Search

The mechanisms of cellular absorption and transport underlying the differences between flavonoid aglycones and glycosides and the effect of the structural feature are not well established. In this study, aglycone, mono-, and diglycosides of quercetin and cyanidin were selected to examine the effects of the structural feature on the bioavailability of flavonoids using hexose transporters SGLT1 and GLUT2 in a Caco-2 BBe1 cell model. Cellular uptake and transport of all glycosides were significantly different. The glycosides also significantly inhibited cellular uptake of d-glucose, indicating the involvement of the two hexose transporters SGLT1 and GLUT2 in the absorption, and the potential of the glycosides in lowering the blood glucose level. The in silico prediction model also supported these observations. The absorption of glycosides, especially diglycosides but not the aglycones, was significantly blocked by SGLT1 and GLUT2 inhibitors (phloridzin and phloretin) and further validated in SGLT1 knockdown Caco-2 BBe1 cells.

There is a growing international and regional interest in Health Research Systems (HRSs) in light of a global strategy for HRS stakeholders' (HRSSHs) active involvement. HRSSHs in Palestine have rarely been investigated with regard to uncertainties.This study aimed to analyse perceptions of HRSSHs in order to understand their roles and involvement, identify gaps, and offer policy solutions for stakeholders' engagement in the Palestinian HRS.This qualitative study targeted three local Palestinian health sectors, government, academia, and local and international agencies. Data were collected through 52 in-depth interviews (IDIs) and 6 focus group discussions (FGDs) and then analysed using MAXQDA 12 software. Participants and institutions were selected purposively based on a set of criteria and peer review.The overall HRS stakeholders' roles were unsatisfactory, with low involvement from society, the private sector, local and international sectors. The role of academia and the Ministry of Health is vital but observed moderate in health research while that of international agencies is weak due to conflicting agendas and lack of a guiding body. Most universities have poor representation in public decision-making and scarcity in health research potential and capacity. Interest-power imbalance among stakeholders is reported where political, organizational, and technical shortfalls were indicative of weak roles and low involvement, along with a lack of health research culture, structure, resources, defined roles, and network.Tackling the inadequate roles, interests' disparity, and poor involvement of HRSSHs is imperative for HRS strengthening. Redefining HRSSHs' roles and involving all stakeholders is key through strategic dialogue, consolidated leadership, and resource mobilization.تحديد أصحاب المصلحة في النظام الفلسطيني للبحوث الصحية: دراسة نوعية.محمد الخالدي، عبد السلام الخياط، كونستانزي بفيفر، سليم حاج يحيى، حمزة مغاري، حسن أبو عبيد، علي شعار، يوسف الجيش، مارسيل تانر، يحيى عابد.يتنامى الاهتمام الدولي والإقليمي بنظم البحوث الصحية في ضوء الاستراتيجية العالمية لإشراك أصحاب المصلحة بفعالية في نظم البحوث الصحية. وفي حالات نادرة فقط جرى الاستقصاء بشأن أصحاب المصلحة في نظم البحوث الصحية في فلسطين فيما يتعلق بأوجه عدم اليقين.هدفت الدراسة إلى تحليل تصورات أصحاب المصلحة بشأن نظم البحوث الصحية لاستيعاب أدوارهم، وكيفية إشراكهم، وتحديد الثغرات، وعرض حلول للسياسات بخصوص إشراك أصحاب المصلحة في نظم البحوث الصحية الفلسطينية.استهدفت هذه الدراسة النوعية ثلاثة قطاعات صحية فلسطينية، وهي الحكومة، والأوساط الأكاديمية، والهيئات المحلية والدولية. وقد جُعت البيانات من خلال عقد 52 مقابلةً مُعمقة، و6 مناقشات ضمن مجموعات بؤرية، ثم خضعت للتحليل ببرنامج تحليل البيانات النوعية 12 MAXQDA. واختيِر المشاركون والمؤسسات اختياراً عَمْدياً، استناداً إلى مجموعة من المعايير ومراجعة الأقران.كانت الأدوار التي يضطلع بها أصحاب المصلحة في نظم البحوث الصحية غير مُرضية عامةً، بالإضافة إلى انخفاض مستوى المشاركة من جانب المجتمع، والقطاع الخاص، والقطاعات المحلية والدولية. وكان الدور المهم الذي تؤديه الأوساط الأكاديمية ووزارة الصحة متوسطاً، بينما كان دور الهيئات الدولية ضعيفاً نظراً لتضارب الخطط وعدم وجود هيئة توجيهية. أيضاً فإن تمثيل الجامعات ضعيفٌ في عملية صنع القرار، علاوةً على نُدرة الإمكانيات في مجال البحوث الصحية. ويوجد اختلال في توازن المصالح والقوى بين أصحاب المصلحة، ويُستدل من أوجه القصور في النواحي السياسة، والتنظيمية، والتقنية على ضعف الأدوار والمشاركة، بالإضافة إلى الافتقار إلى ثقافة البحوث، وهيكلية لمنظومة البحث الصحي، الموارد وأدوار مُددة لشبكة الأطراف ذات العلاقة.من المحتم معالجة عدم كفاية الأدوار، وتباين المصالح، وضعف مشاركة أصحاب المصلحة في نظم البحوث الصحية بغية تعزيز هذه النظم. ويلزم أساساً إعادة تعريف أدوار أصحاب المصلحة وتحديدها في نظم البحوث الصحية من خلال حوار استراتيجي، وقيادة موحَّدة، وتعبئة الموارد.Cartographie des parties prenantes du système de recherche en santé palestinien : étude qualitative.Il existe un intérêt croissant, aux plans régional et international, pour les systèmes de recherche en santé du fait de la stratégie mondiale consistant à impliquer activement les parties prenantes desdits systèmes. Ces dernières ont rarement fait l’objet d’études portant sur leurs incertitudes en Palestine.La présente étude visait à analyser les perceptions des parties prenantes des systèmes de recherche en santé, afin de comprendre leurs rôles et leur implication, d’identifier les éventuelles lacunes et d’offrir des solutions politiques à leur engagement dans le système de recherche en santé palestinien.Cette étude qualitative ciblait trois secteurs locaux de la santé en Palestine, les agences gouvernementales, universitaires, et locales et internationales. Les données ont été recueillies par le biais de 52 entretiens approfondis et de six discussions thématiques de groupe, puis analysées à l’aide du logiciel MAXQDA 12. Les participants et les établissements ont été sélectionnés intentionnellement sur la base d’un ensemble de critères et d’un examen collégial.Globalement, les rôles des parties prenantes du système de recherche en santé n’étaient pas satisfaisants. Ils démontraient en effet un faible degré d’implication de la part de la société, du secteur privé et des secteurs local et international. Le rôle des universités et du ministère de la Santé est vital, mais on observe qu’ils jouent un rôle modéré dans la recherche en santé. Celui des agences internationales est mineur en raison de la divergence de leurs programmes et de l’absence d’organe directeur. La plupart des universités sont mal représentées dans les processus de prise de décision publique et doivent faire face à la pénurie des potentiels et des capacités en matière de la recherche en santé. Un déséquilibre entre intérêt et moyens a été relevé parmi les parties prenantes, avec des déficits politiques, organisationnels et techniques indicatifs de la faiblesse des rôles et de l’implication. On note par ailleurs des insuffisances en termes de culture, de structure, de ressources, de définition des rôles et de réseau relativement à la recherche en santé.Il est impératif de s’attaquer à l’inadéquation des rôles, à la divergence des intérêts et au faible degré d’implication des parties prenantes des systèmes de recherche en santé si l’on veut renforcer ces systèmes. Pour ce fait, il importe de redéfinir les rôles des parties prenantes et de les impliquer toutes par la voie d’un dialogue stratégique, d’un encadrement renforcé et d’une mobilisation des ressources.

Background: This study aimed to estimate the prevalence of and determine the factors associated with antihypertensive medication (A-HTNM) non-adherence among hypertension care seekers attending primary health clinics in the Gaza Strip. Methods: A cross-sectional survey was conducted as the recruitment phase of a clustered randomized controlled trial including 538 participants. The participants were randomly selected from 10 primary health care centers by two-stage cluster random sampling. A structured questionnaire was used to collect data through face-to-face interview. The questionnaire was developed based on the World Health Organization determinants for medication non-adherence and the Health Belief Model. The main outcomes of this study were the prevalences of A-HTNM non-adherence and its associated factors. Adherence status was assessed using the eight-item Morisky Self-Report Medication Adherence Scale. Data were analyzed by STATA ver. 14.0 (Stata Corp., College Station, TX, USA) using a standard complex survey, accounting for unresponsiveness and the clustering sampling approach. Results: The overall prevalence of A-HTNM non-adherence was 65.8% (95% confidence interval [CI], 59.2–71.8). Among all studied predictors, only self-efficacy of participants (odds ratio [OR], 3.8; 95% CI, 1.79–2.84) and social support (OR, 2.26; 95% CI, 2.82–5.11) remained significantly associated with A-HTNM non-adherence after adjusting for age, education level, number and frequency of A-HTNM doses per day, and comorbidities. Conclusion: The high prevalence of non-adherence highlights the need for serious intervention to enhance the adherence rate among hypertension patients. The associated factors can be considered when developing appropriate interventions. Keywords: Antihypertensive Drugs; Medication Non-adherence; Prevalence الخلفية: هدفت هذه الدراسة إلى تقدير انتشار وتحديد العوامل المرتبطة بعدم الالتزام بالأدوية الخافضة للضغط (A-HTNM) بين الباحثين عن رعاية ارتفاع ضغط الدم الذين يترددون على عيادات الصحة الأولية في قطاع غزة. الطرق: تم إجراء مسح مقطعي كمرحلة التوظيف لتجربة مجمعة معشاة ذات شواهد تضم 538 مشاركًا. تم اختيار المشاركين عشوائياً من 10 مراكز رعاية صحية أولية عن طريق أخذ العينات العنقودية العشوائية من مرحلتين. تم استخدام استبيان منظم لجمع البيانات من خلال مقابلة وجهاً لوجه. تم تطوير الاستبيان بناءً على محددات منظمة الصحة العالمية لعدم الالتزام بالأدوية ونموذج المعتقدات الصحية. كانت النتائج الرئيسية لهذه الدراسة هي انتشار عدم التزام A-HTNM والعوامل المرتبطة به. تم تقييم حالة الالتزام باستخدام مقياس التقيد بالأدوية Morisky Self-Report المكون من ثمانية عناصر. تم تحليل البيانات بواسطة STATA الإصدار. 14.0 (ستاتا كورب ، كوليدج ستيشن ، تكساس ، الولايات المتحدة الأمريكية) باستخدام مسح معياري معقد ، مع مراعاة عدم الاستجابة ونهج أخذ العينات العنقودية. النتائج: كان الانتشار العام لعدم الالتزام A-HTNM 65.8٪ (95٪ فاصل الثقة [CI] ، 59.2-71.8). من بين جميع المتنبئين المدروسين ، بقيت الفعالية الذاتية فقط للمشاركين (نسبة الأرجحية [OR] ، 3.8 ؛ 95٪ CI ، 1.79-2.84) والدعم الاجتماعي (OR ، 2.26 ؛ 95٪ CI ، 2.82-5.11) مرتبطة بشكل كبير بـ A- عدم التزام HTNM بعد تعديل العمر ومستوى التعليم وعدد وتكرار جرعات A-HTNM في اليوم والأمراض المصاحبة. الخلاصة: ارتفاع معدل انتشار عدم الالتزام يسلط الضوء على الحاجة إلى التدخل الجاد لتعزيز معدل الالتزام بين مرضى ارتفاع ضغط الدم. يمكن النظر في العوامل المرتبطة عند تطوير التدخلات المناسبة. الكلمات الرئيسية: الأدوية الخافضة للضغط. عدم الالتزام بالأدوية؛ انتشار

The factors that influence the organizational commitment of healthcare professionals, particularly organizational communication and work satisfaction, are essential for all healthcare organizations. This is particularly important for those who are under the pressure of high demand, economic constraints, and staff shortages. This study examined the relationship between organizational communication satisfaction and organizational commitment among healthcare professionals and the mediating role of work satisfaction in the relationship. A validated self-administered questionnaire and a universal sampling approach were used to conduct a cross-sectional survey of 235 healthcare professionals in the Gaza Strip, Palestine. The data were analyzed using SPSS version 25 and SmartPLS software to perform partial least squares structural equation modeling (PLS-SEM). A STROBE checklist was used to report the results. The results show a significant positive correlation between all measured variables. Work satisfaction partially mediates the relationship between organizational communication satisfaction and organizational commitment. The results of the PLS-SEM analyses suggest that communication satisfaction and work satisfaction account for 61% of the variation in organizational commitment. This study reveals that work satisfaction and communication satisfaction are imperative to building a sense of commitment in healthcare professionals. These results reinforce the existing evidence on the factors that influence the organizational commitment of healthcare professionals. Strategies to better shape internal communication practices and improve the work environment through regular feedback to healthcare professionals are essential to strengthening their organizational commitment.

An all-optical method of ultrafast spin rotation is put forward to precisely manipulate the polarization of relativistic charged particle beams of leptons or ions. In particular, laser-driven dense ultrashort beams are manipulated via single-shot interaction with a co-propagating moderate temporally asymmetric (frequency-chirped or subcycle THz) laser pulse. Using semi-classical numerical simulations, we find that in a temporally asymmetrical laser field, the spin rotation of a particle can be determined from the flexibly controllable phase retardation between its spin precession and momentum oscillation. An initial polarization of a proton beam can be rotated to any desired orientation (e.g., from the common transverse to the more useful longitudinal polarization) with extraordinary precision (better than 1\%) in tens of femtoseconds using a feasible frequency-chirped laser pulse. Moreover, the beam qualities, in terms of energy and angular divergence, can be significantly improved in the rotation process. This method has potential applications in various areas involving ultrafast spin manipulation, like laser-plasma, laser-nuclear and high-energy particle physics.

This study aims to identify key Islamic religious practices performed by Muslim employees that may cause conflict in secular workplaces in Sydney, Australia. In addition, it aims to examine how managers in these workplaces respond to religious diversity among employees. As such, diversity management is discussed from the macro-national, meso-organisational, and micro-individual perspectives, and examined closely at the meso and micro levels. A multi case study design was employed in this study. An online survey of Muslim employees and one-on-one interviews with Muslim employees and non-Muslim managers were the primary data collection methods. The results of this study show that the number of Muslim employees practising their faith in the workplace varied significantly between the Agency and the University (33% and 89% respectively). Approximately 30% of Muslim employees experienced religion-based conflict in the Agency compared to approximately 10% of University employees. The Agency case study findings revealed that the organisation's diversity policy slightly supported managers to accommodate the religious practices of employees. Opinions varied among Muslim employees regarding the effectiveness of the diversity policy in practice. Most Muslim employees sought to integrate into the organisational culture while maintaining a separate Muslim identity. There was no evidence that Muslim women experienced religion-based workplace conflict to a greater extent than Muslim men. The University case study findings showed that management pro-actively attempted to accommodate employees' religious needs and that management and staff had a good awareness of religious diversity in this organisation. Most Muslim employees sought to integrate their Muslim identity into the organisational culture. The findings suggest that workplace diversity management strategies that rely on legislative compliance are largely inadequate in preventing religion-based workplace conflict. Everyday enactments by employees and managers in religiously diverse workplaces that demonstrate acceptance and support are also required. This study recommends that future research should investigate the factors impacting the development and implementation of effective workplace communication strategies relevant to religion and work.

High-energy spin-polarized electron, positron, and $\gamma$-photon beams have many significant applications in the study of material properties, nuclear structure, particle physics, and high-energy astrophysics. Thus,efficient production of such polarized beams attracts a broad spectrum of research interests. This is driven mainly by the rapid advancements in ultrashort and ultraintense laser technology. Currently available laser pulses can achieve peak intensities in the range of $10^{22}-10^{23}$ Wcm$^{-2}$, with pulse durations of tens of femtoseconds. The dynamics of particles in laser fields of the available intensities is dominated by quantum electrodynamics (QED) and the interaction mechanisms have reached regimes spanned by nonlinear multiphoton absorbtion (strong-field QED processes). In strong-field QED processes, the scattering cross sections obviously depend on the spin and polarization of the particles, and the spin-dependent photon emission and the radiation-reaction effects can be utilized to produce the polarized particles. An ultraintense laser-driven polarized particle source possesses the advantages of high-brilliance and compactness, which could open the way for the unexplored aspects in a range of researches. In this work, we briefly review the seminal conclusions from the study of the polarization effects in strong-field QED processes, as well as the progress made by recent proposals for production of the polarized particles by laser-beam or laser-plasma interactions.

AIM To assess the impact of organisational communication satisfaction (OCS) on the work engagement of health care professionals (HCPs). BACKGROUND Organisational communication can influence employees' work engagement, which is an essential component of an organisation's effectiveness. However, these concepts have not been broadly investigated in health care organisations. METHODS A cross-sectional survey was administered to 235 HCPs in the Gaza Strip, Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data. RESULTS The HCPs reported a moderate level of OCS (M = 4.96, SD = 0.94) and work engagement (M = 5.56, SD = 0.96). The impact of OCS on work engagement was found to be positive and statistically significant (β = .524, p

Background: Substance use disorders (SUDs) are a serious threat to health and society, Focusing on the positive personality traits of the addict and reinforcing them through the CBT program is an important factor in addiction treatment. Objectives: The study aims to evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) in reinforcing positive adaption among patients with SUBs in Gaza Strip. Methods: The experimental design was used, 30 male Participants were distributed randomly into two groups: experimental and control (n = 15) per group. Both groups received the standard treatment, while only the experimental group undergoes the CBT program consisting of (16) sessions over 2 months. All of the subjects completed a positive adaption questionnaire before and after the intervention, and 2 months later (follow-up). The required data were collected and analyzed. Results: a statistically significant difference between the two groups in favor of the experimental group in the level of positive adaption. There are statistically significant differences between the grades ranking averages of the experimental group regarding the post and follow-up measurements on the positive adaption scale after 2 months, the p-value < 0.05 in positive-Adaption in posttest and follow-up measurement. Results indicated that CBT was effective in reinforcing positive adaption among patients with SUDs. Conclusions: The study concludes that CBT sessions have been effective and successful in reinforcing the positive adaption among patients with SUD. الخلفية: تعتبر اضطرابات استخدام المواد المخدرة (SUDs) تهديدًا خطيرًا للصحة والمجتمع ، والتركيز على السمات الشخصية الإيجابية للمدمن وتعزيزها من خلال برنامج العلاج المعرفي السلوكي هو عامل مهم في علاج الإدمان. الأهداف: تهدف الدراسة إلى تقييم فاعلية العلاج السلوكي المعرفي (CBT) في تعزيز التكيف الإيجابي بين مرضى SUBS في قطاع غزة. الطريقة: تم استخدام التصميم التجريبي حيث تم توزيع 30 مشارك ذكر بشكل عشوائي على مجموعتين: التجريبية والضابطة (عدد = 15) لكل مجموعة. تلقت المجموعتان العلاج القياسي ، بينما خضعت المجموعة التجريبية فقط لبرنامج العلاج السلوكي المعرفي المكون من (16) جلسة على مدى شهرين. أكمل جميع الأشخاص استبيان التكيف الإيجابي قبل التدخل وبعده ، وبعد شهرين (متابعة). تم جمع وتحليل البيانات المطلوبة. النتائج: فرق ذو دلالة إحصائية بين المجموعتين لصالح المجموعة التجريبية في مستوى التكيف الإيجابي. توجد فروق ذات دلالة إحصائية بين متوسطات ترتيب درجات المجموعة التجريبية فيما يتعلق بالقياسات البعدي والمتابعة على مقياس التكيف الإيجابي بعد شهرين ، والقيمة الاحتمالية

"Background: Substance use disorders (SUDs) are a serious threat to health and society; Focusing on improving the self-esteem of substance users through the Cognitive Behavioral Therapy (CBT) program is an important factor in addiction treatment. Objectives: The study aims to evaluate the effectiveness of CBT in improving self-esteem among patients with SUBs in the Gaza Strip. Methods: The experimental design was used, 30 male Participants were divided randomly into two groups: experimental and control (n = 15) per group. Both groups received the standard treatment, while only the experimental group underwent the CBT program consisting of (16) sessions over 2 months. All of the subjects completed a self-esteem questionnaire before and after the intervention, and 2 months later (follow-up). The required data were collected and analyzed. Results: a statistically significant difference between the two groups in favor of the experimental group in the level of self-esteem was found. There are statistically significant differences between the mean scores of the experimental group regarding the post and follow-up measurements on the self-esteem scale after 2 months, p < .05 in self-esteem in posttest and follow-up measurement. Results indicated that CBT was effective in improving self-esteem among patients with SUDs. Conclusions: The study concludes that CBT sessions have been effective and successful in improving self-esteem among patients with SUD" "Background: Substance use disorders (SUDs) are a serious threat to health and society; Focusing on improving the self-esteem of substance users through the Cognitive Behavioral Therapy (CBT) program is an important factor in addiction treatment. Objectives: The study aims to evaluate the effectiveness of CBT in improving self-esteem among patients with SUBs in the Gaza Strip. Methods: The experimental design was used, 30 male Participants were divided randomly into two groups: experimental and control (n = 15) per group. Both groups received the standard treatment, while only the experimental group underwent the CBT program consisting of (16) sessions over 2 months. All of the subjects completed a self-esteem questionnaire before and after the intervention, and 2 months later (follow-up). The required data were collected and analyzed. Results: a statistically significant difference between the two groups in favor of the experimental group in the level of self-esteem was found. There are statistically significant differences between the mean scores of the experimental group regarding the post and follow-up measurements on the self-esteem scale after 2 months, p < .05 in self-esteem in posttest and follow-up measurement. Results indicated that CBT was effective in improving self-esteem among patients with SUDs. Conclusions: The study concludes that CBT sessions have been effective and successful in improving self-esteem among patients with SUD"

With the noticed steady increase of global demand for animal proteins coupled with the current farming practices falling short in fulfilling the requested quantities, more attention is being paid for means and methods intended to maximize every available agricultural-resource in a highly sustainable fashion to address the above growing gap between production and consumers' demand. Within this regard, considerable efforts are being invested either in identifying new animal feed ingredients or maximizing the utilization of already established ones. The public preference and awareness of the importance of using waste products generated by fruit-dependent industries (juice, jams, spirits, etc.) has improved substantially in recent years where a genuine interest of using the above waste(s) in meaningful applications is solidifying and optimization-efforts are being pursued diligently. While many of the earlier reported usages of fruit pomaces as feedstuffs suggested the possibility of using minimally processed raw materials alone, the availability of exogenous digestive and bio-conversion enzymes is promising to take such applications to new un-matched levels. This review will discuss some efforts and practices using exogenous enzymes to enhance fruit pomaces quality as feed components as well as their nutrients' accessibility for poultry and swine production purposes. The review will also highlight efforts deployed to adopt numerous naturally derived and environmentally friendly catalytic agents for sustainable future feed applications and animal farming-practices.

"Background: According to Ministry of Health since the beginning of the great marches return (GMR) in March 2018, the number of injured people 35.703, who had amputated limbs was 157 The amputees may experiences body images disturbances, stress, depression, and anxiety, Many reviews and studies done to define the psychological burden of amputations, Social supports received by different amputees is vital in structuring effective treatment plan as a holistic approach in treating these physically disabled patients. Aim: the objective of current study is to examine the efficacy of peer support group in alleviating the emotions state of Depression, Anxiety and stress among amputees in Gaza strip. Method: Using semi-experimental (pre, post and follow-up) design, 60 Amputees after assessment using DASS , assigned to Peer Group Support (PGS). and its effect measured on the dependent variable, Emotional state of Depression, Anxiety and Stress. Result: The prevalence of depression in the amputee is estimated to be (%59), anxiety is (59.6%), and stress is (%65.5), The mean score of the patients’ depression, stress and anxiety before intervention was 1.8424 after the intervention of the peers group support in the post test measurements was reduced to 0.8668 compared to that of pretest measurements which is significant in value of (p

"Background: Dry eye (DE) is a multifactorial disorder that can influence tear production, functional visual acuity and ultimately increase the osmolarity of the tear film. The prevalence of DE ranges from 7% to 33% across the world. However, to the best of our knowledge, the prevalence range of DE in Arab countries is not precisely documented in the literature. Aim: The aim of this article was to determine the prevalence range of DE, investigate the major risk factors of DE and identify the clinical diagnosis and medical management of DE. Method: In this study, only English language articles from 2017 to 2020 were selected. There were 52 articles on prevalence, risk factors, clinical diagnosis and medical management of DE in the Arab population. Results: The prevalence of DE in the Arab population varies in reports, from 10% in the United Arab Emirates (Dubai) to 69% in Palestine (West Bank). Gender difference (DE more in women), wearing of contact lenses, diabetes mellitus and glaucoma were all known to intensify the symptoms of DE. Lastly, there are two approaches to reduce DE in the Arab population, namely, pharmacologic and non-pharmacologic methods. Conclusion: The prevalence of DE in the Arab population was relatively high. In addition, the ocular surface disease index is one of the most common tools for the diagnosis of DE, whilst tear break-up time test is the common clinical test used in the Arab reports. Lastly, the most common treatment for DE is artificial tears." "Background: Dry eye (DE) is a multifactorial disorder that can influence tear production, functional visual acuity and ultimately increase the osmolarity of the tear film. The prevalence of DE ranges from 7% to 33% across the world. However, to the best of our knowledge, the prevalence range of DE in Arab countries is not precisely documented in the literature. Aim: The aim of this article was to determine the prevalence range of DE, investigate the major risk factors of DE and identify the clinical diagnosis and medical management of DE. Method: In this study, only English language articles from 2017 to 2020 were selected. There were 52 articles on prevalence, risk factors, clinical diagnosis and medical management of DE in the Arab population. Results: The prevalence of DE in the Arab population varies in reports, from 10% in the United Arab Emirates (Dubai) to 69% in Palestine (West Bank). Gender difference (DE more in women), wearing of contact lenses, diabetes mellitus and glaucoma were all known to intensify the symptoms of DE. Lastly, there are two approaches to reduce DE in the Arab population, namely, pharmacologic and non-pharmacologic methods. Conclusion: The prevalence of DE in the Arab population was relatively high. In addition, the ocular surface disease index is one of the most common tools for the diagnosis of DE, whilst tear break-up time test is the common clinical test used in the Arab reports. Lastly, the most common treatment for DE is artificial tears."

UV radiation is one of the main contributors to skin photoaging by promoting the accumulation of cellular senescence, which in turn induces a proinflammatory and tissue-degrading state that favors skin aging. The members of the sirtuin family of NAD(+)-dependent enzymes play an anti-senescence role and their activation suggests a promising approach for preventing UV-induced senescence in the treatment of skin aging. A two-step screening designed to identify compounds able to protect cells from UV-induced senescence through sirtuin activation identified shikimic acid (SA), a metabolic intermediate in many organisms, as a bona-fide candidate. The protective effects of SA against senescence were dependent on specific activation of SIRT1 as the effect was abrogated by the SIRT1 inhibitor EX-527. Upon UV irradiation SA induced S-phase accumulation and a decrease in p16INK4A expression but did not protect against DNA damage or increased polyploidies. In contrast, SA reverted misfolded protein accumulation upon senescence, an effect that was abrogated by EX-527. Consistently, SA induced an increase in the levels of the chaperone BiP, resulting in a downregulation of unfolded protein response (UPR) signaling and UPR-dependent autophagy, avoiding their abnormal hyperactivation during senescence. SA did not directly activate SIRT1 in vitro, suggesting that SIRT1 is a downstream effector of SA signaling specifically in the response to cellular senescence. Our study not only uncovers a shikimic acid/SIRT1 signaling pathway that prevents cellular senescence, but also reinforces the role of sirtuins as key regulators of cell proteostasis.

High risk Human papillomavirus infections are linked to highly prevalent cancers; a consequence of aborted viral cycles and deregulation of HPV oncogenes E6 and E7. In many cases of cancer, meiotic genes can be seen upregulated, activation of meiotic genes in normal tissue can have detrimental effects due to the unique characteristics of gametogenesis that if observed in normal cells can be oncogenic. The gene of interest investigated in this project is SYCP2; it is a meiosis specific gene that is a part of the synaptonemal complex that links homologous chromosomes and facilitates synapsis. Recent studies showed it is strongly upregulated in HPV associated cancers when it’s normal expression should be restricted to testis, it has been linked to what is called Cancer Testis Antigens (CTA) which are a group of genes that has been associated to tumours of different histological origins whose normal expression is restricted to testes. This gene is of interest because CTAs hold unique therapeutic potential as biomarkers or immunotherapeutics. It has been documented that SYCP2 is upregulated, however, existing data thus far only shows the mRNA level. In order to explore any therapeutic potential of this gene its expression profile needs to be investigated, and its possible correlation to viral infection or oncogenesis. In this project we aim to investigate if the large increase in SYCP2 transcript levels in HPV16+ cancers is paralleled by a similar increase in SYCP2 protein levels. This study has looked into the protein expression of SYCP2 that if further investigated, could form a useful model in understanding HPV infection and the possible role SYCP2 has in aiding oncogenesis.

Background: Hypertension is one of the most prevalent long-term diseases seen in many countries, including Palestine. Patients with poorly controlled blood pressure are more likely to develop several complications. Therefore; it is imperative to control their blood pressure by improving their adherence to the treatment regimen. Aim: The objective of this study was to evaluate the impact of using a mobile phone app on the level of adherence to treatment regimens among hypertensive patients in the Gaza Strip. Methods and results: This study used an experimental design with a pre and post-intervention assessment. Using the Hill–Bone compliance to high blood pressure therapy scale, 191 participants completed the study: 94 in the control group and 97 in the intervention group. The intervention group used a phone app which reminds participants to take their medication, reminding them about their follow-up appointments and sending educational information about hypertension management. After 3 months of intervention, the level of adherence to treatment was reassessed. Results showed that participants in both groups showed a significant improvement in adherence levels, with higher improvements in the intervention group in the total score as well as all three domain scores: adherence to medication, diet and keeping appointments. Conclusion: The use of a mobile phone app resulted in improvements in adherence to hypertension treatment. Thus, this study confirms the potential effectiveness of mobile technology in improving treatment adherence in hypertension and an opportunity to reduce cardiovascular mortality and morbidity. However, wider adoption has to be accompanied by ongoing evaluation and integration in public health systems. خلفية البحث: يعتبر ارتفاع ضغط الدم من أكثر الأمراض طويلة الأمد انتشارًا في العديد من البلدان ، بما في ذلك فلسطين. المرضى الذين يعانون من ضعف التحكم في ضغط الدم هم أكثر عرضة للإصابة بعدة مضاعفات. وبالتالي؛ من الضروري التحكم في ضغط الدم من خلال تحسين التزامهم بنظام العلاج. هدف البحث: الهدف من هذه الدراسة هو تقييم أثر استخدام تطبيق الهاتف المحمول على مستوى الالتزام بالأنظمة العلاجية لدى مرضى ارتفاع ضغط الدم في قطاع غزة. الطرق والنتائج: استخدمت هذه الدراسة تصميمًا تجريبيًا مع تقييم ما قبل التدخل وبعده. باستخدام مقياس Hill-Bone لقياس مدى التزام مرضى الضغط بعلاجهم علاج، أكمل 191 مشاركًا الدراسة: 94 في المجموعة الضابطة و 97 في مجموعة التدخل. استخدمت مجموعة التدخل تطبيقًا على الهاتف يذكر المشاركين بتناول أدويتهم ، وتذكيرهم بمواعيد المتابعة الخاصة بهم وإرسال معلومات تثقيفية حول إدارة ارتفاع ضغط الدم. بعد 3 أشهر من التدخل ، تم إعادة تقييم مستوى الالتزام بالعلاج. أظهرت النتائج أن المشاركين في كلا المجموعتين أظهروا تحسنًا ملحوظًا في مستويات الالتزام ، مع تحسينات أعلى في مجموعة التدخل في النتيجة الإجمالية بالإضافة إلى جميع النطاقات الثلاثة: الالتزام بالأدوية والنظام الغذائي والحفاظ على المواعيد. استنتاج: أدى استخدام تطبيق الهاتف المحمول إلى تحسينات في الالتزام بعلاج ارتفاع ضغط الدم. وبالتالي ، تؤكد هذه الدراسة الفعالية المحتملة للتكنولوجيا الهواتف المتنقلة في تحسين الالتزام بالعلاج للسيطرة على ارتفاع ضغط الدم وفرصة لتقليل الوفيات والأمراض القلبية الوعائية. ومع ذلك ، يجب أن يكون التبني الأوسع مصحوبًا بالتقييم المستمر والتكامل في أنظمة الصحة العامة.

Introduction. Hypertension is a major health concern, especially in low-income countries. Nonadherence and poor or no persistence in adhering to hypertension treatment regimens result in uncontrolled high blood pressure, increasing rates of mortality and morbidity, and preventable healthcare costs. The aim of this study was to assess the level of adherence and barriers to treatment regimens among hypertensive patients living in the Gaza Strip, Palestine. Methods. A convenience sample of 648 participants completed the Hill-Bone Compliance to High Blood Pressure Therapy Scale. The great majority of participants (n = 521, 80.4%) was highly adherent to their treatment regimen, 123 participants (18.98%) were classified as moderately nonadherent, and 4 (0.62%) participants were classified as highly nonadherent to their hypertension treatment regimen. Participants of this study showed the highest adherence rate to the domain of medication adherence (mean of 1.42 out of 4) followed by appointment keeping (mean 1.8), while they were least adherent to diet (mean of 2.18). The greatest three barriers to adherence to the recommended treatment regimen reported by participants were inability to exercise, inability to resist fast and fried food, and inability to keep themselves away from salty foods. Conclusion. Overall adherence to medication in Gaza was surprisingly good in patients with a diagnosis of hypertension for at least one year. However, adherence to lifestyle advice or dietary regimes remains poor. A combination of interventions using low-cost mobile technology, combined with face-to-face interventions by healthcare professionals, can be applied to improve adherence to hypertension treatment regimens in order to reduce the consequences of uncontrolled blood pressure. مقدمة: ارتفاع ضغط الدم هو مصدر قلق صحي كبير ، لا سيما في البلدان منخفضة الدخل. يؤدي عدم الالتزام وسوء أو عدم الاستمرار في الالتزام بنظم علاج ارتفاع ضغط الدم إلى ارتفاع ضغط الدم غير المنضبط ، وزيادة معدلات الوفيات والحالات المرضية ، وتكاليف الرعاية الصحية التي يمكن الوقاية منها. الهدف من هذه الدراسة هو تقييم مستوى الالتزام والحواجز التي تعترض أنظمة العلاج لدى مرضى ارتفاع ضغط الدم المقيمين في قطاع غزة ، فلسطين. منهجية البحث: أكملت عينة ملائمة من 648 مشاركًا مقياس Hill-Bone Compliance to High Blood Pressure Therapy. . كانت الغالبية العظمى من المشاركين (521 ، 80.4 ٪) ملتزمة للغاية بنظام العلاج الخاص بهم ، وتم تصنيف 123 مشاركًا (18.98 ٪) على أنهم غير ملتزمين إلى حد ما ، وتم تصنيف 4 (0.62 ٪) من المشاركين على أنهم غير ملتزمين بدرجة كبيرة بنظام علاج ارتفاع ضغط الدم . أظهر المشاركون في هذه الدراسة أعلى معدل التزام بمجال الالتزام بالأدوية (متوسط ​​1.42 من 4) متبوعًا بحفظ المواعيد (متوسط ​​1.8) ، بينما كانوا أقل التزامًا بالنظام الغذائي (متوسط ​​2.18). كانت أكبر ثلاثة عوائق للالتزام بنظام العلاج الموصى به والتي أبلغ عنها المشاركون هي عدم القدرة على ممارسة الرياضة ، وعدم القدرة على مقاومة الأطعمة السريعة والمقلية ، وعدم القدرة على إبعاد أنفسهم عن الأطعمة المالحة. استنتاج: كان الالتزام العام بأخذ أدوية الضغط في غزة جيدًا بشكل مدهش لدى المرضى الذين تم تشخيصهم بارتفاع ضغط الدم لمدة عام على الأقل. ومع ذلك ، لا يزال الالتزام بنصائح نمط الحياة أو الأنظمة الغذائية ضعيفًا. يمكن تطبيق مجموعة من التدخلات باستخدام تكنولوجيا الهاتف المحمول منخفضة التكلفة ، جنبًا إلى جنب مع التدخلات وجهًا لوجه من قبل المتخصصين في الرعاية الصحية ، لتحسين الالتزام بنظم علاج ارتفاع ضغط الدم من أجل تقليل عواقب ضغط الدم غير المنضبط.

A Zevatron is an accelerator scheme envisaged to accelerate particles to ZeV energies (1 ZeV = 1021 eV). Schemes, most notably the internal shock model, have been proposed to explain the acceleration of ultra-high-energy cosmic-ray particles that have been sporadically detected reaching Earth since 1962. Here, the cyclotron auto-resonance acceleration (CARA) mechanism is tailored and used to demonstrate the possible acceleration of particles ejected as a result of violent astrophysical processes such as the merger of a binary system or a supernova explosion. Such events result in emission of highly energetic particles and ultra-intense beamed radiation. In the simultaneous presence of a super-strong magnetic field, the condition for cyclotron auto-resonance may be met. Thus CARA can act like a booster for particles pre-accelerated inside their progenitor by shock waves, possibly among other means. As examples, it is shown that nuclei of hydrogen, helium, and iron-56, may reach ZeV energies by CARA, under which conditions the particles, while gyrating around the lines of an ultra-strong magnetic field, also surf on the waves of a super-intense radiation field. When radiation-reaction is taken into account, it is shown that the ZeV energy gained by a particle can fall off by less than an order of -magnitude if the resonance condition is missed by roughly less than 20%.

Marwan Mosleh, 1, 2 Yousef Aljeesh, 3 Koustuv Dalal, 1, 4 Charli Eriksson, 5 Heidi Carlerby, 1 Eija Viitasara 1 1Department of Health Sciences (HLV), Public Health Science, Mid Sweden University, Sundsvall, Sweden; 2Ministry of Health, Gaza, Palestine; 3International Public Health Medicine, Islamic University, Gaza, Palestine; 4Department of Epidemiology, Biostatistics, and EBM; Faculty of Medicine and Health Care, Al-Farabi Kazakh National University, Almaty, Kazakhstan; 5Department of Public Health, Stockholm University, Stockholm, SwedenCorrespondence: Marwan Mosleh Tel +970599859122Email Marwan.mosleh@miun.seBackground: Palestine, like other low-income countries, is confronting an increasing epidemic of non-communicable disease (NCD) and trend of war injury. The management of health problems often presents a critical challenge to the Palestinian health system (PHS). Understanding the perceptions of healthcare providers is essential in exploring the gaps in the health system to develop an effective healthcare intervention. Unfortunately, health research on management of NCD and war injury has largely been neglected and received little attention. Therefore, the study aimed to explore the perspectives of healthcare providers regarding NCD and war injury management in the PHS in the Gaza Strip.Methods: A qualitative study approach was used, based on four focus group discussions (FGDs) involving a purposive sampling strategy of 30 healthcare providers from three main public hospitals in Gaza Strip. A semi-structured topic guide was used, and the focus group interviews data were analyzed using manifest content analysis. The study was approved by the Palestinian Health Research Council (PHRC) for ethics approval.Results: From the healthcare providers perspective, four main themes and several sub-themes have emerged from the descriptive manifest content analysis: functioning of healthcare system; system-related challenges; patients-related challenges; strategies and actions to navigating the challenges and improving care. Informants frequently discussed that despite some positive aspects in the system, fundamental changes and significant improvements are needed. Some expressed serious concerns that the healthcare system needs complete rebuilding to facilitate the management of NCD and war-related injury. They perceived important barriers to effective management of NCD and war injury such as poor hospital infrastructure and logistics, shortage of micro and sub-specialities and essential resources. Participants also expressed a dilemma and troubles in communication and interactions, especially during emergencies or crises. The informants stressed the unused of updated clinical management guidelines. There was a consensus regarding poor shared-care/task sharing, partnership, and cooperation among healthcare facilities.Conclusion: Our findings suggest that fundamental changes and significant reforms are needed in the health system to make healthcare services more effective, timely, and efficient. The study disclosed the non-use of clinical guidelines as well as suboptimal sectorial task-sharing among different stakeholders and healthcare providers. A clear and comprehensive healthcare policy considering the gaps in the system must be adopted for the improvement and development of care in the PHS.Keywords: NCD, management, Palestinian health system, perception, war injury

Background This trial aimed to evaluate the effectiveness of motivational interviewing (MINT) among medication non-adherent hypertensive patients attending primary healthcare centres in Gaza Strip. Methods and results A clustered randomized controlled trial was run among 355 hypertensive participants; who were identified as non-adherent by a self-reported adherent scale and were recruited from 10 centres by two stages cluster random sampling approach (five centres were randomly allocated to each group). Standard of hypertension care was provided to 173 participants, parallel to 182 one who received their standard of care including non-blinded MINT sessions for 3 months. The change in medication adherence status was the primary outcome and within-patient changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), self-efficacy and intrinsic motivation were the secondary outcomes. Data were collected via an interview-based structured questionnaire and were analysed by generalizing equation estimation model adjusting for covariates. The results showed a significant improvement in medication adherence status among participants in the intervention group (n = 159) [OR= 6.28; 95% confidence interval (CI): 3.20, 12.33; P Conclusion Standard of care including MINT is an effective client-centred approach which promoted medication adherence, decreased mean blood pressure, and improved self-efficacy and intrinsic motivations among hypertensive patients.

The study aimed to evaluate the effectiveness of cognitive behaviour therapy (CBT) program in reinforcing motivation to change among patients with substance use disorders (SUDs) in the Gaza Strip. The experimental design was used, Participants were 30 males distributed randomly into two groups: experimental and control, (n = 15) per group, using a random sampling method. The experimental group was subjected to a CBT program consisting of (16) sessions over two months. The control group did not undergo any program. Motivation to change scale was applied pre, post- and after two months of follow up. The study shows that weight mean for motivation to change in the pre-experimental group equals to 49.4% and the weight mean post-experimental group equals 65.07%, in another hand, the weight mean in pre-control group equals 41.8% and the weight mean post- control group equals 41.3%. The study found P-value equals 0.000, which is less than 0.05 in both groups in the posttest. Also, p-value 0.001 “ which is less than 0.05 in pre-test and post-intervention. Besides, the effect size for the CBT program in motivation to change equals 24.7%. The results revealed that p-value equals 0.001 which is less than 0.05 in post-test and follow-up, the results proved the significant effectiveness of CBT and its survival, The study conclude that CBT sessions have been effective and successful in reinforcing the motivation to change among patients with SUDs. Keywords: Cognitive Behaviour Therapy; Motivation to change; Substance Use Disorders الملخص هدفت الدراسة إلى تقييم فاعلية برنامج العلاج السلوكي المعرفي (CBT) في تعزيز الدافعية للتغيير لدى مرضى اضطرابات تعاطي المخدرات (SUDs) في قطاع غزة. تم استخدام التصميم التجريبي حيث بلغ عدد المشاركين 30 ذكر موزعين عشوائياً على مجموعتين: التجريبية والضابطة (عدد = 15) لكل مجموعة باستخدام طريقة أخذ العينات العشوائية. خضعت المجموعة التجريبية لبرنامج العلاج المعرفي السلوكي المكون من (16) جلسة على مدى شهرين. لم تخضع المجموعة الضابطة لأي برنامج. تم تطبيق الدافع لتغيير المقياس قبل وبعد شهرين من المتابعة. أظهرت الدراسة أن متوسط ​​الوزن للدافع للتغيير في المجموعة قبل التجريبية يساوي 49.4٪ ومتوسط ​​الوزن لمجموعة ما بعد التجربة 65.07٪ ومن ناحية أخرى متوسط ​​الوزن في المجموعة الضابطة 41.8٪ والوزن. متوسط ​​المجموعة الضابطة يساوي 41.3٪. وجدت الدراسة أن القيمة الاحتمالية تساوي 0.000 ، وهي أقل من 0.05 في كلا المجموعتين في الاختبار البعدي. أيضًا ، القيمة الاحتمالية 0.001 "وهي أقل من 0.05 في الاختبار القبلي وبعد التدخل. إلى جانب ذلك ، فإن حجم تأثير برنامج العلاج المعرفي السلوكي في الدافع للتغيير يساوي 24.7٪. أظهرت النتائج أن القيمة الاحتمالية تساوي 0.001 أي أقل من 0.05 في الاختبار اللاحق والمتابعة ، وأثبتت النتائج فاعلية العلاج السلوكي المعرفي واستمراره ، وخلصت الدراسة إلى أن جلسات العلاج السلوكي المعرفي كانت فعالة وناجحة في تعزيز الدافع. للتغيير بين مرضى SUDs. الكلمات المفتاحية: علاج السلوك المعرفي. الدافع للتغيير. اضطرابات استخدام المواد المخدرة

Craniopharyngiomas usually involve the sella and suprasellar space. Their occurrence in the posterior fossa without extension to the suprasellar region is uncommon with only 16 cases reported in the literature. We report a case of a primary posterior fossa craniopharyngioma that was managed by complete excision with a good recovery. Our case was unique in that the craniopharyngioma occurred in the fourth ventricle and extended downward to the level of C1, a manifestation that was reported only twice in the past. The literature on the topic is reviewed.