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Abdulsalam M Halboup,1,2 Karem H Alzoubi,3,4 Omar F Khabour,5 Mahmoud A Alomari,6 Moath Refat,7 Abdulrazzaq Y Al-Khazzan,1 Ammar Ali Saleh Jaber,8 Usman Abubakar9 1Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen; 2Discipline of Clinical Pharmacy, University Sains Malaysia, Penang, Malaysia; 3Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates; 4Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; 6Department of Rehabilitation, Jordan University of Science and Technology, Irbid, Jordan; 7Department of Biochemistry and Molecular Biology, Xi’an Jiaotong, University, Xi’an, China; 8Department of Clinical Pharmacy & Pharmacotherapeutics, Dubai Pharmacy College for Girls, Dubai, United Arab Emirates; 9Department of Clinical Pharmacy and Practice, Qatar University, Doha, QatarCorrespondence: Abdulsalam M Halboup, Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen, Tel +967774960247, Email a_halboob@yahoo.com; a.halboup@student.usm.myBackground: Following the coronavirus disease (COVID-19) declaration as a pandemic, Yemen has started applying preventive measures to prevent its spread. This study aims to identify the perception regarding the nature of the COVID-19 disease, susceptibility to severe forms of the disease, and its relationship to seasonal influenza among the population of Yemen.Methods: This was a cross-sectional study of the public in Yemen. The relationship between participants’ sociodemographic factors and their responses was assessed by the chi-square test.Results: A total of 748 participants agreed to participate in the study. Regarding the nature of the diseases, nearly half of the participants (48.8%, n=352) believed that COVID-19 is a naturally occurring human virus that is a serious and fatal disease (61.2%, n=448). The majority (74.9%; n=518) did not agree that bacteria cause COVID-19. More than half of the participants (57.5%, n=423) believed this disease is transmitted to humans through a host animal. Regarding the vulnerable groups to develop severe COVID-19 infection, most of the participants pointed out that the elderly (94.3%, n=705), people with chronic diseases (89.9%, n=669), and pregnant women (53%, n=365) were more susceptible to severe diseases. Regarding symptoms, the majority (61.9%, n=458) of the participants agreed that the symptoms of COVID-19 are similar to those of seasonal influenza. Additionally, the majority (81.9%, n=579) agreed that some individuals develop more severe symptoms than seasonal influenza, particularly those with chronic illness. Gender, age, and education were found to be associated with participants’ perceptions regarding the nature of the virus and susceptibility to severe disease.Conclusion: Participants demonstrate a good understanding of the nature and susceptibility to complications associated with COVID-19 disease and its relationship to influenza. However, the respondents with a lower level of education might require additional educational campaigns to improve their awareness of the disease.Keywords: public perception, COVID-19, susceptibility, complications, Yemen

Omar F Khabour,1 Mahmoud A Alomari,2 Karem H Alzoubi,3 Mahmoud A Alfaqih4 1Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Physical Education, Qatar University, Doha, Qatar; 3Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 4Department of Physiology and Biochemistry, Jordan University of Science and Technology, Irbid 22110, JordanCorrespondence: Mahmoud A AlomariDepartment of Physical Education, Qatar University, Doha, QatarTel +974 4403-5158Email malomari@qu.edu.qaBackground: COVID-19 was declared by the World Health Organization (WHO) as a pandemic and had spread to most of the globe. In the current study, perception regarding the nature of the COVID-19 disease, susceptibility to its complications, and its relationship to seasonal influenza was investigated among the Jordanian population.Methods: This was a survey-based cross-sectional study among public in Jordan.Results: A total of 1863 participants agreed to participate in this questionnaire-based study. The results showed that more than half (55%) of the sample believed that COVID-19 is a naturally occurring virus which causes a serious and possibly fatal disease (50.7%). The majority (62.9%) did not accept that this disease is actually caused by bacteria, or is similar to seasonal influenza. Interestingly, 45.0% of the sampled population felt that the COVID-19 virus was engineered in the lab. Most of the participants (95%) agreed that the elderly or individuals with chronic illnesses such as diabetes and heart disease were more susceptible to severe COVID-19 infections. With respect to symptoms, about two-thirds of the participants (65.2%) felt that the symptoms of COVID-19 are to a large extent similar to those of seasonal influenza. In addition, the majority (82.7%) believed that only some COVID-19 patients develop symptoms that can be described as severe. Factors such as age, gender, and education were found to modulate some of the perceptions of Jordanians regarding different aspects of COVID-19 disease.Conclusion: The majority of Jordanians have a good perception about the nature, cause and symptoms of COVID-19 disease.Keywords: perception, COVID-19, susceptibility, complications, Jordan

Mahmoud A Alomari,1 Omar F Khabour,2 Karem H Alzoubi3 1Department of Physical Education, Qatar University, Doha, Qatar; 2Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, JordanCorrespondence: Mahmoud A Alomari Department of Physical EducationQatar University, Doha, QatarEmail malomari@qu.edu.qaBackground: Coronavirus disease 19 (COVID-19) has compelled implementing confinement measure across the globe. These measures can potentially lead to many changes in lifestyle. However, no studies examined the effect of COVID-19-induced confinement on physical activity (PA) and sedentary behavior (SB).Methods: During April and May of 2020, the current study surveyed changes in PA and SB induced by COVID-19 confinement.Results: The participants of the study were 1844. Among the participants who were regularly involved in PA, the majority (41.8– 42.2%) of the participants reported a “decrease” (p< 0.05) in walking, jogging, and sports while the majority (46.3– 53.1%) reported a “no change” (p< 0.05) in swimming, cycling, and weight lifting. With regard to the SB, most of the participants reported an “increase” in watching TV (72.3%), using electronics (82.7%), and logging to social media (81.9%). Additionally, gender, job type, obesity, and being worried to contract the disease were associated (p< 0.05) with changes in PA. On the other hand, age, gender, obesity, job type and income were related (p< 0.05) to changes in SB.Conclusion: Results of the current study might enhance knowledge about the impact of COVID-19 on lifestyle, particularly PA and SB. Subsequently, it can also be used to establish strategies to enhance engagement in activities during the current and future pandemics.Keywords: physical activity, sedentary behavior, confinement, COVID-19, pandemic

Nihaya A Al-sheyab,1,2 Mahmoud A Alomari,3 Audai A Hayajneh,4 Smita Shah5 1Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 3Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan; 4Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan; 5Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Background and aims: There is an urgent need to address the role of healthy diet and behaviors promoting health among school adolescents in order to tailor appropriate interventions in Jordanian schools. This study aims to evaluate the reliability and validity of the Arabic version of Students As LifeStyle Activists (SALSA) survey alongside Jordanian adolescents’ attitudes and perceived barriers to healthy eating and physical activity. Methods: This study uses baseline data from a randomized controlled trial recruiting school students from 29 male and 27 female public high schools that have grades 7 and 8. Cronbach’s alpha and principal components analysis/factor analysis were used to check reliability and validity. Numbers, percentages, and chi square were used to explore healthy diet and physical activities preferences among Jordanian school students and determine gender differences for all evaluated items. Results: The Arabic version-SALSA survey has acceptable Cronbach’s alpha values (>0.78) for most of its scales. Five scales were derived from the Arabic version-SALSA survey using principal components analysis/factor analysis (factors loading above 0.3). A higher proportion of female students agreed that “healthy food makes you more comfortable” compared to male students (44% vs 36%, P

Nihaya A Al-Sheyab,1 Mahmoud A Alomari,2,3 Omar F Khabour,4 Khulood K Shattnawi,1 Karem H Alzoubi5 1Faculty of Nursing, Maternal and Child Health Department, Jordan University of Science and Technology, Irbid, 22110, Jordan; 2Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan; 3Department of Physical Education, Qatar University, Doha 2713, Qatar; 4Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan; 5Department of Clinical Pharmacy, Jordan University of Science and Technology. Irbid, 22110, Jordan Background: School students’ views and perceptions of informed parental consent and child assent about child participation in research in the Middle East are not known. Methods: Focus group interviews were conducted to understand high school students’ perspectives toward child and adolescent assents and consents in research including the importance of, and depth of information needed in consent and assent, and perception toward written vs verbal consent and assent. Results: The majority of students agreed that it is necessary to take parental approval and that they would not participate in research if their parents refused. Furthermore, the majority of male students agreed that if the research requires only questionnaires to be completed, then child’s approval is sufficient whereas measures, such as blood sugar screening required approval from both the parent and child. Females believed it is enough to provide parental consent to participate in research unless information provided is adequate, then child approval is enough. All students stressed the importance of including detailed information; however, parental consent needs to have more detailed information than child assent. Conclusion: Parts of the students’ perceptions were congruent, whereas other views were not congruent with proper conduct of pediatric research. Such a situation warrants further research and actions. Keywords: informed consent, adolescent, child, Jordan, Middle East

Background: Serum levels of homocysteine (Hcy), folate, and vitamin B12 in healthy elderly persons living at home (EH) and care residences (ER) were evaluated in subjects from Jordan. Methods: Homocysteine, folate, and vitamin B12 serum levels were measured using commercially available kits. Results: The prevalence of hyperhomocysteinemia (HHcy) was 55% in the ER, 22% in the EH, and 8% in the young. Vitamin B12 deficiency was prevalent in 34% of the elderly groups compared to 9% in the young group. Similarly, the folate deficiency prevalence was 55% and 23% in the ER and EH respectively, whereas it was 13% in the young group. Homocysteine concentration negatively correlated with vitamin B12 in EH males and females, while it negatively correlated with folate in the EH and the young of both genders. Conclusion: Hyperhomocysteinemia and low folate was more prevalent in the ER than in the EH and younger individuals. [ABSTRACT FROM AUTHOR]

Background Plantar fasciitis is characterized by heel pain and is often associated with extended periods of walking or standing, improper footwear, and biomechanical imbalances. This condition primarily affects the bottom of the foot, particularly the area where the heel meets the arch. Despite its prevalence, the potential systemic effects, especially the relationship with cardiovascular disease (CVD) risk factors, require further illumination. This study explores the association between chronic plantar fasciitis and elevated C-reactive protein (CRP) levels in individuals with cardiovascular risk factors. Methods A cross-sectional study of 400 patients with foot or ankle pain was initially assessed clinically and with ultrasound or MRI scans. After excluding those with confounding factors for elevated CRP, 295 patients with concurrent diabetes, hypertension, or dyslipidemia were analyzed. We investigated the correlation between plantar fasciitis and elevated CRP levels, defined as >1 mg/L, in the context of cardiovascular risk assessment. Results The study indicated that nearly half of the patients suffering from foot or ankle pain were diagnosed with plantar fasciitis, accounting for 47.8% of cases. A statistically significant association was observed between plantar fasciitis and elevated CRP levels (p=0.035). Furthermore, a substantial correlation was found between high BMI and plantar fasciitis, but no gender-specific disparity was noted. Elevated CRP levels were significantly associated with diabetes, hypertension, and dyslipidemia. Discussion A definitive cause-and-effect relationship between plantar fasciitis and systemic inflammation has not been established; our study suggests that chronic plantar fasciitis may be more than a localized condition and could be indicative of systemic inflammation, which is known to be a factor in atherosclerosis and CVD. The observed correlation between increased CRP levels and plantar fasciitis suggests that plantar fasciitis might be a clinical indicator of systemic inflammation and could improve the assessment of CVD risk. Conclusions Elevated levels of CRP, associated with chronic plantar fasciitis, suggest a link to systemic inflammation, which could elevate the risk of CVD. Identifying plantar fasciitis as a marker for systemic inflammation in patients with CVD risk factors, including diabetes, hypertension, and dyslipidemia, underscores the importance of thorough cardiovascular evaluations in individuals with persistent heel pain. Further longitudinal and interventional research is essential to substantiate these preliminary findings and understand their impact on CVD risk management and treatment., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Faisal Specialist Hospital and Research Center Research Ethics Committee issued approval RAC#2241149. The research project was conducted according to the ethical principles contained in the Declaration of Helsinki (2000), the WHO Operational Guidelines for Ethical Committees that Review Biomedical Research (2000), the International Ethical Guidelines for Biomedical Research Involving Human Subjects (2002), and the policies of the Research Advisory Committee (RAC) at King Faisal Specialist Hospital and Research Centre, as well as the laws of the Kingdom of Saudi Arabia. The data collected and all files related to the research project were locked in a secure location in the Department of Family Medicine. They were made available to the RAC as per the guidelines of KFSH&RC. The study proposed no additional interventions for patients. The proposal was primarily about collecting data, and no clinical interventions were planned. The study posed no risk to patients; the risk-benefit ratio was considered favourable. The information was kept completely anonymous. The datasheet did not use the patients' names or medical record numbers. Instead, UPN codes were used to ensure confidentiality and privacy. Despite this, verbal consent was obtained from every patient in the study as information was taken from their medical records. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Elabd et al.)

BACKGROUND Familial hypomagnesemia with secondary hypocalcemia (HSH) is a rare autosomal recessive disorder (OMIM# 602014) caused by mutations in the gene encoding transient receptor potential melastatin 6 (TRPM6)) on chromosome 9q22, a channel involved in epithelial magnesium resorption. While a plethora of studies have delineated various clinical manifestations pertinent to this mutation, the literature is devoid of connections between TRPM6 mutations and bleeding diathesis, or sudden infant death syndrome (SIDS). This report presents a case of familial HSH associated with the novel homozygous TRPM6 gene variant c.5281C>G p. (Arg1761Gly) chr9: 77354845. CASE REPORT This report details a 26-day-old neonate, born full term with optimal Apgar scores, who experienced an abrupt emergence of apnea, cyanosis, bilateral nasal bleeding, and diminished alertness. Despite the neonate's initially unremarkable clinical birth indicators, a meticulous assessment unveiled a pronounced family history of SIDS, including a sibling previously diagnosed with hypomagnesemia. Laboratory examination of the infant demonstrated severe hypomagnesemia and hypocalcemia, conditions which were promptly ameliorated following intravenous administration of magnesium and calcium. Whole-exome sequencing identified a homozygous TRPM6 gene mutation c.5281C>G p. (Arg1761Gly) at chr9: 77354845. This gene is crucial for magnesium regulation. The mutation involves a cytosine-to-guanine shift, resulting in an arginine to glycine amino acid substitution at position 1761 of the TRPM6 protein. CONCLUSIONS This report has highlighted that infantile hypomagnesemia may be associated with symptoms and signs that can mimic infection, or it can present with seizures. Although familial HSH is a rare genetic disorder that can be identified by genetic testing, correction of hypomagnesemia is the most important and immediate clinical management strategy.

Background: People with Parkinson's (PwP) are suffering from reduced exercise capacity. However, little information is known about clinical correlates of exercise capacity in this population., Objective: This study aimed to evaluate correlations between motor and non-motor symptoms with exercise capacity in PwP., Methods: A total of 50 individuals with Parkinson's disease participated in the study. Exercise capacity was measured by 6 minutes' walk test (6MWT). Besides, the Movement Disorder Society-Unified Parkinson's Disease Rating Scale-Part III used to evaluate disease motor severity, Berg Balance Scale to assess balance, Montréal Cognitive Assessment to evaluate cognitive status, hospital anxiety and depression scale to assess depression and anxiety, Modified Fatigue Impact scale to evaluate fatigue, and the Pittsburgh Sleep Quality Index to evaluate sleep quality., Results: The results showed that exercise capacity, when measured by the 6MWT, can be significantly predicted by balance, disease motor severity, anxiety, and age (R 2  = 0.61 P < .0001)., Conclusion: These results suggest that exercise capacity in PwP is multifactorial and can potentially be predicted by balance, motor severity, anxiety, and age.

The researchers examined emotional status subsequent to changes in physical (PA) and sedentary (SA) activities during "lenient" COVID-19 prevention protocols that allowed being outdoors. Emotions, PA, and SA were collected from 272 women and 145 men in Qatar. The researchers showed a decrease ( p  < 0.05) in PA and an increase ( p  < 0.05) in SA participation during the pandemic. These alterations were different ( p  < 0.05) between genders and associated ( p  < 0.05) with emotional status during the COVID-19-induced confinement, but only ( p  < 0.05) in men. The "mitigating" role of PA for the adverse emotional effects of the pandemic is demonstrated, especially among men. Therefore, "lenient" regulations should be considered around the globe during future pandemics for adequate PA and emotional wellbeing. However, plans should incorporate additional tactics to PA to manage emotional status among women.

Background: Various aspects of lifestyle seem to change during confinement, particularly during the COVID-19 pandemic. The current study examines confinement's effects on tobacco smoking habits (SH)., Methods: A survey was distributed among adults living in Jordan (age >18 years) of both genders during April-May of 2020, of which 1925 responded to the survey., Results: The prevalence of smoking was 33.3%, 46.1%, and 21.1% for cigarettes (Cg), waterpipe (Wp), and E-cigarettes (ECg), respectively. Among the smokers, 38.5-45.8% reported a "no-change," while 32.1-41.7% reported a "decrease" in SH during confinement. On the other hand, 18.0-22.1% reported an "increase" in the SH. However, concerning the factors that might affect SH, the results showed that age, gender, income, and job sector contribute to the observed changes., Conclusions: Changes in the SH during COVID-19 have been reported in about 50% of participants who smoke tobacco, with a more reported decrease than increase in use. Studies and interventions are needed to confirm further and understand the current results and discourage smoking during the COVID-19 pandemic., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Alomari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The COVID-19 pandemic was detrimental to lifestyle and behavior. In this investigation, changes in reading habits during the pandemic were examined., Methods: The study is cross-sectional and survey-based. 1844 individuals completed an online survey about sociodemographic and reading habits during COVID-19. Multinomial logistic regression was used to examine the relationship between the study variables., Results: Most of the participants were active readers (71.5%-83.2%). Fewer (13.8-18.0%) reported a decrease in reading, while about half reported a no change, and 1/3 rd reported an increase. Changes in reading habits were related to age, education, job type, and income., Conclusion: About half of the participants during the pandemic reported a change in reading habits. Interventions to further enhance reading among people during the pandemic might help ameliorate the negative impacts of the pandemic., Competing Interests: The authors declare no conflict of interest, financial or otherwise., (© 2023 Alomari et al.)

Head-mounted displays (HMDs) have the potential to greatly impact the surgical field by maintaining sterile conditions in healthcare environments. Google Glass (GG) and Microsoft HoloLens (MH) are examples of optical HMDs. In this comparative survey related to wearable augmented reality (AR) technology in the medical field, we examine the current developments in wearable AR technology, as well as the medical aspects, with a specific emphasis on smart glasses and HoloLens. The authors searched recent articles (between 2017 and 2022) in the PubMed, Web of Science, Scopus, and ScienceDirect databases and a total of 37 relevant studies were considered for this analysis. The selected studies were divided into two main groups; 15 of the studies (around 41%) focused on smart glasses (e.g., Google Glass) and 22 (59%) focused on Microsoft HoloLens. Google Glass was used in various surgical specialities and preoperative settings, namely dermatology visits and nursing skill training. Moreover, Microsoft HoloLens was used in telepresence applications and holographic navigation of shoulder and gait impairment rehabilitation, among others. However, some limitations were associated with their use, such as low battery life, limited memory size, and possible ocular pain. Promising results were obtained by different studies regarding the feasibility, usability, and acceptability of using both Google Glass and Microsoft HoloLens in patient-centric settings as well as medical education and training. Further work and development of rigorous research designs are required to evaluate the efficacy and cost-effectiveness of wearable AR devices in the future.

Background: Waterpipe smoking (WP) exposure involves a negative health impact, including memory deficit, which is attributed to the elevation of oxidative stress. Vitamin E (VitE) in combination with swimming exercise exerts protective effects that prevent memory impairment. In the current study, the modulation of WP-induced memory impairment by the combined effect of VitE and swimming exercise (SE) was investigated., Methods: Animals were exposed to WP one hour/day, five days per week for four weeks. Simultaneously, VitE (100 mg/kg, six days/week for four weeks) was administered via oral gavage, and the rats were made to swim one hour/day, five days/week for four weeks. Changes in memory were evaluated using radial arm water maze (RAWM), and oxidative stress biomarkers were examined in the hippocampus., Results: WP exposure induced short-term/long-term memory impairment (p<0.05). This impairment was prevented by a combination of VitE with SE (p<0.05). Additionally, this combination normalized the hippocampal catalase, GPx, and GSH/GSSG ratios that were modulated by WP (p<0.05). The combination further reduced TBARs levels below those of the control group (p<0.05)., Conclusion: WP-induced memory impairments were prevented by the combination of VitE with SE. This could be attributed to preserving the hippocampal oxidative mechanism by combining VitE and SE during WP exposure., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Parkinson's disease is a neurodegenerative disease manifested as increased tremor, bradykinesia, rigidity, and postural instability. Brain-derived neurotrophic factor (BDNF) is essential for neurocognitive function. However, its cardiometabolic effect has recently been identified in health and disease, but not in PD. Therefore, the current study examined the relationship of BDNF with glucose and lipid profile., Methods: This was a cross sectional comparative study where PD patients (n = 26) and age-matched healthy controls (n = 27) were recruited. Blood samples were drawn to determine BDNF, glucose, and lipid profile including total cholesterol (TC), HDL, LDL, triglyceride (TriG)., Result: The linear regression showed that BDNF predicted 11.9 % of TC (p = 0.05), 3.0 % of HDL (p = 0.003), 27.3 % of LDL (p = 0.006), 16.6 % of TriG (p = 0.04), 15.8 % of TC/HDL (p = 0.06), 22.1 % of TC/LDL (p = 0.01), and 35.1 % of TriG/HDL (p = 0.001) but not glucose (B = -0.006; CI = -0.19/0.18; F = 0.005; p = 0.9) and LDL/HDL (B = 0.06; CI = -0.17/0.3; F = 0.3; p = 0.6). Subsequent ANCOVA revealed differences (p < 0.05) in TC, HDL, LDL, TC/LDL, and TriG/HDL but not in glucose, TriG, and TC/HDL among the patients with low-BDNF versus high-BDNF., Significance: The results demonstrate a relationship of BDNF with lipid profile suggesting the importance of BDNF for lipid metabolism in PD., Competing Interests: Declaration of competing interest None., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to evaluate dietary habits (DH) and eating behaviors (EB) among adults during confinement induced by COVID-19 in Jordan., Method: In this cross-sectional study, an online survey designed to assess the change in DH and EB during April and May 2020 was distributed using various social media platforms., Results: The survey was completed by a total of 1844 adult (18-72 years) participants from the public in Jordan. The results indicated an increase (42.5-61.8%) in most of the DH and EB examined in the current study in the majority of participants. Among these changes, they have increased (p < 0.05) the prevalence of fruit and vegetable, immune boosters, water, and hot beverage consumption, as well as decreased (p < 0.05) eating in restaurants and fatty food consumption, indicating a positive change. Conversely, a larger (p < 0.05) proportion of participants reported increased consumption of high-calorie food and late-night eating, indicating a risky behavior for obesity and subsequent chronic complications. Additionally, age, sex, obesity, education, income, and type of job appeared to contribute (p < 0.05) to changes in DH and EB. Overall, confinement caused by COVID-19 appears to compel adults to adopt a specific DH and EB. Although most of these changes were positive, some were negative., Conclusion: This study provides essential information for designing subpopulation recommendations and developmental programs for adults under such conditions., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

The current study investigates different methods to minimize the drag coefficient (C D ) without ignoring the safety factor related to the stability of a vehicle, i.e., the lift coefficient (C L ). The study was carried out by employing an SUV car analyzed numerically using one of the CFD software, Ansys. Four different models such as realizable k-ε, standard k-ω, shear stress transport k-ω, and Reynolds stress model (RSM). The considered models have been validated with experimental data and found in good agreement. The considered inlet velocity varies from 28 to 40 m/s, the results showed that the drag coefficient and the stability are both improved by applying a modification on the roof of the considered car., (© 2022. The Author(s).)

Background: Validated outcome measures are essential for assessment and treatment of children with disabilities. The Children's Hand-use Experience Questionnaire (CHEQ) was developed and validated for use in Western countries for children with unilateral hand dysfunction. This study aimed to perform a cross-cultural adaptation and investigate reliability for the Arabic CHEQ., Methods: Translation and cross-cultural adaptation were performed in four phases: (i) forward-translation and reconciliation with feedback from parents and typically developing children from Jordan ( n = 14); (ii) backward-translation and review; (iii) cognitive debriefing with parents and/or their children with unilateral hand dysfunction ( n = 17); and (iv) review and proofreading. In the psychometric analyses, 161 children from Jordan (mean age [SD] 10y 8 m [5y 8 m]; 88 males) participated. Internal consistency was evaluated with Cronbach's alpha. Test-retest reliability was evaluated in 39 children with intraclass correlation coefficient (ICC) and weighted kappa (κ)., Results: Synonyms of four words were added to accommodate for different Arabic dialects. On average, 93% of children with unilateral hand dysfunction and their parents understood the CHEQ items. One response alternative, ' Get help ', to the opening question was unclear for 70% of the respondents and need further explanation. Two items about using a knife and fork were difficult to comprehend and culturally irrelevant. High internal consistency was demonstrated (Cronbach's alphas 0.94- 0.97) and moderate to excellent ICC (0.77-0.93). For 18 individual items, κ indicated poor to good agreement (κ between 0.28 and 0.66)., Conclusions: After the suggested minor adjustments, the Arabic CHEQ will be comprehensible, culturally relevant and reliable for assessing children with unilateral hand dysfunction in Jordan., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2022.)

COVID-19 pandemic is associated with negative impacts on mental health. The study investigated mental health measures that include depression, stress, and anxiety, and their correlation with gender and age among Jordanians in the COVID-19 era. This investigation adopted a quantitative, cross-sectional, and descriptive design and included 1587 subjects recruited through a convenient sampling approach. Jordanians (≥18 years old) were recruited in the study. The total DASS score of the whole sample was 32.7 ± 0.67. The DASS scale showed significantly high scores for stress, anxiety, and depression in the groups that perceived a moderate-high probability of infection with COVID-19 (P < 0.05). The stress score was greater (P < 0.001) in the men (11.39 ± 0.469) compared to the women (10.74 ± 0.33). On the other hand, anxiety and depression scores were higher in women than men (8.13 ± 0.25, and 12.71 ± 0.30 respectively). Finally, DASS total score significantly decreased with the increasing age of the participants (P < 0.001). Many Jordanians experienced moderate to severe depression, stress, and anxiety during the COVID-19 era. Such experience was associated with the sex and age of subjects. The results of this study will benefit decision-makers in establishing a plan to prevent the consequences of these mental disorders during pandemics., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Background: Coronavirus disease (COVID19) is an ongoing pandemic, which forced governments across the globe to implement confinement measures to limit the spread of the disease. These measures have impacted the daily life and psychological status of people. However, no studies have examined the relationship between changes in psychological status with reading habits during the COVID19 pandemic., Objectives: The study aims at examining the relationship between changes in reading habits and negative emotional states., Method: The psychological status was measured using the Depression, Anxiety, Stress Scales (DASS). In addition, the participants reported changes in four types of reading experiences during COVID19 confinement. These reading types are specialized, general knowledge, story/novels, and religious material. An internet-based survey was used to collect the data among adults., Results: A total of 1711 individuals participated in the study. About 60.0%, 55.1%, 60.5% and 61.0% reported participating in scientific, religious, general, and novel reading, respectively. Additionally, the ANOVA revealed differences ( p  < 0.05) in DASS scores according to the changes in scientific, religious, newspaper, and novel/story reading. Subgroup post hoc comparisons showed that DASS scores were associated with a no-change or increase in all types of reading habits indicating a main effect of emotional state on all types of reading., Conclusions: Current results might suggest that the participants who experienced greater negative emotions, tended to either not change or increase their reading habits. Additionally, individuals with lower negative emotion scores reported a decrease in reading during the COVID19 pandemic., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Mental health is strongly affected by physical (PA) and sedentary (SA) activity. In the current study, the relationships of PA and sedentary activity (SA) with mental status amid confinement caused by COVID-19 were examined. The study is self-reporting, survey-based, and cross-sectional in design. The study was conducted in Jordan and included 1744 participants (≥18 years old). The participants' mental status was obtained using the Depression-Anxiety-Stress Scale (DASS). The results showed involvement in both PA and SA during COVID-19-induced confinement. The involvement includes walking (77.2%), running (70.3%), cycling (84.9%), swimming (83.1%), sports (82.9%), weightlifting (86.4%), watching TV (79.4%), using electronics (86.3%), and logging to social media (85.1%). Lower DASS scores were associated ( p  < 0.05) with lower walking, running, and weightlifting but not ( p  > 0.05) with cycling and swimming PA. Additionally, DASS scores ( p  < 0.05) were associated with changes in television viewing but not ( p  > 0.05) with electronics and social media use during confinement. In conclusion, individuals who experienced higher levels of stress, anxiety, and depression were more likely to turn to more PA and less SA. These findings are important and suggest that individuals during confinement find PA a useful strategy to mitigate the negative mental effects of the pandemic., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Sleep can significantly modulate the immune response to infectious agents. In the current study, changes in sleep quality during COVID-19-induced confinement among adults were investigated. This was a cross-sectional survey study of the public using social media. Participants (n = 1846) were recruited in the study, of which >92% reported a variety of confinement procedures such as self-quarantine, physical distancing, banning of public events, school closure, and lockdown. Majority of the participants (53-59%) reported an increase in most of the sleep parameters except a decrease (49.1%) in daytime sleep. Age was associated with changes in sleeping disturbances during COVID-19 confinement ( p < 0.001). Young participants were more likely to experience sleeping disturbance than older ones ( p < 0.05). In addition, gender ( p < 0.001) is an independent predictor of nighttime sleeping. Being a male is associated with a "decrease" and being a female is associated with an "increase" in nighttime sleeping hours ( p < 0.05). Moreover, change in daytime sleeping was related to age, gender, and job type ( p < 0.05). In conclusion, changes in sleep quality during COVID-19-induced confinement were reported. Intervention programs and strategies are warranted to further improve sleep during the current and future disease-induced confinement., Competing Interests: The authors declare no conflict of interest., (© 2021 The Author(s).)

Background: One possible reason for increased mortality due to SARS-CoV-2 in patients with diabetes is from the complication of diabetic ketoacidosis (DKA)., Objectives: To re-evaluate the association of SARS-CoV-2 and development of DKA and analyse the demographic and biochemical parameters and the clinical outcomes in COVID-19 patients with DKA., Design: A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed., Methods: Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature) were searched from 1 December 2019 to 30 June 2021 in the English language using the following keywords alone or in combination: COVID-19 OR SARS-CoV-2 AND diabetic ketoacidosis OR DKA OR ketosis OR ketonemia OR hyperglycaemic emergency OR hyperglycaemic crisis. We included studies in adults and children of all ages in all healthcare settings. Binary logistic regression model was used to explore the effect of various demographic and biochemical parameters variables on patient's final treatment outcome (survival or death)., Results: Of the 484 papers that were identified, 68 articles were included in the systematic review and meta-analysis (54 case report, 10 case series, and 4 cohort studies). Studies involving 639 DKA patients with confirmed SARS-CoV-2 [46 (7.2%) were children and 334 (52.3%) were adults] were analyzed. The median or mean patient age ranged from < 1 years to 66 years across studies. Most of the patients (n = 309, 48.3%) had pre-existing type 2 diabetes mellitus. The majority of the patients were male (n = 373, 58.4%) and belonged to Hispanic (n = 156, 24.4%) and black (n = 98, 15.3%) ethnicity. The median random blood glucose level, HbA1c, pH, bicarbonate, and anion gap in all included patients at presentation were 507 mg/dl [IQR 399-638 mg/dl], 11.4% [IQR 9.9-13.5%], 7.16 [IQR 7.00-7.22], 10 mmol/l [IQR 6.9-13 mmol/l], and 24.5 mEq/l [18-29.2 mEq/l]; respectively. Mortality rate was [63/243, 25.9%], with a majority of death in patients of Hispanic ethnicity (n = 17, 27%; p = 0.001). The odd ratios of death were significantly high in patients with pre-existing diabetes mellitus type 2 [OR 5.24, 95% CI 2.07-15.19; p = 0.001], old age (≥ 60 years) [OR 3.29, 95% CI 1.38-7.91; p = 0.007], and male gender [OR 2.61, 95% CI 1.37-5.17; p = 0.004] compared to those who survived., Conclusion: DKA is not uncommon in SARS-CoV-2 patients with diabetes mellitus and results in a mortality rate of 25.9%. Mortality key determinants in DKA patients with SARS-CoV-2 infection are individuals with pre-existing diabetes mellitus type 2, older age [≥ 60 years old], male gender, BMI ≥ 30, blood glucose level > 1000 mg/dl, and anion gap ≥ 30 mEq/l., (© 2021. The Author(s).)

Background: Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population., Objectives: To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases., Design: A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed., Methods: Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses., Results: Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I 2  = 81%, p =  < 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I 2  = 99%, p =  < 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I 2  = 85% versus 2.8, 95% CI 0.0 to 5.7, I 2  = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I 2  = 99% versus 63.8, 95% CI 0.0 to 151.8, I 2  = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger's tests confirmed asymmetry by producing p values < 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important., Conclusion: The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination., (© 2021. The Author(s).)

The beneficial effects of exercise training on memory formation are well documented. However, the memory enhancement profile following the time-course of exercise training remains unknown. In this investigation, changes in the spatial hippocampal memory following a time-course of swimming exercise training were examined. Young adult Wistar rats were tested for both short-term and long-term memories using the radial arm water maize (RAWM) paradigm following 0, 1, 7, 14, and 28 days of swimming exercise training (60 min per day, 5 days/week)s. The mean total errors on RAWM during the learning phase and memory testing remained the same (p > 0.5) after 1 day of swimming exercise. On the other hand, swimming exercise-induced significant enhancement to the learning phase and memory formation after 7 days of training (p < 0.01). Errors decreased (p < 0.0001) after 7 days of training and remained lower (p < 0.0001) than baseline without differences between 7, 14, and 28 days (p > 0.5). Similarly, short- and long-term memories improved after 7 days (p < 0.05) of training as compared to the baseline without differences between 7, 14, and 28 days (p > 0.05). The time course of improvement of learning and both short- and long-term memories after swimming exercise were evident after 7 days and plateaued thereafter. Results of the current study could form the base for future utilization of exercises to enhance cognitive function in healthy individuals., (© 2021 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Introduction: Ferritin has been implicated in body physiology and pathology. Smoking cigarettes (Cg) alters ferritin metabolism. Waterpipe (Wp) smoking has recently reemerged as a global epidemic and is linked to the most devastating diseases. However, the effect of smoking Wp on ferritin is not known. Therefore, the current study compared plasma ferritin in adolescents smoking Cg, Wp, both (CgWp) versus never smoked., Material and Methods: Self-reported smoking status and plasma ferritin levels were obtained from 849 boys ( n = 470) and girls ( n = 379) in the 7 th -10 th grade (age range = 13-17 years)., Results: The ANCOVA revealed a main effect for gender ( p < 0.000) and smoking status ( p < 0.02) without an interaction effect ( p > 0.9). Post-hoc analysis showed greater plasma ferritin in the adolescents smoking Wp ( p < 0.03) and CgWp ( p < 0.004) versus never smoked. Gender-stratified ANCOVA showed a main effect for smoking status in the boys ( p < 0.02) and girls ( p < 0.03). Additional comparisons among the boys showed greater plasma ferritin in the Wp ( p < 0.006) and CgWp ( p < 0.008) smoking groups versus never smoking, without differences ( p > 0.5) between Wp and CgWp smoking. Another subgroup comparison showed greater plasma ferritin in the girls smoking Cg ( p < 0.02) and CgWp ( p < 0.02) versus never smoking, without a difference ( p > 0.3) between Cg and CgWp smoking., Conclusions: The results indicate that ferritin is elevated in adolescent smokers, particularly the boys smoking Wp and CgWp and in the girls smoking Cg and CgWp., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2021 Termedia & Banach.)

Background: Waterpipe smoking is spreading worldwide, and it is associated with many adverse effects. The aim of this study was to investigate the interaction of waterpipe smoking puffing topography, and related physiological measures, with both gender and level of dependence on waterpipe., Method: Exclusive waterpipe smokers were asked to smoke a single waterpipe session in a specialized laboratory while their smoking topography, and in-breath CO level were recorded pre- and post- smoking. Waterpipe dependence was measured using the LWDS-11 scale., Results: In the high dependence group, the total number of puffs, was greater in men than women. In addition, the average flow rate was greater in men with high compared to low dependence. For inter-puffing intervals, greater values were recorded in men and women with low versus high dependence. No other differences were found between the subgroups in total session time, average puff duration, average puff volume, and maximum flow rate. Pre-smoking CO content and CO boost were greater in men versus women in both dependence groups. Post-smoking CO content was greater in women with high versus low dependence, whereas it was lower in women versus men with low dependence., Conclusions: The current results indicate several effects for waterpipe smoking dependence on smoking topography. Many of these differences were gender dependent with men having higher exposure than women in most aspects., Competing Interests: Declaration of Competing Interest Dr. Eissenberg is a paid consultant in litigation against the tobacco and the electronic cigarette industry. The other authors declare that there is no conflict of interest., (Copyright © 2020 The Author(s). Published by Elsevier B.V. All rights reserved.)

Aims: Brain derived neurotrophic factor (BDNF) is essential for cognitive function. It is also found in non-neuronal tissues with various regulatory actions, including metabolic. Physical fitness (PF) is associated with improved synthesis and secretion of BDNF and reduced obesity. However, the importance of PF for the relationship of BDNF with obesity has not been investigated. This study aims at examining the relationship of PF with BDNF and obesity in 174 young (age = 25.30 ± 9.2 years) healthy adults., Main Methods: Serum BDNF was evaluated using ELISA while obesity was determined using body weight (BW), BMI, and waist circumference (WC). Six minute walk distance (6MWD) test was used to estimate PF., Key Findings: Serum BDNF was greater ( p = 0.000) in the participants with high (Hi6MWD) versus low (Lw6MWD) PF group. Additionally, 6MWD explained 6.8% of serum BDNF. Obesity measures were greater ( p < 0.05) in the participants with low versus high BDNF. In regression analyses, serum BDNF explained 4.7% of BW ( p = 0.004), 3.8% of BMI ( p = 0.011), and 6.2% of WC ( p = 0.001). However, when the participants were divided into Hi6MWD and Lw6MWD, BDNF explained 8.2% of BW ( p = 0.009), 6.0% of BMI ( p = 0.03), and 7.0% of WC ( p = 0.013), only in the Hi6MWD, but not in the Lw6MWD ( p > 0.05) groups., Significance: The finding confirms the relationship of BDNF with obesity. Additionally, it further suggests the importance of PF level to this relationship among young adults. Future studies are needed to confirm these findings., (© 2020 Published by Elsevier Ltd.)

Smoking tobacco and metabolic disorders are global epidemics associated with cardiovascular, immune, respiratory, and metabolic diseases. Cigarette smoking seems to affect metabolic disorders. However, the effect of water pipe (Wp), also called hookah, smoking duration on obesity and lipid profile is still a sparse. The present study examined the relationship of smoking Wp with body weight (Bw), body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), total cholesterol/HDLc, LDLc/HDLc, and triglycerides. Obesity, lipid profile, and smoking status were obtained from a total of 291 participants of which 147 smoked Wp. Smokers were divided into 3 groups: smoked <10 years (Wp1) (n = 72), smoked 10-20 years (Wp2) (n = 43), and smoked >20 years (Wp3) (n = 30). The ANCOVA revealed greater BMI and Bw and lipid profile measures in individuals smoking Wp vs never (P < .01). Additional analysis revealed that Bw and BMI were greater in the women (n = 11) with longer Wp smoking history (P < .05) but not the men (n = 19). In addition, Tc, LDLc, Tc/HDLc, and LDLc/HDLc levels were greater among the men smoking Wp for longer time (P < .05), but not the women. In conclusion, the study found greater obesity and lipid profile in the adults smoked Wp vs never, especially the ones smoked for longer time., (Copyright © 2020. Published by Elsevier Inc.)

Teachers play a vital role in facilitating research in schools. However, teachers' views of informed consent/assent for children participation in research in the Middle East have not been investigated. In this study, focus group interviews were conducted to understand high-school teachers' perspectives toward adolescent assents and consents. The teachers indicated that parent consent is important and should be coupled with sufficient information about the research study. The teachers added that assent is most important for children above 13 years old. Conversely, the teachers believed that parent approval is only important for invasive (such as research involves blood withdrawal) but not simple procedures. Most importantly, for procedures that are considered simple, part of the teachers do not acknowledge the significance of parental approval, such as body weight, or beneficial, such as new treatment. The results indicate that some of the teachers' views were consistent with proper conduction of pediatric research. However, other views were worrisome and might warrant further studies and actions. Risks related need to be assessed and policies needs to be developed in order to ensure the proper conduction of pediatric research., (© 2020 The Authors.)

Background: The effect of concurrent cigarette and waterpipe (i.e. both) smoking on cardiovascular function is still a scarce, especially among adolescents. Objective: Therefore, the study aimed at comparing cardiovascular measures among adolescents smoking cigarettes, waterpipe, or both, versus never smoking. Methods: Self-reported smoking status and cardiovascular measures were obtained from 771 boys ( n  = 475) and girls ( n  = 296) in the 7th-10th grade. Results: Stepwise regression showed that smoking explained ( p  < .05) 4.8% of heart rate, 6.1% of diastolic blood pressure, 3.9% of mean arterial pressure, 2.8% of pulse pressure, and 4.0% of rate pressure products. The gender-stratified one-way (4 smoking group) ANCOVA revealed greater ( p  < .05) heart rate and diminished ( p  < .05) diastolic blood pressure, mean arterial pressure, and rate pressure product in the boys smoking cigarettes, waterpipe, or both versus the ones never smoked, but not in the girls. No differences ( p  > .05) were found between the smoking groups (cigarettes, waterpipe, versus both). Conclusions: The study indicates that cardiovascular measures are equally altered among the boys, but not the girls, smoking cigarettes, waterpipe, or both as compared to the ones never smoked.

Waterpipe tobacco smoking (WP) is associated with a vast range of detrimental health effects, including memory impairment and anti-oxidative scavenging dysfunction. Forced swimming exercise (FSE) is known to improve cognitive function and general wellbeing. In this study, we evaluated the neuroprotective effect of FSE on memory impairment induced by exposure to WP in the rat model. Wistar male rats were divided into four groups: fresh air (control), WP exposure, FSE, and WP/FSE. Animals were exposed to WP for 1 h/day, 5 days/week for 4 weeks. At the same time, animals were forced to swim 1 h/day as 5 min swimming followed by 5 min rest, 5 days/ week for 4 weeks. Spatial learning and memory was assessed using Radial Arm Water Maze (RAWM). Additionally, hippocampal oxidative stress biomarkers including reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG ratio, glutathione peroxidase (GPx), Catalase, and TBARS were analyzed. Key findings: this study showed that WP exposure impaired both short- and long-term memory (P < 0.05). On the other hand, FSE prevented memory impairment induced by WP exposure (P < 0.05). Moreover, WP exposure reduced activity of catalase, GPx, and GSH/GSSG ratio (P < 0.05) in the hippocampus, which were also normalized by FSE. However, no changes were detected in GSH and TBARS levels in WP exposure and/or FSE groups. In conclusion, WP exposure induced both short- and long- term memory impairments, which was prevented by FSE. This improvement in memory function might be attributed to oxidative stress biomarkers pathways., (Copyright © 2019 Elsevier Inc. All rights reserved.)

There is increasing evidence that oxidative stress is a causal factor in different neurodegenerative disorders such as Alzheimer's disease and epilepsy. High-fat diet (HFD) has been shown to induce oxidative stress and neuronal damage that may increase susceptibility to seizures. The present study was undertaken to investigate the relationships between vitamin E, a potent antioxidant, HFD, and chemically induced seizures, using the PTZ seizure model in rats. Animals were randomly assigned into four groups: control, HFD, vitamin E (Vit E), and high-fat diet with vitamin E (HFD + Vit E) group. Vitamin E and/or HFD were administered to animals for 6 weeks. Thereafter, PTZ seizure threshold was measured in control and treated rats, and different brain regions were analyzed for levels of oxidative stress biomarkers. Current results revealed a significant reduction in PTZ seizure threshold in rats consuming HFD, which could be prevented by vitamin E supplement. Alongside, vitamin E supplement prevented HFD induced changes in oxidative stress biomarkers and capacity enzymes. Therefore, current results suggest that prolonged consumption of HFD increases susceptibility to PTZ induced seizures, which may be related to HFD induced oxidative stress. This increase in the PTZ susceptibility could be prevented by the administration of vitamin E, probably through its antioxidant effect, particularly at the brain hippocampal region., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Aims: Tobacco smoking is associated with a vast range of adverse health effects, including diminished cognitive and anti-oxidative capabilities. Conversely, vitamin E (VitE) is known to enhance data acquisition and retention and hippocampal oxidative defense. No studies, however, examined the protective effect of VitE with tobacco administration. Therefore, this study examined the protective effect of VitE on the cognitive and oxidative debilitating effects induced by waterpipe smoking., Materials and Methods: Wistar male rats were divided into four groups: waterpipe smoking, VitE, waterpipe combined with VitE, and control group. The exposure to waterpipe and VitE was for one month and then spatial learning and memory were assesses using Radial Arms Water Maze. Additionally, oxidative stress biomarkers (Catalase, GPx, and TBARS, GSH, GSSG, and GSH/GSSG ratio) were assessed in the hippocampus., Key Findings: The results revealed that waterpipe smoking impaired short-term and long-term memory (P < 0.05). Waterpipe smoking reduced activity of catalase (P < 0.05), GPx (P < 0.05) and GSH/GSSG ratio (P < 0.05) in the hippocampus. Administration of VitE prevented memory impairment and alterations in oxidative stress biomarkers., Significance: waterpipe smoking induces short-term and long-term memory impairments, which were prevented by administration of VitE via its anti-oxidative properties., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Circulatory Ferritin concentration varies with age, sex, and body composition. Studies that determine the relationship of different body weight measurements with plasma ferritin concentration in adolescents are lacking. A descriptive cross-sectional design was utilized. Data collection involved self-reporting demographics, blood samples, and body composition measures for a sample of 814 healthy Jordanian adolescents. Ferritin deficiency was observed in 55.8% of the study population. Simple linear regression showed that BMI, gender, location, and smoking status 2.5%, 3.9%, 0.4%, and 0.4%, respectively, associated positively with plasma ferritin level (p < 0.05). After controlling for gender, location, and smoking status, additional hierarchal multiple linear regression showed that BMI explained 2.2% of plasma ferritin (p < 0.000). However, the obesity-stratified hierarchal multiple linear regression, showed that BMI explained 2.1% of plasma ferritin in the overweight and obese (HI) adolescents (p = 0.02), but not in the under and normal weight (LO) adolescents (p = 0.91). After controlling for gender, location, and smoking status, the ANCOVA showed that plasma ferritin level was greater (p < 0.000) in the HI (19.00 ± 13.6) versus the LO (15.20 ± 10.4) obesity group. Our results indicated that normal ferritin level among obese people does not necessarily indicate normal iron storage.

Waterpipe (Wp) use is associated with most devastating diseases and particularly popular among adolescents. Vascular endothelium growth factor (VEGF) is essential for generating new vessels. The effect of smoking tobacco on VEGF is controversial and unknown among adolescents. Therefore, the current study compared serum VEGF in adolescents smoking cigarettes (Cg) only (9.3%), Wp only (19.6%), and dual (Wp and Cg) (36.4%) versus nonsmokers (34.6%) in adolescents. A self-reported questionnaire and enzyme-linked immunosorbent assay (ELISA) were used to obtain smoking status and serum VEGF, respectively, in 475 (age: 14.6 ± 1.0 years) boys ( n = 263) and girls ( n = 212) from Irbid, Jordan. The analysis showed that smoking status (R² = 0.021; p = 0.001) and gender (R² = 0.035; p = 0.000) can predict VEGF. Furthermore, 2-way-ANCOVA revealed that VEGF was lower in the dual cohort versus the Cg (33.4%; p = 0.04) and nonsmoker (29.6%; p = 0.003) cohorts; VEGF in smokers, was lower (33.6%; p = 0.04) in the Wp versus nonsmokers in the boys but not the girls. These results are unique and suggest that smoking lowers VEGF, which might adversely affect vascular growth and function. This is alarming given that adolescents are still in the development stage and smoking, particularly Wp, is popular among them. Therefore, interventions targeting smoking among schoolchildren are urgently needed to avoid the negative effects of smoking, especially on vascular health.

Aim: The current study examined the relationship of handgrip, leg and arm neuromuscular performance with cardiovascular function in patients with Parkinson's disease (PD)., Materials & Methods: Blood pressure, vascular measures and handgrip, shoulder and leg neuromuscular performance were obtained in PD persons and healthy controls., Results: The data reveal that muscular and cardiovascular functions are altered (p < 0.05) in PD. Most importantly, regression indicates that altered central and peripheral cardiovascular function measures demonstrate a moderately strong relationship (p < 0.05) with deteriorated handgrip (R 2 -range = 0.196-0.257), shoulder (R 2 -range = 0.146-0.289) and leg (R 2 -range = 0.19-0.35) neuromuscular performance in PD., Conclusion: These results suggest that deteriorated neuromuscular performance and cardiovascular function are related in PD. Future studies are needed to determine that developing muscular strength might contribute to improving cardiovascular function in PD.

The effect of homocysteine on cardiovascular diseases is still equivocal, especially in rheumatoid arthritis patients. In this investigation, the association between homocysteine with blood flow and vascular resistance in rheumatoid arthritis was examined. Serum levels of homocysteine were determined in thirty-one rheumatoid arthritis patients and nineteen apparently healthy subjects using ELISA. Additionally, strain-gauge plethysmography was used to determine both forearm blood flow and vascular function at rest and after occlusion. Forearm occlusion blood flow (patients: 21.9 ± 6.55 versus control: 25.5 ± 6.10ml/100mL/min) was lower (p < 0.05) while occlusion vascular resistance (patients: 4.77 ± 2.08 versus controls 3.05 ± 0.96U) was greater (p < 0.01) in rheumatoid arthritis than in the controls. Level of serum homocysteine was similar (p = 0.803) in rheumatoid arthritis group and healthy group. In addition, level of serum homocysteine was correlated with resting blood flow (r = -0.41; p < 0.02) and resting vascular resistance (r = 0.31, p < 0.05) in the patients group. The study confirms altered vascular function in rheumatoid arthritis. Uniquely, the results show that homocysteine was related to resting, but not postischemia, vascular measures. These relationships indicate that homocysteine might impact the vasculature in rheumatoid arthritis.

The current study examined the effect of single nucleotide (SNPs) polymorphisms in the ADIPOQ gene (I146T and G276T) on body mass index (BMI) of young adult women. The women were divided into underweight, normal, overweight and obese according to BMI. The circulating levels of adiponectin were measured using commercially available ELISA kits. Genetic polymorphisms were genotyped using the PCR-RFLP method. G276T and I164T SNPs are common in the examined population as the frequency of G allele of 276 SNP was 54.8% and for the T allele of 164 SNP it was 41.7%. Circulating adiponectin levels were related to BMI and were lowest in the obese versus overweight, normal weight and underweight groups (p<0.01). However, ADIPOQ gene SNPs (I146T and G276T) showed no association with BMI groups. In conclusion, the results may suggest that adiponectin level, but not ADIPOQ gene SNPs, is a good indicator to BMI in young adult women.

Background: Adult waterpipe smokers are at increased risk of obesity. However, it is unclear if adolescents, who are at the epicenter of the global waterpipe epidemic, are at similar risk., Objective: Therefore, the current study examined the waterpipe smoking relationship with obesity among adolescents., Methods: A sample of 2,313 boys and girls in grades 7-10 were surveyed about waterpipe and cigarette use in Jordan. Weight, body mass index (BMI), waist circumference, waist-to-hip ratio, and waist-to-height ratio were measured. Obesity indices were assessed as a function of smoking status (never used tobacco, current waterpipe only, current cigarettes only, and current dual smoking) as well as frequency of use of each tobacco product., Results: About 51.5% of adolescents smoked waterpipe whereas 29.8% were overweight/obese. Students who smoked waterpipe weekly had twofold greater odds of being obese than never-smokers (OR = 2.14; 95% CI = 1.08-4.21). Approximately 12% of students currently smoked waterpipe but not cigarettes, 2% smoked cigarettes but not waterpipe, and 11% smoked both. Body weight and age- and gender-specific BMI were greater for waterpipe and dual users compared to never users, especially for dual vs. never users (58.6 ±.8 vs. 55.6 ±.4 and.48 ±.07 vs..29 ±.03, respectively; p <.005)., Conclusions: For dual users, greater frequency of tobacco use was associated with greater weight and BMI. Waterpipe and dual use is associated with greater obesity, BMI, and body weight among Jordanian adolescents. Given the rising epidemics of both tobacco use and obesity among Middle Eastern adolescents, the clustering of these risk factors warrants public health action.

Background: Brain-derived neutrophic factor (BDNF) and tobacco consumption can affect many body functions and health. However, the relationship of BDNF with waterpipe (Wp) smoking is unknown. Therefore, the current study examined the relationship between Wp smoking and BDNF in adolescents., Methods: Self-reported tobacco consumption and serum BDNF were determined in 195 waterpipe and 288 nonsmokers in 7th-10th grade students., Results: Stepwise regression that included Wp smoking, gender, BMI, and location, showed that only Wp smoking (p < 0.0001) and gender (p < 0.0001) were related to serum BDNF. In addition, the ANCOVA found a main effect for Wp smoking (p < 0.0001) and gender (p < 0.0001) with lower BDNF in males smoking waterpipe., Discussion: BDNF was diminished in adolescent Wp smokers, which might predispose adolescents for systematic adverse health and behavioral alterations. These results extend the negative health risks associated with cigarette smoking to that of water-pipe tobacco smoking., (Copyright © 2018 ISDN. Published by Elsevier Ltd. All rights reserved.)

Introduction: The relationship between waterpipe smoking and eating habits among adolescents has not been investigated, thus the aim of the current study was to compare eating habits among adolescent cigarette-only, waterpipe-only, dual smokers versus non-smokers. We hypothesize that adolescent smokers practice unhealthy eating habits with worse habits among waterpipe smokers and dual smokers., Methods: Using a descriptive, cross-sectional design, self-reporting patterns of waterpipe, cigarette smoking and eating habits were collected from a random representative sample of 1720 boys and girls in grades 7-10 in Northern Jordan., Results: A total of 6.9%, 23.2% and 26.2% reported cigarette-only, waterpipe-only, and dual smoking, respectively. After controlling for gender, family income and education level of the mother and father, subsequent post hoc ANCOVA analyses revealed the following: mean (±SD) weekly breakfast consumption was greater in non-smokers (3.9±2.4) than waterpipe-only smokers (3.5±2.5, p=0.040) and dual smokers (3.2±2.5, p<0.000). Mean soda consumption frequency was lower in non-smokers (3.6±2.3) versus waterpipe-only (4.2±2.3, p=0.004) and dual smokers (2.7±2.2, p<0.000). Mean vegetable consumption was less in waterpipe-only (4.5±2.0, p=0.026) and dual smoking (4.4±2.0, p=0.013) smokers versus non-smokers (4.8±1.8). Mean consumption of energy drinks was the highest among dual smokers (1.2±1.9) versus non-smokers (0.5±1.4, p<0.000), cigarette-only (0.6±1.4, p≤0.01), and waterpipe-only (0.6±1.4, p<0.000) smokers., Conclusions: Overall, both waterpipe and dual smoking are associated with several unhealthy eating habits in adolescents. Given the growing epidemic of tobacco smoking in the Eastern Mediterranean Region, especially adolescent waterpipe smoking, and its association with unhealthy eating habits, public health actions and enforcing policies to decrease uptake of waterpipe smoking as well as improving food choices in schools among youth are urgently needed., Competing Interests: Authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

Brain-derived neurotrophic factor (BDNF) has been linked to cardiovascular health and function, however, the exact role is yet to be understood. The current study examined the relationship of circulatory BDNF with vascular function in Parkinson's disease (PD). ELISA was used to determine plasma BDNF in PD patients and healthy control (CT). Additionally, forearm resting blood flow (RBf), vascular resistance (RVr), venous capacitance (RVc), and venous outflow (RVo) as well as post occlusion blood flow (OcBf), vascular resistance (OcVr), venous capacitance (OcVc), and venous outflow (OcVo) were obtained using strain-gauge plethysmography. Simple linear regression showed that being PD patient can predict (p < 0.05) 12.9% of BDNF, 16.8% of RVc, 15.0% of OcVc, and 13.6% of OcVo. Subsequent stepwise regression included BDNF, RVc, OcVc, and OcVo, showed that being PD patient predicted (p < 0.05) 58.0% of BDNF, 47.7% of OcVo, and 15.1% of OcVc. Another simple linear regression demonstrated that BDNF predicted (p < 0.05) 18.5% of OcBf, 22.0% of OcVr, and 24.1% of OcVc in PD. In a subsequent stepwise linear regression, BDNF explained 26% ofOcVr (p = 0.008) and 42% of OcVc (p = 0.002) in PD. The study showed that BDNF is reduced and related to altered vascular function in PD. The results suggest that BDNF might contribute to preserving and maybe improving vascular function in PD.