π-π Stacking at the Perovskite/C60 Interface Enables High-Efficiency Wide-Bandgap Perovskite Solar Cells.

Interface passivation is a key method for improving the efficiency of perovskite solar cells, and 2D/3D perovskite heterojunction is the mainstream passivation strategy. However, the passivation layer also produces a new interface between 2D perovskite and fullerene (C60), and the properties of this interface have received little attention before. Here, the underlying properties of the 2D perovskite/C60 interface by taking the 2D TEA2PbX4 (TEA = C6H10NS; X = I, Br, Cl) passivator as an example are systematically expounded. It is found that the 2D perovskite preferentially exhibits (002) orientation with the outermost surface featuring an oriented arrangement of TEACl, where the thiophene groups face outward. The outward thiophene groups further form a strong π-π stacking system with C60 molecule, strengthening the interaction force with C60 and facilitating the creation of a superior interface. Based on the vacuum-assisted blade coating, wide-bandgap (WBG, 1.77 eV) perovskite solar cells achieved impressive records of 19.28% (0.09 cm2) and 18.08% (1.0 cm2) inefficiency, respectively. This research not only provides a new understanding of interface processing for future perovskite solar cells but also lays a solid foundation for realizing efficient large-area devices.

Protective role of iron oxide nanocomposites on disease index, and biochemical resistance indicators against Fusarium oxysporum induced-cucumber wilt disease: In vitro, and in vivo studies.

Recently nanocomposites have become a super-growth inducers as well as vital antifungal agents, which enhance plant growth and suppress plant diseases. A new strategy regarding the fabrication of humic acid (H) and boron (B) conjugated Fe2O3 nanocomposites was performed. Fe2O3 NP-B and Fe2O3 NP-H were synthesized in the presence of gamma-rays (as a direct reducing agent). Gamma-rays provoked reduction of metal ions due to the liberated reducing electrons, (e-aq), in aqueous solutions which can be considered as a direct reduction. Antifungal potential against Fusarium oxysporum, the causative agent of wilt disease in cucumber was determined. Disease index percent, metabolic resistance indicators in cucumber plant as response to promotion of systemic resistance (SR) were recorded. Results illustrated that both Fe2O3 NPs-B and Fe2O3 NPs-H nanocomposites had antifungal activity against F. oxysporumin vitro as well as in vivo. Results revealed that minimum inhibitory concentrations of Fe2O3 NPs-B and Fe2O3 NPs-H nanocomposites were 0.25 and 0.125 mM, respectively. Application of Fe2O3 NPs-B (0.25 mM) and Fe2O3 NPs-H (0.125 mM) appeared highly reduced the cucumber wilt disease symptoms incidence caused by F. oxysporum, and recorded disease severity by 83.33%. Fe2O3 NPs-B was the best treatment reducing disease indexes by 20.83% and gave highly protection against wilt disease by 75.0% and came next Fe2O3 NPs-H which reduced disease indexes by 25% and gave 69.99% protection against disease. Fe2O3 NPs-B and Fe2O3 NPs-H treatments improved morphological traits, photosynthetic pigments, osmolytes, total phenol and antioxidant enzymes activities in both infected and non-infected plants. The beneficial effects of the synthesized Fe2O3 NPs-B and Fe2O3 NPs-H nanocomposites were extended to increase not only the total phenol, and total soluble protein contents but also the activities of peroxidase (POD), and polyphenol oxidase (PPO) enzymes of the healthy and infected cucumber plants in comparison with control.

Prevalence, characteristics, and factors associated with caffeine-withdrawal headache during the first day of Ramadan.

BACKGROUND: Data regarding prevalence, characteristics, and factors associated with caffeine-withdrawal headache are lacking. This work aimed to study the prevalence of caffeine-withdrawal headache among caffeine consumers during Ramadan's first day and describe its characteristics and associated factors. METHODS: This analytical cross-sectional study targeted 755 caffeine consumers eligible to fast on the first day of Ramadan. Two methodological approaches were followed: an online open survey and a face-to-face interview. Using an adjusted form of food frequency questionnaire, eligible participants were requested to report their intake of caffeine-containing products during the last week of Shaaban month, the month preceding Ramadan. RESULTS: The prevalence of caffeine-withdrawal headache on the first day of Ramadan was 419 (55.5%), with 95% confidence interval (CI; 51.9-59.0%). The headache in the majority of the participants was throbbing in character (249/419, 59.4%), diffuse (146/419, 34.8%), and moderate in intensity (227/419, 54.2%). Participants who developed caffeine-withdrawal headache had significantly higher body mass index (27.2 ± 5.1 vs. 26.3 ± 5 [mean ± standard deviation], p-value = 0.012), daily caffeine intake, mg (316 [185.2-537.8] vs. 144.4 [60.0-312.4] [median interquartile range (IQR)], p-value < 0.001), and caffeine intake mg/kg body weight (4.7 [2.6-7.2] vs. 1.9 [0.8-4.4] [median (IQR)], p-value < 0.001) than participants who did not develop it. Mild, moderate, and severe caffeine use disorder were found to have adjusted associations with developing caffeine-withdrawal headache. They increased the odds of headache by 5.3 (95% CI = 3.40-8.3), 10.2 (95% CI = 5.9-17.5), and 15.5 (95% CI = 9.0-26.8) times, respectively. The optimal cut-off value of daily caffeine intake/Kg body weight was determined at 1.97 mg/kg with an area under the curve of 0.722 and sensitivity and specificity of 85.1% and 50.2%, respectively. CONCLUSION: Daily caffeine intake/kg body weight and caffeine use disorder are significantly associated with a caffeine-withdrawal headache.

Exploration of the nutrition knowledge among general population: multi-national study in Arab countries.

BACKGROUND: Knowing what to eat and realizing the significance of healthful eating habits are among the important steps to promoting eating behavior. The current study aims to assess the nutrition knowledge (NK) among a convenient sample in four different countries, determine the association between different demographic factors and NK, and investigate the need for future interventions on nutrition in the four selected countries. METHODS: A cross-sectional multi-national survey study among a convenient sample of 8,191 subjects from Egypt, Syria, Saudi Arabia, and Jordan who undertook surveys between January 2019 and January 2020. A pre-tested interview questionnaire was utilized for data collection from study participants. It included three sections: i) Sociodemographic characteristics:. ii). Section two included twenty-one questions related to NK.. iii). Section three included one question about NK sources. RESULTS: About three-quarters showed inadequate nutrition knowledge (73.1%). Youth (15-24 yrs.) were more dependent on social media, with 87% using it as a primary source of NK, while adults (≥ 25 yrs.) demonstrated that 43% of them used social media. In contrast, TV was more prominent among them, with participants' characteristics such as living with parents, body mass index, and country of residence showing no association with NK. However, female sex, education, and reading nutrition articles are significantly correlated with adequate knowledge (p < 0.001). Significant predictors of satisfactory knowledge were age, sex, education, living with parents, and reading nutrition articles. CONCLUSION: The study revealed low levels of NK indicating an urgent need to implement educational programs to promote nutrition knowledge. As NK is a modifiable determinant of diet intake and can positively impact the need for developing strategies in counselling and raising awareness among the general population to improve their health status.

Enhancement of Cerium Sorption onto Urea-Functionalized Magnetite Chitosan Microparticles by Sorbent Sulfonation-Application to Ore Leachate.

The recovery of strategic metals such as rare earth elements (REEs) requires the development of new sorbents with high sorption capacities and selectivity. The bi-functionality of sorbents showed a remarkable capacity for the enhancement of binding properties. This work compares the sorption properties of magnetic chitosan (MC, prepared by dispersion of hydrothermally precipitated magnetite microparticles (synthesized through Fe(II)/Fe(III) precursors) into chitosan solution and crosslinking with glutaraldehyde) with those of the urea derivative (MC-UR) and its sulfonated derivative (MC-UR/S) for cerium (as an example of REEs). The sorbents were characterized by FTIR, TGA, elemental analysis, SEM-EDX, TEM, VSM, and titration. In a second step, the effect of pH (optimum at pH 5), the uptake kinetics (fitted by the pseudo-first-order rate equation), the sorption isotherms (modeled by the Langmuir equation) are investigated. The successive modifications of magnetic chitosan increases the maximum sorption capacity from 0.28 to 0.845 and 1.25 mmol Ce g-1 (MC, MC-UR, and MC-UR/S, respectively). The bi-functionalization strongly increases the selectivity of the sorbent for Ce(III) through multi-component equimolar solutions (especially at pH 4). The functionalization notably increases the stability at recycling (for at least 5 cycles), using 0.2 M HCl for the complete desorption of cerium from the loaded sorbent. The bi-functionalized sorbent was successfully tested for the recovery of cerium from pre-treated acidic leachates, recovered from low-grade cerium-bearing Egyptian ore.

Adjustment of family planning service statistics reports to support decision-making at central and governorate level, Egypt.

BACKGROUND: The Ministry of Health and Population (MOHP)-Family Planning Sector (FPS) has a strong management information system (MIS) that allows the flow of data from MOHP-FP clinics, health districts, and governorates up to the central level. Yet, family planning (FP) quarterly reports issued at the central level are presented as database/spreadsheet software documents. These data are not used to provide indicators or information that aid in decision-making or the tracking of FP services over time. The objective of the study is to organize data in the database, develop key performance indicators, and design FP reports and policy briefs. METHODS: The study is operations research that is driven by published data derived from MOHP-FP sector-head, and 2014 service statistics quarterly hardcopy reports. The information was entered into an excel program, and 15 key performance indicators (KPIs) were calculated and used to rank Egypt's 27 governorates. We developed an annual FP report form, settled tables, and colored graphs that are liable to rank the governorates from best to least favorable. RESULTS: The quarterly data sheets issued by the MOHP-FP sector were organized for the quarters, and one annual sheet was developed with the organization of Egypt's Governorates into 4 specific regions, with each governorate having a fixed position in all reports. The key performance indicators were as follows: percent of clients aged 35 and up; percent of clients with fewer than three children; proportion of current FP users by method; percent of clients reported as first-time clients; percent of clients defined as new clients (non-FP users and FP discontinuers); and contraceptive coverage rate, i.e., percent coverage of married women of reproductive age with dispensed FP methods expressed as couple years. CONCLUSION: MOHP-FP sector service statistics data could be used for the development of fifteen key performance indicators. Having those indicators at governorate, district, and central levels in quarterly and annual reports and their communication with decision-makers at all levels and their tracking overtime will guide them to timely decision-making for improving performance in FP services at all levels.

The antibacterial and antihemolytic activities assessment of zinc oxide nanoparticles synthesized using plant extracts and gamma irradiation against the uro-pathogenic multidrug resistant Proteus vulgaris.

In the case of Proteus vulgaris infection, the increased occurrence of multidrug-resistance strains has become a critical challenge in the treatment of urinary tract diseases. Therefore, using plant extracts as eco-friendly antibacterial provides an attractive solution to battle bacterial infection. The current study investigates the antibacterial and antihemolytic activity of nine medicinal plant extracts against P. vulgaris. Citrus limon extract at 150 µg/ml exhibited the highest antimicrobial action against P. vulgaris (the inhibition zone diameter; 22.7 mm). Zinc oxide nanoparticles (ZnO NPs) are synthesized using the plant extracts of C. limon, Allium sativum, Sonchus bulbosus, Allium cepa, and Asparagus racemosus. The antibacterial activity of ZnO NPs synthesized using C. limon extract at 150 µg/ml is significantly increased (33.8 mm). ZnO NPs synthesized using A. cepa, A. racemosus, and C. limon plant extracts are effectively protective for human red blood cells. The ZnO NPs synthesized using C. limon extract are characterized using UV-Visible spectroscopy, FTIR, XRD, and TEM. FTIR revealed that the plant extracts may serve as reducing and capping agents of ZnO NPs. XRD spectra confirmed the crystallinity of ZnO NPs. TEM image demonstrated the formation of spherical shapes of ZnO NPs with an average size of 37.05 nm. SEM of P. vulgaris cells treated with ZnO NPs showed cellular morphological damage compared to the untreated cells. ZnO NPs are synthesized by gamma irradiation as a clean and novel method. This study recommended the promising uses of the biosynthesized ZnO NPs using plant extracts as a natural, unique approach, to control the pathogenicity of P. vulgaris.

The Influence of Parametric Uncertainty on Projections of Forest Land Use, Carbon, and Markets.

This paper uses Monte Carlo methods and regression analysis to assess the role of uncertainty in yield function and land supply elasticity parameters on land use, carbon, and market outcomes in a long-term dynamic model of the global forest sector. The results suggest that parametric uncertainty has little influence on projected future timber prices and global output, but it does have important implications for regional projections of outputs. A wide range of outcomes are possible for timber outputs, depending on growth and elasticity parameters. Timber output in the U.S., for instance, could change by -67 to +98 million m3 per year by 2060. Despite uncertainty in the parameters, our analysis suggests that the temperate zone may sequester +30 to +79 Pg C by 2060 and +58 to +114 Pg C by 2090 while the tropics are projected to store -35 to +70 Pg C and -33 to +73 Pg C for the same time periods, respectively. Attributional analysis shows that uncertainty in the parameters regulating forest growth has a more important impact on projections of future carbon storage than uncertainty in the land supply elasticity parameters. Moreover, the results suggest that understanding growth parameters in regions with large current carbon stocks is most important for making future projections of carbon storage.

Novel Pyrazolo[3,4-b]pyridine Derivatives: Synthesis, Characterization, Antimicrobial and Antiproliferative Profile.

Three novel series of pyridine derivatives, namely Schiff's bases, 4-thiazolidinones and azetidin-2-ones bearing pyrazolo[3,4-b]pyridine moiety, have been synthesized. The chemical structures of the synthesized compounds were characterized. The compounds were tested for their antimicrobial activity using the agar well diffusion and broth macrodilution methods. The compounds were also evaluated for their antiproliferative activity using the sulforhodamine B (SRB) assay. The majority of the tested compounds exhibited slight to high antimicrobial activity against the test microorganisms with minimum inhibitory concentrations (MICs) of 0.12-62.5 µg/mL when compared to that of 3 standard antimicrobial agents (Ampicillin, 0.007-0.03 µg/mL; Gentamicin; 0.015-0.24 µg/mL; and Amphotericin B, 0.03-0.98 µg/mL). Compound (7b) was found to be nearly as active as the standard antimicrobial drug Amphotericin B against Fusarium oxysporum fungal strain with MIC of 0.98 µg/mL. Some of the test compounds showed remarkable cytotoxic activities against Hep G2 (hepatocellular carcinoma) cells (IC50=0.0158-71.3 µM) in comparison to the standard anticancer drug doxorubicin (IC50=0.008 µM). Among the compounds tested, (5), (6a), (6b), (7b), and (10) exhibited antiproliferative potency (IC50=0.0001-0.0211 µM) that was found to be better than that of doxorubicin (IC50=0.099 µM) against MCF7 (breast adenocarcinoma) cells. In particular, (7b) displayed the highest significant antiproliferative efficacy against both Hep G2 and MCF7 cell lines showing IC50 values of 0.0158 µM and 0.0001 µM, respectively. Our findings suggest that the synthesized compounds may be promising candidates as novel antimicrobial and antiproliferative agents.

Antioxidant Activity of Novel Fused Heterocyclic Compounds Derived from Tetrahydropyrimidine Derivative.

6-(Benzo[d][1,3]dioxol-5-yl)-4-oxo-2-thioxo-1,2,3,4-tetrahydropyrimidine-5-carbonitrile has been utilized for synthesis of the fused heterocyclic compounds namely thiazolopyrimidines, tetrazolopyrimidine, pyrimidoquinazoline, pyrimidothiazolopyrimidine, pyrimidothiazolotriazine and pyrrolothiazolopyrimidine derivatives. The newly synthesized compounds were characterized by IR, (1)H-NMR, (13)C-NMR, and mass spectral data. Antioxidant activities of all synthesized compounds were investigated.

The incidence of breast cancer in Egyptian females in correlation to different mammographic ACR densities.

INTRODUCTION: The density of breast tissue, radiologically referred to as fibroglandular mammary tissue, was found to be a predisposing factor for breast cancer (BC). However, the stated degree of elevated BC risk varies widely in the literature.

Optimizing Transport Carrier Free All-Polymer Solar Cells for Indoor Applications: TCAD Simulation under White LED Illumination.

This work inspects the utilization of all-polymer solar cells (APSCs) in indoor applications under LED illumination, with a focus on boosting efficiency through simulation-based design. The study employs a SCAPS TCAD device simulator to investigate the performance of APSCs under white LED illumination at 1000 lux, with a power density of 0.305 mW/cm2. Initially, the simulator is validated against experimental results obtained from a fabricated cell utilizing CD1:PBN-21 as an absorber blend and PEDOT:PSS as a hole transportation layer (HTL), where the initial measured efficiency is 16.75%. The simulation study includes an examination of both inverted and conventional cell structures. In the conventional structure, where no electron transportation layer (ETL) is present, various materials are evaluated for their suitability as the HTL. NiO emerges as the most promising HTL material, demonstrating the potential to achieve an efficiency exceeding 27%. Conversely, in the inverted configuration without an HTL, the study explores different ETL materials to engineer the band alignment at the interface. Among the materials investigated, ZnS emerges as the optimal choice, recording an efficiency of approximately 33%. In order to reveal the efficiency limitations of these devices, the interface and bulk defects are concurrently investigated. The findings of this study underscore the significance of careful material selection and structural design in optimizing the performance of APSCs for indoor applications.

Synthesis, antibacterial, and antiviral evaluation of new heterocycles containing the pyridine moiety.

A facile one-pot four-component reaction was utilized to construct 2-oxo-1,2-dihydropyridine-3-carbonitrile as a scaffold for the synthesis of many fused heterocyclic systems, namely, furopyridine, pyridothiadiazepinthione, and pyridotriazine, as well as non-fused heterocyclic systems such as phthalazin-2(1H)-ylnicotinonitrile, pyridin-2-yl-1H-pyrazole, and pyrazol-1-ylnicotino-nitrile,1-(3-cyanopyridin-2-yl)-1H-pyrazole. The new compounds were evaluated as antimicrobial and antiviral agents.

Device Modeling of Efficient PBDB-T:PZT-Based All-Polymer Solar Cell: Role of Band Alignment.

In this study, we present some design suggestions for all-polymer solar cells by utilizing device simulation. The polymer solar cell under investigation is formed by a photoactive film of a blend comprising PBDB-T as a polymer donor and PZT as a polymerized small molecule acceptor. The initial cell is based on a fabricated cell whose structure is ITO/PEDOT:PSS/PBDB-T:PZT/PFN-Br/Ag, which has a power conversion efficiency (PCE) of about 14.9%. A calibration procedure is then performed by comparing the simulation results with experimental data to confirm the simulation models, and the material parameters, implemented in the SCAPS (Solar Cell Capacitance Simulator) simulator. To boost the open circuit voltage, we investigate a group of hole transport layer (HTL) materials. An HTL of CuI or P3HT, that may replace the PEDOT:PSS, results in a PCE of higher than 20%. However, this enhanced efficiency results in a minor S-shape curve in the current density-voltage (J-V) characteristic. So, to suppress the possibility of the appearance of an S-curve, we propose a double HTL structure, for which the simulation shows a higher PCE with a suppressed kink phenomenon due to the proper band alignment. Moreover, the designed cell is investigated when subjected to a low light intensity, and the cell shows a good performance, signifying the cell's suitability for indoor applications. The results of this simulation study can add to the potential development of highly efficient all-polymer solar cells.

Full Optoelectronic Simulation of Lead-Free Perovskite/Organic Tandem Solar Cells.

Organic and perovskite semiconductor materials are considered an interesting combination thanks to their similar processing technologies and band gap tunability. Here, we present the design and analysis of perovskite/organic tandem solar cells (TSCs) by using a full optoelectronic simulator (SETFOS). A wide band gap lead-free ASnI2Br perovskite top subcell is utilized in conjunction with a narrow band gap DPPEZnP-TBO:PC61BM heterojunction organic bottom subcell to form the tandem configuration. The top and bottom cells were designed according to previous experimental work keeping the same materials and physical parameters. The calibration of the two cells regarding simulation and experimental data shows very good agreement, implying the validation of the simulation process. Accordingly, the two cells are combined to develop a 2T tandem cell. Further, upon optimizing the thickness of the front and rear subcells, a current matching condition is satisfied for which the proposed perovskite/organic TSC achieves an efficiency of 13.32%, Jsc of 13.74 mA/cm2, and Voc of 1.486 V. On the other hand, when optimizing the tandem by utilizing full optoelectronic simulation, the tandem shows a higher efficiency of about 14%, although it achieves a decreased Jsc of 12.27 mA/cm2. The study shows that the efficiency can be further improved when concurrently optimizing the various tandem layers by global optimization routines. Furthermore, the impact of defects is demonstrated to highlight other possible routes to improve efficiency. The current simulation study can provide a physical understanding and potential directions for further efficiency improvement for lead-free perovskite/organic TSC.

Impact of nutrition counseling on anthropometry and dietary intake of multiple sclerosis patients at Kasr Alainy Multiple Sclerosis Unit, Cairo, Egypt 2019-2020: randomized controlled clinical trial.

BACKGROUND: Faulty dietary habits and overnutrition are prevalent among Egyptian patients with multiple sclerosis (MS) who do not receive nutrition care as part of treatment. Thus, this study was conducted to identify the effect of nutrition counseling on the nutritional status of patients with MS. This endeavor might provide evidence for the value of counseling in such a setting and advance the integration of nutrition counseling into the routine management of patients with MS. METHODS: A single-blinded, parallel-randomized controlled clinical trial was conducted at Kasr Alainy MS Unit on 120 eligible patients with MS from September 2019 to February 2020. Patients were randomly allocated to either the nutrition counseling intervention group (IG) or the control group (CG). Allocation concealment was performed by using sequentially numbered opaque sealed envelopes. All patients were assessed initially and complied with the Kasr Alainy MS Unit standard management protocol for the study period. Only patients in the IG underwent initial nutrition counseling sessions followed by a monthly evaluation. All patients were assessed at the end of the 3-month follow-up period. Sociodemographic data were gathered through a structured interview. Nutritional status was assessed anthropometrically and via 24-h recall. The 2 groups were compared initially and at the end of the follow-up. Both intention-to-treat and per-protocol analyses were conducted. RESULTS: At baseline assessment, the prevalence of overweight and obesity was 31.7% and 32.5%, respectively, and the mean body mass index was 27.7 ± 5.7 kg/m2. Mean waist circumference was 93.5 ± 11.9 and 99.2 ± 13.1 cm for males and females, respectively. Approximately 27.3% of males and 83.9% of females showed abdominal obesity. After 3 months of counseling, weight, body mass index, waist circumference, nutrient intake and adequacy significantly improved in the IG (p < 0.05). CONCLUSION: Nutrition counseling significantly improved anthropometric measurements, dietary habits, nutrient intake and adequacy. TRIAL REGISTRATION: The study was registered on ClinicalTrial.gov and was given a code (NCT04217564).

Non-alcoholic fatty liver disease related knowledge among a sample of Egyptians: an exploratory cross-sectional study.

Introduction: The global prevalence of Non-alcoholic fatty liver disease (NAFLD) is about 25% worldwide making it an actual health disaster. This study aimed to assess non-alcoholic fatty liver disease (NAFLD)-related knowledge in a sample of Egyptians. Materials and methods: This exploratory cross-sectional study was conducted on 3,124 individuals using 2000 online and 1,124 printed questionnaire forms. These questionnaires, covering sociodemographic characteristics and fatty liver-related knowledge, comprised 30 items. These items include ten questions on definition, symptoms, and complications: 14 about risk factors, and six about prevention and therapy. The data were analyzed using SPSS. Categorical variables were expressed in proportions and percentages. Chi-square and Fisher's exact tests were applied as appropriate. For quantitative variables, the t-test, Mann-Whitney U test, Kruskal-Wallis test, and ANOVA test were used for comparisons. Results: A total of 3,124 respondents were enrolled in the current study. More than half (57%) were females, and 25% ranged in age from 18 to 29. 10.8% of the participants believed that fatty liver patients were asymptomatic, and 34% knew that fatty liver disease was caused by fat accumulation. Regarding predisposing factors, hypercholesterolemia, increased fat in the diet, and obesity had the highest proportion of accurate responses (60, 54, and 46.6%, respectively). On the other hand, 89.3% believed it could be prevented, and 81.4% of the respondents knew that weight reduction could prevent the condition. All respondents (100%) stated wrongly that it was a familial disease related to aging, and most participants (97.3%) did not believe that fatty liver could be treated. Females demonstrated a significantly higher score in preventive measures, while the employed participants scored significantly higher in general knowledge of fatty liver, risk factors, and preventive measures. Conclusion: Despite the increasing NAFLD prevalence, the current study indicated that Egyptians had fair to moderate knowledge about fatty liver and its risk factors, preventive measures, and therapy. However, a false belief was documented by all respondents that it is a disease that runs in families and occurs only in old age. A fundamental shift in healthcare management with a prioritization of prevention, proactive measures, and early detection of NAFLD should be emphasized.

Boosting the Electrostatic MEMS Converter Output Power by Applying Three Effective Performance-Enhancing Techniques.

This current study aims to enhance the electrostatic MEMS converter performance mainly by boosting its output power. Three different techniques are applied to accomplish such performance enhancement. Firstly, the power is boosted by scaling up the technology of the converter CMOS accompanied circuit, the power conditioning, and power controlling circuits, from 0.35 µm to 0.6 µm CMOS technology. As the converter area is in the range of mm2, there are no restrictions concerning the scaling up of the accompanied converter CMOS circuits. As a result, the maximum voltage of the system for harvesting energy, Vmax, which is the most effective system constraint that greatly affects the converter's output power, increases from 8 V to 30 V. The output power of the designed and simulated converter based on the 0.6 µm technology increases from 2.1 mW to 4.5 mW. Secondly, the converter power increases by optimizing its technological parameters, the converter thickness and the converter finger width and length. Such optimization causes the converter output power to increase from 4.5 mW to 11.2 mW. Finally, the converter structure is optimized to maximize its finger length by using its wasted shuttle mass area which does not contribute to its capacitances and output power. The proposed structure increases the converter output power from 11.2 mW to 14.29 mW. Thus, the three applied performance enhancement techniques boosted the converter output power by 12.19 mW, which is a considerable enhancement in the converter performance. All simulations are carried out using COMSOL Multiphysics 5.4.

The impact of systemic methotrexate and surgical management on fertility preservation in tubal ectopic pregnancy among Saudi women.

BACKGROUND: The impact of various management plans on subsequent fertility after tubal ectopic pregnancy (EP) is not well known. The objective of the present study was an evaluation of the subsequent fertility outcome among women with EP managed either surgical or medical with systemic methotrexate or medical management followed by surgical one. PATIENTS AND METHODS: A retrospective cohort study was done by reviewing of medical records of all women diagnosed with EP at King Faisal Military Hospital, Southern Region, Saudi Arabia throughout the period from January 2015 to December 2016 provided that they were hemodynamic stable, with starting ßhCG level less than 10000 IU/L, and adnexal mass less than 5 cm. These cases were followed for four years from January 2017 to December 2020. RESULTS: The study included 85 women with EP. Their mean age was 31.3 ± 6.7 years. Medical management (systemic Methotrexate) was followed in 48.2% of cases whereas surgical management was applied for 43.5% of them while medical management followed by surgical one was seen in 8.2% of cases. Complete follow-up throughout 2017-2020 was available for 52 women. A history of recurrent EP was observed among 3 women (5.8%). Most of them (75%) had a viable pregnancy. There was no statistically significant association between the method of management of EP and subsequent fertility, although the rate of normal pregnancy (intrauterine viable pregnancy ≥ 24 weeks which is the age of viability at our hospital) was higher among those managed surgically or by medical followed by surgical management than those managed medical only (84.6% and 100% vs. 62.5%). CONCLUSION: Although the normal pregnancy rate was higher among those managed surgically or by medical followed by surgical management than those managed medically only, this was not statistically significant.

Barriers to adequate nutrition care for child malnutrition in a low-resource setting: Perspectives of health care providers.

Introduction: Several studies in developing countries found that more need-based training is required for health care providers (HCPs) in child malnutrition management. Methods: An exploratory cross-sectional study was conducted to explore barriers to providing adequate nutrition care as perceived by the healthcare providers (HCPs) in the child malnutrition clinic at a Children's University Hospital in Egypt. Participants were selected using the purposive sampling technique. Five out of seven HCPs in the clinic were included (two male physicians, one female physician, and two female nurses). Qualitative data were collected through in-depth interviews. The interview guide consisted of semi-structured open-ended questions. Quantitative data were the resulting scores from the scoring system used to assess the understandability and actionability of the patient education materials (PEMs) that are available in the clinic. The Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) for the scoring. Statistical analysis: The thematic content analysis technique was employed for qualitative data. The percent score was generated for the PEM actionability and understandability for quantitative data. Results: Most common child malnutrition conditions encountered by HCPs were nutritional deficiencies. Barriers to the delivery of adequate nutrition care to children were physician-centered: limited nutrition education in the medical school, health system-centered: an insufficient number of HCPs, lack of nutritional supplements, lack of patient education materials (PEMs) that suit the characteristics of the served community, lack of updated standard of practice (SOP) and guidelines, inadequate nutrition training of HCPs, and insufficient time for each patient, and caregivers-centered: the low socioeconomic status and false cultural, nutritional beliefs. Conclusion: There are different barriers to adequate nutrition care for child malnutrition in low-resource healthcare settings. Mainly nutritional deficiencies. Most of the barriers were health system-related in the form of insufficient resources (shortage of workforce; concerning the high caseload, nutritional supplements, and PEMs) and inadequate management of resources (lack of skill-based training, lack of updated SOP and guidelines, and lack of properly designed PEMs that facilitate communication with the target caregivers).