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Abstract Background Palliative care aims to improve quality of life for patients with end-stage illnesses by addressing physical, psychological, social and spiritual needs. Early referral to palliative care improves patient outcomes, quality of life and overall survival in a variety type of cancers. This study aimed to assess knowledge, attitudes and perceived benefits of early integration of palliative care among oncology nursing. Methods A descriptive cross-sectional study was conducted in public, private, and educational hospitals located in Palestine. Data were collected using paper based self-administered questionnaires from nurses working in hematology, general oncology, and bone marrow transplantation departments. Results Among of 128 nurses, the study revealed a moderate level of knowledge (3.64 ± 0.96), Positive attitude (3.59 ± 1.02) and moderately recognized the perceived benefits of early palliative care (3.57 ± 1.02). A statistically significant difference in nurses’ knowledge, attitudes and perceived benefits of early palliative care based on clinical experience. Pearson’s correlation showed a significant positive relationship between the total knowledge and attitudes score (r = 0.211, p

Background: Bronchiolitis is the most common acute infection of infants’ lower respiratory tract especially in the first two years of age. Its clinical course is complex where symptoms vary in severity and may progress rapidly to respiratory failure. Some factors can predispose to severe bronchiolitis like inhalation of cigarette smoke, crowded living environment, congenital heart defects and lack of breastfeeding. Aim of the study: The study aims to study the clinical and sociodemographic factors that are related to the severity of acute bronchiolitis in the patients included in the study. Patients and Methods: A cross-sectional study achieved at Hevi pediatric teaching Children Hospital in Duhok north of Iraq in the period from 1st November 2022 to 1st February 2023. The study included all patients aged 1-24 months diagnosed to have bronchiolitis and treated as inpatient in the hospital during that period. The diagnosis was made according to the American Academy of Pediatrics (AAP) diagnostic criteria in 2014. The severity of bronchiolitis was classified according to the Modified Cincinnati Bronchiolitis Score (MCBS). For every participant, the clinical aspects and epidemiological factors associated with bronchiolitis were obtained through a questionnaire filled by direct interview with parents. The data were analyzed by using Statistical Package for Social Sciences (SPSS) software version 26; the clinical significance was considered when P value is less than 0.05. Results: The study included 148 patients with bronchiolitis. Most of them were of moderate severity and female were more common. The age group (3-6 months) was significantly associated with severity. Most of patients lived in urban areas and were delivered by Caesarean section. Exposure to tobacco smoke was significantly associated with the severity of the disease. The artificial feeding was the most common with significant association with the severity. Most of patients had siblings attending school and childcare without significant association with the severity and less than a quarter of them had a family history of asthma. Poor living conditions was significantly associated with severity. Local cradle (landik) was significantly associated with severity. Most chest X ray findings were normal in 126 patients (85.1%) with no significant association with severity. Conclusion: Age, exposure to tobacco smoke, type of feeding, poor living conditions and sleeping in the local cradle (landik) were significantly related to the bronchiolitis severity in Duhok.

Introduction: Sepsis is a life-threatening complication in pediatric patients. This study primarily aimed to investigate sepsis-causing bacteria and their antimicrobial resistance profile and check the change in the antimicrobial resistance trend for some selected bacteria. In addition, we evaluated the incidence of sepsis, the related mortality rate, and the effectiveness and outcome of the treatment regimes in sepsis pediatric patients.Methods: A retrospective analysis was conducted on 4-year data (2018–2021) collected from three intensive care units at the Hevi Pediatric Teaching Hospital. Sepsis screening involved clinical detection and confirmation by blood culture.Results: A total of 520 out of 1,098 (47.35%) blood samples showed positive microbial growth. A decrease in sepsis rate was observed during the COVID-19 pandemic. Coagulase-negative Staphylococci (CoNS) and Klebsiella pneumonia were the most commonly isolated bacteria. A notable variation in the antimicrobial resistance trend was observed among sepsis-causing bacteria. The empirical sepsis treatment recommended by the WHO was ineffective, as certain bacteria exhibited 100% resistance to every antibiotic tested. The mortality rate significantly increased from 1.3% in 2018 to 16.5% in 2021.Discussion: The antimicrobial resistance profile of sepsis causing bacteria is of concerns, indicating a potentially serious situation. Thus, to avoid treatment failure, the monitoring of antimicrobial resistance in pediatric patients is essential.

Background: Palliative care aims to improve quality of life for patients with end-stage illnesses by addressing physical, psychological, social and spiritual needs. Early referral to palliative care improves patient outcomes, quality of life and overall survival in a variety type of cancers. This study aimed to assess knowledge, attitudes and perceived benefits of early integration of palliative care among oncology nursing. Methods: A descriptive cross-sectional study was conducted in public, private, and educational hospitals located in Palestine. Data were collected using paper based self-administered questionnaires from nurses working in hematology, general oncology, and bone marrow transplantation departments. Results: Among of 128 nurses, the study revealed a moderate level of knowledge (3.64 ± 0.96), Positive attitude (3.59 ± 1.02) and moderately recognized the perceived benefits of early palliative care (3.57 ± 1.02). A statistically significant difference in nurses' knowledge, attitudes and perceived benefits of early palliative care based on clinical experience. Pearson's correlation showed a significant positive relationship between the total knowledge and attitudes score (r = 0.211, p < 0.001), as well as with perceived benefits total score (r = 0.567, p < 0.001). Moreover, there was a significant positive relationship between the total attitude score and perceived benefits score (r = 0.303, p < 0.001). Conclusions: These findings suggest that enhancing knowledge and highlighting the benefits of early palliative care integration could foster more favorable attitudes among oncology nurses. investing in education and training to have all nurses prepared to provide high-quality palliative care results in better patient outcomes and less suffering. Patients with advanced cancer should be referred to the palliative care teams at an early stage of treatment in conjunction with their treatment in order to improve patient outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Background: Nurses' knowledge of pressure injuries causes and risk factors helps to prevent their occurrences and protect the patient. Aim: To assess the level of knowledge of medical device‐related pressure injuries and to identify risk factors that affect the knowledge. Methods: A cross‐sectional design was used in this study considering a convenience sample from critical care nurses. The nurses were invited to complete the Medical Device‐Related Pressure Injuries Knowledge Questionnaire. Results: About 71 nurses participated in the study. The mean score of MDRPI_KQ was 23.28 ± 4.14 out of 36. Mann–Whitney Test did not show statistically significant relationships between the MDRPI_KQ mean score and related variables (p > 0.05). The regression results indicated that the three predictors explained 46.4% of the variance (R2 = 0.215, F(3, 6.114) = 3.75, p = 0.001). It was found that the Frequency of encountering a patient with MDRPIs significantly predicted MDRPI_KQ score, job position, and assuming the care responsibility for MDRPIs in the department. Conclusions: Poor knowledge of pressure injuries can negatively affect patient care so training programs and policies should be developed based on the level of knowledge and practices of the staff to be more effective. [ABSTRACT FROM AUTHOR]

Abstract A broad-spectrum reactive oxygen species (ROS)-scavenging hybrid material (CASCADE) was developed by sequential adsorption of heparin (HEP) and poly(L-lysine) (PLL) polyelectrolytes together with superoxide dismutase (SOD) and horseradish peroxidase (HRP) antioxidant enzymes on layered double hydroxide (LDH) nanoclay support. The synthetic conditions were optimized so that CASCADE possessed remarkable structural (no enzyme leakage) and colloidal (excellent resistance against salt-induced aggregation) stability. The obtained composite was active in decomposition of both superoxide radical anions and hydrogen peroxide in biochemical assays revealing that the strong electrostatic interaction with the functionalized support led to high enzyme loadings, nevertheless, it did not interfere with the native enzyme conformation. In vitro tests demonstrated that ROS generated in human cervical adenocarcinoma cells were successfully consumed by the hybrid material. The cellular uptake was not accompanied with any toxicity effects, which makes the developed CASCADE a promising candidate for treatment of oxidative stress-related diseases.

Background: Bronchiolitis is the most common acute infection of infants' lower respiratory tract especially in the first two years of age. Its clinical course is complex where symptoms vary in severity and may progress rapidly to respiratory failure. Some factors can predispose to severe bronchiolitis like inhalation of cigarette smoke, crowded living environment, congenital heart defects and lack of breastfeeding. Aim of the study: The study aims to study the clinical and sociodemographic factors that are related to the severity of acute bronchiolitis in the patients included in the study. Patients and Methods: A cross-sectional study achieved at Hevi pediatric teaching Children Hospital in Duhok north of Iraq in the period from 1st November 2022 to 1st February 2023. The study included all patients aged 1-24 months diagnosed to have bronchiolitis and treated as inpatient in the hospital during that period. The diagnosis was made according to the American Academy of Pediatrics (AAP) diagnostic criteria in 2014. The severity of bronchiolitis was classified according to the Modified Cincinnati Bronchiolitis Score (MCBS). For every participant, the clinical aspects and epidemiological factors associated with bronchiolitis were obtained through a questionnaire filled by direct interview with parents. The data were analyzed by using Statistical Package for Social Sciences (SPSS) software version 26; the clinical significance was considered when P value is less than 0.05. Results: The study included 148 patients with bronchiolitis. Most of them were of moderate severity and female were more common. The age group (3-6 months) was significantly associated with severity. Most of patients lived in urban areas and were delivered by Caesarean section. Exposure to tobacco smoke was significantly associated with the severity of the disease. The artificial feeding was the most common with significant association with the severity. Most of patients had siblings attending school and childcare without significant association with the severity and less than a quarter of them had a family history of asthma. Poor living conditions was significantly associated with severity. Local cradle (landik) was significantly associated with severity. Most chest X ray findings were normal in 126 patients (85.1%) with no significant association with severity. Conclusion: Age, exposure to tobacco smoke, type of feeding, poor living conditions and sleeping in the local cradle (landik) were significantly related to the bronchiolitis severity in Duhok. [ABSTRACT FROM AUTHOR]

Introduction: Helicobacter pylori(H. pylori) is a gram negative bacteria that causes gastritis and peptic ulcer disease (PUD). It is widely accepted that the infection may occur early in life and may persist for decades before causing diseases. The aim of this paper was to determine the prevalence of H. pyloriseropositivity in pediatric age group and to examine the associated risk factors. Patients and methods: Blood samples were collected from 100 subjects attending Hevi Pediatric Teaching Hospital over a period of 6 months and IgG positivity was determined. A questionnaire sheet was prepared and used for each study subject. Data were collected by a face-to-face interview.Results: It was found that 28/100 (28%) of the recruited sample was positive for H. pyloriseropositivity. A significant association was found between the number of siblings and H. pyloripositivity (P=0.01, OR=1.3). No significant relationships were found between other factors and H. pyloripositivity. Conclusions: The prevalence of H. pyloriinfection was less than that reported in the city previously and less than that reported in neighboring countries. A significant positive association was found between number siblings and H. pyloriinfection rate. Further studies are needed recruiting larger sample size to explore H. pyloriprevalence and its associated risk factors.

Aptamers are widely used in biosensing due to their specific sensitivity toward many targets. Thus, gold nanoparticle (AuNP) aptasensors are subject to intense research due to the complementary properties of aptamers as sensing elements and AuNPs as transducers. We present herein a novel method for the functional coupling of thrombin‐specific aptamers to AuNPs via an anionic, redox‐active poly(ferrocenylsilane) (PFS) polyelectroyte. The polymer acts as a co‐reductant and stabilizer for the AuNPs, provides grafting sites for the aptamer, and can be used as a redox sensing element, making the aptamer‐PFS‐AuNP composite (aptamer‐AuNP) a promising model system for future multifunctional sensors. The aptamer‐AuNPs exhibit excellent colloidal stability in high ionic strength environments owing to the combined electrosteric stabilizing effects of the aptamer and the PFS. The synthesis of each assembly element is described, and the colloidal stability and redox responsiveness are studied. As an example to illustrate applications, we present results for thrombin sensitivity and specificity using the specific aptamer. [ABSTRACT FROM AUTHOR]

Aptamers are widely used in biosensing due to their specific sensitivity toward many targets. Thus, gold nanoparticle (AuNP) aptasensors are subject to intense research due to the complementary properties of aptamers as sensing elements and AuNPs as transducers. We present herein a novel method for the functional coupling of thrombin‐specific aptamers to AuNPs via an anionic, redox‐active poly(ferrocenylsilane) (PFS) polyelectroyte. The polymer acts as a co‐reductant and stabilizer for the AuNPs, provides grafting sites for the aptamer, and can be used as a redox sensing element, making the aptamer‐PFS‐AuNP composite (aptamer‐AuNP) a promising model system for future multifunctional sensors. The aptamer‐AuNPs exhibit excellent colloidal stability in high ionic strength environments owing to the combined electrosteric stabilizing effects of the aptamer and the PFS. The synthesis of each assembly element is described, and the colloidal stability and redox responsiveness are studied. As an example to illustrate applications, we present results for thrombin sensitivity and specificity using the specific aptamer. [ABSTRACT FROM AUTHOR]

Introduction: Sepsis is a life-threatening complication in pediatric patients. This study primarily aimed to investigate sepsis-causing bacteria and their antimicrobial resistance profile and check the change in the antimicrobial resistance trend for some selected bacteria. In addition, we evaluated the incidence of sepsis, the related mortality rate, and the effectiveness and outcome of the treatment regimes in sepsis pediatric patients. Methods: A retrospective analysis was conducted on 4-year data (2018-2021) collected from three intensive care units at the Hevi Pediatric Teaching Hospital. Sepsis screening involved clinical detection and confirmation by blood culture. Results: A total of 520 out of 1,098 (47.35%) blood samples showed positive microbial growth. A decrease in sepsis rate was observed during the COVID-19 pandemic. Coagulase-negative Staphylococci (CoNS) and Klebsiella pneumonia were the most commonly isolated bacteria. A notable variation in the antimicrobial resistance trend was observed among sepsis-causing bacteria. The empirical sepsis treatment recommended by the WHO was ineffective, as certain bacteria exhibited 100% resistance to every antibiotic tested. The mortality rate significantly increased from 1.3% in 2018 to 16.5% in 2021. Discussion: The antimicrobial resistance profile of sepsis causing bacteria is of concerns, indicating a potentially serious situation. Thus, to avoid treatment failure, the monitoring of antimicrobial resistance in pediatric patients is essential. [ABSTRACT FROM AUTHOR]

Background: Sickle cell disease (SCD) constitutes an important health problem in the Eastern Mediterranean countries including Iraq. Previous studies from northern Iraq had focused on various aspects of these hemoglobinopathies, but none focused on response of these patients to hemoglobin F modulating agents. Patients and Methods: In this prospective study, a total of 106 patients with SCD were enrolled. They were aged 5–56 years (median 19.2 years) with a male to female ratio of 2.1:1.0. The patients were initiated on hydroxycarbamide and evaluated clinically and hematologically for response prior to therapy, at 2 and 6 months post-therapy, and at last follow-up. Results: Out of the 106 patients enrolled, 100 (94%) patients had a significant response. The responders showed a significant increase in their total hemoglobin (Hb), mean corpuscular volume (MCV), and fetal hemoglobin (HbF), reduction in their blood requirement, and vaso-occlusive crises. The therapy was quite well tolerated and there were very limited number of side effects. After a median follow-up of 4 years and 7 months (range 1–9 years), those responders at 6 months continued to do so, with 72% remaining transfusion free at their last follow-up. Conclusion: The remarkable response to hydroxycarbamide in the enrolled patients is consistent with other studies worldwide, and thereby hydroxycarbamide offers itself as a cost-effective first-line management option in SCD patients in developing countries.

Counteracting reactive oxygen species (ROS, e.g., superoxide radical ion, H2O2 and hydroxyl radical) is an important task in fighting against oxidative stress-related illnesses and in improving product quality in industrial manufacturing processes. This review focuses on the recent advances on two-dimensional (2D) nanomaterials of antioxidant activity, which are designed for effective decomposition of ROS and thus, for reduction of oxidative stress. Some materials featured in this paper are of uni- or multi-lamellar structures modified with small molecular or enzymatic antioxidants. Others are enzyme-mimicking synthetic compounds (the so-called nanozymes) prepared without antioxidant additives. However, carbon-based materials will not be included, as they were extensively reviewed in the recent past from similar aspects. Given the landmark development around the 2D materials used in various bio-applications, sheet-like antioxidant compounds are of great interest in the scientific and technological communities. Therefore, the authors hope that this review on the recent progresses will be helpful especially for researchers working on novel developments to substantially reduce oxidative stress either in biological systems or industrial liquors.

This paper presents a new type diode connected MOS transistor to improve CMOS conventional rectifier's performance in RF energy harvester systems for wireless sensor networks in which the circuits are designed in 0.18 μm TSMC CMOS technology. The proposed diode connected MOS transistor uses a new bulk connection which leads to reduction in the threshold voltage and leakage current; therefore, it contributes to increment of the rectifier’s output voltage, output current, and efficiency when it is well important in the conventional CMOS rectifiers. The design technique for the rectifiers is explained and a matching network has been proposed to increase the sensitivity of the proposed rectifier. Five-stage rectifier with a matching network is proposed based on the optimization. The simulation results shows 18.2% improvement in the efficiency of the rectifier circuit and increase in sensitivity of RF energy harvester circuit. All circuits are designed in 0.18 μm TSMC CMOS technology.