and other examples include magneto-taxis, photo-taxis, chemotaxis and geo-taxis (reflecting the response of micro-organisms to magnetic field, light, chemical concentration or gravity, respectively). The bioconvection fuel cell also contains diffusing oxygen species which mimics the cathodic behavior in a proton membrane exchange (PEM) system. The vertical wall is maintained at iso-solutal (constant oxygen volume fraction and motile micro-organism density) and iso-thermal conditions. Wall values of these quantities are sustained at higher values than the ambient temperature and concentration of oxygen and biological micro-organism species. Similarity transformations are applied to render the governing partial differential equations for mass, momentum, energy, oxygen species and micro-organism species density into a system of ordinary differential equations. The emerging eight order nonlinear coupled, ordinary differential boundary value problem features several important dimensionless control parameters, namely Lewis number (Le), buoyancy ratio parameter i.e. ratio of oxygen species buoyancy force to thermal buoyancy force (Nr), bioconvection Rayleigh number (Rb), bioconvection Lewis number (Lb), bioconvection Péclet number (Pe) and the mixed convection parameter spanning the entire range of free and forced convection. The transformed non-linear system of equations with boundary conditions is solved numerically by a finite difference method with central differencing, tridiagonal matrix manipulation and an iterative procedure. Computations are validated with the symbolic Maple 14.0 software. The influence of buoyancy and bioconvection parameters on the dimensionless temperature, velocity, oxygen concentration and motile microorganism density distribution, Nusselt, Sherwood and gradient of motile microorganism density are studied. The work clearly shows the benefit of utilizing biological organisms in fuel cell design and presents a logical biomathematical modelling framework for simulating such systems. In particular, the deployment of gyrotactic micro-organisms is shown to stimulate improved transport characteristics in heat and momentum at the fuel cell wall

The diagnostic performance of chest computed tomography in the detection of rib fractures in children investigated for suspected physical abuse: a systematic review and meta-analysis

Objectives To assess the diagnostic performance of chest CT in the detection of rib fractures in children investigated for suspected physical abuse (SPA). Methods Medline, Web of Science and Cochrane databases were searched from January 1980 to April 2020. The QUADAS-2 tool was used to assess the quality of the eligible English-only studies following which a formal narrative synthesis was constructed. Studies reporting true-positive, false-positive, true-negative, and false-negative results were included in the meta-analysis. Overall sensitivity and specificity of chest CT for rib fracture detection were calculated, irrespective of fracture location, and were pooled using a univariate random-effects meta-analysis. The diagnostic accuracy of specific locations along the rib arc (anterior, lateral or posterior) was assessed separately. Results Of 242 identified studies, 4 met the inclusion criteria. Of these, 2 were included in the meta-analysis. Chest CT identified 142 rib fractures compared to 79 detected by initial skeletal survey chest radiographs in live children with SPA. Post-mortem CT (PMCT) has low sensitivity (34%) but high specificity (99%) in the detection of rib fractures when compared to the autopsy reference standard. PMCT has low sensitivity (45%, 21% and 42%) but high specificity (99%, 97% and 99%) at anterior, lateral and posterior rib locations, respectively. Conclusions Chest CT detects more rib fractures than initial skeletal survey chest radiographs in live children with SPA. PMCT has low sensitivity but high specificity for detecting rib fractures in children investigated for SPA. Key Points • PMCT has low sensitivity (34%) but high specificity (99%) in the detection of rib fractures; extrapolation to CT in live children is difficult. • No studies have compared chest CT with the current accepted practice of initial and follow-up skeletal survey chest radiographs in the detection of rib fractures in live children investigated for SPA

Professional practice and awareness of child abuse among radiologists and radiologic technologists: results from Saudi Arabia

Background The knowledge, awareness and professionalism of health care providers in the field of child protection are crucial in identifying and reporting suspected child abuse. Radiologic technologists and radiologists play a vital role in the diagnosis of suspected physical child abuse. Objective To assess current practice, knowledge and awareness of child abuse among radiologic technologists and radiologists in Saudi Arabia. Materials and methods We distributed an internet-based questionnaire to radiologic technologists and radiologists working in Saudi Arabia via national radiology societies and social media channels over a 6-week period (27 October to 8 December 2021). Survey questions covered knowledge regarding child abuse, professional practice in radiology departments in Saudi Arabia in cases of suspected physical abuse (SPA), and knowledge of the national legislation and reporting and acting procedures in child abuse. Results A total of 315 respondents (224 radiologic technologists and 91 radiologists) participated in this study. The median score for knowledge of abuse was higher amongst radiologists (4.8) than radiologic technologists (4.0); P < 0.001. In total, 210 (93.8%) radiologic technologists and 61 (67.0%) radiologists reported that there was no protocol (i.e. skeletal survey) at their hospital for imaging children with SPA. Most radiologic technologists had no training in paediatric radiology (165/224, 73.7%) and most radiologists had received no training in evaluating imaging performed for SPA (73/91, 80.2%). More than half of respondents — 131 (58.5%) radiologic technologists and 44 (48.4%) radiologists — were not familiar with the reporting and acting procedures at their hospitals in cases of child abuse. Conclusion Although radiologic technologists and radiologists in Saudi Arabia have good knowledge and awareness of child abuse in general, they lack specific knowledge of the reporting and acting procedures at their hospitals in cases of suspected child abuse. National imaging guidelines and training courses are needed to develop appropriate skills in the recognition, imaging and reporting of SPA in infants and young children in Saudi Arabia

C19orf12 mutation leads to a pallido-pyramidal syndrome.

Pallido-pyramidal syndromes combine dystonia with or without parkinsonism and spasticity as part of a mixed neurodegenerative disorder. Several causative genes have been shown to lead to pallido-pyramidal syndromes, including FBXO7, ATP13A2, PLA2G6, PRKN and SPG11. Among these, ATP13A2 and PLA2G6 are inconsistently associated with brain iron deposition. Using homozygosity mapping and direct sequencing in a multiplex consanguineous Saudi Arabian family with a pallido-pyramidal syndrome, iron deposition and cerebellar atrophy, we identified a homozygous p.G53R mutation in C19orf12. Our findings add to the phenotypic spectrum associated with C19orf12 mutations

A founder CEP120 mutation in Jeune asphyxiating thoracic dystrophy expands the role of centriolar proteins in skeletal ciliopathies.

Jeune asphyxiating thoracic dystrophy (JATD) is a skeletal dysplasia characterized by a small thoracic cage and a range of skeletal and extra-skeletal anomalies. JATD is genetically heterogeneous with at least nine genes identified, all encoding ciliary proteins, hence the classification of JATD as a skeletal ciliopathy. Consistent with the observation that the heterogeneous molecular basis of JATD has not been fully determined yet, we have identified two consanguineous Saudi families segregating JATD who share a single identical ancestral homozygous haplotype among the affected members. Whole-exome sequencing revealed a single novel variant within the disease haplotype in CEP120, which encodes a core centriolar protein. Subsequent targeted sequencing of CEP120 in Saudi and European JATD cohorts identified two additional families with the same missense mutation. Combining the four families in linkage analysis confirmed a significant genome-wide linkage signal at the CEP120 locus. This missense change alters a highly conserved amino acid within CEP120 (p.Ala199Pro). In addition, we show marked reduction of cilia and abnormal number of centrioles in fibroblasts from one affected individual. Inhibition of the CEP120 ortholog in zebrafish produced pleiotropic phenotypes characteristic of cilia defects including abnormal body curvature, hydrocephalus, otolith defects and abnormal renal, head and craniofacial development. We also demonstrate that in CEP120 morphants, cilia are shortened in the neural tube and disorganized in the pronephros. These results are consistent with aberrant CEP120 being implicated in the pathogenesis of JATD and expand the role of centriolar proteins in skeletal ciliopathies

The Risks of Renal Angiomyolipoma: Reviewing the Evidence

Renal angiomyolipoma (RAML), though a rare benign tumor, may impose a significant morbidity or even mortality due to its unique characteristics and the complications subsequent to its treatment. The classic tumor variant is composed of smooth muscular, vascular, and fatty components. The most straightforward diagnosis is when the fat component is abundant and gives a characteristic appearance on different imaging studies. In fat-poor lesions, however, the diagnosis is difficult and presumed a renal cell carcinoma. Yet, some variants of RAML, though rare, express an aggressive behavior leading to metastasis and mortality. The challenge lies in the early detection of benign variants and identifying aggressive lesions for proper management. Another challenge is when the vascular tissue component predominates and poses a risk of hemorrhage that may extend to the retroperitoneum in a massive life-threatening condition. The predicament here is to identify the characteristics of tumors at risk of bleeding and provide a prophylactic treatment. According to the clinical presentation, different treatment modalities, prophylactic or therapeutic, are available that span the spectrum of observation, embolization, or surgery. Renal impairment may result from extensive tumor burden or as a complication of the management itself. Improvement of diagnostic techniques, super-selective embolization, nephron-sparing surgery, and late treatment with the mammalian target of rapamycin inhibitors have provided more effective and safe management strategies. In this review, we examine the evidence pertaining to the risks imposed by RAML to the patients and identify merits and hazards associated with different treatment modalities