Navigating parental attitudes on childhood vaccination in Jordan: a cross-sectional study

This study investigated parental attitudes toward childhood vaccination in Jordan, focusing on acceptance, concerns, and perceptions. A cross-sectional survey conducted from January to February 2024 included 939 parents. Findings indicated that 85.4% (n = 802) of respondents received the COVID-19 vaccine, while only 25% (n = 229) vaccinated their children. Concerns regarding vaccine safety and efficacy were prevalent, with 63.9% (n = 600) expressing worries about side effects and 46.9% (n = 440) trusting immunization programs. Post-pandemic, 34% (n = 319) reported a more negative attitude. Logistic regression showed parents not vaccinating their children against COVID-19 were significantly less likely to exhibit positive attitudes toward childhood vaccination (OR = 0.412, p < 0.001). Older participants were more inclined toward negativity post-pandemic (OR = 1.031, p = 0.007). In conclusion, parental attitudes shifted post-COVID-19, reflecting hesitancy and decreased trust. Addressing concerns and restoring confidence are crucial, especially for children's health. Education through healthcare providers and dispelling social media misinformation are essential. Implementing strategies to enhance post-pandemic vaccine acceptance is imperative for preventing outbreaks of vaccine-preventable diseases.

Pandemic H1N1 influenza virus triggers a strong T helper cell response in human nasopharynx-associated lymphoid tissues

The pH1N1 belongs to influenza A family that is sometimes transmitted to humans via contact with pigs. Human tonsillar immune cells are widely used as in vitro models to study responses to influenza viruses. In the current study, human memory (M) and naïve (N) T cells responses in mononuclear cells of tonsil (TMCs) and peripheral blood (PBMCs) were stimulated by pH1N1/sH1N1, and then stained for estimation of T cells proliferation index. Individuals with an anti-pH1N1 hemagglutination (HA) inhibition (HAI) titer of forty or greater exhibited stronger HA-specific M-CD4+ T cells responses to pH1N1 in TMCs/PBMCs than those with an HAI titer of less than forty (P < 0.01). In addition, a positive correlation was observed between proliferation indices of M-CD4+ T cells induced by exposure to sH1N1/pH1N1 (p < 0.01). Moreover, a strong correlation (p < 0.001) was detected between subjects' age and their HA-specific M-CD4+ T cells induced by pH1N1 exposure, indicating that this response was age-dependent. Finally, stimulation of TMCs with pH1N1-HA resulted in a significant M-CD8+ T cells response (p < 0.05). In conclusion, pH1N1 HA elicits a strong M-CD4+ T cells response in TMCs. Additionally, this response correlates with the response to sH1N1 suggesting cross-reactivity in T cells epitopes directed against HAs of both viral strains.

Vitamin B12 Protects Against Genotoxicity Induced by Cisplatin

BACKGROUND

Cisplatin is an effective synthetic chemotherapeutic drug used for cancer treatment. Vitamin B12 has been shown to possess anti-genotoxic activity. This study aimed to investigate the effect of vitamin B12 on chromosomal damage induced by cisplatin.

METHODS

The level of sister chromatid exchanges (SCEs) and chromosomal aberrations (CAs) were measured in cultured human blood lymphocytes treated with cisplatin and/or vitamin B12.

RESULTS

The results showed a significantly elevated frequency of CAs and SCEs of cisplatin-treated cultures compared to the control (P < 0.05). The CAs and SCEs induced by cisplatin were significantly lowered by pretreatment of cell cultures with vitamin B12. In addition, cisplatin caused a slight reduction in the mitotic index (MI), while vitamin B12 did not modulate the effect of cisplatin on MI.

CONCLUSION

Vitamin B12 can protect human lymphocytes against genotoxicity associated with cisplatin.

Long-term effects of neonatal pain and sucrose treatment

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.

Attitude towards donation of the excised foreskin after circumcision surgery for research: A study from Madinah, Saudi Arabia

Studies have shown the possibility of using the part of the foreskin removed after circumcision in the field of scientific and therapeutic research. Donations of tissues and organs are always associated with ethical challenges posed by bioethicists and societies to ensure the appropriate use of these tissues/organs. The purpose of this study was to understand the attitudes and awareness of parents/guardians regarding donation of excised foreskin to research and medical use. The study was based on a questionnaire and included 133 parents/guardians who visited Uhud Children's Hospital in Madinah, Saudi Arabia for newborn male circumcision. The results showed a high willingness (61.7%) to donate the extracted foreskin to research. The willingness to donate the extracted foreskin to research associated with undergraduate degree (P = 0.018), male sex (P = 0.011), high income (P = 0.029), and participation in previous research studies (P = 0.002). About 41.8% were convinced that written informed consent should be obtained before circumcision surgery, 38.1% (n = 51) were convinced that written informed consent should be taken after surgery, while the remaining 19.4% reported that the timing of written informed consent is unimportant. Finally, fear of excision of excess tissue (74.5%), lack of confidence in the research (68.6%), and potential for commercial use (64.7%) were the main barriers to unwillingness to donate the excised foreskin for research. In conclusion, a reasonable portion of Saudis agreed to donate their foreskin for research purposes. There is an urgent need to enhance awareness and attitudes towards tissue donation for research and therapeutic use.

Investigation of the association of the RAN (rs14035) and XPO5 (rs11077) polymorphisms with venous thromboembolism

INTRODUCTION

Venous thromboembolism (VTE) is the third most common hemostatic disease worldwide. Studies have reported a role for microRNA (miRNA) in the homeostasis and development of VTE. The ras-related nuclear protein (RAN) and exportin 5 (XPO5) genes are involved in miRNA biogenesis, as both regulate the transport of pre-miRNA from the nucleus to the cytoplasm. Therefore, the aim of the current study is to examine the association between RAN (rs14035) and XPO5 (rs11077) single nucleotide polymorphisms (SNPs) and VTE.

METHODS

The study sample consisted of 300 subjects (150 patients and 150 age and sex matched controls). The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and tetra-primer amplification refractory mutation system (T-ARMS) techniques were used to genotype rs14035 and rs11077, respectively.

RESULTS

The results showed that there was a significant association between the XPO5 rs11077 and the risk of VTE (P < 0.05). Subjects with AC (OR: 2.08, CI:1.26-3.44) and CC (OR: 1.77, CI: 0.88-3.55) genotypes were at increased risk of the developing VTE. Regarding RAN gene, no association was found between rs14035 and VTE (P > 0.05). In addition, no associations were found between XPO5 rs11077 and RAN rs14035 genotypes with blood cell parameters (P > 0.05). As for the demographic characteristics, the results indicated a strong association between family history and body mass index (BMI) with the risk of VTE (P < 0.01).

CONCLUSION

The XPO5 rs11077, BMI and family history might contribute to the development of VTE in Jordan.

Coriandrum sativum and Aloysia triphylla can Protect the Development of Cancer: an in Vivo Study Using Mouse Painting Assay

AIM

The aim of this study is to examine the protective properties of Coriandrum sativum and Aloysia triphylla against the development of skin cancer.

METHOD

The skin cancer balb/c mouse model was utilized in the study. Plant extracts were administered to animals using oral gavage. In addition, skin cancer was induced using 7,12-dimethylbenz(a) anthracene (DMBA).

RESULTS

The study found that A. triphylla extract reduced both tumor incidence (P<0.01) and papilloma frequency (P<0.001) and delayed the onset of tumor development (P<0.001). The A. triphylla extract did not affect tumor size in animals. C. sativum leaf extract reduced the number of tumors per animal, the incidence of tumors, and the frequency of papilloma (P<0.05). In addition, it delayed (P<0.01) the onset of tumors. Treatment of animals with C. sativum seed extract reduced the frequency of papilloma (P<0.05) and delayed the onset of tumors (P<0.05). However, the examined plant extracts did not impact the size of tumors induced by DMBA (P>0.05).

CONCLUSION

The findings of this study revealed that C. sativum and A. triphylla could protect against cancer development as indicated using the animal model of skin painting assay.

The impact of COVID-19 pandemic on tobacco use: A population-based study

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.

The Impact of COVID-19 Confinement on Reading Behavior

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 1/3rd 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.

Health-Related Quality of Life for Jordanian-Recovered Individuals During Post-COVID-19 Era: A Cross-Sectional Study

Aim

This study aims to determine health-related quality of life (HRQoL) that includes the physical and mental health of recovered patients of COVID-19 and examines the significant impact of variables such as period of infection, sample demographics characteristics, hospitalization past, and chronic disease past and the other variables on HRQoL of COVID-19-recovered patients.

Methods

An exploratory, community-based, cross-sectional research layout was adopted, using an electronic self-reporting survey disseminated online to recovered COVID-19 patients in Jordan. Targeted COVID-19 patients were individuals who were 18 years old or above. They had a documented background of COVID-19 illness, as stated in the following inclusion requirements: Those who had not been formally proven to have been afflicted by COVID-19 were excluded.

Results

The mean of the physical well-being of study participants during COVID-19 was M=68.00 (SD=6.95), representing medium physical well-being status. The mean of psychological well-being of study participants during COVID-19 was M=60.20 (SD=8.85), representing medium physical health. Multiple regression showed that female recovered patients who are not working, with a low level of income, married women, and who getting COVID-19 more than once are having lower health-related quality of life compared to other recovered patients.

Conclusion

The HRQoL of COVID-19 patients was significantly impacted, independent of the period since hospitalization or rehabilitation. Policymakers and health workers should research strong ways to enhance the HRQoL of COVID-19 patients as soon as possible. Elderly patients and those who have been infected more than one time and being hospitalized have a greater probability of decreased HRQoL after infection.

Mental health of COVID-19 recovered individuals: A national study from Jordan

<b>Aim:</b> To investigate the relationship between COVID-19 infection and subsequent long-term mental consequences among patients recovering from the disease.<br /> <b>Methods:</b> A cross-sectional and survey-based study was conducted in Jordan using Google Forms during the period from March to July of 2022. The requirement to participate was that individuals be at least 18 years old and have at least one symptomatic COVID-19 infection. A total of 2,055 subjects recruited in the study. Mental health was assessed using mental health inventory-38 (MHI-38).<br /> <b>Results: </b>Females represent 64.8% (n=1,182) of the sample. The mean age of the participants was 39.9±14.4 years. Subjects who recovered from COVID-19 scored slightly higher than moderate on different scales of MHI-38. These include anxiety, depression, loss of behavioral and emotional control, general positive affect, emotional ties, and life-satisfactions. The prevalence of depression among participants was 46.3% (n=952). The prevalence of anxiety among participants was 45.8% (n=942). The prevalence of loss of physical and emotional control was 47.2% (n=970). Multiple regression showed that employment status, tobacco use, and severe COVID-19 infection were associated with mental illness. Not working, using tobacco, and having severe COVID-19 infection were more likely to develop mental illness (p&lt;0.01).<br /> <b>Conclusion:</b> Individuals who recover from COVID-19 are susceptible to developing mental illnesses. Factors associated with such susceptibility include employment status, tobacco use and severity of infection. The current findings can be used in mental health interventions targeting individuals who recovered from COVID-19.

Breast Cancer Beliefs and Screening Practices among Syrian Refugee Women and Jordanian Women

Despite significant declines in breast cancer (BC) incidence in the West, this disease is widespread in Jordan, where cancer detection occurs at much advanced stages. This is particularly concerning for Syrian refugee women resettled in Jordan, who are less likely to undergo cancer preventative procedures because of poor health literacy and lack of health services access. The present work assesses and compares breast cancer awareness and breast cancer screening behaviors among Syrian refugee women and Jordanian women residing close to the Syrian-Jordanian border city of Ar-Ramtha. A cross-sectional survey was conducted using a validated Arabic version of the Breast Cancer Screening Beliefs Questionnaire (BCSBQ). A total of 138 Syrian refugee women and 160 Jordanian women participated in the study. Results indicate that 93.6% of Syrian refugee women and Jordanian women ≥ 40 years of age reported never having undergone a mammogram. Syrian refugee women and Jordanian women reported low attitudes toward general health checkup (mean score for Syrian refugees 45.6 vs. 42.04 among Jordan women; p = 0.150). Barriers for BC screening were higher among Syrian refugees (mean score = 56.43) than Jordanian women (mean score = 61.99, p = 0.006). Women with higher education were more likely to report fewer barriers to screening (p = 0.027). The study documents a significant lack of BC screening awareness among Syrian refugee women and Jordanian women, indicating that future work is needed to alter current attitudes towards mammograms and early detection measures especially for Syrian refugee women and Jordanian women residing in rural areas of Jordan.

Understanding Mental Health Status of Syrian Refugee and Jordanian Women: Novel Insights from a Comparative Study

(1) Background: War and displacement are well-known predictors of negative mental health outcomes among affected populations. This is especially relevant for refugees of war, particularly women, who often repress their mental health needs due to family responsibilities, social stigma, and/or cultural pressures. In this study, we compared the mental health status of urban Syrian refugee women (n = 139) with local Jordanian women (n = 160). (2) Methods: Psychometrically validated Afghan Symptom Checklist (ASC), Perceived Stress Scale (PSS), and Self-Report Questionnaire (SRQ) examined psychological distress, perceived stress, and mental health, respectively. (3) Results: According to independent t-tests, Syrian refugee women scored higher than Jordanian women on the ASC [mean score (SD): 60.79 (16.67) vs. 53.71 (17.80), p < 0.001], PSS [mean score (SD): 31.59 (8.45) vs. 26.94 (7.37), p < 0.001], and SRQ [mean score (SD): 11.82 (4.30) vs. 10.21 (4.72), p = 0.002]. Interestingly, both Syrian refugee and Jordanian women scored higher than the clinical cutoff in the SRQ. Regression analyses indicated that more educated women were less likely to score high on the SRQ (β = -0.143, p = 0.019), particularly in the anxiety and somatic symptoms subscale (β = -0.133, p = 0.021), and were less likely to exhibit symptoms of ruminative sadness (β = -0.138, p = 0.027). Employed women were more likely to exhibit high coping ability than unemployed women (β = 0.144, p = 0.012). (4) Conclusions: Syrian refugee women scored higher than Jordanian women in all used mental health scales. Access to mental health services and enhancing educational opportunities would help mitigate perceived stress and may enhance stress-coping abilities.

Sleep quality and sleep patterns among recovered individuals during post-COVID-19 among Jordanian: A cross-sectional national study

This study aims to investigate sleep patterns and quality in patients who had SARS-CoV-2 (COVID-19) infection and to determine the sleep quality and pattern among patients. A cross-sectional design was used to assess sleeping patterns during the post-COVID-19 era for recovered individuals from April 1st, 2022, to June 1st, 2022. The participants had to meet the following requirements: both genders, ages 18 to 70, and previously infected with COVID-19. The prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was 834 (40.6%), and the prevalence of disturbance in sleep quality was 1308 (63.6%). Lower economic status and younger ages in twenties and thirties experienced more disturbances in sleep patterns than other older ages. Many predictors were determined the quality of sleep. These predictors were age (B = .105, P = .00), income (B = .05, P = .035) and educational level (B = .20, P = .006). To sum up, our study found that the prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was moderate, and the prevalence of disturbance in sleep quality was high. The predictors of quality of sleep were age, income, and educational level. Practitioners should be trained to evaluate and manage sleep disturbances, as this comprehensive approach has the potential to reduce mental distress and prevent the consequences of sleep disturbances.

The Protective Effects of the Combination of Vitamin E and Swimming Exercise on Memory Impairment Induced by Exposure to Waterpipe Smoke

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.

Review of Clinical Equipoise: Examples from Oncology Trials

BACKGROUND

The current standards that govern clinical research have been shaped over the years through many historical, social, and political events. The third principle of the Belmont Report, Justice, guides the scientific community toward the equal distribution of benefits and risks in research involving human subjects. Clinical equipoise is the status of genuine uncertainty by the investigator about the superiority of one treatment arm over the other. The term clinical equipoise was proposed to provide an ethical ground to conduct randomized controlled clinical trials.

OBJECTIVE

The objective of this review is to provide the reader with an overview of the emergence of the term equipoise and its utilization in randomized controlled trials.

METHODS

In the current review article, the major oncology clinical trials and relevant patents were reviewed for the application/utilization of clinical equipoise.

RESULTS

The concept of clinical equipoise has been challenged, and different alternatives were proposed. Yet, these alternatives received numerous critiques and failed to fully replace equipoise. In addition, several patents related to anticancer agents tested in the described studies were examined. No specific reference was made as part of the patent to the status of clinical equipoise. Alternatively, a description of the study arms was provided.

CONCLUSION

There is a need for revisiting the concept of equipoise and its suggested alternatives for its ethical essence while addressing related challenges.

Reduction of Genotoxicity of Carbamazepine to Human Lymphocytes by Pre-treatment with Vitamin B12

BACKGROUND

Carbamazepine (CBZ) is widely used as an anti-epileptic drug. Vitamin B12 has been shown to protect against DNA damage caused by several mutagenic agents.

OBJECTIVE

This study aimed to investigate the effect of vitamin B12 on CBZ-induced genotoxicity in cultured human lymphocytes.

METHODS

Sister chromatid exchanges (SCEs) and chromosomal aberrations (CAs) genotoxic assays were utilized to achieve the study objective.

RESULTS

The results showed significantly higher frequencies of CAs and SCEs in the CBZ-treated cultures (12 μg/mL) compared to the control group (P<0.01). The genotoxic effects of CBZ were reduced by pre-treatment of cultures with vitamin B12 (13.5μg/ml, P<0.05). Neither CBZ nor vitamin B-12 showed any effects on mitotic and proliferative indices.

CONCLUSION

CBZ is genotoxic to lymphocyte cells, and this genotoxicity can be reduced by vitamin B12.

Public Perception Toward COVID-19 Disease Nature, Susceptibility to Complication, and Relationship to Influenza: A Cross-Sectional Study from Yemen

Background

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.

Genotoxicity of nedaplatin in cultured lymphocytes: modulation by vitamin E

Nedaplatin is a chemotherapeutic agent used widely in cancer therapy. Nedaplatin has been shown to cause DNA damage to cells via the induction of oxidative stress. Vitamin E (Vit E) has an anti-mutagenic activity that can protect cells from DNA damaging agents. The objective of this study is to examine the genotoxic and cytotoxic effects of nedaplatin in human cultured lymphocytes. In addition, modulation of such effects by Vit E was also examined. The frequencies of sister chromatid exchange (SCE) and chromosomal aberrations (CAs) were used as an indicator for genotoxicity. The mitotic and proliferative indices were used to examine the cytotoxic effects of nedaplatin. The results showed that nedaplatin significantly elevated SCE and CA frequencies in human lymphocytes (p ˂ 0.01). The increases in the frequencies of SCE and CA caused by nedaplatin were lowered by pretreatment treatment with Vit E (p < 0.05). Nedaplatin significantly lowered mitotic index but Vit E pretreatment did not modulate this effect. These results suggest that Vit E has the potential to ameliorate the genotoxicity of nedaplatin in cultured lymphocytes.

Changes in dietary habits and eating behaviors during COVID-19 induced confinement: A study from Jordan

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.

The attitude of fully vaccinated individuals towards COVID-19 vaccine booster dose: a transverse study from Jordan

Objectives

COVID-19 vaccines are efficient against serious infections, and those initiated by the various variants. Many high- and middle-income countries have decided to offer third-dose boosters to ensure their populations remain protected against novel COVID-19 variants before additional waves of COVID-19. This study aims to assess individuals’ attitudes towards COVID-19 booster vaccination dose and to determine predictors of this attitude.

Methods

This study used a cross-sectional descriptive design. The inclusion criteria for participants were Jordanian adults who had been fully vaccinated against COVID-19. A quota sampling strategy based on the participant’s, age and gender was used to ensure that the sample was broadly representative of the general population in Jordan. The instrument was distributed across popular social networking sites such as Facebook and WhatsApp. The study was conducted in October 2021.

Key findings

The response rate of this study was 63.5% (n = 952). The mean score of attitudes towards a booster dose of COVID-19 was 47.1 ± 8.2, indicating that about half of the sample was supportive to the booster dose. There were differences in the acceptability of a booster dose for COVID-19 according to the demographic and clinical characteristics of the participants. Individuals with high income (B = 0.210, P = 0.000), high educational level (B = −0.076, P = 0.026), those who have suffered vaccine side effects (B = −0.081, P = 0.013) and follow the news about COVID-19 (B = 0.076, P = 0.043) were more likely to accept the booster dose than the other groups.

Conclusions

Participants had mixed attitudes towards the booster dose with about half of the participants willing to take the booster. Some factors associated with such attitude were identified. The findings are useful in developing and implementing effective vaccination strategies that target people who are not ready to take a booster dose.

Attitudes and knowledge of dental radiography amongst students of dentistry and related fields

OBJECTIVES

This study aimed to evaluate the level of knowledge and attitude towards quality control in dental radiography amongst students of dentistry, allied dental sciences and radiologic technology programmes.

METHODS

A cross-sectional survey was conducted using self-administered questionnaire on a convenience sample of 580 students from three universities in Jordan. The questionnaire was divided into sections that include personal sociodemographic variables, knowledge about quality assurance in dental radiography and attitude towards quality assurance in dental radiography.

RESULTS

A total of 286 students completed the questionnaire (response rate = 49.3%), of whom 70% were women. The respondents' knowledge scores ranged from 12.2% (n = 35) to 35.2% (n = 100). The mean of the quality assurance knowledge scores for the whole study sample was 20.3% ± 14.5%, with no significant difference between men and women (p = .643). Allied dental sciences students showed significantly higher knowledge scores (25.0 ± 13.0) than dentistry (17.8 ± 14.40) or radiologic technology students (20.9 ± 14.8). The average attitude scores towards quality assurance in dental radiography were fairly good (69.5 ± 26.4) with no statistically significant differences by study programme.

CONCLUSION

Knowledge of students about quality assurance in the three programmes is inadequate. The participants' attitude towards quality assurance was fairly good. The study provides feedback to dental schools to improve their curriculum by including quality assurance into student clinical practices. Further studies are requested to investigate the reasons behind this low level of knowledge.

The COVID-19 vaccine acceptance in Jordan: a meta-analysis and review of the literature

OBJECTIVE

The COVID-19 pandemic continues to impose a health and economic burden on the global population with millions of deaths linked to infection with the virus. Vaccination remains the most effective intervention to reduce infection, severity, and hospitalization for COVID-19. However, vaccine hesitancy has emerged as a global phenomenon facing the effective implementation of coronavirus vaccination programs. Several studies have been conducted in Jordan to examine vaccine acceptability. This study aims at calculating the pooled acceptance rate for the COVID-19 vaccine in Jordan.

MATERIALS AND METHODS

The Systematic Reviews and Meta-Analysis (PRISMA) guideline was adopted to conduct the present meta-analysis. The RevMan software was utilized to estimate the poled acceptance rate and to construct the study Figures.

RESULTS

Data from 22 studies that fit the study inclusion criteria were included in the analysis. The total number of participants was 38,600. The pooled COVID-19 vaccine acceptance rate was estimated to be 39.89% [95%-CI: 33.52-46.27]. Subgroup analysis, according to the year of publication, showed a pooled COVID-19 vaccine acceptance rate of 36.70% [95%-CI: 29.27-44.12, I2=100%, p<0.0001) for 2021, and 48.90% [95%-CI: 40.21-57.65, I2=91.0%, p<0.0001) for 2022. This indicates about a 33% increase in vaccine acceptance through 2022.

CONCLUSIONS

The reported COVID-19 vaccine acceptance rate in Jordan is below expectations. While the acceptance rate has increased in 2022 compared to 2021, there is still a need for more efforts and awareness interventions to reach a convincing level of vaccination against COVID-19 in Jordan.

Sources of SARS-CoV-2 transmission in Jordan: Self-reported approach

Background

Understanding the dynamics of virus transmission is essential for controlling the COVID-19 pandemic. Demographic factors could influence transmission of the virus in different communities. Herein, the sources of COVID-19 infection in Jordan were explored. In addition, the effects of demographic factors and the adherence to preventive measures on household transmission were investigated.

Methods

The study recruited Jordanian adults who recovered from COVID-19 from March to July 2021. Using a questionnaire, information about participants’ demographics, level of adherence to personal protective measures, and their perceived source of COVID-19 infection were collected. Crosstabs were used to test for differences in household transmission ratios between different demographic variables. Logistic regression analysis was used to predict risk factors for household transmission.

Results

The study recruited a total of 2313 participants. Household transmission was the most frequently reported source of infection (44.9%). Other sources of transmission were work/education related (16.0%), friends (8.6%), healthcare facilities (4.8%), social/event gathering (3.1%), shopping activities (2.2%), and public transport (1.6%). Significantly higher ratios of household transmission were reported by older adults (>60 years), college/university students, and female participants. No significant difference in household transmission was found between low-income and medium-high income groups. A significant increase in household transmission ratios was found with increased adherence to mask-wearing and social distancing. This could be a reflection of the reduced risk of community transmission with increased adherence to these preventive measures, coupled with the difficulty in adhering to these measures within the household setting. In multivariate logistic regression, females, young adults (18–30 years), older adults (>60 years), and those who adhere to mask-wearing most of the time were associated with an increased risk of infection in the household setting.

Conclusion

The results reported in the current study provided an insight into the transmission dynamics of the virus in Jordan, as an example of the MENA region. These findings could be invaluable for the future design of public health policies to control COVID-19 and possibly future pandemics.

Associations between rs2241766 and rs3774261 polymorphisms in ADIPOQ gene and atopic dermatitis

Atopic dermatitis (AD) is a common skin condition that affects both children and adults. Adipokines have been shown to play a role in the pathogenesis of AD. In the current study, the association between adiponectin gene (ADIPOQ) polymorphisms and AD was investigated. In addition, changes in serum adiponectin levels in AD patients were examined. Restriction fragment length polymorphism-PCR technique was used to genotype ADIPOQ SNPs. The ELISA assay was used to measure serum Adiponectin levels. A total of 324 participants (162 AD and 162 healthy controls) were included in the study. The frequency of the GG genotype of rs3774261 was higher in the AD group (44.5%) than in the control group (32.7%, P<0.05). Regarding the rs2241766 SNP, the frequency of the GG genotype was higher in the AD group (10.5%) than in the control group (3.1%), while the frequency of the TT genotype was lower (P<0.001) in the AD group (35.8%) than the control group (57.4%). Moreover, the GG haplotype of rs3774261 and rs2241766 significantly increased the risk of AD by about 2-fold (P<0.05). Finally, serum adiponectin levels were lower in the AD group than in the control group (P<0.05). These results indicate an association of the rs2241766 and rs3774261 SNPs with the risk of developing AD among the population examined.

Time course of changes in inflammatory and oxidative biomarkers in lung tissue of mice induced by exposure to electronic cigarette aerosol

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 < 0.05) in total inflammatory cells, eosinophils, macrophages and TNFα in the lung tissue after 1, 2 and 4 weeks of exposure. Furthermore, level of IL-10 significantly decreased, whereas levels of neutrophils and basophils significantly increased (P < 0.05) after 1 week of exposure. Exposure of animals to e-cigarette aerosol also induced significant decreases (P < 0.05) in the GSH/GSSG ratio, and GPx levels after 2 and 4 weeks of exposures. The activity of catalase was also reduced (P < 0.05) after 4 weeks of exposure. Level of TBARS showed a trend of elevation with time and it reached a significant elevation after 4 weeks (P < 0.01).

Conclusion

Current results indicate that inhalation of unflavored e-cigarette aerosol might be associated with inflammation in lung tissue that worsen as the duration of exposure increases. Further experiments including more time points, histopathology and pulmonary physiology experiments are needed to confirm the current results.

Awareness and perception of pharmacy researchers about conflict of interest: A study from the MENA region

The literature has shown some bias in research about the effectiveness and efficacy of medications due to the influence of the pharmaceutical industry. Thus, researchers' understanding of conflict of interest (COI) is substantial and may influence the quality of scientific research. Therefore, in this study, we aimed to assess pharmacy researchers' awareness and perception about COI in the Middle East and North Africa (MENA) region and the factors affecting their disclosure of COI. In this cross-sectional study, a convenience sample of pharmacy researchers from the MENA region was surveyed for their awareness and perception about the principles of COI. The questionnaire was divided into three main sections. The first section assesses the demographic information of the study participants; the second section assesses researchers' awareness and practices in dealing with COI; and, finally, the third section assesses participants' perception about COI. The questionnaire was uploaded on the Google Forms electronic platform, and it was distributed to the potential study participants via their professional emails. Finally, logistic analysis was used to evaluate predictors affecting COI disclosure by the study participants. A total of 271 pharmacy researchers participated in this study. Researchers were distributed based on their academic rank as follows: 63 professors (23.3%), 59 associate professors (21.8%), 97 assistant professors (35.8%), and 52 lecturers (19.2%). The majority of researchers indicated that they were familiar with the concept of COI (88.9%), and they agreed that the existence of COI should be disclosed by all authors (84.5%). About 33.2% of the study participants did not know if their institution had a policy for COI. About half of the participants (48.70%) believed that disclosure is the only way for the management of COI. However, only 41.7% of them (n = 113) indicated that they had disclosed COI in their published research. Finally, participants who have a collaboration with the industry showed a significantly lower tendency to disclose their COI than those who do not have any partnership with the industry (OR = 0.471, p = 0.017). The majority of the pharmacy researchers from the MENA region are familiar with the principles of COI, but a lower percentage of them disclose their COI in their published research. Efforts should be made to educate researchers about the importance of disclosing COI, which might reduce the potential of bias in their published research.

The public's attitude to and acceptance of periodic doses of the COVID-19 vaccine: A survey from Jordan

AIMS

This study surveyed people regarding their acceptance of periodic doses (i.e., annual boosters) of the COVID-19 vaccine. Moreover, factors that correlate with attitudes toward periodic COVID-19 vaccines were assessed and identified.

METHOD

The study employed a cross-sectional methodology. The study questionnaire was distributed using Google Forms. Data were collected during the last quarter of 2021, and 1,416 adults (18 years old and over) from Jordan responded. Acceptance of COVID-19 periodic vaccine doses was calculated as a percentage of the total number of study participants, and their attitudes were scored. A multiple regression model was used to determine the predictors of public attitudes toward the annual dose of COVID-19 vaccines.

RESULTS

The acceptance rate for receiving periodic doses of the COVID-19 vaccine was low (19.3%). Additionally, 26% of participants were unsure about receiving additional doses of the vaccine. However, 54.7% had a negative attitude toward getting periodic doses. The mean score for attitudes toward periodic doses was 47.9 (range: 29-66). Among the identified factors leading to decisions not to receive periodic doses were side effects (49.1%), waiting for further clinical studies (38.8%), and perceived no risk of contracting COVID-19 (17.7%). Regression analysis showed that income, educational attainment, and following the news about COVID-19 were predictors of participants' attitudes toward the periodic COVID-19 vaccine.

CONCLUSION

Acceptance of periodic doses of the COVID-19 vaccine in Jordan is low, and the public's attitude is generally negative. Health programs and educational interventions are needed to promote vaccine acceptance and positive attitudes.

Effect of natural products use prior to infection with COVID-19 on disease severity and hospitalization: A self-reported cross-sectional survey study

Background: Managing coronavirus disease 2019 (COVID-19) using available resources is essential to reduce the health burden of disease. The severity of COVID-19 is affected by nutritional status. In this study the effect of natural product use prior to infection with COVID-19 on disease severity and hospitalization was explored.

Methods: This was a cross-sectional study. Between March and July 2021, a self-administered survey was conducted in Jordan. Individuals who recovered from COVID-19 and were ≥18 years old were the study population. Study measures included the use of natural products, COVID-19 severity, and hospitalization status. A multivariate regression model was used for statistical analysis.

Results: The mean age (mean ± SD) of the study sample (n=2,148) was 40.25 ± 15.58 years old. Multivariate logistic regression showed that the regular intake of carnation (OR [0.56], CI [0.37–0.85]), onion (OR [0.69], CI [0.52–0.92]), lemon (OR [0.68], CI [0.51–0.90]), and citrus fruits (OR [0.66], CI [0.50–0.89]) before infection were associated with a substantial reduction in COVID-19 severity (P<0.01). Also, the consumption of carnation (OR [0.55], CI [0.34–0.88]), lemon (OR [0.57], CI [0.42–0.78]), and citrus fruits (OR [0.61], CI [0.44–0.84]) were associated with a significant decrease in the frequency of COVID-19-induced hospitalization (P<0.01).

Conclusions: Regular consumption of carnation, lemon, and citrus fruits before infection was associated with better outcomes for COVID-19. Studies on other populations are required to confirm these findings.

The effects of tobacco waterpipe smoking on the ocular surface

CLINICAL RELEVANCE

This study was conducted to determine the effect of tobacco waterpipe smoking on the ocular surface. The findings could be useful in understanding ocular surface changes and associated symptoms in waterpipe smokers.

BACKGROUND

Tobacco smoking has been reported to have many systemic and ocular adverse effects. However, the effect of specific delivery methods of tobacco using a waterpipe on the eye has not been commonly studied.

METHODS

This study enrolled 33 waterpipe smokers (with no history of cigarette smoking) and 31 non-smokers of age-matched control group. Participants were tested in the following sequence: the presence of ocular symptoms using Ocular Surface Disease Index questionnaire, tear osmolarity, tear film break-up time and corneal staining. Statistical analysis using unpaired sample t-tests was performed to study the difference in ocular surface parameters obtained for each group. The prevalence of dry eye disease was also measured in each group.

RESULTS

The mean tear osmolarity values and corneal staining were significantly higher (P < 0.05) in the waterpipe smoking group (314.64 ± 15.24 mOsm/L and 0.73 ± 0.94, respectively) compared to non-smokers (306.42 ± 13.48 mOsm/L and 0.10 ± 0.30, respectively). The mean values obtained from tear film break-up time test were significantly lower (P < 0.05) in the waterpipe smoking group (5.82 ± 3.77 s) compared to non-smokers (8.32 ± 3.46 s). The difference in the average Ocular Surface Disease Index scores in the study groups was not statistically significant (P > 0.05). The prevalence of dry eye disease was significantly higher (p < 0.05) in the waterpipe smoking group (57.6%), compared to the control group (35.5%).

CONCLUSION

Waterpipe smoking could have a significant effect on tear film parameters and be associated with dry eye disease. Dryness also seems to be more prevalent among waterpipe smokers.

Predictors of COVID-19 severity and hospitalization: A survey-based study from Jordan

Objectives

To explore the possible predictors of severe illness and hospitalization due to COVID-19 among Jordanians.

Method

The study was cross-sectional, survey-based and was conducted from March to July of 2021. Individuals who had recovered from COVID-19 (n = 2148) were recruited in the study. Participants were categorized according to the severity of COVID-19 infection and hospitalization. The study sample was stratified according to age, gender, body mass index (BMI), comorbidities, family income, smoking status, and ABO blood groups. Risk factors were investigated using the Chi-square test and multivariate logistic regression analyses.

Results

Severe illness and hospitalization were associated with older age, males, individuals with comorbidities, higher BMI, and lower-income. No significant differences were found in the incidence of severe illness or hospitalization frequency between the ABO groups or between smokers and non-smokers. Multivariate logistic regression analyses predicted male gender, being older than 40, having a BMI of over 30, having 3 or more comorbidities, and low family income as risk factors for severe COVID-19 outcomes.

Conclusion

Age was the strongest predictor for severe COVID-19 outcome, followed by having 3 or more comorbidities and to a lesser extent male gender and obesity. These results could help target at-risk groups with infection prevention measures including prioritizing primary COVID-19 vaccines, as well as booster doses.

Negative emotional symptoms during COVID19 confinement: The relationship with reading habits

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.

The relationships between 7-kchol, 7β-ohchol, chol-triol, Lp (A) and PON1 with coronary heart disease in patients with diabetes mellitus T1DM and T2DM

Oxysterols (OXY) are oxidized derivatives of cholesterol associated with oxidation and can increase the risk of cardiovascular diseases. The aim of the current study is to examine the relationships between OXY profile, lipids, lipoprotein(a) [Lp(a)] and paraoxonase1 (PON1) with coronary heart disease (CHD) in patients with diabetes mellitus type1 (T1DM) and type2 (T2DM). 120 diabetic patients (T1DM=40, T2DM=80) and 60 healthy subjects were recruited in the study. OXY profile (7-KChol, 7β-OHChol and Chol-triol) was measured using liquid chromatography-mass spectrometry. The clinical profile of the study participants was also collected. 7-KChol, 7β-OHChol and Chol-triol and Lp(a), FBG and glycation parameters were higher in diabetic patients compared to controls (p>0.01), whereas PON1 was lower in patients compared to controls (p>0.01). Within the T2DM group, 7-KChol and 7β-OHChol levels were associated with CHD, obesity, and smoking (p<0.05). In addition, KChol, 7β-OHChol and Chol-triol levels were associated with smoking in T1DM (p>0.05). In both diabetic types, 7-KChol, 7β-OHChol and Chol-triol were significantly correlated with TC, LDL, ApoB and Lp(a), glycation parameters and inversely with PON1 (p>0.05). OXY profile in diabetic patients can be used as a reliable biomarker of CHD, particularly in T2DM.

The beneficial effect of Adansonia digitata products success to modulate lipid profiles and inhibit LDL oxidation in-vitro: An associational study

BackgroundThere is a growing interest in medicinal plants in recent years due to their many therapeutic benefits and low side effects. Among the medicinal plants is the African Adansonia digitata (baobab) that has edible fruit. In the current study, the effect of A. digitata juice consumption on the lipid profile was investigated. In addition, inhibition of the oxidation of low-density lipoprotein cholesterol (LDL-C) in-vitro by A. digitata essential oil (EO) was also investigated. MethodsIn this cohort study, a total of 70 subjects of A. digitata users (AD group, 42 male and 28 female) and 70 non A. digitata users (Non-AD group, 44 male and 26 female) were recruited to participate in this study. We evaluated lipid profile, HbA1c, liver/kidney functions, and phytosterol contents in fasting blood samples of all participants.ResultsThe present findings illustrated significantly lower levels of total cholesterol, triglycerides, and LDL in the AD group compared to Non-AD (p < 0.01). In addition, essential oil of A. digitata inhibited LDL oxidation in-vitro as shown by the significant decreases in the formation of malonaldehyde (MDA), protein carbonyl (PC), and lipid hydroperoxide (LHP) (P<0.05). No significant changes in fasting blood glucose, HbA1c, HDL, kidney function, and liver function enzymes between the two groups were detected (P>0.05). ConclusionThe juice of A. digitata has hypolipidemic and antioxidative effects and might be beneficial for the management of lipid levels in the body.

Genotoxicity of Glyphosate on Cultured Human Lymphocytes

Glyphosate-based herbicides are the most used herbicides in the world. Despite being widely used, a dispute exists whether glyphosate-based herbicides have a negative effect on human health, particularly genotoxic effects. Therefore, the aim of this study was to investigate glyphosate genotoxicity on cultured human lymphocytes. Cultured human lymphocytes were treated with different concentrations of glyphosate (20, 40, and 200 µmol/L). Four toxicity measures were examined: frequency of chromosomal aberrations (CAs), frequency of sister-chromatid exchange (SCE), production of 8-OHdG, and cell kinetics analysis. The results show that glyphosate induced significant (P < 0.05) increases in the levels of SCE at the highest used concentration (200 μmol/L). However, no significant elevation in SCE levels was observed at the lower examined concentrations (20 and 40 μmol/L). No significant changes in CA were detected at all examined concentrations (P = 0.86). Also, glyphosate did not induce changes to the normal level of 8-OHdG at all examined concentrations (P = 0.98). Last, no significant changes in either mitotic index or proliferative index were observed at any examined concentrations (P > 0.05). The results collectively indicate a lack of genotoxicity and cytotoxicity of glyphosate in cultured human lymphocytes when dealing with environmentally relevant concentrations (20 and 40 μmol/L). However, being exposed to higher concentrations (200 μmol/L) led to slightly higher level of SCE. Therefore, we recommend cautionary measures when dealing with glyphosate-based herbicides for individuals, such as farmers, who may be extensively exposed to high concentrations of these herbicides.

Cytotoxicity of 3D Printed Materials for Potential Dental Applications: An In Vitro Study

Aim of the Study:

This study aims to evaluate the cytotoxicity of different stereolithographic 3D printed materials and the polyetheretherketone for varying time intervals using MTT assay and by application of these materials for intra-oral usage.

Materials and Methods:

Three groups of disc specimens (5 mm diameter, 2 mm thick) were manufactured by either selective laser melting (PA6 nylon, fiber reinforced PA6 nylon) or milling (PEEK). The cytotoxicity of these materials was tested by culturing the samples on human fibroblast cell lines prior to MTT assays (3- (4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, a yellow tetrazole). MTT assays were completed at 3, 6, and 10 days. Cell grown in normal medium without experimental material served as control. The total cell number and viability of cells pre-incubated with PA6 nylon, fiber-reinforced PA6 nylon, and PEEK were comparable to the control samples. Differences between the growth inhibitory effects of the samples in the MTT assay were below 0.05%.

Results:

Both nylon and fiber-reinforced nylon reduced the proliferation of normal human fibroblasts up to 6 days of treatment. PEEK had better biocompatibility than PA6 nylon and fiber-reinforced nylon. Both PA6 nylon and fiber-reinforced are 3DPrinted materials that showed cytotoxicity at 10 days. However, soaking the nylon materials for 6 days made them safe on normal human cells.

Conclusion:

PEEK material can be considered for intraoral usage as the material is biocompatible. Both PA6 nylon and fiber-reinforced PA6 nylon materials showed increased in-vitro cell death at 10 days, suggesting that they are non-biocompatible for intraoral usage beyond 6 days.

Lack of association between fat mass and obesity-associated genetic variant (rs8050136) and type 2 diabetes mellitus

Objectives:

To study the genotype and allele frequency of the fat mass and obesity-associated (FTO) rs8050136 A>C genetic variant and investigate its association with type 2 diabetes mekkitus (T2DM) parameters.

Methods:

This study was carried out on 118 diabetic patients and 106 healthy individuals (control) from Prince Mohammed bin Abdulaziz Hospital, Al Madinah Al Munawarah, Saudi Arabia. The TaqMan single-nucleotide polymorphism (SNP)genotyping assay was used for rs8050136 genotyping.

Results:

The frequency of the genotype AA was the same among T2DM and healthy control groups (21%). However, the frequency of genotype CC was 19.5% in T2DM patients and 24.5% in control individuals. There was no significant association between FTO SNP rs8050136 and an increased risk of T2DM. Furthermore, there was no association between the risk AA genotype and fasting blood glucose (p=0.092), glycated hemoglobin (p=0.177), or body mass index (p=0.561).

Conclusion:

Our findings show that the FTO rs8050136 A>C variant is not associated with T2DM in the Saudi population.

Human Cytomegalovirus Seroprevalence Among Blood Donors in the Madinah Region, Saudi Arabia

Background and objective

Human cytomegalovirus (HCMV), a double-stranded DNA virus of the Herpesviridae family, can remain latent for long periods of time. HCMV may cause severe illness in immunocompromised patients and is associated with congenital anomalies. This study aimed to determine the anti-HCMV immunoglobulin G (IgG) and IgM antibody seroprevalence among blood-donating Saudi men in the Madinah region.

Methods

A total of 375 blood-donating Saudi men were recruited from the Central Blood Bank in Madinah, the Kingdom of Saudi Arabia (KSA), and stratified into three age groups: 18-30, 31-40, and 41-61 years. Anti-HCMV IgG and IgM antibody levels were measured by enzyme-linked immunosorbent assay (ELISA). Pearson’s correlation coefficient was used to correlate antibody levels with variables.

Results

Most of the tested samples (95.73%, n=356) were positive for anti-HCMV IgG antibodies, but only 1.6% (n=6) were positive for both IgM and IgG antibodies, and all of them belonged to the age groups of 31-40 and 41-61 years. A strong inverse correlation was found between anti-HCMV IgG antibody levels and age (r=−0.51, p<0.0001). Additionally, there was an inverse correlation between anti-HCMV IgG antibody levels and body mass index (BMI) (r=−0.11, p=0.036). No correlations were found between anti-HCMV IgG levels and hemoglobin levels or blood groups of the participants.

Conclusions

Blood-donating Saudi men in Madinah had a high seroprevalence of anti-HCMV IgG antibodies, indicating previous viral exposure. Age and BMI might influence the humoral immunologic memory response against HCMV, which appears to be endemic in Madinah.

Evaluating the effect of selenium on spatial memory impairment induced by sleep deprivation

Sleep deprivation (SD) impairs memory due to disturbing oxidative stress parameters. Selenium is a main component of several antioxidant enzymes and provides a neuroprotective effect. The present study aimed to investigate the potential neuroprotective effect of chronic selenium administration on cognitive impairments induced by chronic SD. Adult male Wister rats were randomly assigned into five groups (n = 12/group). The SD was induced in rats using modified multiple platform model. Selenium (6 µg/kg of animal's body weight) was administered to rats via oral gavage for 6 weeks. The spatial learning and memory were assessed using the radial arm water maze (RAWM). Moreover, we measured the levels of reduced glutathione (GSH), oxidized glutathione (GSSG) and GSH/GSSG, catalase, glutathione peroxidase (GPx), superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS) and brain derived neurotrophic factor (BDNF) in the hippocampus. The results indicate that short- and long-term memory were impaired by chronic sleep deprivation (P < 0.05), while selenium administration prevented this effect. Moreover, selenium normalized antioxidants activities which were reduced by SD such as: catalase (P < 0.05), and SOD (P < 0.05), and significantly enhanced the ratio of GSH/GSSG in sleep-deprived rats (P < 0.05), without significant alteration of BDNF (P > 0.05), GSH (P > 0.05), or TBARS levels (P > 0.05). In conclusion, chronic SD induced memory impairment, and chronic treatment with selenium prevented this impairment by normalizing antioxidant enzymes activities in the hippocampus.

Respiratory Infectious Diseases and Adherence to Nonpharmacological Interventions for Overcoming COVID-19 Pandemic: A Self-Reported Study

BACKGROUND

The aim of the study was to examine changes in the frequency of respiratory diseases during the COVID-19 pandemic and to correlate the changes with nonpharmacological interventions for overcoming the pandemic. In addition, the study explored the predictors of adherence to nonpharmacological interventions among the Jordanian public.

METHOD

The study is survey-based and self-reported, using convenient sampling. The study was conducted during October-November of 2021.

RESULTS

The study included 1714 participants. About one-quarter of participants reported decreases in the incidence of cold (21.9%), influenza (24.7%), respiratory infections other than cold and influenza (23.3%), tonsillitis (23.0%), and oral ulcers (23.5%). On the other hand, the majority reported no change in the incidence of the above infections (62.0-64.4%). Adherence of the sample to nonpharmacological interventions of COVID-19 was moderate. The percentages of people who always wear a mask, follow social distancing, and use sanitizing procedures were 47.1%, 37.8%, and 68.8% respectively. ANOVA test showed a significant correlation between the incidence of respiratory/oral infections and adherence to nonpharmacological interventions. The multiple regression test showed that people who followed COVID-19 news, have children, have a job, and being married were more adhered to nonpharmacological measures compared to others.

CONCLUSION

Implementation of nonpharmacological interventions used to overcome the COVID-19 pandemic can be applied to reduce other respiratory infections during their peak seasons.

Sleeping habits during COVID-19 induced confinement: A study from Jordan

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.

Exception from informed consent for biomedical research in emergency settings: A study from Jordan

BACKGROUND

Research conduction in emergency settings is of paramount importance to promote knowledge and experiences related to treating acutely ill patients. However, the complexity of situations creates a considerable ethical challenge facing researchers who basically deal with emergent cases. This study aimed to determine attitudes of healthcare providers (HCPs) towards exception from informed consent (EFIC) and enrollment willingness in emergency research in Jordan.

METHODS

A quantitative research with face-to-face questionnaire was conducted by an interviewer during 6-month period in 2019. Survey measures included items related to EFIC policy and overall willingness of HCPs to participate or support their family members' participation in emergency research.

RESULTS

A total of 151 HCPs in the emergency departments (EDs) in Jordan was recruited. Positive attitude toward emergency research dominated among participants; about 21.9% of participants reported previous experience in the conduction of emergency research and 12.3% had related publications. Regarding EFIC policy, there was a general consensus of disagreement to most of the examined items. There was a trend for little support of EFIC policy when questioned about the enrollment of family members or public in emergency research, however, the application of EFIC was accepted for self-enrollment of respondents in emergency research. No significant differences (P = 0.37), among participants from different disciplines, were reported regarding the attitudes towards EFIC items or willingness to enroll in emergency research.

CONCLUSIONS

Generally, HCPs reported an overall positive support to emergency research despite a consensus of disagreement related to EFIC terms. Therefore, it is recommended to pursue future studies to compare well-informed subjects; recruited from well-developed institutions in regard to emergency research potentials; with the present basic attitudinal surveillance in order to dissipate the effect of such confounder and to get better insight of the actual attitudes related to emergency research and EFIC. In addition, efficient multidisciplinary communication channels between researchers and policy makers can lather the way to collaborative research with simultaneous innovative delivery of quality emergency care.

Withdrawal Symptoms among Cigarette and Waterpipe Smokers: A Study in Natural Setting

Background:

The rates of tobacco use, including cigarette and waterpipe smoking, are surging in the Eastern Mediterranean region. The use of these products causes nicotine dependence that makes even short-term tobacco abstinence difficult due to aversive symptoms. During the daytime fasting of the month of “Ramadan”, people accept significant disruption in regular activities, including tobacco smoking. Thus, daytime during Ramadan (before sunset) is likely associated with abstinence symptoms emerging among tobacco smokers. We assessed this hypothesis by measuring tobacco/nicotine abstinence symptoms and craving among smokers of cigarettes or waterpipes during Ramadan.

Methods:

A cross-sectional survey-based study was conducted on a convenience sample of adults. Participants were assessed for general information about tobacco smoking, dependence, and nicotine desire or craving, and withdrawal symptoms using the Minnesota Nicotine Withdrawal Scale (MNWS) and the Tiffany-Drobes Questionnaire on Smoking Urges.

Results:

The study sample included 632 exclusive cigarette smokers and 161 exclusive waterpipe tobacco smokers. After fasting and abstaining from tobacco during the day, approximately 75% of cigarette smokers and 20% of waterpipe smokers reported smoking within the first 30 minutes. In addition, 10% of cigarette smokers and 30% of waterpipe smokers reported smoking within the first 60 minutes. Regarding smoking urge, no significant difference was found between cigarette and waterpipe smokers. For nicotine craving and withdrawal, significant differences between cigarette and waterpipe smokers were found when comparing mean scores for each of the following items: (i) urge to smoke, (ii) craving nicotine, (iii) hunger, (iv) desire for sweets, and (v) depression/feeling blue (P-values < 0.05).

Conclusion:

This study provided evidence from the month of Ramadan that waterpipe smoking is associated with abstinence-induced smoking urge and withdrawal symptoms that are comparable to cigarette smoking. More interdisciplinary research must be focused on developing interventions to reduce tobacco smoking, including waterpipe.

Effect of E-cigarettes aerosol exposure during lactation in rats: Hormonal and biochemical aspects

Electronic cigarettes (e-cigarettes) have been marketed as a less lethal substitute for smoking traditional cigarettes. This study aims to investigate the impact of e-cigarettes aerosol exposure on lactating dams and pups, whose dams were exposed. Lactating dams received fresh air (control) or e-cigarettes aerosol during lactation (day 4-21). Maternal exposure to e-cigarettes aerosol during lactation induced significant reduction (P < 0.0001) in the fat content of the milk and serum Leptin level (P < 0.005) compared to control dams. Furthermore, pups whose dams were exposed to e-cigarettes during lactation showed an increased level of glucose, thyroxine and decreased level of insulin. The exposure to e-cigarettes aerosol during lactation altered the composition of milk as well as the hormonal and biochemical profile in dams and pups. This result, if observed in women using e-cigarettes, suggests that e-cigarettes' use during lactation may have consequences on the milk production and hormonal and biochemical profile in breastfeeding mothers and nursing babies.

Challenges Faced by Behavioral Genetic Studies: Researchers Perspective from the MENA Region

Background:

Behavioral genetic studies are important for the understanding of the contribution of genetic variations to human behavior. However, such studies might be associated with some ethical concerns.

Methods:

In the current study, ethical challenges related to studies of genetic variations contributing to human behavior were examined among researchers. To achieve the study purpose, the Middle East and North Africa (MENA) region researchers were taken as an example, where the aftermentioned ethical challenges were discussed among a group of researchers, who were the participants of an online forum. Discussions and responses of the participants were monitored and were later qualitatively analyzed.

Results:

Discussions revealed that several ethical challenges, including subjects’ recruitment, the difficulty of obtaining informed consents, and issues of privacy and confidentiality of obtained data as information leakage, in this case, will lead to social stigma and isolation of the participants and their immediate family members. Jordanian social and cultural norms, faith, and the tribal nature of the population were raised as a major challenge that might face conducting behavioral genetic studies in the Arab populations of the MENA. The lack of regulation related to the conduction of genetic studies, misunderstanding, and misuse of genetic information are other challenges. A full explanation of genetic research and the current and future possible benefits/risks of such research could be potential solutions.

Conclusion:

In conclusion, the MENA populations are tackled with major challenges in relation to conducting research studies in genetics/antisocial behavior field/s. Establishment of guidelines related to genetic studies, capacity building, increasing public awareness about the importance of genetic testing, and enhancing responsible conduct of research will facilitate the conduct of such sensitive studies in the future in the region.

Tau (MAPT) haplotypes in Jordan: new evidence on the Middle East as a melting-pot predating Neolithic migration

Frequencies of H1 and H2 haplotypes of the microtubule-associated protein tau (MAPT) gene were examined in two Jordanian samples. The criterion for haplotype assignment was the presence/absence of the intronic 238-bp deletion, located between exons 9 and 10 of the MAPT genomic region. We further compiled MAPT haplotype frequencies in Middle Eastern, South Asian, and European populations to widen the scope of analyses. Jordan MAPT*H2 haplotype frequencies peaked among worldwide samples analysed to date, with the Jordan general population featuring the top value (0.386). AMOVA tests results indicated spatial genetic structuring, as they unveiled significant differences in H2 frequencies between South Asia and Europe, with a hypothetical contact zone in the Middle East. The southeastern region of the Middle East shares low H2 frequencies with South Asia, while the northwestern area shows high H2 frequencies, similar to and even higher than observed in Europe. We suggest that high H2 frequencies could have originated at the beginning of the Neolithic in the western region of the Middle East, most likely through genetic drift episodes associated with founding events. Subsequently, the arrival of Neolithic farmers boosted the H2 haplotype spreading throughout Europe.

Biosynthesis of Silver Nanoparticles from Citrobacter freundii as Antibiofilm Agents with their Cytotoxic Effects on Human Cells

BACKGROUND

Nanomaterials have recently been identified for their potential benefits in the areas of medicine and pharmaceuticals. Among these nanomaterials, silver nanoparticles (Ag-NPs) have been widely utilized in the fields of diagnostics, antimicrobials, and catalysis.

OBJECTIVE

To investigate the potential utility of Citrobacter freundii in the synthesis of silver Nanoparticles (Ag-NPs), and to determine the antimicrobial activities of the Ag-NPs produced.

METHODS

Aqueous Ag+ ions were reduced when exposed to C. freundii extract and sunlight, leading to the formation of Ag-NPs. Qualitative microanalysis for the synthesized Ag-NPs was done using UVvis spectrometry, Energy Dispersive X-ray analysis (EDX), and scanning and transmission electron microscopy. The hydrodynamic size and stability of the particles were detected using Dynamic Light Scattering (DLS) analysis. The Ag-NPs' anti-planktonic and anti-biofilm activities against Staphylococcus aureus and Pseudomonas aeruginosa, which are two important skin and wound pathogens, were investigated. The cytotoxicity on human dermal fibroblast cell line was also determined.

RESULTS

Ag-NPs were spherical with a size range between 15 to 30 nm. Furthermore, Ag-NPs displayed potent bactericidal activities against both S. aureus and P. aeruginosa and showed noticeable anti-biofilm activity against S. aureus biofilms. Ag-NPs induced minor cytotoxic effects on human cells as indicated by a reduction in cell viability, a disruption of plasma membrane integrity, and apoptosis induction.

CONCLUSION

Ag-NPs generated in this study might be a future potential alternative to be used as antimicrobial agents in pharmaceutical applications for wound and skin related infections.

Exploring perception and hesitancy toward COVID-19 vaccine: A study from Jordan

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.

Clavulanic Acid in the Scope of Helicobacter pylori Treatment: A Literature Review and Beyond

BACKGROUND

Helicobacter pylori (H. pylori) infection is the most common cause of peptic ulcer disease and it can be associated with many complications, including malignancies. In clinical practice, some clinicians may use Clavulanic Acid (CA) in combination with amoxicillin or other beta-lactams as an addition to the standard treatment regimens. This practice may be done by habitual mistake, non-evidence based hypothetical assumptions, or by prescribing it as an alternative treatment. This review aims to expose the effect of CA against H. pylori infection and to review the possible mechanisms that may contribute to that effect.

METHODS

A PubMed and Google Scholar literature search was obtained on both pre-clinical and clinical studies related to CA and H. pylori infection.

RESULTS

Available clinical studies showed improvement in the eradication of H. pylori by about 10- 20% when CA was added to the treatment regimens. This effect for CA could be related to several mechanisms including inhibition of H. pylori growth by binding to Penicillin-Binding Proteins (PBPs), the transformation of H. pylori from the active filamentous form into coccoidal form, induction of the release of dopamine, modulation of immunological response towards H. pylori infection and its relationship with other microbiota. Randomized-controlled studies on patients with resistance to H. pylori are needed. Moreover, in vitro studies to evaluate the mechanisms by which CA may influence H. pylori are warranted.

CONCLUSION

The presented literature suggests potential avenues for the use of CA in the management of peptic ulcer disease and H. pylori infection.