Fabrication of Erbium-Doped Upconversion Nanoparticles and Carbon Quantum Dots for Efficient Perovskite Solar Cells.

Upconversion nanoparticles (UCNPs) and carbon quantum dots (CQDs) have emerged as promising candidates for enhancing both the stability and efficiency of perovskite solar cells (PSCs). Their rising prominence is attributed to their dual capabilities: they effectively passivate the surfaces of perovskite-sensitive materials while simultaneously serving as efficient spectrum converters for sunlight. In this work, we synthesized UCNPs doped with erbium ions as down/upconverting ions for ultraviolet (UV) and near-infrared (NIR) light harvesting. Various percentages of the synthesized UCNPs were integrated into the mesoporous layers of PSCs. The best photovoltaic performance was achieved by a PSC device with 30% UCNPs doped in the mesoporous layer, with PCE = 16.22% and a fill factor (FF) of 74%. In addition, the champion PSCs doped with 30% UCNPs were then passivated with carbon quantum dots at different spin coating speeds to improve their photovoltaic performance. When compared to the pristine PSCs, a fabricated PSC device with 30% UCNPs passivated with CQDs at a spin coating speed of 3000 rpm showed improved power conversion efficiency (PCE), from 16.65% to 18.15%; a higher photocurrent, from 20.44 mA/cm2 to 22.25 mA/cm2; and a superior fill factor (FF) of 76%. Furthermore, the PSCs integrated with UCNPs and CQDs showed better stability than the pristine devices. These findings clear the way for the development of effective PSCs for use in renewable energy applications.

Comparing Actual and Rounded Serum Creatinine Concentration for Assessing the Accuracy of Vancomycin Dosing in Elderly Patients: A Single-Center Retrospective Study.

Prescribers often face the challenge of predicting creatinine clearance (CrCl) in elderly patients who are 65 years or older and have serum creatinine (SCr) concentrations below 1 mg/dL. Studies have shown that utilizing rounded SCr would underestimate CrCl in this population, which could lead to the under-dosing of some medications like vancomycin. The current study aimed to compare the accuracy of vancomycin dosing using actual SCr versus rounded SCr to 1 mg/dL in elderly patients. A total of 245 patients were included. The therapeutic trough level (10-20 mg/L) was achieved in 138 (56.3%) patients using actual SCr. Sub-therapeutic (<10 mg/L) and supra-therapeutic (>20 mg/L) trough levels were observed in 32 (13.1%) and 75 (30.6%) patients, respectively. The predictive performance of different vancomycin doses based on actual SCr and rounded SCr compared to the targeted maintenance dose (TMD) showed a stronger correlation of dosing based on actual SCr with TMD (r = 0.55 vs. 0.31) compared to rounded SCr dosing; both doses showed similar precision, with ranges of ±552 mg/day for the dosing based on actual SCr and ±691 mg/day for the dosing based on rounded SCr. Furthermore, the dosing based on actual SCr showed a lower error percentage (69%) and a higher accuracy rate (57.6%) within ±10% of the TMD compared to the dosing based on rounded SCr, which had an error percentage of (92.3%) and an accuracy rate of (40%). The prevalence of vancomycin-associated nephrotoxicity (VAN) was seen in 44 (18%) patients. Patients between 75 and 84 years of age, those who were bedridden, and those with vancomycin trough concentrations greater than 20 mg/L had a higher risk of developing VAN. In conclusion, in elderly patients, estimating vancomycin dosing based on actual SCr was more accurate compared to rounded SCr to 1 mg/dL. The efficacy of vancomycin could be negatively affected by rounding up SCr, which could underestimate CrCl and result in the under-dosing of vancomycin.

Transplantation of hyaluronic acid and menstrual blood-derived stem cells accelerated wound healing in a diabetic rat model.

Diabetic wounds require a multifactorial approach because several factors are involved in its occurrence. Herein we investigated whether transplantation of hyaluronic acid (HA) in combination with menstrual blood derived stem cells (MenSCs) could promote healing in diabetic rats. Thirty days after induction of diabetes, sixty animals were randomly planned into four equal groups: the untreated group, HA group, MenSC group, and HA+MenSC group. Sampling was done for histological, molecular, and tensiometrical assessments. Our results indicated that the wound contraction rate, volumes of new epidermis and dermis, collagen density, as well as tensiometrical parameter were considerably increased in the treatment groups compared to the untreated group and these changes were more obvious in the HA+MenSC ones. In addition, the expression levels of TGF-ß and VEGF genes were significantly upregulated in treatment groups in comparison with the untreated group and were greater in the HA+MenSC group. This is while expression levels of TNF-α and IL-1ß genes were more considerably downregulated in the HA+MenSC group than the other groups. We concluded that the combined use of HA and MenSCs has more effects on diabetic wound healing.

Development and psychometric evaluation of the asthma Action plan questionnaire (AAPQ).

OBJECTIVE: To develop a practical and psychometrically sound tool to evaluate caregiver knowledge of their child's asthma action plan (AAP). METHODS: A pilot study was conducted in a sample of 40 caregivers of children with asthma to assess the content validity, item difficulty, and item discrimination of the Asthma Action Plan Questionnaire (AAPQ). The inter-rater and intra-rater agreement of the AAPQ's scoring rubric were also examined. Subsequently, a large-scale study was conducted in a sample of 80 caregivers of children with asthma and 40 caregivers of children without current asthma and no prior exposure to patients with asthma to evaluate the internal consistency, test-retest reliability, and known-groups validity of the AAPQ. RESULTS: The 7-item AAPQ demonstrated acceptable content validity (a scale-content validity index of 0.98) and internal consistency (Cronbach's alpha =.63 and mean inter-item correlation coefficient of.20) and very strong test-retest reliability over a two-to-four-week period (r = .88, p < .001). The AAPQ discriminated between caregivers of children with asthma and caregivers of children without asthma (M ± SD 8.3 ± 1.6 vs. 4.3 ± 1.7, p < .001, respectively). CONCLUSION: The AAPQ is a valid and reliable questionnaire that provides an assessment of caregivers' knowledge of their child's AAP and can guide educational interventions by healthcare providers.

Preparation and Characterization of Uniform and Controlled Silica Encapsulating on Lithium Yttrium Fluoride-Based Upconversion Nanoparticles.

In this work, we present an advancement in the encapsulation of lithium yttrium fluoride-based (YLiF4:Yb,Er) upconversion nanocrystals (UCNPs) with silica (SiO2) shells through a reverse microemulsion technique, achieving UCNPs@SiO2 core/shell structures. Key parameters of this approach were optimized to eliminate the occurrence of core-free silica particles and ensure a controlled silica shell thickness growth on the UCNPs. The optimal conditions for this method were using 6 mg of UCNPs, 1.5 mL of Igepal CO-520, 0.25 mL of ammonia, and 50 µL of tetraethyl orthosilicate (TEOS), resulting in a uniform silica shell around UCNPs with a thickness of 8 nm. The optical characteristics of the silica-encased UCNPs were examined, confirming the retention of their intrinsic upconversion luminescence (UC). Furthermore, we developed a reliable strategy to avoid the coencapsulation of multiple UCNPs within a single silica shell. This approach led to a tenfold increase in the UC luminescence of the annealed particles compared to their nonannealed counterparts, under identical silica shell thickness and excitation conditions. This significant improvement addresses a critical challenge and amplifies the applicability of the resulting UCNPs@SiO2 core/shell structures in various fields.

Novel Nanocomposites for Luminescent Thermometry with Two Different Modalities.

In this work, we successfully integrated fluorescent nanodiamonds (FNDs) and lanthanide ion-doped upconversion nanoparticles (UCNPs) in a nanocomposite structure for simultaneous optical temperature sensing. The effective integration of FND and UCNP shells was confirmed by employing high-resolution TEM imaging, X-ray diffraction, and dual-excitation optical spectroscopy. Furthermore, the synthesized ND@UCNP nanocomposites were tested by making simultaneous optical temperature measurements, and the detected temperatures showed excellent agreement within their sensitivity limit. The simultaneous measurement of temperature using two different modalities having different sensing physics but with the same composite nanoparticles inside is expected to greatly improve the confidence of nanoscale temperature measurements. This should resolve some of the controversy surrounding nanoscale temperature measurements in biological applications.

Complementary Feeding for Children Aged 6-24 Months: Impact and Maternal Awareness in Al Baha City, Saudi Arabia.

Background Breastfeeding and complementary feeding are essential for baby health and nutrition. Concerning these feeding habits, there is a dearth of information on mother awareness and behaviors in Saudi Arabia. This study intends to evaluate maternal knowledge of breastfeeding and complementary feeding in Al Baha City, Saudi Arabia. Methodology This cross-sectional prospective study was conducted among mothers in Al Baha City, Saudi Arabia. Data were collected using a structured electronic questionnaire and analyzed using descriptive statistics and a chi-square test. Results We received 524 responses. The majority of participants (358, 68.2%) were found to have sufficient understanding of breastfeeding and complementary feeding. Four hundred and forty participants (84%) were aware that breastfeeding should begin immediately after birth, but only 250 (47.7%) participants knew the proper time to start complementary feeding. Three hundred and ninety-six (75.6%) participants were aware of the proper duration of exclusive breastfeeding, whereas 128 (24.4%) of them did not know. The study showed that factors such as occupation, family economic status, and educational level influence maternal knowledge of complementary feeding.  Conclusions The study revealed that the majority of participants had good knowledge about breastfeeding and complementary feeding. The study highlights effective training and public awareness initiatives aimed at improving mothers' knowledge and practices regarding feeding. Additionally, it sheds light on the healthcare providers' exemplary knowledge and attitudes toward appropriate feeding practices among mothers in Al Baha City.

Prevalence of Adverse Pregnancy Outcomes in Women With and Without Gestational Diabetes Mellitus in Al-Baha Region, Saudi Arabia.

BACKGROUND: Gestational diabetes mellitus (GDM) is a condition characterized by glucose intolerance that develops during pregnancy. It is associated with adverse maternal and fetal outcomes and has long-term health implications for both the mother and the child. This study aimed to estimate the prevalence of adverse pregnancy outcomes in women with and without GDM in the Al-Baha region, Saudi Arabia. METHODS: A cross-sectional study was conducted in the Al-Baha region from April 2023 to November 2023. The study included mothers residing in the Al-Baha region who were willing to participate and had access to a social media account. A simple random sampling technique was used, and the estimated sample size was 422. A self-administered electronic questionnaire was used to collect data on socio-demographic and lifestyle factors, as well as the pregnancy outcomes of diabetic and non-diabetic mothers. Descriptive and inferential statistical analyses were performed using IBM SPSS Statistics for Windows, Version 28.0 (Released 2012; IBM Corp., Armonk, New York, United States). RESULTS: We included 422 women in the study with the majority of participants in the age group of 36-40 years(15.4%, n=74). Most participants (66.6%, n=321) had attained a university degree, and a significant proportion resided in Al-Baha City (52.3%, n=252). Maternal outcomes indicated a significant association between GDM and the development of eclampsia (OR = 8.296, 95%CI: 4.353-15.810, p < 0.001), as well as an increased risk of thyroid diseases (OR = 2.723, 95%CI: 1.428-5.193, p = 0.002). Fetal outcomes revealed a significant association between GDM and respiratory distress/lack of oxygen in newborns (OR = 2.032, 95%CI: 1.085-3.805, p = 0.024), and infants of GDM patients had a higher risk of hypoglycemia (OR = 8.099, 95%CI: 3.350-19.581, p < 0.001). CONCLUSION: We found that GDM increased the risk of complications such as eclampsia, thyroid problems, and postpartum hemorrhage. GDM was also associated with shorter pregnancy durations, higher cesarean section rates, and an increased risk of developing type 2 diabetes post pregnancy. The study emphasized the importance of comprehensive GDM therapy and monitoring.

Altered Pharmacokinetics Parameters of Vancomycin in Patients with Hematological Malignancy with Febrile Neutropenia, a Bayesian Software Estimation.

The pharmacokinetics of vancomycin vary significantly between specific groups of patients, such as critically ill patients and patients with hematological malignancy (HM) with febrile neutropenia (FN). Recent evidence suggests that the use of the usual standard dose of antibiotics in patients with FN may not offer adequate exposure due to pharmacokinetic variability (PK). Therefore, the purpose of this study is to assess the effect of FN on AUC0-24 as a key parameter for vancomycin monitoring, as well as to determine which vancomycin PK parameters are affected by the presence of FN using Bayesian software PrecisePK in HM with FN. This study was carried out in King Abdulaziz Medical City. All adult patients who were admitted to the Princess Norah Oncology Center PNOC between 1 January and 2017 and 31 December 2020, hospitalized and received vancomycin with a steady-state trough concentration measured before the fourth dose, were included. During the trial period, 297 patients received vancomycin during their stay at the oncology center, 217 of them meeting the inclusion criteria. Pharmacokinetic parameters were estimated for the neutropenic and non-FN patients using the precise PK Bayesian platform. The result showed that there was a significant difference (p < 0.05) in vancomycin clearance Clvan, the volume of distribution at a steady-state Vdss, the volume of distribution for peripheral compartment Vdp, half-life for the elimination phase t½ß, and the first-order rate constant for the elimination process ß in FN compared to non-FN patients. Furthermore, AUC0-24 was lower for FN patients compared to non-FN patients, p < 0.05. FN has a significant effect on the PK parameters of vancomycin and AUC0-24, which may require specific consideration during the treatment initiation.

Efficient Lithium-Based Upconversion Nanoparticles for Single-Particle Imaging and Temperature Sensing.

Upconversion Nanoparticles (UCNPs) have attracted exceptional attention due to their great potential in high-contrast, free-background biofluorescence deep tissue imaging and quantum sensing. Most of these interesting studies have been performed using an ensemble of UCNPs as fluorescent probes in bioapplications. Here, we report a synthesis of small and efficient YLiF4:Yb,Er UCNPs for single-particle imaging as well as sensitive optical temperature sensing. The reported particles demonstrated a bright and photostable upconversion emission at a single particle level under a low laser intensity excitation of 20 W/cm2. Furthermore, the synthesized UCNPs were tested and compared to the commonly used two-photon excitation QDs and organic dyes and showed a nine times better performance at a single particle level under the same experimental conditions. In addition, the synthesized UCNPs demonstrated sensitive optical temperature sensing at a single particle level within the biological temperature range. The good optical properties of single YLiF4:Yb,Er UCNPs open an avenue for small and efficient fluorescent markers in imaging and sensing applications.

Physiomorphic and molecular-based evaluation of wheat germplasm under drought and heat stress.

Drought and heat stress are potential problems that can reduce wheat yield, particularly during the terminal growth stages in arid and semiarid regions of the world. The current study intended to examine the impact of individual and combined drought and heat stress on the biochemical contents (antioxidant enzymes, proline, soluble proteins, and soluble sugars), physiological parameters (chlorophyll content, cell membrane stability, photosynthesis, stomatal conductance, and transpiration), plant-water relations (relative water content, water potential, osmotic potential, and pressure potential), agronomic traits (flag leaf area, plant height, number of tillers per plant, spike length, grains per spike, and thousand-grain weight), and gene expression (TaHSF1a, TaWRKY-33, TaNAC2L, and TaGASR1) in four different thermostable and drought-tolerant wheat genotypes (i.e., Gold-16, HS-240, Suntop, and Hemai-13) collected from different countries. The tri-replicate experiment was conducted using two factorial arrangements in a randomized complete block design (RCBD). All measured traits, except total soluble sugars, proline, and cell membrane stability index, showed significant reduction under both combined and individual treatments. Furthermore, correlation analysis revealed a significant association between biochemical and physiological characteristics and crop agronomic productivity. Furthermore, principal component analysis (PCA) and heatmap analysis demonstrated significant levels of variation in traits according to the type of stress and nature of wheat genotype. The spectrographs and micrographs generated by scanning electron microscopy for the selected high- and low- tolerance samples revealed clear differences in mineral distribution and starch granulation. All studied genes showed comparatively high levels of relative expression under combined treatments of drought and heat stress in all wheat genotypes, but this expression was the highest in 'Gold-16' followed by 'HS-240', 'Suntop', and 'Hemai-13'. Overall, this study concluded that plants are proactive entities and they respond to stresses at all levels; however, the tolerant plants tend to retain the integrity of their biochemical, physiological, and molecular equilibrium.

Uncorrected Refractive Errors Among Children Attending Pediatric Ophthalmology Clinic at Security Forces Hospital, Makkah, Saudi Arabia.

BACKGROUND: Refractive errors are globally one of the most prevalent ocular disorders among pediatrics. This study aimed to determine the pattern of uncorrected refractive errors among children attending pediatric ophthalmology clinics at Security Forces Hospital, Makkah, Saudi Arabia. METHODS: This was a retrospective cohort clinic-based study including the records of children attending the pediatric ophthalmology clinic at Security Forces Hospital, Makkah, Saudi Arabia, between July 2021 and July 2022 who were diagnosed with refractive errors, ages between 4 and 14 years. RESULTS: A total of 114 patients were included in the study while 26 patients with other ocular disorders were excluded from the study. The mean age of children included in the study was 9.1 ± 2.9. The most prevalent refractive errors were hyperopic astigmatism (64%), followed by myopic astigmatism (28.1%), then myopia (5.3%), and hyperopia (2.6%). The overall uncorrected refractive error of this study was estimated to be 36%. No significant association was found between the factors of age and gender on the type of refractive errors (P-value > 0.05). CONCLUSION: The most prevalent pattern of uncorrected refractive errors among children attending pediatric ophthalmology clinics at Security Forces Hospital, Makkah, Saudi Arabia was hyperopic astigmatism followed by myopic astigmatism. No differences were found between different age groups and between genders on the type of refractive errors. Implementation of adequate vision screening programs for school-aged children is essential to detect uncorrected refractive errors at an early age.

Compliance of Primary Healthcare Workers in Saudi Arabia With the National Surveillance System of Tropical and Non-tropical Dermatological Diseases.

BACKGROUND:  Control and prevention of infectious diseases has been a primary health mandate. The reporting system is a vital step in preventing and controlling of these diseases. Most important, healthcare workers who have a responsibility to report must be aware of this responsibility. The present study aimed to improve the compliance of primary healthcare workers against reportable tropical and non-tropical dermatological diseases. OBJECTIVE OF THE STUDY: The objective was to assess the knowledge, skills, and practice of primary healthcare workers in Saudi Arabia regarding the surveillance system of reportable tropical and non-tropical dermatological diseases using an assessment tool featuring closed-ended questions. As a secondary objective, this study assessed the satisfaction of primary healthcare workers with the surveillance system. SUBJECTS AND METHODS:  Through a cross-sectional design, the study used an electronic self-administered questionnaire targeting the primary healthcare workers who met the inclusion criteria through a non-probability sampling technique. RESULTS: By the end of the study period, data had been collected from 377 primary healthcare workers. Slightly more than half of them worked for the ministry of health facilities. In the last year, the vast majority (88%) of participants did not report any infectious diseases. Poor or low knowledge was reported by almost half of the participants concerning which dermatological diseases should be notified immediately on clinical suspicion or routinely on a weekly basis. Clinically and in response to the skills assessment, 57% of the participants had lower skills scores in detecting and identifying the skin ulcer of leishmania. Half of the participants were less satisfied with the feedback after their notification and considered the notification forms complicated and time-consuming, especially with the usual high workload in primary healthcare centers. Furthermore, the observed significant differences (p < 0.001) in knowledge and skill scores were demonstrated with female healthcare workers, older participants, employees from the Ministry of National Guard Health Affairs, and workers with more than ten years of experience. CONCLUSION: The present study has shown the limitations of public health surveillance due to underreporting and lack of timeliness. The dissatisfaction of study participants with feedback after the notification step is another finding that demonstrates the need for collaboration among public health authorities and healthcare workers. Fortunately, health departments can implement measures to improve practitioners' awareness through continuous medical education and providing frequent feedback to overcome these hurdles.

COVID-19 vaccine hesitancy in the Saudi Arabian population.

This study aimed to measure the level of vaccine hesitancy among the Saudi population using the WHO Vaccine Hesitancy Scale (VHS). A cross-sectional study using a modified vaccine hesitancy scale (VHS) was conducted among Saudi Arabian residents between April 4 and May 24, 2021. The relationship between participants' willingness to uptake COVID-19 vaccines and their demographics, awareness of COVID-19, and health status was evaluated. The chi-square test was employed to compare categorical variables and logistic regression for the associations of demographical characteristics with acceptance of the vaccine. We received a total of 1657 completed responses. 1,126 participants (68%) were vaccinated, of which 19% were vaccinated with one dose only, and 49% were fully vaccinated (with two doses). Safety concerns and worries about side effects were higher among the hesitant group (p<0.001). 96% of the participants from the willing group were not hesitant to have the vaccine, whereas in the same group, 70% thought they had good health and the vaccine was not needed. Logistic regression analysis revealed that participants with chronic diseases had lower odds of being willing to be vaccinated (OR=0.583, p-value 0.04). The study findings suggest key factors associated with COVID-19 vaccine hesitancy in the Saudi population and can help public health authorities plan strategies to minimize vaccine hesitancy and improve awareness about vaccine acceptance.

Differential response of nano zinc sulphate with other conventional sources of Zn in mitigating salinity stress in rice grown on saline-sodic soil.

Salinization causes the degradation of the soil and threatening the global food security but the application of essential micronutrients like zinc (Zn), improve the plant growth by stabilizing the plant cell and root development. Keeping in view the above-mentioned scenario, an experiment was conducted to compare the efficiency of conventional Zn fertilizers like zinc sulphate (ZnSO4), zinc ethylene diamine tetra acetic acid (Zn-EDTA) and advance nano Zn fertilizers such as zinc sulphate nanoparticles (ZnSO4NPs), and zinc oxide nanoparticles (ZnONPs) (applied at the rate of 5 and 10 mg/kg) in saline-sodic soil. Results revealed that the maximum plant height (67%), spike length (72%), root length (162%), number of tillers (71%), paddy weight (100%), shoot dry weight (158%), and root dry weight (119%) was found in ZnSO4NPs applied at the rate of 10 mg/kg (ZnSO4NPs-10) as compared to salt-affected control (SAC). Similarly, the plants physiological attributes like chlorophyll contents (91%), photosynthesis rate (113%), transpiration rate (106%), stomatal conductance (56%) and internal CO2 (11%) were increased by the application of ZnSO4NPs-10, as compared to SAC. The maximum Zn concentration in root (153%), shoot (205%) and paddy (167%) found in ZnSO4NPs-10, as compared to control. In the body of rice plants, other nutrients like phosphorus and potassium were also increased by the application of ZnSO4NPs-10 and soil chemical attributes such as sodium and sodium adsorption ratio were decreased. The current experiment concluded that the application of ZnSO4NPs at the rate of 10 mg/kg in salt-affected paddy soil increased the growth, physiology, up take of essential nutrients and yield of rice by balancing the cationic ratio under salt stress.

The Bayesian-Based Area under the Curve of Vancomycin by Using a Single Trough Level: An Evaluation of Accuracy and Discordance at Tertiary Care Hospital in KSA.

The AUC0-24 is the most accurate way to track the vancomycin level while the Cmin is not an accurate surrogate. Most hospitals in Saudi Arabia are under-practicing the AUC-guided vancomycin dosing and monitoring. No previous work has been conducted to evaluate such practice in the whole kingdom. The current study objective is to calculate the AUC0-24 using the Bayesian dosing software (PrecisePK), identify the probability of patients who receive the optimum dose of vancomycin, and evaluate the accuracy and precision of the Bayesian platform. This retrospective study was conducted at King Abdulaziz medical city, Jeddah. All adult patients treated with vancomycin were included. Pediatric patients, critically ill patients requiring ICU admission, patients with acute renal failure or undergoing dialysis, and febrile neutropenic patients were excluded. The AUC0-24 was predicted using the PrecisePK platform based on the Bayesian principle. The two-compartmental model by Rodvold et al. in this platform and patients' dose data were utilized to calculate the AUC0-24 and trough level. Among 342 patients included in the present study, the mean of the estimated vancomycin AUC0-24 by the posterior model of PrecisePK was 573 ± 199.6 mg, and the model had a bias of 16.8%, whereas the precision was 2.85 mg/L. The target AUC0-24 (400 to 600 mg·h/L) and measured trough (10 to 20 mg/L) were documented in 127 (37.1%) and 185 (54%), respectively. Furthermore, the result demonstrated an increase in odds of AUC0-24 > 600 mg·h/L among trough level 15-20 mg/L group (OR = 13.2, p < 0.05) as compared with trough level 10-14.9 mg/L group. In conclusion, the discordance in the AUC0-24 ratio and measured trough concentration may jeopardize patient safety, and implantation of the Bayesian approach as a workable alternative to the traditional trough method should be considered.

The Effects of Booking Status on the Outcome of Infants of ≥32 Weeks Gestational Age Admitted to the Neonatal Intensive Care Unit in a Tertiary Academic Center.

Introduction Antenatal care (ANC) is a systematic examination and follow-up of pregnant women that involves education, counseling, screening, and treatment of any complications encountered. ANC is an essential measure that significantly decreases devastating maternal and fetal outcomes. This study aimed to explore the maternal and fetal outcomes of mothers who did and did not book follow-ups and had their newborns admitted to the neonatal intensive care unit (NICU) at the King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Methodology We conducted a cross-sectional study between January 1, 2021, and January 1, 2022, at KAUH in Jeddah, Saudi Arabia. Data were collected from electronic medical records and paper documents. Maternal demographic and pregnancy information were collected in addition to neonatal outcomes. Results The study included 186 participants, with a median maternal age of 32 years (interquartile range (IQR) 27-36). Cesarean section was the predominant mode of delivery (67.2%), with a median gestational age at birth of 36 weeks (IQR 34-38). Most women (69.4%) booked follow-ups, while 40.3% developed chronic comorbid conditions during pregnancy. The newborn sex ratio was nearly even between males and females, with a median birthweight of 2325 g (IQR 1740-2900) and median Apgar scores of 7 (IQR 5-9) and 9 (IQR 8-10) at 1 and 5 min, respectively. Jaundice was the most common postnatal complication (51.6%), followed by hypoglycemia (18.8%), while 23.7% of babies had congenital anomalies. There was a significant association between booking status and nationality, maternal age, cesarean section, maternal comorbid conditions, the outcome of multiple gestations, and postnatal complications, including jaundice and hypoglycemia. Decreasing maternal age (odds ratio (OR) 0.755, 95% confidence interval (CI) 0.585-0.974) and Apgar score at 5 min (OR 0.096, 95% CI 0.012-0.795) were the only significant predictors of fetal mortality. Conclusion The study revealed suboptimal adherence to ANC among pregnant women with newborns admitted to the NICU, along with poorer maternal and fetal outcomes, with respect to neonatal jaundice, hypoglycemia, and the need for resuscitation.

The Overriding of Computerized Physician Order Entry (CPOE) Drug Safety Alerts Fired by the Clinical Decision Support (CDS) Tool: Evaluation of Appropriate Responses and Alert Fatigue Solutions.

Introduction Most computerized physician order entry (CPOE) software come with clinical decision-support components (CDS) that provide prescribers assistance and notify them about adverse drug reactions. An excessive number of alerts in a repeated and non-relevant manner leads to alert fatigue and enforces physicians and pharmacists to alert overrides. King Abdulaziz Medical City (KAMC) in Jeddah still reports a higher percentage of drug alerts overridden by clinicians and pharmacists. Thus, this study was conducted to evaluate CDS alerts overriding and to determine which alerts are clinically irrelevant and need modifications. Methods The study was carried out in the inpatient setting at KAMC in Jeddah, from September 1, 2020, to December 31, 2020. It was designed as a retrospective chart review study that included all red alerts that required comments and were overridden by a physician and pharmacist. Results Among 11350 red alerts, potential drug-drug interaction (pDDI), dose, and allergy alerts represent 57%, 41%, and 2%, respectively, of the total alerts. The most common drug-drug interactions (DDIs) in category X were proton pump inhibitors and clopidogrel (9.9%). The appropriate response by prescribers and pharmacists toward allergy alerts was associated with the highest odds compared with the other alerts (p < 0.05) while there is a significant decrease in the odds of appropriate action being taken by both prescribers and pharmacists in the dose screen alerts (p < 0.05). Among all clinical specialties, there is an increased odds of appropriate action being taken by residents and fellows for allergy and dose alerts, respectively, compared to other groups (p < 0.05). For diminishing the unnecessary alerts, we provided 14 alert refinements strategies and advised turning off four alerts. Applying this will terminate 32% of irrelevant alerts. Conclusion Our study's findings indicated that a substantial number of alerts are ignored, and the rate of appropriateness varies significantly by alert type and prescriber level.

Impact of climate change on agricultural production; Issues, challenges, and opportunities in Asia.

Agricultural production is under threat due to climate change in food insecure regions, especially in Asian countries. Various climate-driven extremes, i.e., drought, heat waves, erratic and intense rainfall patterns, storms, floods, and emerging insect pests have adversely affected the livelihood of the farmers. Future climatic predictions showed a significant increase in temperature, and erratic rainfall with higher intensity while variability exists in climatic patterns for climate extremes prediction. For mid-century (2040-2069), it is projected that there will be a rise of 2.8°C in maximum temperature and a 2.2°C in minimum temperature in Pakistan. To respond to the adverse effects of climate change scenarios, there is a need to optimize the climate-smart and resilient agricultural practices and technology for sustainable productivity. Therefore, a case study was carried out to quantify climate change effects on rice and wheat crops and to develop adaptation strategies for the rice-wheat cropping system during the mid-century (2040-2069) as these two crops have significant contributions to food production. For the quantification of adverse impacts of climate change in farmer fields, a multidisciplinary approach consisted of five climate models (GCMs), two crop models (DSSAT and APSIM) and an economic model [Trade-off Analysis, Minimum Data Model Approach (TOAMD)] was used in this case study. DSSAT predicted that there would be a yield reduction of 15.2% in rice and 14.1% in wheat and APSIM showed that there would be a yield reduction of 17.2% in rice and 12% in wheat. Adaptation technology, by modification in crop management like sowing time and density, nitrogen, and irrigation application have the potential to enhance the overall productivity and profitability of the rice-wheat cropping system under climate change scenarios. Moreover, this paper reviews current literature regarding adverse climate change impacts on agricultural productivity, associated main issues, challenges, and opportunities for sustainable productivity of agriculture to ensure food security in Asia. Flowing opportunities such as altering sowing time and planting density of crops, crop rotation with legumes, agroforestry, mixed livestock systems, climate resilient plants, livestock and fish breeds, farming of monogastric livestock, early warning systems and decision support systems, carbon sequestration, climate, water, energy, and soil smart technologies, and promotion of biodiversity have the potential to reduce the negative effects of climate change.

High-Performance and Stable Perovskite Solar Cells Using Carbon Quantum Dots and Upconversion Nanoparticles.

Upconversion nanoparticles (UCNPs) and carbon quantum dots (CQDs) have recently received a lot of attention as promising materials to improve the stability and efficiency of perovskite solar cells (PSCs). This is because they can passivate the surfaces of perovskite-sensitive materials and act as a spectrum converter for sunlight. In this study, we mixed and added both promising nanomaterials to PSC layers at the ideal mixing ratios. When compared to the pristine PSCs, the fabricated PSCs showed improved power conversion efficiency (PCE), from 16.57% to 20.44%, a higher photocurrent, and a superior fill factor (FF), which increased from 70% to 75%. Furthermore, the incorporation of CQDs into the manufactured PSCs shielded the perovskite layer from water contact, producing a device that was more stable than the original.