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Abstract Test anxiety is a widespread problem among university students, with negative consequences for their social, physical, and academic well-being. Therefore, students may engage in activities that might alleviate anxiety symptoms, including taking medication. The study aimed to identify factors affecting test anxiety among medical and non-medical students during examination period and their coping approaches. A cross-sectional study was conducted using a survey to collect data. The westside test anxiety scale was used to measure the students’ anxiety levels. Univariate and post hoc analyses were used. The number of participants was 925 from 14 colleges, and 82.9% of them were female. The results indicated that the test anxiety was moderately high. Young students, females, junior students, and students with low cumulative grade point averages (cGPAs) has statistically significant high test levels with p-values 0.042, 0.01,

Abstract Meaningful communication between health service users and providers is essential. However, when stakeholders are unfamiliar with new health services, innovative communication methods are necessary to engage them. The aim of the study was to create, validate, and evaluate a video-vignette to enhance stakeholders’ (physicians, pharmacists, and laypeople) engagement and understanding of an innovative pharmacy-based diabetes screening and prevention program. Also, to assess the video-vignette’s capacity to measure appetite and appeal for such preventive programs. This mixed-methods study consisted of two phases. In phase one, a video-vignette depicting the proposed screening and prevention program was developed and validated following established international guidelines (n = 25). The video-vignette was then evaluated by stakeholders (n = 99). In phase two, the video-vignette’s capacity as a communication tool was tested in focus groups and interviews to explore stakeholders’ perspectives and engagement on the proposed service (n = 22). Quantitative data were analyzed descriptively, while qualitative data underwent thematic analysis. In total, 146 stakeholders participated. The script was well-received, deemed credible, and realistic. Furthermore, the video-vignette received high ratings for its value, content, interest, realism, and visual and audio quality. The focus groups and interviews provided valuable insights into the design and delivery of the new service. The video-vignette compellingly portrayed the novel pharmacy-based diabetes screening and prevention service. It facilitated in-depth discussions among stakeholders and significantly enhanced their understanding and appreciation of such health services. The video-vignette also generated significant interest in pharmacy-based diabetes screening and prevention programs, serving as a powerful tool to promote enrollment in these initiatives.

Abstract Background Integrating artificial intelligence (AI) into healthcare has raised significant ethical concerns. In pharmacy practice, AI offers promising advances but also poses ethical challenges. Methods A cross-sectional study was conducted in countries from the Middle East and North Africa (MENA) region on 501 pharmacy professionals. A 12-item online questionnaire assessed ethical concerns related to the adoption of AI in pharmacy practice. Demographic factors associated with ethical concerns were analyzed via SPSS v.27 software using appropriate statistical tests. Results Participants expressed concerns about patient data privacy (58.9%), cybersecurity threats (58.9%), potential job displacement (62.9%), and lack of legal regulation (67.0%). Tech-savviness and basic AI understanding were correlated with higher concern scores (p

Background There is a global call for upscaling and optimising the role of community pharmacists (CPs) in the control of non-communicable diseases (NCDs). In the United Arab Emirates (UAE), where NCDs are classified as a public health pandemic, upscaling CPs contributions has become more critical. Several contextual, professional, and educational challenges constrain the role of CPs.Objective To synthesise the perspectives of key stakeholders in the UAE healthcare system and propose a roadmap for advancing the role of CP s in controlling NCDs in the UAE.Methods This research followed a qualitative design using the International Pharmaceutical Federation (FIP) framework for quality assurance of pharmacy profession development. Data were collected using semi-structured interviews with 28 experts and senior leaders, then analysed using the thematic analysis technique with the assistance of NVivo software.Results The analysis yielded three main themes that outlined the prospective roadmap: education, work environment, and policy. Some of the generated subthemes were establishing accredited NCD-specialised programmes, building a national framework for interprofessional education and collaboration, and upscaling the engagement of CPs in public health platforms and initiatives.Conclusion Improving the role of CPs in controlling the NCD pandemic in the UAE requires coherent and well-structured multidisciplinary endeavours from health policymakers, educational institutions, and all groups of healthcare professionals, including the CPs themselves.

Background: Antibiotics have significantly reduced mortality and improved outcomes across various medical fields; however, the rise of antibiotic resistance poses a major challenge, causing millions of deaths annually. Deprescribing, a process that involves discontinuing unnecessary antibiotics, is crucial for combating this threat. This study was designed to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan.Methods: A cross-sectional survey was conducted between January-February 2024 to assess the knowledge, perceptions, and practices of physicians regarding antibiotic deprescribing in Jordan. An electronic questionnaire served as the data collection tool. Descriptive analysis was performed using SPSS software version 26. Additionally, logistic regression analysis was carried out to identify independent factors associated with physicians’ willingness to deprescribe antibiotics.Results: The study involved 252 physicians, primarily male (n = 168, 67.7%), with a median age of 33 years. Regarding antibiotics deprescribing, 21.8% (n = 55) expressed willingness to deprescribe inappropriate antibiotics.High awareness of deprescribing was evident, with 92.9% (n = 234) familiar with the concept, 94% (n = 237) knowledgeable about appropriate situations, and 96.8% (n = 244) recognising its potential benefits. Furthermore, 81.8% (n = 205) reported having received formal training in antibiotics deprescribing, and 85.3% (n = 215) were informed about the availability of deprescribing tools.Physicians highlighted challenges including insufficient time (44.4%, n = 112) and resistance from patients (41.3%, n = 104) and colleagues (42.1%, n = 106). Despite challenges, a significant proportion regularly assessed antibiotic necessity (46.9%, n = 117) and educated patients about antibiotic-related harms (40.5%, n = 102). Logistic regression analysis revealed no significant demographic factors influencing physicians’ willingness to deprescribe antibiotics (p > 0.05).Conclusion: Physicians in Jordan exhibit high awareness of antibiotics deprescribing and recognise its benefits. Challenges such as time constraints and communication barriers need to be addressed to facilitate effective deprescribing practices. Comprehensive guidelines and interdisciplinary collaboration are essential for promoting judicious antibiotic use and combating antimicrobial resistance.

Background: Patients with multiple myeloma (MM) are at risk of venous thromboembolism (VTE), worsened by immunomodulatory drugs. Although antithrombotics are recommended for prophylaxis, existing guidelines are suboptimal and treatment outcomes remain unclear. Objectives: This study aimed to investigate adverse events, antithrombotic utilization, and their associations with survival outcomes in patients with MM initiating multi-drug immunomodulatory combinations. Design: A posthoc analysis of individual-participant level data (IPD). Methods: IPD from three daratumumab clinical trials (MAIA, POLLUX, and CASTOR) were pooled. Adverse events incidence and antithrombotic utilization were assessed. Logistic and Cox regression were utilized to examine associations between antithrombotics use with adverse events and survival outcomes at the baseline and 6-month landmark. Results: Among 1804 patients, VTE occurred in 10%, bleeding in 14%, ischemic heart disease in 4%, and stroke in 2%. Patients with these adverse events demonstrated elevated rates of any grade ⩾3 events. Antiplatelet (primarily aspirin) and anticoagulant (primarily LMWH and direct oral anticoagulants) prescriptions have seen an increase from baseline (25% and 14%, respectively) to 6 months (35% and 31%). The primary indication for their use was prophylaxis. Anticoagulant use within 6 months was associated with reduced VTE (OR (95% CI) = 0.45 (0.26–0.77), p = 0.004), while antiplatelet use showed no associations with any evaluated adverse events. Antithrombotics and survival outcomes had no significant associations. Conclusion: This study underscores the complexities of antithrombotic therapy and adverse events in MM and highlights the need for vigilant and proactive management due to increased grade ⩾3 adverse events. While anticoagulant use was associated with reduced VTE risk, further research is needed to optimize thromboprophylaxis guidelines and explore antithrombotic efficacy and safety in patients with MM. Trial registration: MAIA (NCT02252172), POLLUX (NCT02076009), CASTOR (NCT02136134).

COVID-19 is a highly contagious infectious disease that has posed a global threat, leading to a widespread pandemic characterized by multi-organ complications and failures. Aims: The present study was conducted to evaluate the impact of Pfizer and Sinopharm vaccines on metabolomic changes and their correlations with immune pathways. Main methods: The study used a cross-sectional design and implemented an untargeted metabolomics-based approach. Plasma samples were obtained from three groups: non-vaccinated participants, Sinopharm-vaccinated participants, and Pfizer-vaccinated participants. Comparative metabolomic analysis was conducted using TIMS-QTOF, and multiple t-tests with a 5 % false discovery rate (FDR) were performed using MetaboAnalyst software. Key findings: Out of the 105 metabolites detected, 72 showed statistically significant changes (p-value < 0.05) across the different groups. Notably, several metabolites such as neopterin, pyridoxal, and syringic acid were markedly altered in individuals vaccinated with Pfizer. Conversely, in the Sinopharm-vaccinated group, significant alterations were observed in sphinganine, neopterin, and sphingosine. These metabolites hold potential as biomarkers for evaluating vaccine efficacy. Additionally, both Pfizer and Sinopharm vaccinations were found to influence sphingolipid and histidine metabolisms compared to the control group. The Sinopharm group also displayed changes in lysine degradation relative to the control group. When comparing the enriched pathways between the Pfizer and Sinopharm-vaccinated groups, differences were observed in purine metabolism. Furthermore, alterations in tryptophan and vitamin B6 metabolism were noted when comparing the Pfizer-vaccinated group with both the control and Sinopharm-vaccinated groups. Significance: These findings highlight the importance of metabolomics in assessing vaccine effectiveness and identifying potential biomarkers for monitoring the efficacy of newly developed vaccines in a shorter timeframe.

Over 80% of genetic studies in the Parkinson’s disease (PD) field have been conducted on individuals of European descent. There is a social and scientific imperative to understand the genetic basis of PD across global populations for therapeutic development and deployment. PD etiology is impacted by genetic and environmental factors that are variable by ancestry and region, emphasising the need for worldwide programs to gather large numbers of patients to identify novel candidate genes and risk loci involved in disease. Only a handful of documented genetic assessments have investigated families with PD in AfrAbia, which comprises the member nations of the Arab League and the African Union, with very limited cohort and case-control studies reported. This review article summarises prior research on PD genetics in AfrAbia, highlighting gaps and challenges. We discuss the etiological risk spectrum in the context of historical interactions, highlighting allele frequencies, penetrance, and the clinical manifestations of known genetic variants in the AfrAbian PD patient community.

Background: Psychosocial stress, a common feature in modern societies, impairs cognitive functions. It is suggested that stress hormones and elevated excitatory amino acids during stress are responsible for stress-induced cognitive deficits. Reduced brain-derived neurotrophic factor (BDNF) levels, increased oxidative stress, and alteration of synaptic plasticity biomarkers are also possible contributors to the negative impact of stress on learning and memory. Sildenafil citrate is a selective phosphodiesterase type 5 (PDE5) inhibitor and the first oral therapy for the treatment of erectile dysfunction. It has been shown that sildenafil improves learning and memory and possesses antioxidant properties. We hypothesized that administering sildenafil to stressed rats prevents the cognitive deficit induced by chronic psychosocial stress. Methods: Psychosocial stress was generated using the intruder model. Sildenafil 3 mg/kg/day was administered intraperitoneally to animals. Behavioral studies were conducted to test spatial learning and memory using the radial arm water maze. Then, the hippocampal BDNF level and several antioxidant markers were assessed. Results: This study revealed that chronic psychosocial stress impaired short-term but not long-term memory. The administration of sildenafil prevented this short-term memory impairment. Chronic psychosocial stress markedly reduced the level of hippocampal BDNF (P˂0.05), and this reduction in BDNF was normalized by sildenafil treatment. In addition, neither chronic psychosocial stress nor sildenafil significantly altered the activity of measured oxidative parameters (P > 0.05). Conclusion: Chronic psychosocial stress induces short-term memory impairment. The administration of sildenafil citrate prevented this impairment, possibly by normalizing the level of BDNF.

Background: As the use of technology has increased, a set of problematic psychological behaviors associated with internet use has evolved. This bibliometric research aims to discover and analyze internet addiction (IA) articles trends from 1996 to 2022. Methods: This research is based on a bibliometric examination of internet addiction papers published between 1996 and 2022. The Scopus database was utilized to extract the needed documents, examine citation patterns and publication growth, and identify prolific authors and institutions. Results: There were 9692 publications on internet addiction from 1996 to 2022, with an average of 359 documents each year. A total of 21906 authors contributed to the literature, with the majority of publications (86.9%) being multi-authored. The United States (US) ranked first in terms of volume of publications (18.8%, n = 1819), followed by China (12.3%, n = 1194), the United Kingdom (8.3%, n = 808), and Turkey (6.2%, n = 602). However, the majority of the productive institutions were located in East Asia. Conclusion: There is a substantial body of literature on internet addiction, with numerous worldwide collaborations. As IA will be a lingering problem with the increased digitization of all sectors, future research should focus on emerging topics such as social media and gaming addiction. Internet addiction among adolescents in particular is a key research area.

Background: Patient-centered care and integrating health informatics are essential to delivering high-quality healthcare services and improving patient outcomes. Despite their crucial role, research on health informatics in community settings is limited in Jordan, emphasizing the necessity for evaluating the state of pharmacy informatics. Purpose: The study aimed to evaluate community pharmacists' prior experience, attitudes, and perceived barriers to adopting information technology in their practice. Methods: An online cross-sectional survey was conducted from August to November 2020 to assess community pharmacists' prior experience, attitudes, and perceived barriers to using information technology to enhance their daily practice. Results: A total of 431 Community pharmacists participated in the study. Most of the participants were female (68.7%), aged 25 to 35 (53.8%), and having 5–10 years of professional experience (47.1%). Only 12.8% had prior experience with health informatics. The majority agreed that health informatics systems would be clear and understandable to use (84 %), limit drug addiction (82.1%), facilitate data exchange between physicians and pharmacists (81.7%), and enhance medication safety (82.1%). However, over two-thirds of participants agreed on potential barriers to implementing health information technology in their daily practice, such as technology difficulties (71.2%), resistance to change (73.8%), and a lack of competencies (77.5%). Statistically significant relationships were found between positive attitudes and age (p = 0.001), gender (0.004), experience duration (p = 0.001), and education level (p = 0.001). Apart from the workplace, sociodemographic characteristics were significantly associated with perceived barriers to implementing health informatics (p

Purpose: In neonatal intensive care units, applying sucrose solution for analgesia is now a routine treatment for mild procedural pain. Studies of animal and human infants provide clear evidence of benefits in the short term, but few studies have investigated the long term benefits. Thus, we determined whether sucrose could ameliorate painful stimulation during infancy in Sprague–Dawley rats and also explored the long-term effects of repeated sucrose administration during infancy. Female and male rats were included to investigate sex-related differences. Methods: Rat pups were stimulated either with painful or tactile stimuli for the first 14 days of their lives. Pups were pretreated either with sucrose or not treated before stimulation. Behavioral tests were conducted during adolescence and adulthood. Hotplate, rotarod, open field, elevated plus maze, and radial arm water maze tests were employed to assess the behavioral consequences of early life manipulations and treatments. Results: Painful stimulation during infancy increased the sensitivity to pain later in life, and sucrose did not remedy this effect. Motility, coordination, anxiety, and cognition tests in adulthood obtained mixed results. Pain during infancy appeared to increase anxiety during adulthood. Learning and memory in adulthood were affected by pain during infancy, and sucrose had a negative effect even in the absence of pain. No sex-related differences were observed in any of the behavioral tests by employing this model of neonatal pain. Conclusion: Painful stimulation during infancy resulted in deficiencies in some behavioral tests later in life. Sucrose pretreatment did not mitigate these shortcomings and it actually resulted in negative outcomes.

AbstractBackground Glioblastoma (GBM) is a primary malignancy of the central nervous system and is classified as a grade IV astrocytoma by the World Health Organization (WHO). Although GBM rarely metastasizes, its prognosis remains poor. Moreover, the standard treatment for GBM, temozolomide (TMZ), is associated with chemoresistance, which is a major factor behind GBM-related deaths. Investigating drugs with repurposing potential in the context of GBM is worthwhile to bypass lengthy bench-to-bedside research. The field of omics has garnered significant interest in scientific research because of its potential to delineate the intricate regulatory network underlying tumor development. In particular, proteomic and metabolomic analyses are powerful approaches for the investigation of metabolic enzymes and intermediate metabolites since they represent the functional end of the cancer phenotype.Methods We chose two of the most widely prescribed anticancer drugs, cisplatin and paclitaxel. To our knowledge, the current literature lacks studies examining their effects on metabolic and proteomic alterations in GBM. We employed the mass spectrometry technological platform ‘UHPLC-Q-TOF-MS/MS’ to examine the changes in the proteome and metabolome profiles of the U87 cell line with defined concentrations of cisplatin and/or paclitaxel via an untargeted approach.Results A total of 1,419 distinct proteins and 90 metabolites were generated, and subsequent analysis was performed. We observed that upon treatment with cisplatin (9.5 μM), U87 cells exhibited apparent efforts to cope with this exogenous stressor, understanding the effect of paclitaxel (5.3 μM) on altering the transport machinery of the cell, and how the combination of cisplatin and/or paclitaxel suggests potential interactions with promising benefits in GBM therapeutics.Conclusion Our research provides a detailed map of alterations in response to cisplatin and paclitaxel treatment, provides crucial insights into the molecular basis of their action, and paves the way for further research to identify molecular targets for this elusive malignancy.

Background and Aim: Human monkeypox is an emerging global threat. Hundreds of publications were disseminated in the last few months. This study aimed to map, analyze, and evaluate the bibliometric indicators of the global monkeypox research output. Materials and Methods: All documents published in the past 20 years were retrieved using the Scopus database. Papers published in English and peer-reviewed journals were included. VOSviewer was used to create density and network visualization maps. Results: A total of 1725 published documents were retrieved. Of these, 53% were published in 2022. The average number of authors per document was 4.2. Authors from the USA were the most active and published about 42.1% of the total documents. International collaboration was evident between the USA and both UK and Congo. Keywords mapping identified the main research lines in this field that correlate monkeypox with public health, smallpox, vaccination, and antiviral treatment. Conclusion: This study analyzed and mapped the expanding field of monkeypox research across the world. The bibliometric analysis revealed that the United States has contributed greatly in terms of both individual researchers and academic institutions. There was less cooperation on a global scale than was anticipated. Fostering international cooperation is essential for countering this worldwide danger. Additional scientific research should be conducted to investigate the link between smallpox immunization and monkeypox epidemics.

Presence of pathogens on the cellphones and their accessories poses a significant risk for public health. This study aimed to determine the biofilm-forming capability of S. aureus and E. coli on pieces made from a different commercially available cell phone and aadditionally to test the effectiveness of the most common commercially available sanitizers. Therefore, bacterial biofilm biomasses were quantitatively determined on cellphone covers using crystal violet assay in the presence and absence of common sanitizers. This study revealed that S. aureus and E. coli could form biofilms on the surfaces of all cellphones covers. Additionally, the sanitizers that contain sodium hypochlorite 5.25% and those composed of 38.9% ethanol and 0.05% dodecyl dimethyl ammonium chloride showed the highest log reduction in the number of viable cells after 5 minutes of exposure against biofilms formed by both E. coli and S. aureus compared to other tested sanitizers (chloroxylenol 4.8%, 2-propanol 64%, and ethanol 70%). Moreover, 4.8% chloroxylenol and 70% ethanol-based sanitizers showed log reductions significantly higher than 2-propanol-based ones. In conclusion, cellphone covers were shown to be suitable surfaces for microbial biofilm formation produced by S. aureus and E. coli. The antimicrobial activity of commercially available sanitizers against these bacterial biofilms was variable, with sodium hypochlorite and ethanol/dodecyl dimethyl ammonium chloride sanitizer being the most effective.

Prostate cancer (PCa) is a significant global contributor to mortality, predominantly affecting males aged 65 and above. The field of omics has recently gained traction due to its capacity to provide profound insights into the biochemical mechanisms underlying conditions like prostate cancer. This involves the identification and quantification of low-molecular-weight metabolites and proteins acting as crucial biochemical signals for early detection, therapy assessment, and target identification. A spectrum of analytical methods is employed to discern and measure these molecules, revealing their altered biological pathways within diseased contexts. Metabolomics and proteomics generate refined data subjected to detailed statistical analysis through sophisticated software, yielding substantive insights. This review aims to underscore the major contributions of multi-omics to PCa research, covering its core principles, its role in tumor biology characterization, biomarker discovery, prognostic studies, various analytical technologies such as mass spectrometry and Nuclear Magnetic Resonance, data processing, and recent clinical applications made possible by an integrative “omics” approach. This approach seeks to address the challenges associated with current PCa treatments. Hence, our research endeavors to demonstrate the valuable applications of these potent tools in investigations, offering significant potential for understanding the complex biochemical environment of prostate cancer and advancing tailored therapeutic approaches for further development.

Rosmarinic acid (RA), a natural ester phenolic compound, is known to have antioxidant and anti-inflammatory properties. RA has also been reported to exhibit a hypoglycemic effect; however, the mechanisms underlying this effect have yet to be investigated. Therefore, the present study focused on the anti-diabetic effects and mechanism of RA in INS-1 cells using in vitro model. Streptozotocin (STZ) at a concentration of 3 mM was applied to INS-1 cells for 4 h to create a diabetic model. The cells were pretreated for 24 h with various concentrations (1 and 2.5 μM) of RA. The Cell viability, glucose-stimulated insulin secretion (GSIS), glucose uptake, lipid peroxidation, reactive oxygen species (ROS), apoptosis, and protein expression of Bcl-2, NF-κB, 1L-1β, and PARP were assessed. Results showed that STZ-treated INS-1 cells exhibited reduced cell viability, insulin release, insulin content, glucose uptake, and elevated MDA and ROS levels. Cells pretreated with RA maintained the function and morphology of β-cells against STZ-induced damage. Moreover, RA sustained high protein expression levels of Bcl-2 and low expression levels of NF-κB, IL-1β, and PARP. In conclusion, RA preserved β-cells function against STZ-induced damage by altering NF-κB and Bcl-2 pathways.

Introduction: Drug-related problems (DRPs) are events or circumstances involving drug therapy that actually or potentially interferes with desired health outcomes. Objectives: To assess community pharmacists’ knowledge and practice regarding DRP-reduction services, as well as the barriers and factors associated with decreased provision of these services. Methods: This cross-sectional study utilized a validated questionnaire to assess pharmacists’ knowledge, practice, and barriers to the provision of DRP-reduction services in the community pharmacy setting. Binary regression model was used to assess the variables associated with the practice of DRP-reduction services. Results: A total of 412 pharmacists participated in the study. The pharmacists demonstrated strong knowledge but inadequate practice of DRP-reduction services. The most reported DRPs were inappropriate combination of drugs, or drugs and herbal medications, or drugs and dietary supplements (52.4%), patients’ inability to understand instructions properly (46.1%), inappropriate drug according to guidelines (43.7%), and too high dose (40.3%). The most common barriers to these services were increased workload (60.5%), limited time (53.2%), and lack of good communication skills (49.8%). The presence of a counselling area in the pharmacy increased the practice of DRP-reduction services (OR: 3.532, 95%Cl: 2.010–5.590, P

Royal jelly (RJ) is a multifunctional bee product with a unique composition and wide-ranging biological properties, including antioxidant, anti-inflammatory and antiproliferative activities. Still, little is known about the possible myocardial protective properties of RJ. Considering that sonication could enhance RJ bioactivity, this study aimed to assess the effects of non-sonicated (NS) and sonicated (S) RJ on fibrotic signaling, cell proliferation, and collagen production in cardiac fibroblasts. S-RJ was produced by ultrasonication at 20 kHz. Ventricular fibroblasts isolated from neonatal rats were cultured and treated with different concentrations of NS-RJ or S-RJ (0, 50, 100, 150, 200, and 250 µg/well). S-RJ significantly depressed the expression levels of transglutaminase 2 (TG2) mRNA across all the concentrations tested and was inversely associated with the expression of this profibrotic marker. S-RJ and NS-RJ displayed distinct dose-dependent effects on mRNA expression of several other profibrotic, proliferation, and apoptotic markers. Unlike NS-RJ, S-RJ elicited strong negative dose-dependent relationships with the expression of profibrotic markers (TG2, COL1A1, COL3A1, FN1, CTGF, MMP-2, α-SMA, TGF-β1, CX43, periostin), as well as proliferation (CCND1) and apoptotic (BAX, BAX/BCL-2) markers, indicating that RJ dose-response effects were significantly modified by sonification. NS-RJ and S-RJ increased the content of soluble collagen, while decreasing collagen cross-linking. Collectively, these findings show that S-RJ has a greater range of action than NS-RJ for downregulating the expression of biomarkers associated with cardiac fibrosis. Reduced biomarker expression and collagen cross-linkages upon cardiac fibroblast treatment with specific concentrations of S-RJ or NS-RJ suggests putative roles and mechanisms by which RJ may confer some protection against cardiac fibrosis.

Gold nanoparticles (GNPs) are widely searched for their usage in breast cancer research because of their unique features. For example, these particles can deliver drugs to specific sites, making imaging and photothermal therapy possible, thus rendering them suitable particles for theranostic purposes. Bibliometric research is a statistical analytical technique useful for the data systematically found in the literature. In this bibliometric study, the global research output regarding GNPs in breast cancer (BC) research was analyzed, mapped, and evaluated using bibliometric indicators.All documents related to the application of GNPs applications in BC research that were published in English-language, peer-reviewed journals over the past 20 years were retrieved from the Scopus database. Bibliometric indicators were extracted using VOSviewer and Biblioshiny. Thematic maps, conceptual maps, and visualization graphs were created.A total of 2035 published documents were retrieved. Chinese authors were the most active, having published approximately 27.5% of the total documents, while researchers from the United States (USA) had the most significant scientific impact. The study revealed weak international collaboration in this research area. Keywords mapping identified the main research themes and hotspots in this research field. Multimodal approaches in cancer treatment and diagnostics, targeted and effective cancer treatment, aptamers and biosensors, and green synthesis of GNPs were the four clusters retrieved from theme and hotspot analyses. This study analyzed and mapped the expanding field of GNPs in breast cancer research (GNP-BCR) and identified various applications of GNPs in this field. GNPs were used as drug delivery systems to target specific cancer cells and improve anticancer drug bioavailability. Different treatment and diagnostic modalities were revealed, such as photodynamic therapy (PDT) and photothermal therapy (PTT). Moreover, the development of aptamer-based biosensors using gold nanoparticles was identified as a niche theme in this research, while the green synthesis of GNPs emerged as a new and promising theme. However, clinical research is still warranted to translate this fundamental knowledge into practical and human-useable formulas.

Calotropis procera is a perennial flowering plant of the Apocynaceae family, traditionally used in medicine to treat various ailments. Recent investigations have revealed its potential therapeutic activities such as anti-inflammatory, gastroprotective, analgesic, anti-obesity, and anti-diabetic properties. RP-HPLC qualitatively and quantitatively evaluated the phenolic acids and flavonoids in the ethanolic extract at two different wavelengths, 280 and 330 nm. In addition, total phenolic and flavonoid contents were measured via spectrophotometric determination in addition to the antioxidant activity. The antiproliferative effects of C. procera were investigated on two cancer cell lines: human colon (HCT-116) and breast (MCF-7) cancer. Several methods were utilised to analyse the effectiveness of the plant extract on the cytotoxicity, apoptosis, cell cycle progression, genes involved in the cell cycle, and protein expression profiles of HCT-116 and MCF-7 cells. These included the MTT assay, Annexin V-FITC/PI, analysis of the cell cycle, and Western blot. Results indicated that ferulic and caffeic acids were the major compounds at λmax 280 nm (1.374% and 0.561%, respectively), while the major compounds at λmax 325 nm were kaempferol and luteolin (1.036% and 0.512%, respectively). The ethanolic extract had significantly higher antioxidant activity (80 ± 2.3%) compared to ascorbic acid (90 ± 3.1%).C. procera extract exhibited dose-dependent cell growth inhibition, with an estimated IC50 of 50 μg/mL for MCF-7 and 55 μg/mL for HCT-116 cells at 24 h. Annexin V-FITC/PI confirmed the induction of apoptosis. Remarkably, cell cycle arrest occurred at the sub-G1 phase in MCF-7 cells, while in HCT-116 cells, it was observed at the G2-M phase. The sub-G1 arrest was associated with dysregulation of Akt, p-AKT, mTOR, and p-mTOR proteins, as confirmed by the Western blot analysis, while downregulation of CDK1, cyclin B1, and survivin caused G2-M arrest.

Hypoxia-inducible factor-1 (HIF-1) is a key regulator for balancing oxygen in the cells. It is a transcription factor that regulates the expression of target genes involved in oxygen homeostasis in response to hypoxia. Recently, research has demonstrated the multiple roles of HIF-1 in the pathophysiology of various diseases, including cancer. It is a crucial mediator of the hypoxic response and regulator of oxygen metabolism, thus contributing to tumor development and progression. Studies showed that the expression of the HIF-1α subunit is significantly upregulated in cancer cells and promotes tumor survival by multiple mechanisms. In addition, HIF-1 has potential contributing roles in cancer progression, including cell division, survival, proliferation, angiogenesis, and metastasis. Moreover, HIF-1 has a role in regulating cellular metabolic pathways, particularly the anaerobic metabolism of glucose. Given its significant and potential roles in cancer development and progression, it has been an intriguing therapeutic target for cancer research. Several compounds targeting HIF-1-associated processes are now being used to treat different types of cancer. This review outlines emerging therapeutic strategies that target HIF-1 as well as the relevance and regulation of the HIF-1 pathways in cancer. Moreover, it addresses the employment of nanotechnology in developing these promising strategies.

Dietary supplements (DSs) intake has been increasing worldwide despite no consensus evidence for the efficacy and safety of disease prevention, control, or treatment in nutrient-replete populations. This study aimed to determine the prevalence of DSs use, knowledge, attitude, and practice (KAP) and associated factors among university students in Jordan. A national cross-sectional study was carried over across universities in Jordan. Participants completed a valid and reliable online questionnaire (Cronbach's alpha = 0.802 and correlation coefficients between 0.72 and 0.26). Univariate analyses were used to determine the relationship between variables. Multivariable regression was carried out to identify significant factors contributing DSs usage. A total of 448 university students completed the study (73.7% females). More than half of the students used DSs (60.9%), with single-nutrient ingredient supplements being the most commonly used type. The primary motivators were maintaining health and most students reported no side effects associated with consumption. The results revealed poor knowledge, a negative attitude towards DSs usage among all participants, even non-users, and high-risk practices among the DSs users. Normal weight and overweight individuals were more likely to use DSs (OR:2.88, 95%CI:1.61–5.16, OR:1.95, 95%CI:1.01–3.79, respectively). Low and medium-family income categories were more likely to use DSs than those in the high-income category (OR: 0.04, 95%CI: 0.02–0.07, OR: 0.06, 95CI:0.03–0.11, respectively). Undergraduate students were more likely to use DSs than postgraduate students (OR:5.56, 95%CI:3.19–9.69). In this study, a high prevalence of DSs use was highlighted. The results suggest that nutrition education is required to improve awareness of DSs and to promote safe practices.

Candida albicans is a common pathogenic fungus that presents a challenge to healthcare facilities. It can switch between a yeast cell form that diffuses through the bloodstream to colonize internal organs and a filamentous form that penetrates host mucosa. Understanding the pathogen’s strategies for environmental adaptation and, ultimately, survival, is crucial. As a complementary study, herein, a multi-omics analysis was performed using high-resolution timsTOF MS to compare the proteomes and metabolomes of Wild Type (WT) Candida albicans (strain DK318) grown on agar plates versus liquid media. Proteomic analysis revealed a total of 1793 proteins and 15,013 peptides. Out of the 1403 identified proteins, 313 proteins were significantly differentially abundant with a p-value < 0.05. Of these, 156 and 157 proteins were significantly increased in liquid and solid media, respectively. Metabolomics analysis identified 192 metabolites in total. The majority (42/48) of the significantly altered metabolites (p-value 0.05 FDR, FC 1.5), mainly amino acids, were significantly higher in solid media, while only 2 metabolites were significantly higher in liquid media. The combined multi-omics analysis provides insight into adaptative morphological changes supporting Candida albicans’ life cycle and identifies crucial virulence factors during biofilm formation and bloodstream infection.

This study addresses the crucial aspect of childhood COVID-19 vaccination and its impact on parental decisions concerning learning modalities during the pandemic. This study aimed to gauge parental hesitancy towards vaccinating their children and its influence on choosing between distance and face-to-face learning options. Following STROBE guidelines for cross-sectional studies, this study surveyed 1973 parents in the United Arab Emirates using Google Forms during the COVID-19 pandemic. The results revealed that while more than half of the parents (51.6%) were willing to vaccinate their children if the COVID-19 vaccine was accessible and affordable, a significant majority (91.2%) expressed concerns about the rapid vaccine development process, which was the primary reason for vaccine rejection. Interestingly, a sizable portion (55.3%) had experienced online learning in the previous academic term, and, of those, 59.6% believed it negatively influenced their children’s academic performance. Consequently, 66.4% expressed intent to shift their children back to face-to-face learning once feasible. Significantly, parents with medical backgrounds were more inclined (91.6%) to opt for face-to-face schooling compared to those without such backgrounds. Logistic regression analysis indicated associations between sociodemographic characteristics, educational level and background, and the decision to return children to face-to-face learning. Interestingly, when it comes to vaccine hesitancy, a noteworthy connection exists between the parents’ reluctance to vaccinate their children and their preference for distance learning. In fact, parents who responded negatively to vaccinating their children against COVID-19, if the vaccine was available, showed a clear preference for the distance learning modality (p-value < 0.0001). This study underscores the complex interplay of factors and community perspectives shaping parental acceptance of childhood COVID-19 vaccination. The development pace of vaccines significantly influences parents’ attitudes and beliefs about vaccination programs. Parents’ medical backgrounds exhibit a clear correlation with their perceptions of sending children back to school safely. This highlights the potential impact of parental medical knowledge on decision making, emphasizing the need to consider parents’ professional backgrounds when devising education- and vaccination-related policies.

Significance: Electronic cigarettes (e-cigarettes) have become a popular way to smoke all over the world. Chronic exposure to e-cigarette aerosol may influence lung health. This study uses an animal model to explore the time course of the effect of exposure to e-cigarette aerosols on the lung. Methods: Lung samples were collected after exposure of Balb/c mice to e-cigarette aerosols for 1 h/day (6 times/week) for 1, 2 and 4 weeks and compared to sham-exposed controls. Examined biomarkers including inflammatory cells, tumor necrosis factor α (TNFα), interleukin-6 (IL-6), interleukin-10 (IL-10), reduced glutathione (GSH), oxidized glutathione (GSSG), glutathione peroxidase (GPx), catalase, superoxide dismutase (SOD), and Thiobarbituric acid reactive substances (TBARS). Results: Exposure of animals to e-cigarette aerosols induced significant increases (P

Numerous variations of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), including D614G, B.1.1.7 (United Kingdom), B.1.1.28 (Brazil P1, P2), CAL.20C (Southern California), B.1.351 (South Africa), B.1.617 (B.1.617.1 Kappa & Delta B.1.617.2) and B.1.1.529, have been reported worldwide. The receptor-binding domain (RBD) of the spike (S) protein is involved in virus-cell binding, where virus-neutralizing antibodies (NAbs) react. Novel variants in the S-protein could maximize viral affinity for the human angiotensin-converting enzyme 2 (ACE2) receptor and increase virus transmission. Molecular detection with false-negative results may refer to mutations in the part of the virus's genome used for virus diagnosis. Furthermore, these changes in S-protein structure alter the neutralizing ability of NAbs, resulting in a reduction in vaccine efficiency. Further information is needed to evaluate how new mutations may affect vaccine efficacy.

This study aimed to investigate changes in awareness, attitudes, acceptability, and possible barriers to using Arabicized medical terms in teaching and daily communication in medical colleges in Jordan. Using a cross-sectional online survey, medicine students and professors in Jordanian universities were sampled to survey their awareness, attitudes, and barriers toward Arabicized medical terms. Responses to the surveys were quantified into awareness, attitudes, and barriers scores and compared according to the sociodemographic variables of the study sample. Results of the current study showed positive awareness/acceptability and attitudes among medicine students toward Arabicized medical terms. The most common perceived barriers toward Arabicization among medicine students were that teaching and assessments (exams, quizzes, projects, etc.) are in English and the unavailability of valuable medical references that use Arabic terms. Several demographic variables were associated with acceptability, attitudes, and/or barriers toward Arabicized terms among medicine students, including gender, income, place of living, level of medicine study, having more than one mother tongue, and language proficiency. Medicine university professors showed acceptable awareness and generally positive attitudes toward Arabicized terms. The most frequently cited barriers among medicine professors were in concordance with those pointed out by medicine students, which indicates the validity of these barriers. Gender and English language proficiency were the only factors associated with acceptability, attitudes, and/or barriers toward Arabicized terms among medicine university professors. In conclusion, the current study indicated a generally more suitable environment for utilizing Arabicized medical terms, especially when delineating major barriers facing medicine students and professors.

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

Vaccination against COVID-19 may present the most effective strategy to control current viral pandemic. The success of delivering mass vaccination, on the scale of what would be applied to contain COVID-19, largely depends on the compliance of the public to programs mandated by public health officials. This study was aimed to evaluate the perception and possible hesitance of people in Jordan toward a tentative COVID-19 vaccine using self-administrated online survey. During the study period, a total of 1287 agreed to participate in the study. More than half of the participants (n = 734, 57%) were females and the majority (n = 893, 69%) had a University degree. Most of the participants (n = 871, 68%) believed that scientists have adequate tools to develop a safe and efficacious COVID-19 vaccine and two-third of them (n = 861, 67%) believed that developing vaccines would end the pandemic. However, around half of them (n = 665, 52%) reported not having adequate information on the benefits of COVID-19 vaccination. Preference of study participants to achieve immunity against COVID-19 using natural way was the most commonly reported reason to refuse vaccination (n = 826, 64%), followed by their concern about adverse effects associated with the vaccine (n = 781, 61%). In conclusion, the sampled participants showed an overall positive attitude toward receiving a COVID-19 vaccine. Educational campaigns using television and social media are recommended to better inform the public of the benefits of COVID-19 vaccine in reaching a “herd immunity” based strategy to control the current pandemic.

Background: COVID-19 is a pacing pandemic that affected health systems, economy, and social life in the whole world. Currently, there is no treatment for it, but the world is in a race that yielded, in a relatively short time than usual, several approved, promising vaccines in the middle of a storm of debates because of the speed of their production and approval. Objective: This study assessed the willingness of Middle Eastern Arab publics to receive COVID-19 vaccines and investigated the factors behind any reluctance to receive them. Methods: A self-administered questionnaire was distributed through social media applications in four Arab countries (Jordan, Saudi Arabia, Lebanon, and Iraq). Participants’ demographics, medical history, their experience with COVID-19, and their willingness to receive the available vaccines were obtained and analyzed. Results: A total of 2,925 completed forms were included. Only 25% of the participants were willing to receive a vaccine while 33% were hesitant. Iraqis were the most willing to receive it while Jordanians were the least (35% and 17% of each country, respectively). Interestingly, 60% of the acceptors were ready to pay for the vaccine if not covered by governments. It was also found that American vaccines were preffered by 50% of the acceptors. However, 30% of acceptors were unsure of which vaccine is the best and 11% stated that any vaccine is good. Social media were the major source of information about COVID-19 and its vaccines. Finally, predictors of acceptance of the vaccines included living in Saudi Arabia and Iraq, being unmarried, having monthly income > $1,000, holding a medical degree, having high fear from COVID-19, feeling of being at risk of getting infected with COVID-19, and previous reception of influenza vaccine, whereas predictors of refusal included female sex and previous infection with COVID-19. Conclusion: Middle Eastern Arabs are less likely to accept receiving the COVID-19 vaccines compared with non-Arabs. Health authorities in these countries are advised to intensify their awareness-raising activities about the vaccines while ensuring fair distribution of them.

Background: The number of COVID-19 infected patients has been soaring in the Middle East countries.The disease poses a significant threat, decisions about prioritizing care should be made in accordance with the proven risk factors for complications. Objective: The present study provides the first bespoke prediction model in the Middle East to identify COVID-19 patients, who are at higher risk for complications. Method: A case-control study design was adopted to compare the characteristics of successfully recovered patients with those who had complications. Complications were defined as admission to the intensive care unit, mechanical ventilation, sepsis or septic shock, pneumonia or respiratory failure, and death. The prediction model was created through multivariable logistic regression. Overall statistical significance tests for the model were carried out. Results: All COVID-19 infected hospitalized patients (n = 133) in Amman – Jordan were included in the study. Successfully recovered were 125 patients. The median age (IRQ) was 26 (10–40). Almost 30% were >40 years. Patients with complications were eight patients, age 63 (51.5–71.5). The prediction model identified the following variables as risk factors: diabetes (OR = 59.7; 95% CI: 3.5–1011.5, p = 0.005), fever (OR = 24.8; 95% CI: 1.4–447.3, p = 0.029), SHORTNESS OF BREATH (OR = 15.9; 95% CI: 1.3–189.7, p = 0.029), body mass index (OR = 0.74; 95% CI: 0.61–0.88, p = 0.001), abnormal Neutrophils (OR = 16.8; 95% CI: 1.0–292.0, p = 0.053). Prediction model was statistically significant, χ2(5) = 86.1, p < 0.0005. Conclusions: Unlike reports from China, the most influential variables that led to disease progression in Jordanian patients were diabetes, fever, shortness of breath, body mass index, and abnormal neutrophils. Similar to reports from the USA, smoking was not a leading factor for complications. Comorbidities and patient health status, rather than age, were the primary risk factors for complications. Treatment with Hydroxychloroquine showed no protective effect.

ObjectivesThe main goal of the current study was to investigate pharmacists' perception of home delivery of medications service in Jordan and their willingness to use the service.MethodThis cross-sectional observational study was conducted between March and April 2022. The study targeted community pharmacists working at different community pharmacies across Jordan. The study questionnaire was distributed through Facebook to target Jordanian community pharmacists' groups.ResultsThree hundred and twenty-four community pharmacists participated in the study, 75% (n = 244) of pharmacists reported being willing to use the home delivery and 274 (84.6%) thought it increases the efficiency of their community pharmacies' services. Only 129 (39.8%) pharmacists agreed or strongly agreed that unlike in-store service, home delivery of medications is suitable only for OTC but not for prescriptions medications Nearly half the number of participating pharmacists (n = 153, 47.2%) believe that the service is suitable for refill prescriptions but not for new prescriptions. Pharmacists believe that the foremost pros of the service were to continue life-saving medical treatment (n = 249, 76.9%), serve sick, elderly, and disabled patients (n = 241, 74.4%), and decrease congestion at health facilities (n = 228, 70.4%). On the other hand, the cons of this service, as perceived by pharmacists included failing to build a professional relationship with patients (n = 203, 62.7%), and the contribution to communication errors (n = 147, 45.4%). Logistic regression showed that pharmacists who serve 50 patients or more per day were more willing to use the service than those serving less than 50 patients per day (OR = 2.058, P = 0.032).ConclusionThe majority of participating pharmacists in this study were willing to use the service at their community pharmacies, especially those serving a large number of patients per day which may indicate the potential of this service in relieving the pressure on community pharmacies and allowing them to serve more patients efficiently.

To date, studies examining the proconvulsants or anticonvulsants in chronic epileptic models in rat are rare. Propofol has conflicting reports regarding the pro- or anti-convulsant effects on chronic seizures. Midazolam is considered another anesthetic option that used in combination with propofol and has documented anticonvulsant properties. The present study was undertaken to examine the effects of intravenous administration of various doses of propofol, in comparison to midazolam, on seizures activity in chronically epileptic rats, using PTZ seizures kindled model. Kindling in control and experimental rats was induced by intraperitoneal sub - convulsive dose of PTZ (35 mg/kg) every alternate day. After each injection of PTZ, rats were monitored for 30 minutes for behavioral seizures occurrence. Seizure scores were rated according to Racin scale. Once kindled, animals were treated with different doses of midazolam or propofol prior to PTZ challenge and were subsequently observed. The present study showed that, propofol or midazolam intravenous administration suppressed PTZ seizures in kindled rats and led to a significant, dose dependent decrease of behavioral seizures score and increased the percent inhibition of PTZ kindled seizures stage. The ED50 of propofol for percent inhibition of PTZ kindled seizures stage was 5.36 mg/kg, whereas the ED50 of midazolam was 1.85 mg/kg, suggesting that the anticonvulsant effects of midazolam against PTZ kindled seizures are more profound. In conclusion, the current study showed that propofol protected against PTZ kindled seizures and provided further evidence for its anticonvulsant effects reported in other chronic animal seizures, namely amygdala-kindled convulsions in rats.

Background: Increased application of electronic health information systems led to the buildup of patient information and facilitated access to this data. Consequently, the confidentiality of this information became an ethical challenge to medical teams' members including pharmacists. However, no study has been conducted to assess pharmacists’ knowledge or practices of data confidentiality. Thus, the aim of this study was to assess the current practices and knowledge of pharmacists concerning data confidentiality. Methods: This was a cross sectional study that included clinical pharmacists in tertiary hospitals and health care centers in Jordan. Data was collected through phone or face to face interviews using a data collection sheet. All continuous data was presented as median ± interquartile range (IQR) and categorical data as frequency (%). One way Chi square was used to check significant differences among categorical groups. Predictors that may affect knowledge and behavior scores were screened using simple linear regression. Results: A total of 388 pharmacists were interviewed with a mean age of 39.59 ± 8.32 years, with an average experience of 12.55 ± 7.30 years. Pharmacists relied on their personal experience to resolve ethical dilemmas (n = 274, 70.3%), and when they seek advice, their work colleagues (n = 180, 46.4%) %), followed by the head of departments (144 n; 37.1%), were the main source of advice on ethical issues. The overall median knowledge score of pharmacists about data confidentiality was 2.0 out of 5.0 (IQR = 2.0). A considerable percentage of the pharmacists was willing to share information with family members without asking for permission from the patient (n = 98, 25.3%). Pharmacists had a median behavior score of 3.5 out of 4.0 (IQR = 0.4) regarding practices related to data confidentiality, where the majority of them handled medical information from the patient with great confidentiality (304 n, 78.4%), and 85.8% of them (n = 333) gave patient's sexual diseases-related medical information the highest confidentiality. However, based on univariate and multivariate linear regression analysis, none of the examined sociodemographic variables significantly predicted pharmacists’ knowledge or behaviors (P > 0.05). Conclusion: Pharmacists are aware of the importance of confidentiality issues of their patients. However, a number of gaps in their knowledge and practices of data confidentiality were identified. Training that targets these gaps in their knowledge, and rectifies incorrect practices is needed during university education and as part of their continuous medical education.

Waterpipe smoking is a form of tobacco use that causes nicotine/tobacco dependence and has become a global health problem. In this study, the association of rs16969968 SNP in the CHRNA5 gene with waterpipe dependence was investigated. A total of 386 men and women who used a waterpipe to smoke tobacco were recruited and divided into less dependent and more dependent smokers based on their score on the Lebanon Waterpipe Dependence Scale (LWDS). Results showed a significant difference in the distribution of GG, GA, and AA genotypes by waterpipe dependence status (p

Background: Worldwide, the prescribing pattern of the Nonsteroidal Anti-inflammatory Drugs (NSAIDs) has increased. They are considered highly effective medications in controlling various conditions including inflammatory diseases. They are associated with various adverse effects including gastrointestinal bleeding and ulcer and renal toxicity though. These adverse effects are generally potentiated when NSAIDs are co-prescribed with other drugs that share similar adverse effects and toxicities. Developing severe side effects from NSAIDs is more prone among elderly patients. Hence, it is crucial to evaluate prescribing pattern of these agents to prevent/decrease the number of unwanted side effects caused by NSAIDs. Aim: The aim of this study is to assess the prescribing pattern of NSAIDs among elderly and the co-prescribing of NSAIDs and different interacting drugs, which could lead to more incidences of NSAIDs-induced toxicities among Jordanian elderly patients. Settings and Methodology: A multicenter retrospective study was performed during a three months period in Jordan. The study involves a total number of (n = 5916) elderly patient’s records obtained from Four governmental hospitals in Jordan. Results: A total number of (n = 20450) drugs were prescribed and dispensed for patient. NSAIDs drugs prescribing percentage was 10.3% of total medications number. Aspirin was the most commonly prescribed NSAIDs among patients (70.4%), followed by Diclofenac sodium in all dosage forms (25.1%) and oral Ibuprofen (3.1%. In addition, Aspirin was the highest NSAIDs co-prescribed with ACEI (e.g., Enalapril), ARBs (e.g. Candesartan and Losartan), Diuretics (Furosemide, Indapamide, Hydrochlorothiazide, Amiloride, and Spironolactone), Warfarin and antiplatelets (Clopidogreal and Ticagrelor) followed by Diclofenac and other NSAIDs. Conclusion: NSAIDs prescribing rate among elderly patients was high. Additionally the co-prescribing of NSAIDs especially Aspirin with other agents, which contributes to NSAIDs nephrotoxicity and gastrointestinal toxicity, were high. Strict measurements and action plans should be taken by prescribers to optimize the medical treatment in elderly through maximizing the benefits and decreasing the unwanted side effects. Keywords: NSAIDs, Elderly, Jordan, Co-prescribing, COX-1, COX-2, Aspirin

Abstract Background Research ethics is required for high-quality research that positively influences society. There is limited understanding of research ethics in Middle Eastern countries including Jordan. Here, we aim to investigate the level of understanding of research ethics principles among health sciences faculty members in Jordan. Methods This is a cross sectional study where faculty members from the University of Jordan were surveyed for their knowledge and, attitude of research ethics principles. The study was conducted in the period between July 2016 to July 2017 using a customized-design questionnaire involving demographic data and participants’ contributions toward research, and assessment of participants’ knowledge, belief and attitude towards research ethics. Different question-formats have been used including multiple-choice, yes or no, and a four point Likert-type questions. Obtained responses were tabulated according to gender, academic-rank, and knowledge about research ethics principles. Results The study had a response rate of 51%. Among the 137 participants of this study, most (96%) were involved in human and animal research, yet, only 2/3 had prior training in research ethics. Moreover, 91% believed that investigators should have training in research ethics and 87% believed that there should be a mandatory postgraduate course on that. The average correct scores for correct understanding of researchers towards research ethics was 62%. Yet, there were some misconceptions about the major ethical principles as only 43% identified them correctly. Additionally, the role of research ethics committees was not well understood by most of the respondents. Conclusions Although there is acceptable knowledge about research ethics, discrepancies in understanding in research ethics principles seems to exist. There is a large support for further training in responsible conduct of research by faculty in health sciences in Jordan. Thus, such training should be required by universities to address this knowledge gap in order to improve research quality and its impact on society.

Objective: To assess the prevalence of potential drug-drug interactions (pDDIs) among polypharmacy patients in Jordan using Lexicomp®. Additionally, this study aims to categorize and rate the identified pDDIs according to interaction risk, severity, and reliability. Methods: A descriptive cross-sectional study was conducted at six different hospitals representing different public health sectors in Jordan (ministry of health, royal medical services, and university-affiliated hospitals). Polypharmacy patients from outpatient clinics (e.g., cardiology,& and internal medicine) were identified, recruited, and interviewed by clinical pharmacists. pDDIs were assessed using the Lexicomp® mobile application and classified according to interaction risk rating, severity, and reliability rating. Furthermore, the prevalence of pDDIs across chronic medical conditions was assessed. P-value

Abstract Background Obesity is a multifactorial chronic disease that comprises several pathological events, such as adipose hypertrophy, fatty liver and insulin resistance. Inflammation is a key contributer to development of these events, and therefore, targeting inflammation is increasingly considered for management of obesity and its complications. The aim of the current study was to investigate therapeutic outcomes of anti-inflammatory activities of the natural compound Silibinin in reversing obesity and its complication in mice. Methods C57BL/6 male mice were fed high-fat diet for 8 weeks until development of obesity, and then injected with 50 mg/kg silibinin intraperitoneally twice per week, or vehicle for 8 weeks. Throughout the experiment, mice were continuously checked for body weight and food intake, and glucose tolerance test was performed toward the end of the experiment. Animals were sacrificed and serum and tissues were collected for biochemical, histological, and gene expression analysis to assess silibinin effects on adipose inflammation, fat accumulation, liver adipogenesis and glucose homeostasis. Results Silibinin treatment reversed adipose tissue inflammation and adipocyte hypertrophy, and blocked progression in weight gain and obesity development with no significant effects on rates of food intake. Silibinin also reversed fatty liver disease and restored glucose homeostasis in treated animals, and reversed hyperglycemia, hyperinsulinemia and hypertriglyceridemia. Conclusion In this study, we demonstrated that silibinin as an anti-inflammatory therapy is a potential alternative to manage obesity, as well as its related complications. Moreover, silibinin-based therapies could further evolve as a novel treatment to manage various inflammation-driven disorders.

1,2,3-Thiadiazole, 1,2,3-selenadiazole, and semicarbazones that are prepared from ketones are promising moieties for lead compound development. New 1,2,3-thiadiazole (2c-4c) and 1,2,3-selenadiazole derivatives (2d–4d) were prepared from the corresponding semicarbazones (2b-4b). The semicarbazones (2b-4b) were prepared from the corresponding ketones (2a-4a). Characterization of the synthesized compounds was performed using infrared spectra (IR), proton nuclear magnetic resonance (1H-NMR) spectra, carbon nuclear magnetic resonance (13C-NMR), ultraviolet spectra, mass spectrometry, and elemental analysis. The antimicrobial activity of the prepared compounds was explored in vitro against various pathogenic microbes. All heterocyclic compounds had positive antimicrobial activity, but these activities varied in the extent of antimicrobial coverage. Compounds (2c) and (2d) had positive activity against Staphylococcus aureus and Escherichia coli but without any antipseudomonal activity. Compound (3c) had the most activity against Candida albicans with potential as a novel antifungal agent along with activity against some Gram-positive and Gram-negative bacteria. Compounds (4c) and (4d) exhibited broad-spectrum coverage in which both compounds demonstrated antimicrobial activity against all microorganisms explored. Interestingly, they both had substantial antipseudomonal activity against local resistant Pseudomonas aeruginosa and reference P. aeruginosa (ATCC 27853). This may suggest the potential for compounds (4c) and (4d) as novel broad-spectrum antibacterial agents with promising antipseudomonal activity. In conclusion, new 1,2,3-thiadiazole (2c-4c) and 1,2,3-selenadiazole (2d-4d) derivatives were identified as potential lead compounds for novel antibacterial agents.

The outbreak of the COVID-19 pandemic puts a great strain on the healthcare system, as the national and global infection rates increased rapidly. Efforts were devoted to minimizing the effects of the spreading pandemic without overwhelming the already stretched healthcare system. The study objective was to establish how coronavirus lockdown was affecting chronic disease care among pediatric patients admitted to hospitals in developing countries. For that purpose, a cross-sectional survey of registered pediatricians was carried out. Findings showed that the mortality rate from COVID-19 in children seemed to be low. However, children with chronic illnesses were likely to be gravely affected by the disturbance of repetitive healthcare services. About 79% of pediatricians treated a child with a chronic condition during the lockdown. Furthermore, 15% of patients with chronic diseases visiting pediatricians exhibited uncontrolled emerging complications. In addition, 9% of pediatricians reported one to five fatalities among children under their care due to delay or lack of appropriate medical care in the period of the lockdown. Residents (48.9%) reported a significantly (p

Background: Uncontrolled diabetes mellitus (DM) is accompanied by progressive cognitive deterioration mediated by neurodegeneration due to chronic hyperglycemia and subsequent oxidative damage. Oxidative stress damage due to high blood glucose is associated with functional and structural changes in the hippocampus, responsible for cognitive properties, leading to cognitive impairment. Edaravone is a potent antioxidant with neuroprotective properties that has mainly been used to treat amyotrophic lateral sclerosis and has been tested in many models associated with cognition deficits. Our study aimed to assess edaravone's potential neuroprotective activity to reverse memory impairment in a streptozotocin (STZ)-induced diabetic rat model. Methods: DM was induced by a single 50 mg/kg STZ intraperitoneal injection. Rats received edaravone intraperitoneally at 6 mg/kg/day, six days/week, for four weeks. The radial arm water maze behavioral test evaluated both learning and memory. Oxidative stress was evaluated by molecularly measuring hippocampus enzyme activities and biomarker levels. Results: Impairment of short- and long-term memory was observed in rats with STZ-induced diabetes, accompanied by decreased hippocampal superoxide dismutase and glutathione peroxidase activities and reduced/oxidized glutathione ratio. Edaravone significantly attenuated memory impairment (p 0.05). Conclusion: Edaravone prevented STZ-induced memory impairment and attenuated oxidative stress likely by restoring hippocampus antioxidant mechanisms.

Background. Two questionnaires (Berlin Questionnaire (BQ) and Epworth Sleepiness Scale (ESS)) are the widely used screening instruments for subjects suffering from sleep disorders. Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing. The biomimetic oral appliance therapy (BOAT) offers an alternative nonsurgical method, which can improve symptoms and indices of OSA on objective sleep testing. Aim. To describe testing the ability of BQ and EES for prediction of BOAT outcomes during OSA. Methods. Seventeen adults (9 males, 8 females; age, mean (SD): 45.76 (10.31), BMI mean (SD): 33.5(13.43)) who underwent an overnight sleep study were diagnosed by a sleep specialist physician. The BQ and EES were recorded before and after BOAT treatment. Subjects with mild-to-moderate OSA had 2 months of follow-up visits and underwent a final overnight sleep study to measure apnea-hypopnea index (AHI). The subjects were asked to wear the appliance for 10–12 hours/day and at night. Findings were analyzed statistically using paired t-tests. Result. As per sleep test results, pre-BOAT AHI measures versus post-BOAT AHI measures showed significant improvement. Comparing the BQ before versus after treatment showed that at the pretreatment stage, 66.0% of patients had high-risk score, whereas 34% had low-risk score. After treatment, 66.0% of patient had low-risk scores, whereas 34% had high-risk scores. As for the ESS, treatment resulted in significant reduction of total score from 10.43 ± 6.32 to 5.00 ± 5.20 (P0.05, and r = −0.41, N = 26, P>0.05, respectively). Conclusion. The BOAT device may provide a useful form of therapy to improve OSA-related PSG parameters such as AHI. Both BQ and ESS were predictive to improvements detected by the sleep study during BOAT device use.

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

Chemoresistance is one of the major challenges in lung cancer treatment. The identification of new chemotherapeutic therapies with increased efficacy and minimal toxicity over those currently in use is a key area of current research. Calcium channel blockers are emerging as anticancer agents in lung and other cancers. This study evaluates the ability of amlodipine to sensitize non-small cell lung cancer (NSCLC) cells to the first-line chemotherapeutics used in lung cancer treatment. Cell viability in the presence of carboplatin, gemcitabine, pemetrexed, or paclitaxel alone or combined with amlodipine was evaluated in A549 and H1299 NSCLC cell lines using the colorimetric MTT cell proliferation assay. Nonlinear regression curve fit analyses were used to calculate half-maximal inhibitory concentrations (IC50). Sensitization was estimated by the ratio of the IC50 of the monotherapy to the IC50 of the combined therapy that included that drug (R-value). We found that amlodipine significantly reduced cell viability in a dose-dependent manner, with IC50 values of 23 and 25.66 μM in A549 and H1299 NSCLC cells, respectively. In addition, amlodipine combined with carboplatin, gemcitabine, pemetrexed, or paclitaxel had a significant sensitization effect on A549 and H1299 NSCLC cells compared to their single-drug treatments (R > 1.0). Our findings confirm the ability of amlodipine to sensitize NSCLC cells to first-line chemotherapy treatments.

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

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 cycling and swimming PA. Additionally, DASS scores (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.

Background: Colorectal cancer is a leading cause of mortality worldwide. Resistance of this cancer to the available chemotherapeutic agents creates a need to develop new therapeutic agents. Pentoxifylline (PTX) has been shown to have anticancer effects on multiple cancer types. Objective: In this study, we evaluated the anticancer effect of PTX in CRC cells. Methods: We measured PTX's effect on cell proliferation using the MTT assay and on cell death induction by PI staining/flowcytometry. We also assessed the effect of treatment on mitochondrial membrane potential (MMP). Results: We found that PTX arrested the growth SW480 CRC cells with a peak effect plateauing at 10 mM of PTX after 72 h of treatment. Surprisingly, similar effect wasn't noticed in HCT-116 cells. Similar pattern of effect was noticed on apoptosis of both cell lines, as PTX induced more apoptosis on SW480 cells with no similar effect on HCT-116 cells. Studies using variable caspase inhibitors showed involvement of primarily capsase-9, as well as caspases-2 and -3 but not capsase-8. PTX also induced MMP changes leading to caspase-dependent apoptotic cell death. In addition to that, results indicated that apoptosis was caspase-dependent and was mediated through the mitochondria. Conclusion: These findings indicate that PTX has a promising antitumor activity against CRC cells and warrants further clinical evaluation.