The translation and validation of the surgical anxiety questionnaire into the modern standard Arabic language: results from classical test theory and item response theory analyses.

BACKGROUND: Preoperative anxiety is commonly found in patients who are waiting for surgery and can lead to negative surgical outcomes. Understanding the sources of surgical anxiety allows healthcare providers to identify at-risk patients and implement psychosocial interventions such as counseling, relaxation techniques, and cognitive‒behavioral therapy to minimize anxiety. Few comprehensive psychiatric measures are available to assess preoperative anxiety in Arabic. OBJECTIVE: Our study aimed to translate, adapt, and validate the Surgical Anxiety Questionnaire (SAQ) into the modern standard Arabic language, also known as Fusha al-Asr Arabic. METHODS: To translate the questionnaire, the research team used the gold standard process of forward translation by two independent translators along with back translation evaluation by four trained medical doctors. A cross-sectional study was conducted using an online survey completed by 208 Arabic speakers (mean age 38 years, 44% women) from four countries. Psychometric analyses, which included internal consistency, test-retest reliability, convergent validity, confirmatory factor analysis, and item response analysis, were performed. Convergent validity tests were performed against the Generalized Anxiety Disorder 2-item Scale (GAD-2), Patient Health Questionnaire-4 (PHQ-2), Perceived Stress Scale 4 (PSS-4), and Arabic version of the Visual Analog Scale for anxiety (VAS-A). RESULTS: The mean SAQ of our sample was 19.38 ± 12.63 (possible range 0-68). The Arabic SAQ translation demonstrated excellent internal consistency, with McDonald's omega and a Cronbach's alpha of approximately 0.90. The test-retest reliability was also high, with an intraclass coefficient of 0.94. The SAQ showed strong convergent validity against the GAD-2 (r = 0.94, p < 0.01). The SAQ also showed weak-moderate correlations with the PHQ-2 (r = 0.26, p < 0.01), PSS-4 (r = 43, p < 0.01), and VAS-A (r = 0.36, p < 0.01) scores. The original three-factor structure was supported by confirmatory factor analysis, confirming the original structure reported in the original English language version. The results for fitness indices showed acceptable preliminary results (CFI/TLI approximately 0.90), and deleting some items improved the model fit (CFI/TLI > 0.90, RMSEA < 0.08). We suggest retaining the original factorial solution until further validation studies can be conducted. The item response theory (IRT) results identified no items that were excessively difficult or subject to guessing. The multidimensional IRT provided evidence that the SAQ items form a multidimensional scale assessing surgical anxiety that fits the classical model reasonably well. CONCLUSION: The SAQ has demonstrated acceptable reliability and validity; thus, it is a trustworthy and valid tool for evaluating preoperative anxiety in Arabic speakers. Future research could benefit from using the SAQ in both surgical and psychiatric research.

Mediating effect of depression and acute stress between exposure to Israel-Gaza war media coverage and insomnia: a multinational study from five arab countries.

BACKGROUND: In the context of persistent wars and conflicts worldwide, the impact of acute, excessive and constant exposure to media coverage of such events on mental health outcomes becomes a serious problem for public health, and requires therefore urgent investigation to inform an effective prevention and management response. The objective of the present study was to test the hypothesis that war-related media exposure is directly and indirectly associated with insomnia through depression and perceived stress among adults from the general population of different Arab countries. METHODS: A cross-sectional study was carried-out two weeks after the beginning of Israel-Gaza war on the 7th of October 2023. An anonymous online survey and a snowball sampling method were adopted to collect data. A sample of 2635 general population adults (mean age of 23.98 ± 7.55 years, 73.1% females) took part of this study. RESULTS: The results of the mediation analysis showed that, after adjusting over potential confounders, depression and perceived stress fully mediated the association between war media exposure and insomnia; higher war media exposure was significantly associated with higher depression (Beta = 0.13; p < .001) and perceived stress (Beta = 0.07; p < .001), whereas higher depression (Beta = 0.43; p < .001) and perceived stress (Beta = 0.31; p < .001) were significantly associated with higher insomnia. It is of note that war media exposure was not significantly and directly associated with insomnia (Beta = - 0.01; p = .178 and Beta = 0.02; p = .098 respectively). CONCLUSION: The present study is the first to provide evidence that more time spent viewing the horrors of war is significantly associated with insomnia. In addition, symptoms of stress and depression were present as early as two weeks following the beginning of the war, and played a significant role in mediating the association between war media coverage and insomnia. These findings suggest that timely screening for, and management of depression and stress symptoms in clinical and preventive programs might be beneficial for community adults who have been heavily and indirectly exposed to war through media, and present with insomnia.

Three reasons why parental burnout is more prevalent in individualistic countries: a mediation study in 36 countries.

PURPOSE: The prevalence of parental burnout, a condition that has severe consequences for both parents and children, varies dramatically across countries and is highest in Western countries characterized by high individualism. METHOD: In this study, we examined the mediators of the relationship between individualism measured at the country level and parental burnout measured at the individual level in 36 countries (16,059 parents). RESULTS: The results revealed three mediating mechanisms, that is, self-discrepancies between socially prescribed and actual parental selves, high agency and self-directed socialization goals, and low parental task sharing, by which individualism leads to an increased risk of burnout among parents. CONCLUSION: The results confirm that the three mediators under consideration are all involved, and that mediation was higher for self-discrepancies between socially prescribed and actual parental selves, then parental task sharing, and lastly self-directed socialization goals. The results provide some important indications of how to prevent parental burnout at the societal level in Western countries.

Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries.

BACKGROUND: Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. METHOD: The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females). RESULTS: Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. CONCLUSION: Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.

Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals.

BACKGROUND: There is evidence that culture deeply affects beliefs about mental illnesses' causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking. METHODS: We carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public. RESULTS: More than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p < .001), knowledge (F = 88.7, p < .001), and help-seeking attitudes (F = 32.4, p < .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants. CONCLUSION: Interventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations.

Cultural adaptation and validation of the Arabic version of the multidimensional cognitive attentional syndrome scale (MCASS).

The cognitive attentional syndrome (CAS) is a core concept within metacognitive theory. The premise of the CAS is related to metacognition, however its role in psychopathology is distinct. Due to the complex nature of the CAS, a theoretically driven and psychometrically sound self-report measure of the CAS for the Arabic population is yet to be developed. We translated the Multidimensional Cognitive Attentional Syndrome Scale (MCASS) into the Arabic language and tested its structural validity. The MCASS was translated according to the standard guidelines of forward-translation followed by backward-translation. In Study 1, the MCASS was administered to a larger sample (N = 1027), selected from 22 Arabic-speaking countries in the Arab League countries, and exploratory factor analysis (EFA) was used to examine the factor structure of the measure. Those who participated in Study 1 were excluded from participating in Study 2. Confirmatory factor analysis (CFA) was used in Study 2 (N = 567) to assess the latent factor structure of MCASS, which supported a six-factor model. Results support multidimensional assessment of the CAS using the MCASS, and demonstrate suitability for use in Arab speaking samples. Implications of this study and recommendations for use of the Arabic version of MCASS are discussed.

Intentions to be Vaccinated Against COVID-19: The Role of Prosociality and Conspiracy Beliefs across 20 Countries.

Understanding the determinants of COVID-19 vaccine uptake is important to inform policy decisions and plan vaccination campaigns. The aims of this research were to: (1) explore the individual- and country-level determinants of intentions to be vaccinated against SARS-CoV-2, and (2) examine worldwide variation in vaccination intentions. This cross-sectional online survey was conducted during the first wave of the pandemic, involving 6697 respondents across 20 countries. Results showed that 72.9% of participants reported positive intentions to be vaccinated against COVID-19, whereas 16.8% were undecided, and 10.3% reported they would not be vaccinated. At the individual level, prosociality was a significant positive predictor of vaccination intentions, whereas generic beliefs in conspiracy theories and religiosity were negative predictors. Country-level determinants, including cultural dimensions of individualism/collectivism and power distance, were not significant predictors of vaccination intentions. Altogether, this study identifies individual-level predictors that are common across multiple countries, provides further evidence on the importance of combating conspiracy theories, involving religious institutions in vaccination campaigns, and stimulating prosocial motives to encourage vaccine uptake.

Impact of Nomophobia on Musculoskeletal Problems in the Upper Extremity among Adults: Implications for Occupational Therapy.

Nomophobia (NO MObile PHone Phobia) is a psychological condition in which people are anxious of being cut off from their mobile phones and been associated with adverse consequences to physical and psychosocial health. The objective of this study was to measure the impact of nomophobia on musculoskeletal problems in the upper extremity among adults. The Nomophobia scale (NMP-Q) was used to measure addiction to smartphone use among 5,087 Middle Eastern adults. A snowball sampling approach was used to recruit the participants between March and June 2021. Results showed that nomophobia was evident in 1,119 participants (22%) with a mean NMP-Q score of 114.1 (SD 11.1). A total of 3,396 upper extremity symptoms were reported among our participants. The binomial logistic regression showed that NMP-Q score is a significant predictor of symptoms to the thumb only (ß = 0.01, p = .026). This study has provided evidence of the negative physical consequences of addiction to smartphone use. Participants with thumb-related symptoms were more prone to sustain other concurrent upper extremity symptoms, probably due to their maladaptive habits of using the phone. Thus, it is important to increase awareness about the risks associated with the use of smartphones. Implications for occupational therapy are presented.

The Role of Religion and Religiosity in Health-Promoting Care for the Body During the Lockdowns caused by the COVID-19 Pandemic in Egypt, Poland and Romania.

The coronavirus pandemic (COVID-19), as a widespread health threat, has triggered an increase in health-related behaviours, both pro-and anti-health, especially with regard to diet and physical activity. One of the factors modifying the intensity of such activities may be the religious doctrine and religiosity with which a person is associated. A total of 1502 people (1147 women) from countries that feature one dominant religion, took part in the study. Participants represented Sunni Islam (Egypt, n = 798), Roman Catholicism (Poland, n = 443) and Orthodox Christianity (Romania, n = 261). The Coronavirus Anxiety Scale, the Eating Attitudes Test and the Inventory of Physical Activity Objectives were used in the study. Fear of COVID-19 is associated with engagement in pro-health activity, although not to such a significant extent as might be expected. The type of religion in question was revealed to moderate this relationship, but the intensity of religiosity was not found to serve as a moderator.

Pre-eclamptic Fetal Programming Alters Neuroinflammatory and Cardiovascular Consequences of Endotoxemia in Sex-Specific Manners.

Pre-eclampsia (PE)-induced fetal programming predisposes offspring to health hazards in adult life. Here, we tested the hypothesis that pre-eclamptic fetal programming elicits sexually dimorphic inflammatory and cardiovascular complications to endotoxemia in adult rat offspring. PE was induced by oral administration of L-NAME (50 mg/kg per day for seven consecutive days) starting from day 14 of conception. Cardiovascular studies were performed in conscious adult male and female offspring preinstrumented with femoral indwelling catheters. Compared with non-PE male counterparts, intravenous administration of lipopolysaccharide (LPS, 5 mg/kg) to PE male offspring caused significantly greater 1) falls in blood pressure, 2) increases in heart rate, 3) rises in arterial dP/dtmax, a correlate of left ventricular contractility, and 4) decreases in time- and frequency-domain indices of heart rate variability (HRV). By contrast, the hypotensive and tachycardic actions of LPS in female offspring were independent of the pre-eclamptic state and no clear changes in HRV or dP/dtmax were noted. Measurement of arterial baroreflex activity by vasoactive method revealed no sex specificity in baroreflex dysfunction induced by LPS. Immunohistochemical studies showed increased protein expression of toll-like receptor 4 in heart as well as in brainstem neuronal pools of the nucleus of solitary tract and rostral ventrolateral medulla in endotoxic PE male, but not female, offspring. Enhanced myocardial, but not neuronal, expression of monocyte chemoattractant protein-1 was also demonstrated in LPS-treated male offspring. Together, pre-eclamptic fetal programming aggravates endotoxic manifestations of hypotension and autonomic dysfunction in male offspring via exacerbating myocardial and neuromedullary inflammatory pathways. SIGNIFICANCE STATEMENT: Current molecular and neuroanatomical evidence highlights a key role for pre-eclamptic fetal programming in offspring predisposition to health hazards induced by endotoxemia in adult life. Pre-eclampsia accentuates endotoxic manifestations of hypotension, tachycardia, and cardiac autonomic dysfunction in male offspring via exacerbating myocardial and central inflammatory pathways. The absence of such detrimental effects in female littermates suggests sexual dimorphism in the interaction of pre-eclamptic fetal programming with endotoxemia.

Upregulation of cystathionine-γ-lyase/hydrogen sulfide pathway underlies the celecoxib counteraction of cyclosporine-induced hypertension and renal insult in rats.

We recently reported that celecoxib, a selective cyclooxygenase-2 (COX2) inhibitor, counteracts the adverse circulatory and renal actions of cyclosporine (CSA). Despite the seemingly advantageous nature of this interaction particularly in clinical settings that necessitate the combined use of the two drugs such as immune-related arthritis, the underlying mechanism remains elusive. This prompted us to test the hypothesis that the facilitation of the cystathionine-γ-lyase (CSE)/hydrogen sulfide (H2S) signaling accounts for such favorable effects of celecoxib on CSA nephrotoxicity. The data showed that the 10-day co-treatment of rats with celecoxib (10 mg/kg/day) ameliorated the hypertensive and biochemical and renal structural damages caused by CSA (20 mg/kg/day). Celecoxib also reversed the CSA-evoked (i) reductions in the tubular and glomerular protein expression of CSE and levels of H2S, prostaglandin E2 (PGE2), and total antioxidant capacity (TAC), and (ii) increases in inflammatory (tumor necrosis factor-α, TNF-α), fibrotic (transforming growth factor-ß1, TGF-ß1) and apoptotic (caspase-3) cytokines. These celecoxib effects disappeared when rats were treated concomitantly with the CSE inhibitor DL-propargylglycine (DL-PAG), indicating the importance of the CSE-derived H2S in mediating the renoprotective action of celecoxib. This view is bolstered by the observation that the beneficial hemodynamic and renal actions of celecoxib were replicated after supplementation of rats with sodium sulfide (Na2S, H2S donor). Together, the increased abundance of renal CSE and H2S and subsequent dampening down of inflammatory, fibrotic, oxidant, and apoptotic pathways play pivotal roles in the capacity of celecoxib to compromise the troublesome hypertensive and nephrotoxic insults caused by CSA in rats.

Zileuton alleviates acute cisplatin nephrotoxicity: Inhibition of lipoxygenase pathway favorably modulates the renal oxidative/inflammatory/caspase-3 axis.

OBJECTIVE: The current study investigated for the first time the possible beneficial effect of zileuton, a selective 5-lipoxygenase inhibitor (5-LOX), against cisplatin-induced acute renal failure. METHODOLOGY: Male Sprague-Dawley rats (180-200 g) were administered cisplatin once (5 mg/kg, i.p.) alone or combined with oral zileuton (10 mg/kg, given twice; 1 h before and 12 h after cisplatin). RESULTS: Compared with control rats, acute cisplatin administration caused significant increases of BUN (33.76 ±â€¯7.74 vs 61.88 ±â€¯11.35 mg/dl), serum creatinine (0.61 ±â€¯0.21 vs 1.56 ±â€¯0.28 mg/dl), renal levels of MDA (6.40 ±â€¯1.04 vs 20.52 ±â€¯2.18 nmol/g tissue), NOx (3.45 ±â€¯1.20 vs 17.70 ±â€¯2.27 nmol/g tissue), TNF-α (6.71 ±â€¯0.66 vs 23.71 ±â€¯3.41 pg/g tissue), MPO (0.87 ±â€¯0.09 vs 3.12 ±â€¯0.41 U/mg tissue protein) and renal caspase-3 activity (2.81 ±â€¯0.37 vs 12.70 ±â€¯2.94 U/mg tissue protein). Whereas, total SOD activity (1.99 ±â€¯0.53 vs 0.79 ±â€¯0.06 U/mg tissue protein) and IL-10 (110.98 ±â€¯19.70 vs 62.34 ±â€¯14.42 pg/g tissue) were significantly decreased. Cisplatin-induced nephrotoxicity was further confirmed histopathologically (tubular necrosis, cystic dilatation of renal tubules, vacuolar degeneration of renal tubular epithelium with perivascular oedema, and interstitial fibrosis). These changes were accompanied by alteration in 5-LOX pathway manifested as elevated renal levels of 5-LOX, LTD4 and LTB4. Simultaneous administration of zileuton to the cisplatin-treated rats reversed the deleterious renal insults and restored the measured parameters near to control values. CONCLUSIONS: These data establish the first experimental evidence that zileuton abrogates cisplatin nephrotoxicity in rats probably via the inhibition of detrimental actions of 5-LOX products, thus favorably affecting renal oxidative/inflammatory/caspase-3 axis. Based on current findings, the therapeutic prospect of zileuton for this purpose is recommended.

Express saccades in distinct populations: east, west, and in-between.

Express saccades are low latency (80-130 ms), visually guided saccades. While their occurrence is encouraged by the use of gap tasks (the fixation target is extinguished 200 ms prior to the saccade target appearing) and suppressed by the use of overlap tasks (the fixation target remains present when the saccade target appears), there are some healthy, adult participants, "express saccade makers" (ESMs), who persist in generating high proportions (> 30%) of express saccades in overlap conditions. These participants are encountered much more frequently in Chinese participant groups than amongst the Caucasian participants tested to date. What is not known is whether this high number of ESMs is only a feature of Chinese participant groups. More broadly, there are few comparative studies of saccade behaviour across large participant groups drawn from different populations. We, therefore, tested an independent group of 70 healthy adult Egyptian participants, using the same equipment and procedures as employed in the previous studies. Each participant was exposed to two blocks of 200 gap, and two blocks of 200 overlap trials, with block order counterbalanced. Results from the Schwartz Value Survey were used to confirm that this group of participants was culturally distinct from the Chinese and Caucasian (white British) groups tested previously. Fourteen percent (10/70) of this new group were ESMs, and the pattern of latency distribution in these ESMs was identical to that identified in the other participant groups, with a prominent peak in the express latency range in overlap conditions. Overall, we identified three modes in the distribution of saccade latency in overlap conditions, the timing of which (express peak at 110 ms, subsequent peaks at 160 and 210 ms) were strikingly consistent with our previous observations. That these behavioural patterns of saccade latency are observed consistently in large participant groups, drawn from geographically, ethnically, and culturally distinct populations, suggests that they relate to the underlying architecture of the saccade system.

Revisiting Rossion and Pourtois with new ratings for automated complexity, familiarity, beauty, and encounter.

Differences between norm ratings collected when participants are asked to consider more than one picture characteristic are contrasted with the traditional methodological approaches of collecting ratings separately for image constructs. We present data that suggest that reporting normative data, based on methodological procedures that ask participants to consider multiple image constructs simultaneously, could potentially confounded norm data. We provide data for two new image constructs, beauty and the extent to which participants encountered the stimuli in their everyday lives. Analysis of this data suggests that familiarity and encounter are tapping different image constructs. The extent to which an observer encounters an object predicts human judgments of visual complexity. Encountering an image was also found to be an important predictor of beauty, but familiarity with that image was not. Taken together, these results suggest that continuing to collect complexity measures from human judgments is a pointless exercise. Automated measures are more reliable and valid measures, which are demonstrated here as predicting human preferences.

In utero exposure to itraconazole during different gestational periods of rats.

The present study aimed to investigate the teratogenic and genotoxic effects of itraconazole administered orally to pregnant rats on gestation days 1-7 (implantation), 8-14 (organogenesis) and 14-20 (fetal developmental period) at doses 75, 100 or 150 mg/kg b.wt. The results indicated that itraconazole had embryolethal effect when administered at a dose of 150 mg/kg b.wt throughout implantation and organogenesis periods as well as at 100 mg/kg b.wt during implantation period. Itraconazole elevated the teratogenicity when administrated at a dose of 100 mg/kg b.wt during organogenesis period, the most prominent abnormalities were abdominal hernia, protruding tongue, exencephaly, incompletely ossified, unossified or missing skull bones (mostly frontal, parietal and interparietal), abnormal vertebrae and fused and supernumerary ribs. However, minimal adverse effects were observed at doses given during the fetal developmental period. Itraconazole increased DNA damage of fetal osteocytes via significant increase in the measured comet parameters in all the treated groups, indicating that itraconazole severely affects fetal genetic material.

Hikikomori in the Middle East: The role of problematic gaming, social media use, and loneliness.

Hikikomori, a form of severe social withdrawal has been found to be associated with behavioral addictions such as gaming addiction and problematic social media use (PSMU). Since literature related to hikikomori is lacking in the Middle East, this study aimed to determine whether there are significant differences in hikikomori-like traits between two different types of social media users and gamers and investigate loneliness as a potential mediator between hikikomori and the two types of problematic behaviors. A cross-sectional, correlational design was employed, collecting a final sample of 220 participants residing in Middle Eastern countries using a mixture of convenience and snowball sampling. Results showed that passive social media users demonstrated significantly greater hikikomori-like traits compared to active users. Furthermore, hikikomori-like traits exhibited significant positive associations with problematic gaming, PSMU, and loneliness. Two separate mediation analyses, the first with PSMU and a second with problematic gaming as predictors, revealed that loneliness acted as a significant mediator between both these problematic behaviors and hikikomori-like traits.

Suppression by central adenosine A3 receptors of the cholinergic defense against cardiovascular aberrations of sepsis: role of PI3K/MAPKs/NFκB signaling.

Introduction: Despite the established role of peripheral adenosine receptors in sepsis-induced organ dysfunction, little or no data is available on the interaction of central adenosine receptors with sepsis. The current study tested the hypothesis that central adenosine A3 receptors (A3ARs) modulate the cardiovascular aberrations and neuroinflammation triggered by sepsis and their counteraction by the cholinergic antiinflammatory pathway. Methods: Sepsis was induced by cecal ligation and puncture (CLP) in rats pre-instrumented with femoral and intracisternal (i.c.) catheters for hemodynamic monitoring and central drug administration, respectively. Results: The CLP-induced hypotension, reduction in overall heart rate variability (HRV) and sympathovagal imbalance towards parasympathetic predominance were abolished by i.v. nicotine (100 µg/kg) or i.c. VUF5574 (A3AR antagonist, 2 µg/rat). In addition, the selective A3AR agonist, 3-iodobenzyl-5'-N-methylcarboxamidoadenosine IB-MECA, 4 µg/rat, i.c.) exaggerated the hypotension and cardiac autonomic dysfunction induced by sepsis and opposed the favorable nicotine actions against these septic manifestations. Immunohistochemically, IB-MECA abolished the nicotine-mediated downregulation of NFκB and NOX2 expression in rostral ventrolateral medullary areas (RVLM) of brainstem of septic rats. The inhibitory actions of IB-MECA on nicotine responses disappeared after i.c. administration of PD98059 (MAPK-ERK inhibitor), SP600125 (MAPK-JNK inhibitor) or wortmannin (PI3K inhibitor). Moreover, infliximab (TNFα inhibitor) eliminated the IB-MECA-induced rises in RVLM-NFκB expression and falls in HRV, but not blood pressure. Conclusion: Central PI3K/MAPKs pathway mediates the A3AR counteraction of cholinergic defenses against cardiovascular and neuroinflammatory aberrations in sepsis.

Relationship Between Alexithymia, Smartphone Addiction, and Psychological Distress Among University Students: A Multi-country Study.

Objectives: Increasing dependence on smartphones results in the appearance of psychological problems, especially among young people. This study aims to determine the rates of alexithymia and its relationship with smartphone addiction and psychological distress in university students. Methods: A total of 2616 students (mean age = 22.5±3.5 years; 73.1% female) from universities in Egypt, Oman, and Pakistan were included in a cross-sectional and comparative study conducted through a web survey during the COVID-19 pandemic from October to December 2021. The following scales were used: Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Smartphone Addiction Scale-Short Version (SAS-SV). The survey also included questions related to sociodemographic and smartphone usage patterns.

The relationship between quality of life, sleep quality, mental health, and physical activity in an international sample of college students: a structural equation modeling approach.

Objective: We assessed the direct and indirect relationships between sleep quality, mental health, and physical activity with quality of life (QOL) in college and university students. Methods: In a cross-sectional design, 3,380 college students (60% females; age = 22.7 ± 5.4) from four continents (Africa: 32%; America: 5%; Asia: 46%; and Europe: 15%; others: 2%) completed the Pittsburgh Sleep Quality Index (PSQI); Insomnia Severity Index (ISI); Epworth Sleepiness Scale (ESS); the Depression, Anxiety, and Stress Scale 21 (DASS); the International Physical Activity Questionnaire short-form (IPAQ); and the World Health Organization Quality of Life-BREF (WHOQOL-Brief). Results: We showed that sleep quality, insomnia, and depression had direct negative effects on the physical domain of QOL (ß = -0.22, -0.19, -0.31, respectively, p < 0.001). There was a strong negative direct association between depression and the psychological domain of QOL (ß = -0.60, z = -22.21, p < 0.001). Both stress and PSQI had direct effects on social relationships QOL (ß = 0.11; z = 4.09; and ß = -0.13; z = -7.40, respectively, p < 0.001). However, depression had the strongest direct impact on social relationships QOL (ß = -0.41, z = -15.79, p < 0.001). Conclusion: The overall QOL of university students is associated with their sleep quality, mental health, and physical activity warranting further interventional studies aiming at improving students' quality of life.

Gestationally administered RAS modulators reprogram endotoxic cardiovascular and inflammatory profiles in adult male offspring of preeclamptic rats.

Previous studies showed that preeclampsia (PE) amplifies cardiovascular dysfunction induced by endotoxemia in adult male, but not female, offspring. Here, we asked if such aggravated endotoxic insult could be nullified by modulators of the renin-angiotensin system (RAS). PE was induced by gestational administration of Nω-nitro-L-arginine methyl ester(L-NAME, a nitric oxide synthase inhibitor). Adult male offspring of PE mothers treated gestationally with angiotensin 1-7 (Ang1-7, angiotensin II-derived vasodilator), losartan (AT1 receptor antagonist), pioglitazone (peroxisome proliferator-activated receptor gamma, PPARγ, agonist), or combined losartan/pioglitazone were instrumented with femoral indwelling catheters and challenged intravenously with a 5-mg/kg dose of lipopolysaccharides (LPS, 5 mg/kg). LPS caused significant decreases in blood pressure (BP) and spectral index of overall heart rate variability and increases in heart rate and left ventricular contractility (dP/dtmax). These effects were mostly reduced to similar magnitudes by individual drug therapies. In offspring born to Ang1-7-treated dams, the spectral index of cardiac sympathovagal balance showed elevated sympathetic dominance in response to LPS. Immunohistochemistry revealed that Ang1-7, but not losartan/pioglitazone, abolished the exaggerated increases in toll-like receptor 4 (TLR-4) expression caused by PE/LPS in heart tissues and neuronal circuits of brainstem rostral ventrolateral medulla (RVLM). By contrast, the losartan/pioglitazone regimen, but not Ang1-7, decreased and increased angiotensin converting enzyme (ACE) and ACE2 expression, respectively. Together, gestational fetal reprogramming of Ang II (depression) and Ang1-7 (activation) arms of RAS effectively counterbalance worsened endotoxic cardiovascular and inflammatory profiles in adult male offspring of PE rats.