Exploring the prognostic significance of ß-HCG levels in cervicovaginal secretions and maternal risk factors for early birth.

Preterm birth is one of the leading causes of death in the perinatal period, this study was conducted to investigate the predictive value of ß-HCG Levels in cervicovaginal secretions and maternal risk factors in preterm delivery. This cross-sectional study was conducted over a six-month period from January 1 to June 30, 2021, in  Baghdad hospitals. The data were collected and used from the mothers who went to the hospital for delivery. Demographic information of patients and some risk factors were investigated. Vaginal secretions were sampled with a cotton swab. ß-HCG level in weeks 29, 31, 33, and 35 was measured by ELISA method. Data were analyzed with SPSS Ver 25 software and a significance level of less than 0.05 was considered. The mean age of the study participants was 28.29 ± 5.68 years. There was a significant difference in the level of ß-HCG between women with full-term delivery and pre-term women in weeks 29, 31, 33, and 35 of pregnancy (P ≤ 0.001). Maternal factors such as age older than 35 years, BMI, history of thyroid disease, blood pressure, premature rupture of the amniotic sac, parity, twin and multiple births, and decreased amniotic fluid volume have been identified as factors affecting preterm delivery. The ß-HCG level can also be a helpful marker for preterm birth.

Professional Values and Self-Reported Clinical Competence of Acute Care Nurses in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Professional values are the foundation of nursing practice. Current research evidence on the influence of professional values on clinical competence among acute care nurses in the clinical area is lacking. PURPOSE: The purpose of this study was to examine the professional values and self-reported clinical competence among acute care nurses. METHODS: This quantitative study used a cross-sectional, correlational design. A convenience sample of 403 nurses was recruited to answer the survey utilizing the Nurses Professional Values Scale-3 and the Nurse Competence Scale. The Pearson correlation coefficient was computed to test the relationship between study variables, and a stepwise multiple regression analysis was then performed to investigate the predictors of nurses' professional values and clinical competence. RESULTS: The professional value of "caring" received the highest mean score, followed by "professionalism", while the factor "activism" was rated the lowest. Education was a significant predictor of all three factors of professional values. For clinical competence, "managing situations" was rated as the highest dimension, while "ensuring quality" was rated as the lowest. Moderate positive correlations were revealed between the three factors of professional values and all dimensions of nurses' clinical competence. Area of practice and "activism" were the only significant predictors of the nurses' clinical competence. CONCLUSIONS: Nurses perceived all three factors of professional values with high importance in influencing their clinical competence. These findings can contribute to the development of educational interventions to improve and sustain professional values and clinical competence among acute care nurses.

Telehealth Readiness of Healthcare Providers during COVID-19 Pandemic in Saudi Arabia.

OBJECTIVE: This study aimed to assess and explore the telehealth readiness of healthcare providers in Saudi Arabia. METHODS: This descriptive cross-sectional survey was conducted in a government healthcare facility in Saudi Arabia between August and October 2020. The Telehealth Readiness Assessment (TRA) tool was used. RESULTS: A total of 372 healthcare providers participated in this study. Their mean age was 35.5 years (SD = 10.46). The majority of respondents were female (65.6%), nurses (68.0%), married (60.2%), and non-Saudi nationals (64.2%). The analysis shows that healthcare providers generally had moderate-to-high telehealth readiness. Of the five domains, financial contributions had the lowest rating among nurses and physicians, 63.4% and 66.1%, respectively. Gender (ß = 7.64, p = 0.001), years of experience in the organization (ß = 11.75, p = 0.001), and years of experience in the profession (ß = 10.04, p = 0.023) predicted the telehealth readiness of healthcare providers. CONCLUSION: The telehealth readiness of healthcare providers in Saudi Arabia showed moderate to high levels. The COVID-19 pandemic poses a catastrophic threat to both patients and healthcare providers. Assessing telehealth readiness should include both patients and healthcare provider factors. A better understanding of the factors of organizational readiness, particularly healthcare providers, could help avoid costly implementation errors.

Healthcare Workers' Worries and Monkeypox Vaccine Advocacy during the First Month of the WHO Monkeypox Alert: Cross-Sectional Survey in Saudi Arabia.

Background: Monkeypox virus re-surged in May 2022 as a new potential global health threat, with outbreaks bursting in multiple countries across different continents. This study was conducted in Saudi Arabia during the first month following the WHO announcement of the Monkeypox outbreak, to assess healthcare workers (HCWs) perceptions of, worries concerning, and vaccine acceptance for, Monkeypox, in light of the resolving COVID-19 pandemic. Methods: A national cross-sectional survey was conducted between 27 May and 10 June 2022, in Saudi Arabia. Data were collected on: HCWs' sociodemographic and job-related characteristics; COVID-19 infection status; and worries concerning Monkeypox, compared to COVID-19 and its sources; as well as their perceptions and awareness of, and advocacy for, supporting Monkeypox vaccination. Results: A total of 1130 HCWs completed the survey, of which 41.6% have already developed COVID-19. However, 56.5% were more concerned about COVID-19 compared to Monkeypox, while the rest were more worried about Monkeypox disease. The main cause for concern among 68.8% of the participants was the development of another worldwide pandemic, post-COVID-19, followed by their concern of either themselves or their families contracting the infection (49.6%). Most HCWs (60%) rated their level of self-awareness of Monkeypox disease as moderate to high. Males, and those who had previously developed COVID-19, were significantly less likely to worry about Monkeypox. The worry about Monkeypox developing into a pandemic, and the perception of Monkeypox being a severe disease, correlated significantly positively with the odds of high worry concerning the disease. The major predictors of participants' advocacy for vaccination against Monkeypox disease were: those who had developed COVID-19 previously; and those who supported tighter infection control measures (than those currently used) to combat the disease. A total of 74.2% of the surveyed HCWs perceived that they needed to read more about Monkeypox disease. Conclusions: Approximately half of the HCWs in this study were more concerned about Monkeypox disease than COVID-19, particularly regarding its possible progression into a new pandemic, during the first month following the WHO's Monkeypox international alert. In addition, the majority of participants were in favor of applying tighter infection prevention measures to combat the disease. The current study highlights areas requiring attention for healthcare administrators regarding HCWs' perceptions and preparedness for Monkeypox, especially in the event of a local or international pandemic.

Barriers to Implementing Evidence-Based Practice among Primary Healthcare Nurses in Saudi Arabia: A Cross-Sectional Study.

Several studies have been conducted to investigate the barriers to implementing evidence-based practice (EBP) worldwide. In Saudi Arabia, a few studies were conducted in hospital and mental health settings, and no study has explored the topic in primary healthcare settings. This study aimed to examine the barriers perceived by primary healthcare nurses in implementing EBP. This study employed a correlational and cross-sectional design. A total of 284 nurses were surveyed using the BARRIERS scale. Regression analysis was performed to identify the effects of predictor variables on the four subscales. The overall raw score on the BARRIERS scale was 86.21 (standard deviation = 16.15). The highest mean score was reported in the organizational subscale, followed by the innovation and communication subscales, whereas the lowest mean score was reported in the adopter subscale. The findings showed that the three top-ranked barriers were: (1) results of the studies are not generalizable to nurses' setting, (2) facilities are inadequate, and (3) physicians do not cooperate with the implementation. Findings showed that nurses encounter organizational-related barriers to a moderate extent and EBP implementation varies depending on gender, level of education, and job position. There is a need to create and implement educational interventions and programs to overcome the barriers to effective EBP implementation among primary healthcare nurses.

Immediate knowledge retention among nursing students in live lecture and video-recorded lecture: A quasi-experimental study.

AIM/OBJECTIVE: To determine if video-recorded lecture provided better immediate knowledge retention than live lecture BACKGROUND: In line with the call to increase nationally graduated nurses as recommended by KSU 2030 Vision, educational institutions in Saudi Arabia are required to increase the enrollment to the Bachelor of Science in Nursing program. As a result, there is increased number of sections or groupings which created a need for additional faculty. However, to mitigate the impact of faculty shortage, the Administration embarked on exploring innovative teaching strategies that would ensure that lecture contents across groups of students are uniform and instructions are similar. Hence there is a need to explore innovative teaching strategies that would ensure that contents across groups of students are uniform, and instructions are similar. DESIGN: The study employed a quasi-experimental design to examine if video-recorded lectures provided better immediate knowledge retention than live lectures. METHODS: A total of 160 s -year nursing students were randomly assigned to either of the two teaching strategies (video-recorded lecture or live lecture). Data were collected at a public university in Riyadh, Saudi Arabia. Both lectures covered the interpretation of arterial blood gases (ABG) and all students had no prior knowledge on the subject. Pretest and posttest using the same 16 questions were administered to both groups. Each item was comprised of a combination of ABG results. Students were to choose the correct answer from four choices of interpretations of the ABG result. ABG is assessed to determine gas exchange, ventilator control and acid-base balance among patients with acute or chronic illnesses. Assessment of immediate knowledge retention was conducted using a questionnaire comprised of 16 multiple-choice items to be used in both the pretest and posttest. Each item was comprised of a combination of ABG results. RESULTS: The live lecture group's posttest mean score did not differ significantly from that of the video-recorded lecture group; t (156.52) = 0.47, p = 0.64, d = -0.08. The odds ratio is 1.27 and the probability is 95%. CI:.64, 2.50. CONCLUSION: This study found no difference between video-recorded lectures and live lectures in terms of providing immediate knowledge retention. Video-recorded lectures are a viable complementary teaching strategy. There is a need to enhance the instructional design so that learning objectives are more clearly defined, contents are aligned with the learning objectives, teaching strategies should include active participation from learners and outcomes should be assessed based on the learning objectives.

MiR-624-5p enhances NLRP3 augmented gemcitabine resistance via EMT/IL-1ß/Wnt/ß-catenin signaling pathway in ovarian cancer.

The current study investigates the NLRP3's cytotoxicity inhibitory effect among ovarian cancer cells and how it interacts with Wnt/ß-catenin in vitro conditions. Further, the study also analyzed the regulatory role of NLRP3 in resistance to gemcitabine among ovarian cancer cells and its underlying interaction mechanisms with Wnt/ß-catenin in vitro. The current in vitro study detailed that when downregulating NLRP3, it could enhance the gemcitabine sensitivity in GRC cells. In case of gemcitabine-resistant cells, the up-regulation of NLRP3 can increase the drug-resistance through the activation of IL-1ß, EMT and Wnt/ß-catenin signaling pathways. High expression of miR-624-5p was recorded in ovarian drug resistant cancer cells and it also boosted the cell viabilities. NLRP3 can reinstate the functioning of miR-624-5p in drug resistant cells. This phenomenon concludes that NLRP3 is a promising therapeutic target and can be implemented in traditional chemotherapy to increase the efficacy of the treatment. The current study conducted in vitro experiments and the findings infer that the downregulation of NLRP3 can enhance the sensitivity of gemcitabine among GRC cells. This mechanism will increase the treatment efficacy by inhibiting the drug resistance in GRC. These two entities are the new promising biomarkers that can be used in the detection of platinum resistance in ovarian cancer patients and conduct novel clinical research.

Fear of Nurses During COVID-19 Pandemic in Saudi Arabia: A Cross-Sectional Assessment.

Objective: We aimed to assess the level of fear among nurses in Saudi Arabia during the COVID-19 outbreak. Methods: A cross-sectional survey-based study was conducted from June to August 2020. All nurses currently working in public and private hospitals in Saudi Arabia during the COVID-19 pandemic were invited to complete an online survey. We used the 7-item unidimensional Fear of COVID-19 Scale (FCV-19S) to assess the level of fear of COVID-19. Multiple regression analysis was used to identify predictors associated with fear of COVID-19. Results: A total of 969 nurses participated in this study. The participants were relatively young with a mean age of 35.5 ± 10.46 years. About two-thirds of the participants were women (65.9%), married (57.2%), and were non-Saudi nationals (67%). The total mean score for the FCV-19S was 19.7 SD 7.03 (range 7-35), which is near the mid-point, indicating a moderate level of fear of COVID-19. Out of the eight variables measured in the analysis, three variables emerged as a significant predictor (i.e., gender, marital status, and age). A higher level of fear (FCV-19S) was associated with being a woman, married, and older age (p ≤ 0.05). Conclusion: This study demonstrated the level of fear of COVID-19 among nurses in Saudi Arabia. Overall, nurses in Saudi reported moderate levels of fear of COVID-19. Assessing the level of fear of nurses who work during the COVID-19 pandemic should be a priority to health care administrators to prevent mental health difficulties or psychological injury.

Therapeutic value of the metabolomic active neurotransmitter isorhynchophylline in the treatment of spontaneously hypertensive rats by regulating neurotransmitters.

Hypertension is one of the most reported cardiovascular and cerebrovascular diseases with significantly high morbidity and mortality rates. This condition threatens the very existence of human beings. Numerous studies conducted earlier revealed the good therapeutic effect of isorhynchophylline on hypertension since the former regulates the metabolic disorders in neurotransmitters. However, the mechanism behind this action is yet to be deciphered. The current study followed the targeted metabolomics method to investigate the changes in the neurotransmitter level in the hippocampus of spontaneously hypertensive rats (SHRs) after the rats were treated with isorhynchophylline. The authors predicted the metabolic pathways involved in extensively modified neurotransmitters. Further, the expressions of metabolism-key enzymes in mRNA and protein levels were also determined. When treated with isorhynchophylline, it induced notably varying metabolomic profiles of the hippocampus in SHRs. Isorhynchophylline perturbed a total of seven extensively modified neurotransmitters as well as the primarily related pathways such as tyrosine and glutamate metabolism. An increase in the key metabolic enzymes such as DDC, MAO, COMT, TH, and DßH was observed in the SHR group, whereas their levels decreased after treatment with isorhynchophylline. The expression of GAD67 established cross-current validity. So, isorhynchophylline has been proved to have potential therapeutic value to treat hypertension via tyrosine and glutamate metabolism in the hippocampus. Further, the current study also opened new ventures to further investigate the working mechanism of isorhynchophylline in hypertension.

Promising anti- cervical carcinoma and inflammatory agent, Resveratrol targets poly (ADP-ribose) polymerase 1 (PARP-1) induced premature ovarian failure with a potent enzymatic modulatory activity.

Radioprotective effects of Resveratrol is well known in normal cells exposed to the damaging effects of ionizing radiation however, its potential radioprotective effect on ovarian follicle formation and development is still uncertain. Astonishingly, it has been reported that PARP contributed to the pathogenesis of immune-mediated ovarian injury. In this paper, Resveratrol was tested for its inflammatory, anti-cervical carcinoma activity, and checked its targets poly (ADP-ribose) polymerase 1 (PARP-1) induced premature ovarian failure with a potent enzymatic modulatory activity. Through high-throughput virtual screening method, Resveratrol was screened to find its target. That the compound strongly inhibited cervical carcinoma HT-3 cell. The cell proliferation was evaluated by an CCK-8 assay, and the cell apoptosis was assessed by a flow cytometry. Rat model of premature ovarian failure was used to introduce resveratrol preparation and rtPCR was done to measure expression of apoptosis related markers. We report resveratrol as a potential target for PARP-1 and its modulator from a high-throughput virtual screening method. Resveratrol was measured its anti-cervical carcinoma activity by using an CCK-8 assay, which suggested that the compound strongly inhibited HT-3 cell proliferation, the IC50 value is 0.65 µM. In addition, the compound induced HT-3 cell apoptosis in a dose-response manner. Resveratrol preserves the entire ovarian follicle pool manifested by increasing serum anti-Müllerian hormone (AMH) levels. Study suggest that resveratrol restored ovarian function through increasing AMH levels, and diminishing ovarian inflammation, predominantly modulation of PPAR-1 and inhibition of inflammatory cytokines. Resveratrol was identified targets for PARP-1 from a high-throughput virtual screening method, strongly inhibited PARP-1 protein and HT-3 cell proliferation. Resveratrol is a promising PARP-1 modulator with anti-cervical carcinoma activity, which deserves further investigation.

Association of Fear of COVID-19 and Health Literacy Among the General Public in Saudi Arabia: A Cross-Sectional Assessment.

Objective: This study aims to determine the level of fear of coronavirus disease-2019 (COVID-19) among the general public in Saudi Arabia and the association of its scores with their level of health literacy. Methods: A descriptive cross-sectional study was conducted among the general population in Saudi Arabia from April 2020 to May 2020. A three-part online self-reported survey was used to assess the participants' demographic characteristics, fear of COVID-19 of the participants, and levels of health literacy. Results: Of the 848 participants, 56.8% were in the age group of 25-34, 45.6% were females, and 57.1% had a bachelor's degree. The total mean score of the fear of COVID-19 scale of the participants was FCoV-19: mean ± SD = 19.60 ± 7.33 and the health literacy was HL index: mean ± SD = 27.57 ± 11.05. There was a significant difference in the scores of fear of COVID-19 scale in terms of age (F = 2.442, p = 0.050), representing that those aged 45 and above had higher mean fear scores than the younger participants. The analysis revealed that an increased level of fear of COVID-19 was associated with older age (B = 1.87; p = 0.020), being unemployed (B = 0.76; p = 0.023), with no formal education (B = 0.89; p = 0.001), and low level of health literacy (B = 0.02; p = 0.021). Conclusion: The study shows an above-average level of fear of COVID-19 of the general public in Saudi Arabia and its association with a low level of functional health literacy. Timely and comprehensive health interventions should be promoted to enhance the level of health literacy and further reduce the level of fear of COVID-19 in the community.

Perceived stress and coping strategies among ICU nurses in government tertiary hospitals in Saudi Arabia: a cross-sectional study.

BACKGROUND: No study has examined the stress level and coping strategies among critical care nurses in Saudi Arabia. OBJECTIVES: Examine perceived stress and coping behaviors among nurses in intensive care units in Saudi Arabia, and the influence of cop.ing mechanisms on stress. DESIGN: Descriptive cross-sectional. SETTING: Two tertiary training hospitals in Riyadh, Saudi Arabia. SUBJECTS AND METHODS: Nurses from cardiac, surgery and pediatric intensive care units responded to an online survey. Perceived Stress Scale-10 (PSS-10) and the Brief COPE Inventory were used as primary research tools. Multivariate methods were used to analyze the data. MAIN OUTCOME MEASURES: Stress levels, coping strategies, and associated factors. SAMPLE SIZE: 154 nurses. RESULTS: The majority of the respondents reported a moderate level of stress in the past month (87.0%). Mean (SD) scores for nurses working in the cardiac ICU indicated significantly higher levels of stress compared to surgical ICU (18.18 [3.88] vs 6.17 [3.21], P=.025). Belief in religion was the most common coping behavior while the use of substances was the lowest (mean scores [SD] 6.70 [ 1.72] vs 2.22 [0.81]). In the multivariate analysis, behavioral disengagement (P=.016) and self-blame (P less than .001) intensified the PSS-10 score, whereas acceptance (P=.048) reduced the PSS-10 score. CONCLUSION: The additional knowledge that behavioral disengagement and blaming aggravate stress can serve as the basis in formulating work-related stress reduction strategies among nurses caring for critical patients. LIMITATIONS: The use of self-reports, convenience sampling, and selected demographic factors may have limited the scope and generalizability of the findings and induced social desirability bias. CONFLICT OF INTEREST: None.

Antibiotic Skin Testing in the Intensive Care Unit: A Systematic Review.

BACKGROUND: Recent research has shown that a large majority of patients with a history of penicillin allergy are acutely tolerant of penicillins and that there is no clinically significant immunologic cross-reactivity between penicillins and cephalosporins or other ß-lactams. The standard test to confirm acute tolerance is challenge with a therapeutic dose. Skin testing is useful only when the culprit antibiotic can haptenate serum proteins and induce an immunoglobulin E-mediated reaction and the clinical history demonstrates such high risk that a direct oral challenge may result in anaphylaxis. OBJECTIVE: To review and evaluate the current practice of skin testing for antibiotics (other than penicillin) in critically ill patients by means of a systematic literature review. METHODS: This systematic review was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Several electronic databases were searched using the following terms: antibiotics, skin test (tests, testing), intensive care, intensive care unit, ICU, critical care, critical care unit. RESULTS: Twenty-three articles were identified for inclusion in this review. The results indicate a lack of standardized skin testing for all antibiotics in critical care settings. Oral challenge with nonirritating concentrations of antibiotics can be helpful in determining allergy to these drugs. CONCLUSIONS: Critical care providers should evaluate antibiotic allergy using nonirritating concentrations before administering antibiotics to patients. Introduction of a standardized skin test for all antibiotics in intensive care unit patients to help select the most appropriate antibiotic treatment regimen might help save lives and reduce costs.

Readiness for self-directed learning: How bridging and traditional nursing students differs?

BACKGROUND: The dean of the nursing college has an initiative to reform the BSN program in the college to minimize the use of lecturing and maximize interactive and lifelong learning. Appropriate assessment of how our students are prepared to be self-directed learners is crucial. OBJECTIVE: To compare traditional and bridging students in regard to their SDLR scores in the nursing college in Saudi Arabia. DESIGN: This was a comparative study to compare traditional and bridging students in regard to their self-directed learning readiness scores (SDLR). SETTINGS: The data was collected at the Nursing College, King Saud University, Riyadh, Saudi Arabia. PARTICIPANTS: A convenient sample of undergraduate nursing students at the sixth and eighth levels in both regular and bridging programs were recruited in this study to indicate their SDLR scores. METHODS: The study used Fisher et al.'s (2001) Self-Directed Learning Readiness Scale to measure the self-directed learning readiness among undergraduate nursing students. RESULTS: The total mean score of SDLR was 144 out of 200, which indicated a low level of readiness for SDL. There were significant variations between the included academic levels among participants. Students in the sixth academic level scored higher in the total SDLR scores compared to eighth-level students. There were no significant variations with gender and program types in the total SDLR scores. CONCLUSIONS: A comprehensive plan is needed to prepare both faculty members and students to improve the SDL skills.

Transgender Individuals and Osteoporosis Prevention.

BACKGROUND: Risk behaviors and hormone use place transgender individuals (TIs) in jeopardy for osteoporosis. PURPOSE: The purpose of this study was to expand the science about the knowledge, health beliefs, and osteoporosis (OP) preventing behaviors of TIs. METHODS: This was a mixed-methods pilot study of a convenience sample of 31 TIs 30 years and older. Participants completed an online Osteoporosis Bone Health Survey. Fifteen participants were randomly selected for an interview to describe their perceptions of bone health. RESULTS: Transgender individuals performed poorly on the knowledge measure. There were no significant findings for osteoporosis health beliefs. Participants' daily dietary dairy calcium intake was 800 mg and daily walking activity was 17 minutes. Perceptions of bone health revealed two essential elements, knowing and doing. CONCLUSION: Determining TIs' bone health perception is important because of their unique healthcare issues. Healthcare providers need to be aware of TIs' bone health needs to help enhance TIs' OP knowledge, health beliefs, and preventing behaviors.

The Learning Preferences among Nursing Students in the King Saud University in Saudi Arabia: A Cross-Sectional Survey.

OBJECTIVE: The present study aimed to identify the most common learning preferences among the nursing students in Saudi Arabia and to investigate the associations of certain demographic variables with the learning preferences. METHODS: All the undergraduate nursing students in the nursing college were requested to participate in this descriptive cross-sectional study. An Arabic version of the Felder-Silverman learning style model (FSLSM) questionnaire was used to examine the learning preferences among undergraduate nursing students. RESULTS: A total of 56 (43%) completed questionnaires were included in the final analysis. Results of the present study indicate that the most common learning preferences among the nursing students were visual (67.9%), followed by active (50%) and sequential (37.5%) learning preferences. The verbal style was the least common learning preference (3.6%) among the nursing students. There was no association between gender and learning preferences (p > .05). CONCLUSION: The present study concluded that the visual, active, and sequential styles are the commonest learning preferences among the nursing students. The nursing educators should emphasize the use of this information in their teaching methods to improve learning skills among the nursing students.