Search

Author(s): B. Nair [sup.1] , T. Usui [sup.2] , S. Crossley [sup.1] , S. Kurdi [sup.1] , G. G. Guzmán-Verri [sup.1] [sup.3] [sup.4] , X. Moya [sup.1] , S. Hirose [...], Heat pumps based on magnetocaloric and electrocaloric working bodies--in which entropic phase transitions are driven by changes of magnetic and electric field, respectively--use displaceable fluids to establish relatively large temperature spans between loads to be cooled and heat sinks.sup.1,2. However, the performance of prototypes is limited because practical magnetocaloric working bodies driven by permanent magnets.sup.3-5 and electrocaloric working bodies driven by voltage.sup.6-16 display temperature changes of less than 3 kelvin. Here we show that high-quality multilayer capacitors of PbSc.sub.0.5Ta.sub.0.5O.sub.3 display large electrocaloric effects over a wide range of starting temperatures when the first-order ferroelectric phase transition is driven supercritically (as verified by Landau theory) above the Curie temperature of 290 kelvin by electric fields of 29.0 volts per micrometre. Changes of temperature in the large central area of the capacitor peak at 5.5 kelvin near room temperature and exceed 3 kelvin for starting temperatures that span 176 kelvin (complete thermalization would reduce these values from 5.5 to 3.3 kelvin and from 176 to 73 kelvin). If magnetocaloric working bodies were to be replaced with multilayer capacitors of PbSc.sub.0.5Ta.sub.0.5O.sub.3, then the established design principles behind magnetocaloric heat pumps could be repurposed for better performance without bulky and expensive permanent magnets. High-quality multilayer capacitors of a perovskite oxide show that large electric-field-driven caloric effects could improve solid-state refrigeration technology and challenge today's standard (based on magnetocaloric effects in gadolinium).

Majed S Al Yami,1,2 Sawsan Kurdi,2,3 Ivo Abraham2,4,5 1Department of Pharmacy Practice, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, AZ, USA; 3Department of Pharmacy Practice, University of Dammam, Dammam, Saudi Arabia; 4Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA; 5Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA Background: Standard-duration (7–10 days) thromboprophylaxis with low molecular weight heparin, low dose unfractionated heparin, or fondaparinux in hospitalized medically ill patients is associated with ~50% reduction in venous thromboembolism (VTE) risk. However, these patients remain at high risk for VTE post-discharge. The direct oral anticoagulants (DOACs) apixaban, rivaroxaban and betrixaban have been evaluated for extended-duration (30–42 days) thromboprophylaxis in this population. Methods: We review the efficacy and safety results from the 3 pivotal trials of extended-duration DOAC thromboprophylaxis in medically ill patients. We performed a meta-analysis of these pivotal trials focusing on 6 VTE (efficacy) and three bleeding outcomes (safety). These results were integrated into a quantitative risk/benefit assessment. Results: The trials evaluating extended-duration DOAC thromboprophylaxis in medically ill patients failed to establish clear efficacy and/or safety signals for each agent. Our meta-analysis shows that, as a class, DOACs have selective and partial extended-duration prophylactic activity in preventing VTE events. However, this is associated with a marked increase in the risk of various bleeding events. The risk/benefit analyses fail to show a consistent net clinical benefit of extended-duration DOAC prophylaxis in medically ill patients. Conclusion: At this time, the evidence of safe and effective extended-duration thromboprophylaxis with DOACs in this population is inconclusive. Keywords: venous thromboembolism, direct oral anticoagulants, enoxaparin, thromboprophylaxis, medically ill patients

Two thin film deposition routes were studied for the growth of high quality single crystalline Ru (0001) epitaxial films on c-Al2O3 substrates using radio frequency-magnetron sputtering. Such films are very important as buffer layers for the deposition of epitaxial non-collinear antiferromagnetic Mn3X films. The first route involved depositing Ru at 700 °C, leading to a smooth 30 nm thick film. Although, high resolution x-ray diffraction revealed twinned Ru film orientations, in situ post-annealing eliminated one orientation, leaving the film orientation aligned with the substrate, with no in-plane lattice rotation and a large lattice mismatch (13.6%). The second route involved the deposition of Ru at room temperature followed by in situ post-annealing at 700 °C. Transmission electron microscopy confirmed a very high quality of these films, free of crystal twinning, and a 30° in-plane lattice rotation relative to the substrate, resulting in a small in-plane lattice mismatch of –1.6%. X-ray reflectivity demonstrated smooth surfaces for films down to 7 nm thickness. 30 nm thick high quality single-crystalline Mn3Ga and Mn3Sn films were grown on top of the Ru buffer deposited using the second route as a first step to realize Mn3X films for antiferromagnetic spintronics applications. [ABSTRACT FROM AUTHOR]

Numerical simulations of hysteretic ac losses in a tubular superconductor/paramagnet heterostructure subject to an oscillating transverse magnetic field are performed within the quasistatic approach, calling upon the COMSOL finite-element software package and exploiting magnetostatic-electrostatic analogues. It is shown that one-sided magnetic shielding of a thin, type-II superconducting tube by a coaxial paramagnetic support results in a slight increase of hysteretic ac losses as compared to those for a vacuum environment, when the support is placed inside; a spectacular shielding effect with a possible reduction of hysteretic ac losses by orders of magnitude, however, ensues, depending on the magnetic permeability and the amplitude of the applied magnetic field, when the support is placed outside. [ABSTRACT FROM AUTHOR]

Cellular metabolism is inextricably linked to transmembrane levels of proton (H + ), sodium (Na + ), and potassium (K + ) ions. Although reduced sodium-potassium pump (Na + -K + ATPase) activity in tumors directly disturbs transmembrane Na + and K + levels, this dysfunction is a result of upregulated aerobic glycolysis generating excessive cytosolic H + (and lactate) which are extruded to acidify the interstitial space. These oncogene-directed metabolic changes, affecting intracellular Na + and H + , can be further exacerbated by upregulation of ion exchangers/transporters. As Na + /H + imbalances impact tumor invasion, chromosomal rearrangements, proliferation rate, angiogenesis, and immune function, measuring interstitial H + (H + o ) or pH (pH o ) and interstitial Na + (Na + o ) could provide unique insights into cancer hallmarks. We obtained proton ( 1 H) and sodium ( 23 Na) magnetic resonance spectroscopic imaging (MRSI) data to map pH o and Na + o in a human-derived glioblastoma model (U87) in vivo with sorafenib (protein kinase inhibitor) treatment and a placebo. In U87 tumors, sorafenib slowed tumor growth compared to placebo and restored transmembrane H + and Na + levels. Placebo tumors maintained an interstitial space that was less salty and more acidic, similar to naive U87 tumors, implying a proliferative state. However, sorafenib-treated tumors had interstitial space that became more salty and less acidic, comparable to normal tissue. Importantly, these interstitial ionic changes occurred prior to tumor growth changes. These results imply that glioblastoma therapies, which may perturb transmembrane ions by different mechanisms (e.g., ion pumping, exchange, and/or transport), can be tracked by merging 1 H with 23 Na MRSI to measure treatment effectiveness., (© 2025 John Wiley & Sons Ltd.)

This study aimed to evaluate the histological success of pulpotomy in primary molars using white mineral trioxide aggregate (WMTA) mixed with 2.25% sodium hypochlorite (NaOCl) gel and to evaluate in vitro its physical and chemical properties. The study had a clinical stage and an in-vitro stage. The clinical study was conducted with 24 patients aged 8-10 years. It was a randomized controlled trial to perform a histologic evaluation of pulp response following pulpotomy. Primary first molars were randomly assigned in split mouth model to control group-WMTA + distilled water (DW) or experimental group - WMTA + NaOCl gel. Teeth were extracted after 7, 30 or 90 days and submitted to histological analysis. The second stage was an in-vitro study to evaluate the physical and chemical properties of the two materials tested. SEM and EDX analyses and pH level evaluations were performed after 24 h and 28 days. The histological findings revealed that while WMTA + NaOCl gel group showed better odontoblastic integrity (P < 0.05), WMTA + DW group had more favorable outcomes in dentin bridge formation and pulp calcification (P < 0.05). Pulp tissue hemorrhage and pulp fibrosis were similar between them (P > 0.05). Regarding materials' in vitro evaluation, the pH level indicated a higher initial pH for the WMTA + NaOCl gel group, which equalized after 28 days. SEM analysis initially showed a less homogeneous surface for WMTA + NaOCl gel, but it became similar after 28 days. EDX analysis indicated higher calcium and silicon percentages in the WMTA + NaOCl gel group initially, which increased in both groups after 28 days. Adding 2.25% NaOCl gel to WMTA enhanced odontoblastic integrity in both the short and medium term. In addition, it had a similar chemical composition, surface morphology, and alkalinity when compared to WMTA + DW mixture., Competing Interests: Declarations. Competing interests: The authors declare no competing interests. Informed consent: Informed consent was obtained from all subjects., (© 2024. The Author(s).)

School feeding programs can support children's nutrition, health, and education in emergencies. This study assessed the feasibility, trade-offs, cost efficiency, and perceived benefits of school feeding modalities operating in urban Yemen. It draws on primary data from a qualitative evaluation with 21 school feeding implementers and 88 beneficiaries conducted in Feb-Mar 2023, and secondary data from a desk review of published and program literature on school feeding operations. Results showed that school feeding provided students with on average 18%, 40%, and 66% of daily energy, protein, and micronutrient requirements, respectively. Models including fortified snacks were 3-11 times more cost-efficient in terms of nutrient delivery. The most prominent strength of the models examined were the perceived benefits on child, family, and financial outcomes. Among the main weaknesses was the poor nutritional quality of the meal, which in turn emerged as a primary opportunity to improve school feeding through hybrid models providing a combination of fortified snacks and healthy meals. Other weaknesses such as poor water, sanitation, and hygiene infrastructure, and desired improvements such as the school kitchen and canteen, require considerable investments. Hybrid models are cost-efficient, acceptable, and feasible in Yemen and can serve the diet and nutrition needs of school-aged children., (© 2024 The Author(s). Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of The New York Academy of Sciences.)

Armed conflict and forced displacement can significantly strain nurturing family environments, which are essential for child well-being. Yet, limited evidence exists on the effectiveness of family-systemic interventions in these contexts. We conducted a two-arm, single-masked, feasibility Randomised Controlled Trial (fRCT) of a whole-family intervention with Syrian, Iraqi and Jordanian families in Jordan. We aimed to determine the feasibility of intervention and study procedures to inform a fully-powered RCT. Eligible families were randomised to receive the Nurturing Families intervention or enhanced usual care (1:1). Masked assessors measured outcomes at baseline and endline; primary outcome measures were caregiver psychological distress, family functioning, and parenting practices. Families and implementing staff participated in qualitative interviews at endline. Of the 62 families screened, 60 (98%) were eligible, 97% completed the baseline and 90% completed the endline. Qualitative feedback indicated specific improvements in adolescent well-being, caregiver distress and parenting, and family relationships. Data highlighted high participant engagement and adequate facilitator fidelity and competence. Outcome measures had good psychometric properties (most α > 0.80) and sensitivity to change, with significant changes seen on most measures in the intervention but not control group. Findings indicate the acceptability and feasibility of intervention and study procedures. Subsequent full-scale evaluation is needed to determine effectiveness., Competing Interests: The authors have no competing interests to declare., (© The Author(s) 2024.)

Background In pediatric dentistry, sedation aims to eliminate anxiety to facilitate the completion of dental procedures. Sedation in children is a multidimensional field that includes the child, parents/guardians, and the health care team. The rectal route is generally painless, making it suitable for children who are afraid of needles. This route has several advantages over the oral route, including reduced patient cooperation requirements, a faster and more predictable onset, and less physical trauma than the intravenous and intramuscular routes. This case series aimed to evaluate the effectiveness and success rate of rectal sedation with ketamine and midazolam in the management of uncooperative children during dental treatment. Case presentation Ten healthy children with definitely negative behavior were enrolled in this study. Each child was given 7 mg/kg of ketamine in combination with midazolam 0.1 mg/kg by the rectal route. The mean onset sedation time was 9.5 minutes, and pulpotomy procedures were done. Behavioral response was monitored throughout treatment using the Ohio State University Behavioral Rating Scale (OSUBRS), and the depth of sedation was measured using the University of Michigan Sedation Scale (UMSS). The Houpt General Behavior Scale was used to estimate the treatment success rate based on the overall behavior rating. All 10 cases showed good anxiolysis and cooperation following rectal administration, with no side effects observed. Conclusions Rectal administration of ketamine in combination with midazolam may be considered a reliable method in the management of uncooperative children during dental treatment. No adverse effects were observed during or after the sedation procedure., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alzoubi et al.)

Objectives: Orthodontic treatment improves both masticatory function and the aspects of facial esthetics through the correct alignment of the teeth. If oral hygiene is neglected during fixed orthodontic treatment, it may lead to plaque accumulation and gingivitis. The aim of this randomized controlled trial was to evaluate the effectiveness of the dental Water Jet (DWJ), and orthodontic toothbrush (O-TH) in removing dental plaque around the orthodontic braces compared to conventional toothbrush (C-TH) in adolescents., Materials and Methods: This was a three-arm, double-blind, and parallel-group randomized active-controlled trial. Forty-five patients were randomly allocated into three groups: DWJ, the O-TH, and the C-TH (control group). The primary outcome measure was dental plaque accumulation change from the baseline (t 0 ) to post-cleaning (t 1 ), and plaque scores were recorded using the Orthodontic Plaque Index (OPI). The current clinical trial was registered and approved by Australian New Zealand Clinical Trials Registry (ACTRN12623000524695)., Results: A statistically significant difference was noted in the OPI scores between different time points in the DWJ group, the O-TH group, and the C-TH group (p < .05). However, no significant difference was noted between the groups after the cleaning procedure (p > .05)., Conclusion: The level of oral hygiene was not satisfactory in patients undergoing fixed orthodontic treatment. In addition, the efficacy of the DWJ was not superior to O-TH nor to C-TH in plaque removal., (© 2023 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Objective: Using supervised machine learning algorithms (SMLAs), we built models to predict the probability of type 1 diabetes mellitus patients on insulin pump therapy for meeting insulin pump self-management behavioral (IPSMB) criteria and achieving good glycemic response within 6 months., Methods: This was a single-center retrospective chart review of 100 adult type 1 diabetes mellitus patients on insulin pump therapy (≥6 months). Three SMLAs were deployed: multivariable logistic regression (LR), random forest (RF), and K-nearest neighbor (k-NN); validated using repeated three-fold cross-validation. Performance metrics included area under the curve-Receiver of characteristics for discrimination and Brier scores for calibration., Results: Variables predictive of adherence with IPSMB criteria were baseline hemoglobin A1c, continuous glucose monitoring, and sex. The models had comparable discriminatory power (LR = 0.74; RF = 0.74; k-NN = 0.72), with the RF model showing better calibration (Brier = 0.151). Predictors of the good glycemic response included baseline hemoglobin A1c, entering carbohydrates, and following the recommended bolus dose, with models comparable in discriminatory power (LR = 0.81, RF = 0.80, k-NN = 0.78) but the RF model being better calibrated (Brier = 0.099)., Conclusion: These proof-of-concept analyses demonstrate the feasibility of using SMLAs to develop clinically relevant predictive models of adherence with IPSMB criteria and glycemic control within 6 months. Subject to further study, nonlinear prediction models may perform better., Competing Interests: Disclosure The authors have no multiplicity of interest to disclose., (Copyright © 2023. Published by Elsevier Inc.)

Magnetic imaging with nitrogen-vacancy (NV) spins in diamond is becoming an established tool for studying nanoscale physics in condensed matter systems. However, the optical access required for NV spin readout remains an important hurdle for operation in challenging environments such as millikelvin cryostats or biological systems. Here, we demonstrate a scanning-NV sensor consisting of a diamond nanobeam that is optically coupled to a tapered optical fiber. This nanobeam sensor combines a natural scanning-probe geometry with high-efficiency through-fiber optical excitation and readout of the NV spins. We demonstrate through-fiber optically interrogated electron spin resonance and proof-of-principle magnetometry operation by imaging spin waves in an yttrium-iron-garnet thin film. Our scanning-nanobeam sensor can be combined with nanophotonic structuring to control the light-matter interaction strength and has potential for applications that benefit from all-fiber sensor access, such as millikelvin systems., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Background: Oral health has a direct impact on health-related quality of life (HRQoL). Hence, general health and oral health cannot be separated. Pediatricians play a pivotal role in providing primary care for infants and are the first to interact with them since birth. Therefore, the aim of this study was to evaluate the knowledge, perceptions, and behavior of Syrian pediatricians regarding children's oral health., Methods: This was a cross-sectional study. The questionnaire consisted of six main sections and required answers regarding demographic characteristics, knowledge, behavior, perceptions, and training received in oral health. The association between categorical variables was tested with Pearson's chi-square tests and Fishers exact tests using SPSS ver. 23., Results: The response rate was 43.12% (229/531). Most of the participants (64.02%) got a poor level of knowledge and no significant association was found between knowledge level and years of experience (p = 0.270). The majority of the participants (99.13%) perceived that diet, bacteria, and sugar exposure time are the etiological factors of dental caries. The overwhelming majority of the participants (98.25%) acknowledged the need for further oral health training during residency., Conclusions: Most pediatricians reported a poor level of knowledge. It is recommended to update the postgraduate and residency curriculum to equip pediatricians with adequate knowledge regarding children's oral health., (© 2023. The Author(s).)

Background: The impact of the COVID-19 pandemic on the population's mental health is vital for informing public health policy and decision-making. However, information on mental health-related healthcare service utilisation trends beyond the first year of the pandemic is limited., Aims: We examined mental health-related healthcare service utilisation patterns and psychotropic drug dispensations in British Columbia, Canada, during the COVID-19 pandemic compared with the prepandemic period., Methods: We conducted a retrospective population-based secondary analysis using administrative health data to capture outpatient physician visits, emergency department visits, hospital admissions and psychotropic drug dispensations. We examined time trends of mental health-related healthcare service utilisation and psychotropic drug dispensations between January to December 2019 (prepandemic period) and January 2020 to December 2021 (pandemic period). In addition, we calculated age-standardised rates and rate ratios to compare mental health-related healthcare service utilisation before and during the first two years of the COVID-19 pandemic, stratified by year, sex, age and condition., Results: By late 2020, except for emergency department visits, utilisation of healthcare services recovered to prepandemic levels. Between 2019 and 2021, the monthly average rate for overall mental health-related outpatient physician visits, emergency department visits and psychotropic drug dispensations increased significantly by 24%, 5% and 8%, respectively. Notable and statistically significant increases were observed among 10-14 year-olds (44% in outpatient physician visits, 30% in emergency department visits, 55% in hospital admissions and 35% in psychotropic drug dispensations) and 15-19 year-olds (45% in outpatient physician visits, 14% in emergency department visits, 18% in hospital admissions and 34% in psychotropic drug dispensations). Additionally, these increases were more prominent among females than males, with some variation for specific mental health-related conditions., Conclusions: The increase in mental health-related healthcare service utilisation and psychotropic drug dispensations during the pandemic likely reflects significant societal consequences of both the pandemic and pandemic management measures. Recovery efforts in British Columbia should consider these findings, especially among the most affected subpopulations, such as adolescents., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Type 2 diabetes mellitus (T2DM) is a chronic disease with ever-increasing prevalence worldwide. In our study, we evaluated the prevalence of the risk of developing T2DM in Saudi Arabia and investigated associations between that risk and various sociodemographic characteristics. To those ends, a web-based cross-sectional survey of Saudi nationals without diabetes, all enrolled using snowball sampling, was conducted from January 2021 to January 2022. The risk of developing T2DM was evaluated using a validated risk assessment questionnaire (ARABRISK), and associations of high ARABRISK scores and sociodemographic variables were explored in multivariable logistic regression modeling. Of the 4559 participants, 88.1% were 18 to 39 years old, and 67.2% held a college or university degree. High ARABRISK scores were observed in 7.5% of the sample. Residing in a midsize city versus a large city was associated with a lower ARABRISK risk score ( p = 0.007), as were having private instead of governmental insurance ( p = 0.005), and being unemployed versus employed ( p < 0.001). By contrast, being married ( p < 0.001), divorced or widowed ( p < 0.001), and/or retired ( p < 0.001) were each associated with a higher ARABRISK score. A large representative study is needed to calculate the risk of T2DM among Saudi nationals.

Nitrogen-vacancy (NV) magnetometry is a new technique for imaging spin waves in magnetic materials. It detects spin waves by their microwave magnetic stray fields, which decay evanescently on the scale of the spin-wavelength. Here, we use nanoscale control of a single-NV sensor as a wavelength filter to characterize frequency-degenerate spin waves excited by a microstrip in a thin-film magnetic insulator. With the NV probe in contact with the magnet, we observe an incoherent mixture of thermal and microwave-driven spin waves. By retracting the tip, we progressively suppress the small-wavelength modes until a single coherent mode emerges from the mixture. In-contact scans at low drive power surprisingly show occupation of the entire isofrequency contour of the two-dimensional spin-wave dispersion despite our one-dimensional microstrip geometry. Our distance-tunable filter sheds light on the spin-wave band occupation under microwave excitation and opens opportunities for imaging magnon condensates and other coherent spin-wave modes.

Urtica pilulifera is effective against cancer cell growth but its bioactive compounds and the mechanism of action behind its effect are still to be clarified. This study evaluated the anticancer activity of compounds extracted from Urtica pilulifera leaves against cervical cancer cells. The cytotoxic effect of water, methanol and hexane extracts of Urtica pilulifera leaves was assessed by MTT assay. The most potent extract was fractionated by column chromatography and its anticancer activity was evaluated. GC-MS was used to identify the chemical components of the different fractions. Western blotting analysis was used to determine the level of specific apoptotic and cell cycle protein markers. Data showed that the hexanic extract exhibits the most potent cytotoxicity against Hela cells. Fraction 4 of the hexanic extract showed the most potent antiproliferative effect against Hela cells. GC-MS analysis showed that the most prominent compound in fraction 4 is phytol. Fraction 4 treatment induced cell cycle arrest and intrinsic apoptosis in Hela cells as evident by the increasing levels of p21, p53, PARP cleavage and active caspase 9. These findings reveal the ability of U. pilulifera hexanic extract to induce cell cycle arrest and apoptosis in cervical cancer cells.

Introduction: COVID-19 infection in pregnancy ranges from asymptomatic infection to severe disease. However, the maternal and pregnancy outcomes are primarily favorable. Acute Respiratory Illness (ARI) score is a Visual Triage Checklist for Acute Respiratory symptoms created by the ministry of health of Saudi Arabia 12 to screen the patient for acute respiratory infection with MERS-CoV. It has been used during the COVID-19 pandemic to identify suspected cases and place patients in isolation precautions if the score is≥ 4., Method: This study is a cross-sectional study of all pregnant women who tested positive for COVID-19 in four medical centers located in four different cities in Saudi Arabia. The study period was from 1/3/2020 until 31/10/2020. Outcomes investigated were the prevalence of COVID infection in pregnant women at the time of delivery. Rate of asymptomatic disease, different maternal and pregnancy outcomes. Women were divided into symptomatic and asymptomatic groups according to the ARI score. The two groups were compared in maternal, perinatal, and neonatal outcomes. Furthermore, the cohort was divided according to maternal age into two groups: women of advanced maternal age ≥ 35 years and younger. The two groups were compared in maternal, perinatal, and neonatal outcomes RESULTS: During the study period, 9573 women gave birth at KAMCs, and 402 pregnant women were identified as COVID positive. Out of all COVID-positive women, only 394 women gave birth at KAMCs. The screening for COVID infection differed between the centers, but the testing was the same by the Nasopharyngeal polymerase chain reaction (PCR) swab. In Riyadh, screening was based on ARI scoring at the beginning of the pandemic. Then, it became universal. In Jeddah, the screening was based on ARI scoring. Any woman who scored four or more was labeled as suspected, and she was tested. Finally, in Madinah and Dammam, the screening was universal throughout the study. The prevalence of COVID-19 infection among women who gave birth at KAMCs was 4.2% (402/9573). (CI 3.8-4.6%). At the time of diagnosis, most women (62%) were asymptomatic. The most common symptoms were cough and shortness of breath. Twenty-two women (5.5%) had Pneumonia, and five women (1.3%) needed admission to Intensive care units (ICU). One woman died due to respiratory failure. When pregnancy outcomes were compared between symptomatic and asymptomatic women, pregnancy in symptomatic women was more likely to be complicated by Abortion (6 versus 2% p-value 0.00), fetal death (3 versus 1.3%), and cesarean delivery (30.8 versus 22.4%, p-value 0.001). COVID-positive pregnant women of advanced maternal age (AMA) were more likely to be symptomatic, have Abortion (5 versus 1%, p-value 0.01), and have Preterm delivery (17 versus 11% p-value 0.01) than younger women. In addition, neonatal death was more common in AMA COVID-positive women than younger (4 versus 0%), regardless of COVID-related symptoms., Conclusion: Most of the COVID-infected pregnant women are asymptomatic. Therefore, the ARI scoring system does not help to triage patients. Symptomatic women, especially those older than 35, tend to have a higher maternal and pregnancy complication rate., Competing Interests: Conflict of interest None., (Copyright © 2022. Published by Elsevier Ltd.)

Setting: In 2018, a regional health authority in British Columbia (BC) initiated a multi-year project to support planning and response to extreme heat. Climate projections indicate that temperatures in the southern interior of BC will continue to increase, with concomitant negative impacts on human health. Successful climate change adaptation must include cross-sectoral action, inclusive of the health sector, to plan for and respond to climate-related events, including extreme heat., Intervention: The objective of this project was to support the development and implementation of a Heat Alert and Response System (HARS) in a small, rural community. The health authority facilitated collaboration among provincial and local governments, community organizations, and First Nations partners to assess community assets, draft a plan for extreme heat, and prepare for a community-supported response during heat events., Outcomes: Stakeholders expressed the importance of utilizing existing partnerships and community resources, such as physical and procedural infrastructure, in which to embed the HARS. It was imperative that the plan be simple, concise, and considerate of the community's unique context. Educational materials and a tailored method of dissemination were important for collective and individual risk mitigation., Implications: A community-driven approach that utilized existing assets allowed for integration of HARS within municipal response plans and established infrastructure. The result is a sustainable public health intervention that has the potential to mitigate the negative health effects of extreme heat. Knowledge acquired through this initiative is informing similar HARS planning processes in other rural BC communities., (© 2022. The Author(s) under exclusive license to The Canadian Public Health Association.)

Objectives: During the ongoing coronavirus 2019 (COVID-19) pandemic, chronic disease management and medication adherence have become challenging; thus, health-related quality of life may have been compromised. As highly trusted healthcare providers, pharmacies in Saudi Arabia have undergone restructuring or redesign to cope with the current demands during the pandemic. The study assessed satisfaction levels of patients with chronic diseases concerning pharmaceutical care services provided during COVID-19 in addition to medication adherence and quality of life during the pandemic., Methods: An online questionnaire-based cross-sectional study was administered. Saudi residents suffering from chronic diseases and receiving pharmaceutical care from a hospital or community pharmacy during the COVID-19 pandemic were eligible. The survey was created using Google Forms and distributed through online channels. The survey targeted 385 participants., Key Findings: A sample of 317 patients was included. More than half had missed a follow-up visit for their chronic conditions since the beginning of the pandemic. The overall mean score ± standard deviation for the satisfaction level with pharmaceutical care services was 22.0 ± 10.3 on a scale of 0-36 with different satisfaction levels for different services. In addition to a good level of medication adherence, a high percentage of these patients reported no problem in most of the dimensions of the EQ-5D scale., Conclusions: Pharmacists should take a more proactive and consultive role to deliver healthcare needs of patients with a chronic condition and be aware of patient expectations from a pharmacist in situations, such as the current pandemic., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Controlling magnon densities in magnetic materials enables driving spin transport in magnonic devices. We demonstrate the creation of large, out-of-equilibrium magnon densities in a thin-film magnetic insulator via microwave excitation of coherent spin waves and subsequent multimagnon scattering. We image both the coherent spin waves and the resulting incoherent magnon gas using scanning-probe magnetometry based on electron spins in diamond. We find that the gas extends unidirectionally over hundreds of micrometers from the excitation stripline. Surprisingly, the gas density far exceeds that expected for a boson system following a Bose-Einstein distribution with a maximum value of the chemical potential. We characterize the momentum distribution of the gas by measuring the nanoscale spatial decay of the magnetic stray fields. Our results show that driving coherent spin waves leads to a strong out-of-equilibrium occupation of the spin-wave band, opening new possibilities for controlling spin transport and magnetic dynamics in target directions.

Three novel pyrazolo-[4,3- e ][1,2,4]triazolopyrimidine derivatives ( 1 , 2 , and 3 ) were designed, synthesized, and evaluated for their in vitro biological activity. All three compounds exhibited different levels of cytotoxicity against cervical and breast cancer cell lines. However, compound 1 showed the best antiproliferative activity against all tested tumor cell lines, including HCC1937 and HeLa cells, which express high levels of wild-type epidermal growth factor receptor (EGFR). Western blot analyses demonstrated that compound 1 inhibited the activation of EGFR, protein kinase B (Akt), and extracellular signal-regulated kinase (Erk)1/2 in breast and cervical cancer cells at concentrations of 7 and 11 µM, respectively. The results from docking experiments with EGFR suggested the binding of compound 1 at the ATP binding site of EGFR. Furthermore, the crystal structure of compound 3 (7-(4-bromophenyl)-9-(pyridin-4-yl)-7 H -pyrazolo[4,3- e ][1,2,4]triazolo[1,5- c ]pyrimidine) was determined by single crystal X-ray analysis. Our work represents a promising starting point for the development of a new series of compounds targeting EGFR.

Background: Medication adherence in chronic diseases patients is a worldwide concern. Not achieving the goal of treatments because of non-adherence will lead to more complications and eventually may lead to death. In Saudi Arabia, we have insufficient data for interpretation. Hence, this study aims to have a better perspective at the number of the non-adherent patients with chronic diseases to their medications and its associated factors., Material and Method: Cross-sectional quantitative study was conducted among chronic diseases patients living in Saudi Arabia throughout social media and hospital visits from August 2018 to April 2019. A three-section questionnaire consists of patient's health, medications and adherence characteristics. Adherence to Refills and Medication Scale (ARMS) was used to identify the level of adherence among chronic diseases patients. Univariate descriptive statistics and independent sample t-test with one-way ANOVA were used as bivariate analysis. Finally, significant predictors of medical adherence with adjusted coefficient were determined by multivariable linear regression., Results: A total of 385 patients were included in the analysis for the current study. Overall, 96.62% (n = 372) were non-adherent to their medications according to ARMS scale. Multiple linear regression model found types of co-morbidities, medication dosage form and dosage regimen to be independent predictors of medical adherence., Conclusion: Medication adherence is alarmingly low among chronic disease patients in Saudi Arabia. There is a clear need for in-depth understanding for barriers. It is therefore important to conduct a qualitative study. What's known Medication adherence is a critical factor in treatment success. Low adherence to the medication is a common problem among chronic disease patients. Moreover, the majority of the studies in Saudi Arabia showed low adherence rate, and it focused in one single chronic disease only despite that patient may have more. What's new Most patients had more than one single chronic disease, so this study aims to take a snapshot to capture the adherence rate among patients who are suffering from chronic disease Saudi Arabia and its associated factors. This can help in understanding medication adherence behavior in clinical practice., (© 2021 John Wiley & Sons Ltd.)