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Sarah Bakhamis Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Faiqa Imtiaz Centre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Khushnooda Ramzan Centre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Edward De Vol Department of Biostatistics, Epidemiology & Scientific Computing, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Osamah Al-Sagheir Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Abdulrahman Al-Rajhi Department of Orthopedics, King Saud University Medical City, Riyadh, Saudi Arabia

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Abdullah Alashwal Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Bassam Bin Abbas Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Nadia Sakati Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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Afaf Al-Sagheir Department of Pediatrics, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

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and genetic causes of rickets have become a major factor ( 1 ). Despite abundant exposure to sunshine in Saudi Arabia, rickets remains predominant and a major public health problem in the population ( 2 ). A cross-sectional study of 2110 Saudi children

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Shatha Alharazy Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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M Denise Robertson Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

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Susan Lanham-New Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

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Muhammad Imran Naseer Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia

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Adeel G Chaudhary Centre of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
Centre for Innovation in Personalized Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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Eman Alissa Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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-ethnic (white Middle Eastern and black African) postmenopausal women living in western Saudi Arabia where vitamin D deficiency is an extremely prevalent issue despite a high level of sunlight. Methods Subjects and study design This is a cross

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Abdul K Siraj Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Rong Bu Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Maham Arshad Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Kaleem Iqbal Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Sandeep Kumar Parvathareddy Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Tariq Masoodi Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Laila Omar Ghazwani Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Saif S Al-Sobhi Department of Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Fouad Al-Dayel Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Khawla S Al-Kuraya Human Cancer Genomic Research, Research Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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cancer, among females in Saudi Arabia, with a significantly higher incidence rate when compared to other countries, such as the USA ( 2 , 3 ). Amongst the different subtypes, papillary thyroid cancer (PTC) is the most common and accounts for 80–90% of

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Veronica Astro Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia

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Elisabetta Fiacco Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia

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Kelly Johanna Cardona-Londoño Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia

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Ilario De Toma Sequentia Biotech SL, Barcelona, Spain

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Hams Saeed Alzahrani Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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Jumana Alama Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia

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Amal Kokandi Department of Dermatology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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Taha Abo-Almagd Abdel-Meguid Hamoda Department of Urology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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Majed Felemban Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
Center of Innovation in Personalized Medicine, King Abdulaziz University, Jeddah, Saudi Arabia

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Antonio Adamo Biological and Environmental Science and Engineering Division, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia

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North American (ENA) KS- and high-grade SCA patient-derived induced pluripotent stem cells (iPSCs) ( 10 , 11 , 12 , 13 , 14 , 15 ). Here, we present the first iPSC-based disease-modeling study performed on KS patients from Saudi Arabia. Saudi Arabia

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Sandeep Kumar Parvathareddy Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Abdul K Siraj Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Zeeshan Qadri Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Saeeda O Ahmed Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Felisa DeVera Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Saif Al-Sobhi Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Fouad Al-Dayel Department of Pathology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Khawla S Al-Kuraya Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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significantly in recent years ( 3 , 4 ). In Saudi Arabia, PTC is very common among females and ranks second after breast cancer ( 5 ). Although PTC has a favorable outcome, 3–10% of patients demonstrated recurrent disease within the first decade after treatment

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A Chinoy Royal Manchester Children’s Hospital, Manchester, UK

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M Skae Royal Manchester Children’s Hospital, Manchester, UK

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A Babiker King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia

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D Kendall Royal Preston Hospital, Preston, UK

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M Z Mughal Royal Manchester Children’s Hospital, Manchester, UK

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R Padidela Royal Manchester Children’s Hospital, Manchester, UK

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stable on standard doses of ACD, though had already developed signs of nephrocalcinosis. He presented to a tertiary hospital in Saudi Arabia with viral gastroenteritis and subsequent hypocalcaemic seizures. This necessitated increase in doses of ACD up to

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Ann R Webb Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK

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Rehab Alghamdi Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia

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Richard Kift Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK

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Lesley E Rhodes Centre for Dermatology Research, School of Biological Sciences, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, UK

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funding from FAO and WHO. R A is supported by a PhD studentship from King Abdulaziz University, Jeddah, Saudi Arabia. L E R acknowledges support of the NIHR Manchester Biomedical Research Centre. Acknowledgements FAO and WHO provided technical

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Werner F Blum University Children’s Hospital, Giessen, Germany

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Abdullah Alherbish Al Habib Medical Group, Riyadh, Saudi Arabia

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Afaf Alsagheir King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

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Ahmed El Awwa Department of Pediatric Endocrinology & Diabetes, Hamad Medical Center, Doha, Qatar

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Walid Kaplan Tawam Hospital, Al Ain, UAE

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Ekaterina Koledova Global Medical Affairs Endocrinology, Merck KGaA, Darmstadt, Germany

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Martin O Savage William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, London, UK

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The growth hormone (GH)–insulin-like growth factor (IGF)-I axis is a key endocrine mechanism regulating linear growth in children. While paediatricians have a good knowledge of GH secretion and assessment, understanding and use of measurements of the components of the IGF system are less current in clinical practice. The physiological function of this axis is to increase the anabolic cellular processes of protein synthesis and mitosis, and reduction of apoptosis, with each being regulated in the appropriate target tissue. Measurement of serum IGF-I and IGF-binding protein (IGFBP)-3 concentrations can complement assessment of GH status in the investigation of short stature and contribute to prediction of growth response during GH therapy. IGF-I monitoring during GH therapy also informs the clinician about adherence and provides a safety reference to avoid over-dosing during long-term management.

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Budoor Alemadi B Alemadi, Endocrinology, Dubai Health, Dubai, United Arab Emirates

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Fauzia Rashid F Rashid, Endocrinology , Dubai Health, Dubai, United Arab Emirates

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Ali S Alzahrani A Alzahrani, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

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Primary hyperparathyroidism has emerged as a prevalent endocrine disorder in clinical settings, necessitating in most cases, surgical intervention for the removal of the diseased gland. This condition is characterised by overactivity of the parathyroid glands, resulting in excessive parathyroid hormone production and subsequent disturbances in calcium homeostasis. The primary mode of management is surgical treatment, relying on the accurate localisation of the pathological parathyroid gland. Precise identification is paramount to ensuring that the surgical intervention effectively targets and removes the diseased gland, alleviating the hyperfunctioning state. However, localising the gland becomes challenging, as discrepancies between the clinical manifestation of active parathyroid and radiological identification are common. Based on our current knowledge, to date, no comprehensive review has been conducted that considers all factors collectively. This comprehensive review delves into the factors contributing to false-negative 99mTc-sestamibi scans. Our research involved an exhaustive search in the PubMed database for hyperparathyroidism, with the identified literature meticulously filtered and reviewed by the authors. The results highlighted various factors, including multiple parathyroid diseases, nodular goitre, mild disease, or the presence of an ectopic gland that causes discordance. Hence, a thorough consideration of these factors is crucial during the diagnostic workup of hyperparathyroidism. Employing intraoperative PTH assays can significantly contribute to a successful cure of the disease, thereby providing a more comprehensive approach to managing this prevalent endocrine disorder.

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Hanbaro Kim Department of Surgery, Hallym University College of Medicine, Chuncheon, Republic of Korea

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Ki Byung Song Division of Hepatobilliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea

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Dae Wook Hwang Division of Hepatobilliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea

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Jae Hoon Lee Division of Hepatobilliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea

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Shadi Alshammary Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia

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Song Cheol Kim Division of Hepatobilliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea

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This study aimed to evaluate the evolving trends in clinicopathological features of pancreatic neuroendocrine tumors and to analyze the predictors of recurrence after curative resection. Data collected retrospectively from a single center between January 1990 and December 2017 were analyzed. Patients were categorized chronologically into three groups for evolving time-trend analysis. Overall, 542 patients (300 female, 55.4%) underwent surgical resection for pancreatic neuroendocrine tumors, including 435 (80.3%) with non-functional tumors. Time-trend analysis revealed that the surgically resected pancreatic neuroendocrine tumor number increased consistently; however, the incidental non-functional pancreatic neuroendocrine tumor number also increased over time (P < 0.001). The 5- and 10-year disease-free survival rates were 86.4 and 81.3%, respectively. The overall recurrence rate was 13.7%, and the most common site of recurrence was the liver. The median time to recurrence after primary surgery was 19.0 (range 0.8–236.3) months, and the median survival time after recurrence was 22.6 (range 0.4–126.9) months. On multivariate analysis, grade G3 pancreatic neuroendocrine tumors (hazard ratio 4.51; P < 0.001), lymph node metastasis (hazard ratio 2.46; P = 0.009), lymphovascular invasion (hazard ratio 3.62; P = 0.004), perineural invasion (hazard ratio 2.61; P = 0.004) and resection margin (hazard ratio 4.20; P = 0.003) were independent prognostic factors of disease-free survival. The surgically resected pancreatic neuroendocrine tumor number increased over time mainly because of an increase in incidentally discovered non-functional pancreatic neuroendocrine tumors. Grade G3 pancreatic neuroendocrine tumors, lymph node metastasis, lymphovascular invasion, perineural invasion and a positive resection margin were significant predictors of worse disease-free survival in patients with surgically resected pancreatic neuroendocrine tumors.

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