Type 2 diabetes (T2D) is a chronic condition affecting millions globally. A robust predictive model to estimate the number of new cases of T2D can facilitate precise monitoring and effective intervention strategies. This study aims to predict the number of new T2D cases per month in Saudi Arabia and identify the Key Performance Indicators (KPIs) associated with T2D, using count regression models, Poisson Regression (PR), Negative Binomial Regression (NBR), Poisson Inverse Gaussian Regression (PIGR), and Bell Regression (BR). De-identified data from 1,000 patients with T2D in Saudi Arabia were used to develop the models. The performance of the full models, which include recommended Key Performance Indicators (KPIs), is compared using metrics such as the coefficient of determination (R2), root mean squared error (RMSE), mean absolute error (MAE), 10-fold cross-validation (CV-10), Akaike information criterion (AIC), and Bayesian information criterion (BIC). The most significant KPIs identified by the full models were utilized to develop the reduced models. The full NBR model outperformed other models, achieving R² of 0.88, RMSE of 0.93, MAE of 0.69, CV-10 of 1.21, AIC = 873.23, and BIC = 880. The reduced NBR model, focusing solely on the five most influential variables (marital status, age, body mass index (BMI), total cholesterol (TC), and high-density lipoprotein (HDL)), with R² = 0.84, RMSE = 1.10, MAE = 0.86, CV-10 = 1.37, AIC = 899, and BIC = 910, also outperformed other reduced models. The Likelihood Ratio Test (LRT) did not show a significant difference between the full and reduced NBR models (p = 0.694), supporting the adequacy of the reduced model. The proposed reduced model, utilizing only five significant KPIs, can help healthcare providers develop effective, targeted strategies by monitoring a smaller number of KPIs to reduce the rising number of T2D cases in Saudi Arabia.
Background:Accurate detection of metastatic cervical lymph nodes in thyroid cancer is needed for treatment planning. The present study evaluated the diagnostic performance of ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) for detecting metastatic cervical lymph nodes in a Saudi cohort. Methods:This retrospective cohort study reviewed patients with thyroid nodules and cervical lymphadenopathy treated at King Fahd Hospital of the University, Saudi Arabia, between 2015 and 2024. This retrospective cohort study reviewed 150 retrieved records, of which 111 patients underwent detailed assessment; 10 were excluded for missing pathology or incomplete diagnostic data, leaving 101 patients in the final analysis. Conventional imaging features were assessed using predefined modality-specific criteria. US-guided fine needle aspiration cytology was used as the reference standard. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and 95% confidence intervals were calculated. Agreement and discordance were assessed using Cohen's kappa and McNemar's exact test, respectively. Results:A total of 101 patients were included. US was performed in 59 cases, CT in 34, and MRI in 8. FNA cytology was positive in 48/101 cases. Overall radiological classification showed sensitivity of 89.6%, specificity of 88.7%, and accuracy of 89.1%, with substantial agreement with FNA cytology (κ=0.782). In modality-stratified descriptive analyses, US showed the highest observed agreement with FNA cytology, CT showed moderate agreement, and MRI findings were limited by the limited sample size. Conclusion:Within this cohort, ultrasound demonstrated high diagnostic performance, with the highest estimates of agreement and accuracy; CT showed moderate performance; and MRI results were limited by the small sample size. Given the distinct modality‑specific subgroups, these findings should be interpreted as descriptive and hypothesis‑generating rather than as definitive evidence of modality superiority.
Plasma circular RNAs (circRNAs) are stable RNA molecules found in blood, which makes them potential noninvasive biomarkers for acute myocardial infarction (MI). The aim of this study was to describe the plasma circRNA profile in patients with acute MI and to identify circRNA markers that may help detect heart injury and reflect the biological processes involved. We compared plasma samples from patients with acute MI and healthy controls using total RNA sequencing with unique molecular identifiers (UMIs). After sequencing, reads were processed through quality control, alignment, duplicate removal, and circRNA detection. Differential expression was analyzed after adjusting for age, sex, smoking, and technical factors. Several circRNAs were significantly different between MI cases and controls and were able to separate the two groups in principal component and receiver operating characteristic analyses. Among the most increased circRNAs were hsa-PASK_0004, hsa-STXBP3_0002, hsa-RCAN3_0002, and hsa-RANBP9_0044, while hsa-HIF1A_0002, hsa-SUZ12_0049, hsa-PNRC1_0001, and hsa-RAB2A_0002 were decreased. Several candidates showed AUC values above 0.7. Pathway analysis linked the host genes of these circRNAs to inflammation, platelet activation, coagulation, and cardiomyocyte stress responses. Overall, these findings suggest that circulating circRNAs may serve as useful blood-based markers of MI and provide insight into the molecular changes that accompany acute MI.
Maxillofacial fractures can lead to significant ophthalmic complications, affecting patient outcomes. This systematic review synthesizes current evidence regarding the incidence, causes, and types of ocular injuries associated with facial fractures, while evaluating inter-study variability and risk of bias. Following the PRISMA guidelines, a comprehensive search of PubMed, Cochrane, and Web of Science databases was performed. Twenty-one studies, including 7,998 participants, met the inclusion criteria. Among them, 3,693 patients presented with ophthalmic complications after facial fractures. Orbital fractures were the most prevalent, with injuries primarily resulting from road traffic accidents and assaults. Subconjunctival hemorrhage was the most common ocular injury. Heterogeneity across studies was assessed descriptively due to the diversity of study designs and outcomes, while risk of bias was evaluated using adapted criteria for observational studies. The findings underscore the necessity for standardized diagnostic and reporting criteria to enable future quantitative synthesis and guide clinical protocols for early detection and management of ocular complications.
Background:Breast reconstruction surgery (BRS) following mastectomy offers psychological and physical benefits; however, its acceptance remains limited among patients. Cultural perceptions, lack of awareness, and limited communication with healthcare providers may contribute to this gap. Objectives:To assess knowledge, misconceptions, attitudes, barriers, and motivators related to BRS among mastectomy patients in Eastern Saudi Arabia, and to explore associations with demographic and clinical factors. Methods:This cross-sectional survey was conducted from February to June 2025 at King Fahd Hospital of the University, Al Khobar, Saudi Arabia, and included all women who underwent mastectomy for breast cancer between 2016 and 2025. Data were elicited using a self-administered questionnaire assessing demographics, breast cancer history, knowledge and misconceptions about BRS, attitudes, and perceived barriers and motivators. Results:Of 144 eligible patients, 100 completed the questionnaire (response rate: 69.4%). Only 15% of patients had undergone BRS. Most patients had moderate misconceptions (85%), while 22% had excellent knowledge about BRS. Nonetheless, 65% had a positive attitude and 52% expressed willingness to undergo BRS. Key barriers included fear of additional surgery (42.4%) and lack of knowledge (38.8%), while key motivators were restoring body image (93.3%) and improving self-esteem (80%). In the univariate analysis, significant associations were observed between knowledge levels and factors such as age (P = 0.010), education (P < 0.001), income (P = 0.008), and current/past employment in healthcare (P = 0.008). However, in the multivariate logistic regression analysis, no variable was found to be an independent predictor of high knowledge of BRS. Conclusion:In breast cancer patients who underwent mastectomy in Eastern Saudi Arabia, there is positive attitude and willingness toward breast reconstruction surgery, yet the proportion of patients who underwent the surgery is low. The primary barriers identified are modifiable, and thus enhanced patient education and counseling may improve decision-making about breast reconstruction surgery.
