A Multicenter Cross-Sectional Study of the Awareness and Screening for Retinopathy of Prematurity Among NICU Pediatricians in Makkah and Jeddah, Saudi Arabia

Purpose This study aims to evaluate neonatal intensive care unit (NICU) pediatricians' knowledge about retinopathy of prematurity (ROP) in the major tertiary centers in Makkah and Jeddah, Saudi Arabia. Methods This cross-sectional study uses a self-administered electronic questionnaire completed by NICU pediatricians at the main hospitals of Makkah and Jeddah cities. Based on the participants' correctly selected responses to the validated questionnaire, a scoring system was used in the data analysis to show their level of ROP knowledge. Results Seventy-seven responses were analyzed. The male gender was 49.4%. The majority were recruited from the ministry of health hospitals (63.6%). A small proportion (28.6%) correctly identified who performs the examination. Around three-quarters of the participants have correctly stated that ROP therapy is a very good option to prevent blindness (72.7%). The treatment should generally begin within 72 hours after diagnosis of sight-threatening ROP (79.2%). The requirements for ROP screening were unknown to more than half of our participants (53.2%). With the lowest score of 4.0 and a maximum score of 17.0, the median knowledge score was 13.0 (IQR = 11.0 to 14.0). Based on pediatricians' clinical qualifications, knowledge scores varied significantly. Residents had a significantly lower knowledge score than specialists and consultants (median = 7.0, IQR = 6.0 to 9.0, p = 0.001). Additionally, pediatricians with less experience (<5 years) performed significantly lower on the knowledge score (median = 10.0, IQR = 6.2 to 12.8) than those with more experience (median = 13.0, IQR = 11.0 to 15.0) for participants with 5-10 years of experience, and (median = 13.0, IQR = 11.0 to 14.0) for participants with >10 years of experience). Conclusion Our study showed that NICU pediatricians understood ROP risk factors and treatment options. Nevertheless, they needed to understand the ROP screening inclusion criteria and when the screening could be stopped. Residents scored substantially lower in knowledge overall. Accordingly, we emphasized the need for NICU pediatricians to increase their level of awareness by having regular educational sessions and standardizing one guideline to be strictly followed.

Time-Ordered Recent Event (TORE) Volumes for Event Cameras

Event cameras are an exciting, new sensor modality enabling high-speed imaging with extremely low-latency and wide dynamic range. Unfortunately, most machine learning architectures are not designed to directly handle sparse data, like that generated from event cameras. Many state-of-the-art algorithms for event cameras rely on interpolated event representations-obscuring crucial timing information, increasing the data volume, and limiting overall network performance. This paper details an event representation called Time-Ordered Recent Event (TORE) volumes. TORE volumes are designed to compactly store raw spike timing information with minimal information loss. This bio-inspired design is memory efficient, computationally fast, avoids time-blocking (i.e., fixed and predefined frame rates), and contains "local memory" from past data. The design is evaluated on a wide range of challenging tasks (e.g., event denoising, image reconstruction, classification, and human pose estimation) and is shown to dramatically improve state-of-the-art performance. TORE volumes are an easy-to-implement replacement for any algorithm currently utilizing event representations.

COVID-19 vaccination side effects among the child age group: a large cross-sectional online based survey in Saudi Arabia

BACKGROUND

Multiple vaccines have been tested in clinical trials for their efficacy and safety. In Saudi Arabia, Pfizer-BioNTech or Moderna were approved for children, however, previous studies to report their safety profile are limited. This research aims to understand the side effect of children's vaccination against SARS-CoV-2 infection in Saudi Arabia.

METHODS

This was an observational retrospective cross-sectional study was conducted using an online survey in Saudi Arabia from March to May 2022. The inclusion criteria were parents aged 18 years and above who live in Saudi Arabia and have vaccinated their children. The self-reported questionnaire was adopted from published studies to investigate the study objectives Descriptive statistics were used to describe patients' demographic characteristics, continuous data were reported as mean ± S.D., categorical data were reported as percentages (frequencies), and logistic regression was used to identify predictors of persistent post-COVID-19 symptoms.

RESULTS

This study had a total of 4,069 participants. Only 41.9% of the participants reported that their child(ren) had been infected with the coronavirus. 2.00 was the median number of children (IQR: 1.00-4.00). More than half of the study participants (64.2%) reported that a family member had been infected with the coronavirus. Both parents received COVID-19 vaccination, according to most participants (88.7%). Most participants (70.5%) stated that all children who met the vaccination criteria had received the vaccine. Most participants (83.5%) said their child or children had two doses of their vaccine, and about half (50.4%) of those who received the vaccine reported experiencing side effects. In addition, the majority (78.9%) reported that the side effects appeared within one day of receiving the vaccine, and nearly two-thirds (65.7%) reported that the side effects lasted between one and three. A total of 11,831 side effects cases were documented. Pain at the injection site, hyperthermia, and fatigue were the most reported side effects, accounting for 15.3%, 14.1%, and 13.2%, respectively.

CONCLUSION

It appears that the side effects of the COVID-19 vaccine for children are minor, tolerable, and like those described previously in clinical trials. Our data should encourage the public about the safety of receiving the COVID-19 vaccine for children.

The Impact of Social Media Influencers on Food Consumption in Saudi Arabia, a Cross-Sectional Web-Based Survey

Background

Previous studies investigating the impact of social media influencers on food consumption are limited. Therefore, this study explores the influence of social media on people’s health choices to understand the consequences of food consumption among the Saudi community.

Patients and Methods

A cross-sectional study using an online survey was conducted in Saudi Arabia between 24 June and 20 July 2021. A convenience sample of eligible participants was used to recruit the study participants. A 32-items questionnaire was distributed via social media platforms (Facebook, Twitter, Snapchat, and Instagram). In addition, significant predictors of people being affected by social media to change diet and living with obesity were determined using binary logistic regression.

Results

A total of 1124 participants were involved in this study. More than half of them (57.8%) were females and aged below 40 years (57.4%). The study participants’ median body mass index (BMI) was 27.4 kg/m² (IQR: 23.5–32.5). Around one-third of the study participants (36.6%) reported following influencers on social media. The median attitude score for the study participants was 15.00 (IQR: 1.00–27.00) out of 72, equal to 20.8%, which highlights that social media influence the diet of around one-fifth of the study participants. Males were less likely to be affected by social media than females (OR: 0.51; (95% CI: 0.40–0.65). Participants with obesity and participants who had tried a diet to lose weight were more likely to be affected by social media, with odds ratios of 2.14, and 4.83, respectively. Followers of social media influencers were 10-folds more likely to be affected by social media than others.

Conclusion

This study showed that social media might influence the food consumption manner in the Saudi population.

Haematological, Biochemical, and Inflammatory Biomarkers of COVID-19 Patients Hospitalized in Critical Unit: A Retrospective Study

Background: The World Health Organization declared coronavirus disease 2019 (COVID-19) responsible for a catastrophic global pandemic. The complexity of COVID-19 is centred on the unpredictable course of the disease, which can rapidly develop from patients being asymptomatic to having life-threatening symptoms. The unpredictable disease severity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a major problem facing the healthcare system during the pandemic. Identifying the laboratory biomarkers would help predict SARS-CoV-2 pathogenicity. This study focused on the previous literature regarding three laboratory biomarker profiles: haematological, inflammatory, and biochemical biomarkers.

Methods: A retrospective study of COVID-19 patients was conducted between May 2020 and September 2020 to determine the predictors of hospitalization (severity) in COVID-19 patients. Patients were divided into two groups: those admitted to an intensive care unit (ICU, severe) and those admitted to a non-ICU (stable). Patients' data were obtained from their medical records at Al Noor Specialist Hospital and East Arafat Hospital in Saudi Arabia.

Results: A total of 487 patients with COVID-19, including 304 males and 183 females, were investigated in this study. A total of 217 patients were admitted to the ICU. Patients admitted to the ICU had a higher prevalence of chronic comorbidities than non-ICU patients. D-dimer, white blood cells (WBC), neutrophils, ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were more elevated in patients admitted to the ICU compared to non-ICU patients.

Conclusion: Chronic comorbidities are a significant predictor for admission to the ICU. Moreover, tests for D-dimer, WBC, neutrophils, lymphocytes, CRP, LDH, and ALT could be used to predict patients' admission to the ICU.

Chronic Vomiting and Weight Loss Due to Cecal Pinworm Infestation: A Case Report and Brief Literature Review

Enterobius vermicularis (E. vermicularis), also called pinworm or threadworm, is a widespread parasitic infection that has infected approximately 40 million individuals in the United States. However, the infection is rarely seen in the adult population. An atypical presentation of Enterobius vermicularis (E. vermicularis) infection has been reported previously in children and infants. However, there are no previous reports of this infection among adults in the Middle East. We present a case of a 30-year-old Saudi male patient who presented with significant weight loss, diarrhea, and vomiting. A colonoscopy revealed E. vermicularis in the cecum. The patient received one dose of oral albendazole 400 mg and then a repeat dose in two weeks based on his colonoscopy findings. The patient was seen in an outpatient clinic and reported complete resolution of postprandial vomiting. Asking about risk factors if there is any contact with contamination is essential. In addition, colonoscopy and stool analysis may also be considered to confirm the diagnosis. However, future studies investigating the incidence and risk factors of this infection are warranted as similar studies reporting this infection in Saudi Arabia are limited. Proper diagnosis and treatment are also essential to prevent complications of the infection. 

1364. Effect of Cefepime Prophylaxis on Bacterial Bloodstream Infections in Neutropenic Patients with Acute Myelogenous Leukemia

Background

Bacteremia is a major cause of morbidity and mortality among children with acute myelogenous leukemia (AML) and chemotherapy-induced neutropenia. Data evaluating the utility of bacterial prophylaxis in this pediatric population are limited. In April 2014, Children’s Health (CH) implemented the use of cefepime bacterial prophylaxis for AML patients undergoing induction and intensification chemotherapy. The objective of this study was to evaluate the impact of this practice on the frequency of documented bacterial bloodstream infections (BSIs).

Methods

This was an observational, retrospective cohort study of patients < 21 years of age with AML admitted at CH from January 2010 through December 2018. The primary outcome was frequency of documented BSIs before (PRE; Jan 2010 to Mar 2014) and after (POST; Apr 2014 to Dec 2018) implementation of routine bacterial prophylaxis. Secondary outcomes included differences in total antibiotic days per neutropenia days and the occurrence of neutropenia-associated C. difficile infection between groups.

Results

Of 90 patients with AML who met the cohort inclusion criteria, 38 and 52 were treated during the PRE and POST prophylaxis periods, respectively. The incidence rate of documented BSIs per 1000 neutropenia days decreased from 15.5 to 2.8 after the implementation of routine cefepime prophylaxis (incidence rate ratio 0.18, Poisson regression 95% CI 0.09 to 0.33, P< 0.001). Patients were more likely to have febrile neutropenia in the PRE group (OR 11.9, 95% CI 6.6 to 20.8). The POST group had more antibiotic days per total neutropenia days (0.76 PRE vs 0.97 POST, P< 0.0001), but the frequency of first-episode C. difficile infection was not significantly different between groups (OR 0.36, 95% CI 0.1 to 1.4).

Conclusion

Universal cefepime prophylaxis for children with AML and chemotherapy-induced neutropenia was associated with a significant reduction in the incidence of febrile neutropenia and neutropenia-associated BSIs without increasing the incidence of C. difficile infection.

Disclosures

All Authors: No reported disclosures

Distance Surface for Event-Based Optical Flow

We propose DistSurf-OF, a novel optical flow method for neuromorphic cameras. Neuromorphic cameras (or event detection cameras) are an emerging sensor modality that makes use of dynamic vision sensors (DVS) to report asynchronously the log-intensity changes (called "events") exceeding a predefined threshold at each pixel. In absence of the intensity value at each pixel location, we introduce a notion of "distance surface"-the distance transform computed from the detected events-as a proxy for object texture. The distance surface is then used as an input to the intensity-based optical flow methods to recover the two dimensional pixel motion. Real sensor experiments verify that the proposed DistSurf-OF accurately estimates the angle and speed of each events.

Reliability and Variability Assessment of Femoral Artery Pseudoaneurysm Measurements Between Pre- and Postprocessed B-mode Ultrasound Images

Objective:

To assess the reliability and variability of femoral artery pseudoaneurysm (FAP) measurements between pre- and postprocessed sonograms acquired in a major medical center in Saudi Arabia as compared with results obtained from a major medical center in the United States.

Methods:

Retrospective image analysis was conducted on 23 FAP sonograms, which were evaluated by four observers. Observers measured FAP sac and neck from pre- and postprocessed images and remeasured again after 2 weeks, to avoid recall bias.

Results:

The use of image processing was more profound for the novice observers in measuring FAP neck width and length. The intraclass correlation coefficient (ICC) for FAP neck width improved after segmentation from 0.63 to 0.91; in contrast, the ICC improved from 0.91 to 0.97 for experts. The average ICCs for FAP neck length improved from 0.40 to 0.79 for novices and from 0.86 to 0.95 for experts. The largest variation of values, within observers, were for neck length obtained from the original images. The range varied from 0.16 to 0.37 cm and was reduced to 0.10 to 0.18 cm with segmented images.

Conclusion:

As demonstrated previously, sonographic image processing resulted in increased reliability and decreased variability for FAP measurements.

Association between soft drinks consumption and asthma: a systematic review and meta-analysis

OBJECTIVES

To carry out meta-analysis and systematic review on the association between soft drinks consumption and asthma prevalence among adults and children.

DESIGN

Systematic review and meta-analysis of observational research.

DATA SOURCES

Medline, Scopus, ISI Web of Science and the Cochrane Library were searched up to December 2018.

ELIGIBILITY CRITERIA

We included observational studies investigating the association between soft drinks consumption (including maternal consumption during pregnancy) and asthma or wheeze.

DATA EXTRACTION AND SYNTHESIS

Data were extracted by one author and reviewed independently by two other authors. The most adjusted estimate from each original study was used in the meta-analysis. Meta-analysis was conducted using random-effects model. The quality of studies was assessed using the Newcastle-Ottawa scale and heterogeneity was evaluated using I² statistic.

RESULTS

Of 725 publications originally identified, 19 were included in this systematic review, including 3 cohort studies and 16 cross-sectional studies. Ten articles reported on children up to 18 years, 5 articles on adults (>18 years) and 2 articles on prenatal exposure. In total, 468 836 participants were included, with more than 50 000 asthma cases. Soft drinks consumption was associated with significantly increased odds of asthma in both adults (OR=1.37; 95% CI, 1.23 to 1.52) and children (OR=1.14; 95% CI, 1.06 to 1.21). Prenatal exposure had marginally statistically significant association (OR=1.11; 95% CI, 1.00 to 1.23) with asthma in children. In subgroup analysis for childhood exposure, the association persists for sugar-sweetened soft drinks but not for carbonated drinks.

CONCLUSION

Our findings show a positive association between soft drinks consumption and asthma prevalence, mostly from cross-sectional studies. Therefore, more longitudinal research is required to establish causality.