Opinions of pharmacists and herbalists on herbal medicine use and receiving herbal medicine education in Jordan

Purpose: To explore the beliefs of herbalists and community pharmacists on  receiving educational courses in herbal medicine (HM) use by patients at pharmacy schools.Methods: This cross-sectional study was conducted in 2014. Herbalists (n = 48) and pharmacists (n = 163) were randomly recruited into the study. Demographic data, beliefs on HM use by patients, and willingness to attend educational courses were collected using a validated questionnaire and one-onone interviews.Results: The majority of the herbalists (n = 37, 77.1 %) believed that HMs are highly used in Jordan as alternative or add-on therapy to conventional medications, and the majority (n = 39, 81.3 %) reported that they need to be educated on HM use by a professional organization. More than 80 % of the pharmacists believed that they need to be experts on HM use and should apply pharmaceutical care for patients buying registered HMs at their pharmacies; a significantly higher proportion of female pharmacists (p = 0.04) agreed with this concept compared to male pharmacists.Conclusion: Both herbalists and pharmacists showed interest in attending  educational courses on HM use at pharmacy schools to improve their ability to serve their patients.Keywords: Herbalists, Community pharmacists, Herbal medicine, Pharmaceutical car

PRIMARY SPONTANEOUS PNEUMOTHORAX: CLINICAL PROFILE, SEASONALITY AND RECURRENCE OF 132 ADULT PATIENTS IN A UNIVERSITY HOSPITAL, KINGDOM OF SAUDI ARABIA

Objectives: The current study aimed to study the presenting features of Primary Spontaneous Pneumothorax (PSP) patients including demographic (gender, age, smoking, height and weight, Body mass index (BMI)), symptoms and seasonality among adult patients in KKUH during the period from 2010 to 2016. To describe the recurrence of PSP and length of hospital stay in patients who were managed surgically in KKUH during the period from 2010 to 2016. Methods: Quantitative, Observational, Retrospective, Case-series study. 132 Patients was studied who were diagnosed with primary spontaneous pneumothorax disease from Jan 2010 to Dec 2016 in King Khalid University Hospital were studied. Data was collected by reviewing the transfer sheet case report form (CRF), and by reviewing variables in medical records of PSP patients. Results: The mean age was 24.62 (S.D ±8.8) years old. 88.6% of patients were males (11.4% females). 59.8% were smokers and 40.2% were non-smoker. The (BMI) average was 19.4 kg/m2. The season of the attack was more in spring and summer accounting a 29.6% for each. 90.9% of the Patients were treated surgically. The average length of hospital stay after surgical management was 6.45 days (S.D ±3.15), recurrent after surgical management was (4.1%). Conclusion: Based on this case series study, majority of primary spontaneous pneumothorax (PSP) patients were male, at young age group, with low body mass index (BMI). Most of the admissions occurred in warm climate (spring/summer). Furthermore, short hospital stays, and low state of recurrence were noted among the patients treated surgically. Key words: (Primary Spontaneous Pneumothorax, variables, seasonality, recurrence

Effect of dietary polyunsaturated fatty acid and antioxidant supplementation on the transcriptional level of genes involved in lipid and energy metabolism in swine

Porcine fat traits depend mostly on the interaction between nutritional and genetic factors. However, the pathways and biological processes influenced by this interaction are still poorly known in pigs, although they can have a huge impact on meat quality traits. The present research provides new knowledge insight into the effect of four diets (D1 = standard diet; D2 = linseed supplementation; D3 = linseed, vitamin E and selenium supplementation; D4 = linseed and plant-derived polyphenols supplementation) on the expression of 24 candidate genes selected for their role in lipid and energy metabolism. The data indicated that 10 out of 24 genes were differentially expressed among diets, namely ACACA, ADIPOQ, ADIPOR1, CHREBP (MLXPL), ELOVL6, FASN, G6PD, PLIN2, RXRA and SCD. Results from the univar- iate analysis displayed an increased expression of ACACA, ADIPOQ, ADIPOR1, CHREBP, ELOVL6, FASN, PLIN2, RXRA and SCD in D4 compared to D2. Similarly, ACACA, ADIPOQ, ADIPOR1, ELOVL6 and SCD were highly expressed in D4 compared to D3, while no differ- ences were observed in D2-D3 comparison. Moreover, an increased expression of G6PD and ELOVL6 genes in D4 compared to D1 was observed. Results from the multivariate analysis confirmed that D2 was not different from D3 and that ACACA, SCD and FASN expression made D4 different from D2 and D3. Comparing D4 and D1, the expression levels of ELOVL6 and ACACA were the most influenced. This research provides evidence that the addition of both n-3 PUFA and polyphenols, derived from linseed, grape-skin and oregano supplementa- tion in the diets, stimulates the expression of genes involved in lipogenesis and in oxidative processes. Results evidenced a greater effect on gene expression of the diet added with both plant extracts and n-3 PUFA, resulting in an increased expression of genes coding for fatty acid synthesis, desaturation and elongation in pig Longissimus thoracis muscle

Predicting User-Perceived Quality Ratings from Streaming Media Data

Abstract—Media stream quality is highly dependent on under-lying network conditions, but identifying scalable, unambiguous metrics to discern the user-perceived quality of a media stream in the face of network congestion is a challenging problem. User-perceived quality can be approximated through the use of carefully chosen application layer metrics, precluding the need to poll users directly. We discuss the use of data mining prediction techniques to analyze application layer metrics to determine user-perceived quality ratings on media streams. We show that several such prediction techniques are able to assign correct (within a small tolerance) quality ratings to streams with a high degree of accuracy. The time it takes to train and tune the predictors and perform the actual prediction are short enough to make such a strategy feasible to be executed in real time and on real computer networks. I

Exploring the effects of health behaviors and mental health on students' academic achievement: a cross-sectional study on lebanese university students

Background High academic achievement, an important determinant of future success, is known to be influenced by many factors including dietary behavior, lifestyle and mental health, among others. The objectives of the current study were to explore university students’ nutritive habits, daily lifestyle, and mental status, and to scrutinize the associations between these factors and students’ academic achievement. Methods A cross-sectional study was conducted among students of a private Lebanese university, using an electronic survey. Diet, eating habits, physical activity, sleep, and smoking were evaluated, and mental health was assessed using a validated Arabic version of the combined Depression, Anxiety, Stress Score (DASS-8). Academic achievement was measured using the Subjective Academic Achievement Scale (SAAS). Results A total of 1677 students participated in the questionnaire. The results of a linear regression taking the SAAS score as the dependent variable, showed that students who have a non-scientific versus scientific major (Beta = 0.53), and having breakfast ≥ 4 days per week compared to less than 2 days (Beta = 0.28) were significantly associated with higher SAAS scores. More psychological distress (Beta = − 0.06) and a higher number of days of eating out (Beta = − 0.07) were significantly associated with lower SAAS scores. Conclusions This is the first investigation on a Lebanese university students’ academic success in relation to lifestyle and mental profiles. Better academic achievement was demonstrated by students having healthier dietary and lifestyle habits, as well as less distressing mental status. Such results, in light of the compounded and unprecedented crises with which Lebanon has been assailed, suggest the need to focus on promoting healthy habits among students in higher education as a possible driver of better academic success.None.Scopu

Estimates of the global burden of cervical cancer associated with HIV.

BACKGROUND: HIV enhances human papillomavirus (HPV)-induced carcinogenesis. However, the contribution of HIV to cervical cancer burden at a population level has not been quantified. We aimed to investigate cervical cancer risk among women living with HIV and to estimate the global cervical cancer burden associated with HIV. METHODS: We did a systematic literature search and meta-analysis of five databases (PubMed, Embase, Global Health [CABI.org], Web of Science, and Global Index Medicus) to identify studies analysing the association between HIV infection and cervical cancer. We estimated the pooled risk of cervical cancer among women living with HIV across four continents (Africa, Asia, Europe, and North America). The risk ratio (RR) was combined with country-specific UNAIDS estimates of HIV prevalence and GLOBOCAN 2018 estimates of cervical cancer to calculate the proportion of women living with HIV among women with cervical cancer and population attributable fractions and age-standardised incidence rates (ASIRs) of HIV-attributable cervical cancer. FINDINGS: 24 studies met our inclusion criteria, which included 236 127 women living with HIV. The pooled risk of cervical cancer was increased in women living with HIV (RR 6·07, 95% CI 4·40-8·37). Globally, 5·8% (95% CI 4·6-7·3) of new cervical cancer cases in 2018 (33 000 new cases, 95% CI 26 000-42 000) were diagnosed in women living with HIV and 4·9% (95% CI 3·6-6·4) were attributable to HIV infection (28 000 new cases, 20 000-36 000). The most affected regions were southern Africa and eastern Africa. In southern Africa, 63·8% (95% CI 58·9-68·1) of women with cervical cancer (9200 new cases, 95% CI 8500-9800) were living with HIV, as were 27·4% (23·7-31·7) of women in eastern Africa (14 000 new cases, 12 000-17 000). ASIRs of HIV-attributable cervical cancer were more than 20 per 100 000 in six countries, all in southern Africa and eastern Africa. INTERPRETATION: Women living with HIV have a significantly increased risk of cervical cancer. HPV vaccination and cervical cancer screening for women living with HIV are especially important for countries in southern Africa and eastern Africa, where a substantial HIV-attributable cervical cancer burden has added to the existing cervical cancer burden. FUNDING: WHO, US Agency for International Development, and US President's Emergency Plan for AIDS Relief

Upregulation of cortico-cerebellar functional connectivity after motor learning

Interactions between the cerebellum and primary motor cortex are crucial for the acquisition of new motor skills. Recent neuroimaging studies indicate that learning motor skills is associated with subsequent modulation of resting-state functional connectivity in the cerebellar and cerebral cortices. The neuronal processes underlying the motor-learning-induced plasticity are not well understood. Here, we investigate changes in functional connectivity in source-reconstructed electroencephalography (EEG) following the performance of a single session of a dynamic force task in twenty young adults. Source activity was reconstructed in 112 regions of interest (ROIs) and the functional connectivity between all ROIs was estimated using the imaginary part of coherence. Significant changes in resting-state connectivity were assessed using partial least squares (PLS). We found that subjects adapted their motor performance during the training session and showed improved accuracy but with slower movement times. A number of connections were significantly upregulated after motor training, principally involving connections within the cerebellum and between the cerebellum and motor cortex. Increased connectivity was confined to specific frequency ranges in the mu- and beta-bands. Post hoc analysis of the phase spectra of these cerebellar and cortico-cerebellar connections revealed an increased phase lag between motor cortical and cerebellar activity following motor practice. These findings show a reorganization of intrinsic cortico-cerebellar connectivity related to motor adaptation and demonstrate the potential of EEG connectivity analysis in source space to reveal the neuronal processes that underpin neural plasticity

Interacting new generalized Chaplygin gas

We have presented a model in which the new generalized Chaplygin gas interacts with matter. We find that there exists a stable scaling solution at late times in the evolution of the universe. Moreover, the phantom crossing scenario is observed in this model.Comment: 16 pages, 6 figures, accepted for publication in Int. J. Theor. Phy

Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries.publishedVersio