Current Landscape and Future Directions of Deprescribing and Polypharmacy Practices in Jordan.

This review explores the current landscape and future directions of deprescribing and polypharmacy practices in Jordan. The prevalence of polypharmacy, defined as the concurrent use of multiple medications by an individual, has been increasing in recent years due to various factors, such as population aging and the greater availability of medications. However, polypharmacy can lead to adverse drug events, suboptimal medication adherence, increased healthcare costs, and reduced quality of life. Deprescribing, on the other hand, involves the discontinuation or reduction of unnecessary or potentially harmful medications to improve patient outcomes. The findings presented in this review highlight the current state of deprescribing and polypharmacy practices in Jordan, including factors influencing their prevalence. Additionally, it discusses the challenges healthcare professionals face in implementing deprescribing strategies and identifies potential solutions for enhancing these practices in Jordanian healthcare settings. Moreover, this paper provides insights into future directions for deprescribing and polypharmacy practices in Jordan. It explores potential interventions such as educational programs for healthcare professionals and patients to promote appropriate medication use. Furthermore, it discusses policy implications that could enhance deprescribing efforts and improve patient safety. Overall, this review offers valuable insights into the current landscape of deprescribing and polypharmacy practices in Jordan while also providing recommendations for future directions to optimize medication management strategies that can ultimately benefit patient outcomes within a sound healthcare system framework.

Attitude towards cholera vaccination and its related factors in Jordan amid the 2022 Middle East outbreak.

BACKGROUND: An outbreak of cholera was reported in the Middle East by the second half of 2022. Raising public awareness and vaccination against cholera represent critical factors in the preventive efforts. The current study aimed to assess the knowledge of cholera and attitude towards its vaccination among a sample of the general public residing in Jordan. METHODS: An online self-administered questionnaire was distributed to the residents in Jordan using a snowball convenience-based sampling approach. The questionnaire based on previously published studies included items to evaluate sociodemographic variables, knowledge about cholera symptoms, transmission, and prevention and the willingness to accept cholera vaccination. Additionally, four items based on the validated 5 C scale in Arabic were included to assess the psychological factors influencing attitude to cholera vaccination. RESULTS: The final study sample comprised 1339 respondents, of whom 1216 (90.8%) heard of cholera before the study. Among those who heard of cholera, and on a scale from 0 to 20, the overall mean cholera Knowledge score (K-score) was 12.9 ± 3.8. In multivariate analysis, being over 30 years old and occupation as healthcare workers or students in healthcare-related colleges were significantly associated with a higher K-score compared to younger individuals and students in non-healthcare-related colleges. Overall, the acceptance of cholera vaccination if cases are recorded in Jordan, and if the vaccine is safe, effective, and provided freely was reported among 842 participants (69.2%), while 253 participants were hesitant (20.8%) and 121 participants were resistant (10.0%). In linear regression, the significant predictors of cholera vaccine acceptance were solely the three psychological factors namely high confidence, low constraints, and high collective responsibility. CONCLUSIONS: In this study, the identified gaps in cholera knowledge emphasize the need to enhance educational initiatives. Although cholera vaccine acceptance was relatively high, a significant minority of the respondents exhibited vaccination hesitancy or resistance. The evident correlation between the psychological determinants and attitudes toward cholera vaccination emphasizes the need to consider these factors upon designing public health campaigns aimed at cholera prevention. The insights of the current study highlight the importance of addressing both knowledge gaps and psychological barriers to optimize cholera control strategies.

Language discrepancies in the performance of generative artificial intelligence models: an examination of infectious disease queries in English and Arabic.

BACKGROUND: Assessment of artificial intelligence (AI)-based models across languages is crucial to ensure equitable access and accuracy of information in multilingual contexts. This study aimed to compare AI model efficiency in English and Arabic for infectious disease queries. METHODS: The study employed the METRICS checklist for the design and reporting of AI-based studies in healthcare. The AI models tested included ChatGPT-3.5, ChatGPT-4, Bing, and Bard. The queries comprised 15 questions on HIV/AIDS, tuberculosis, malaria, COVID-19, and influenza. The AI-generated content was assessed by two bilingual experts using the validated CLEAR tool. RESULTS: In comparing AI models' performance in English and Arabic for infectious disease queries, variability was noted. English queries showed consistently superior performance, with Bard leading, followed by Bing, ChatGPT-4, and ChatGPT-3.5 (P = .012). The same trend was observed in Arabic, albeit without statistical significance (P = .082). Stratified analysis revealed higher scores for English in most CLEAR components, notably in completeness, accuracy, appropriateness, and relevance, especially with ChatGPT-3.5 and Bard. Across the five infectious disease topics, English outperformed Arabic, except for flu queries in Bing and Bard. The four AI models' performance in English was rated as "excellent", significantly outperforming their "above-average" Arabic counterparts (P = .002). CONCLUSIONS: Disparity in AI model performance was noticed between English and Arabic in response to infectious disease queries. This language variation can negatively impact the quality of health content delivered by AI models among native speakers of Arabic. This issue is recommended to be addressed by AI developers, with the ultimate goal of enhancing health outcomes.

The effect of Jordanian essential oil from coriander seeds on antioxidant, anti-inflammatory, and immunostimulatory activities using RAW 246.7 murine macrophages.

Coriander (Coriandrum sativum L.) is a member of the Umbelliferae/Apiaceae family and one of the well-known essential oil-containing plants, in which the seeds are used in traditional medicine, and as flavoring in food preparation. Knowing the diverse chemical components of different parts of the plant, this work aims to investigate the antioxidant, the anti-inflammatory, and the immunostimulatory modulator effects of the Jordanian C. sativum's seed extracted essential oil (JCEO). Coriander oil extract was prepared by hydro-distillation method using the Clevenger apparatus. Different concentrations of coriander oil were examined by using DPPH radical scavenging assay, MTT assay, pro-inflammatory cytokine (Tumor Necrosis Factor-TNF-alpha) production in RAW264.7 murine macrophages in addition, scratch-wound assessment, NO level examination, Th1/Th2 assay, phagocytosis assay, and fluorescence imaging using DAPI stain were conducted. JCEO had a potential metabolic enhancer effect at a concentration of 0.3 mg/mL on cell viability with anti-inflammatory activities via increasing cytokines like IL-10, IL-4, and limiting NO, INF-γ, and TNF-α release into cell supernatant. Antioxidant activity was seen significantly at higher concentrations of JCEO reaching 98.7% when using 100mg/mL and minimally reaching 50% at 12.5mg/mL of the essential oil. Treated macrophages were able to attain full scratch closure after 48-hrs at concentrations below 0.3mg/mL. The seed-extracted JCEO showed significant free radical scavenging activity even at lower dilutions. It also significantly induced an anti-inflammatory effect via an increase in the release of cytokines but reduced the LPS-induced NO and TNF-α production at 0.16-0.3mg/mL. In summary, coriander essential oil demonstrated antioxidant, anti-inflammatory, and immunostimulatory effects, showcasing its therapeutic potential at specific concentrations. The findings underscore its safety and metabolic enhancement properties, emphasizing its promising role in promoting cellular health.

Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study.

Stroke is a global public health concern, contributing to high rates of morbidity and mortality. In Syria, the current conflict and associated challenges have had a profound impact on healthcare infrastructure, including education and awareness programs related to stroke. An essential aspect of preventing stroke is the awareness of individuals. The study aimed to investigate factors associated with knowledge and awareness of stroke among Syrian people. A cross-sectional national representative study was conducted in Syria. The questionnaire was created on Google form and disseminated as a link through online platform social media like Facebook, WhatsApp, and Twitter. The population of the study was divided using proportionate random sampling into the 14 governorates. A random sample was selected from each area. The STROBE reporting guideline for cross-sectional studies was followed. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. A total of 1013 Syrian adults participated in the study. With more than half of them were females (53.5%) and employed (55.6%). Significant associations were found between ability to identify at least one correct risk factor and employability status (p = 0.029), single group (p = 0.036) and smokers (p < 0.001). In addition, significant associations were found between identifying at least one correct stroke symptom and smokers (p < 0.001) and no-obese people (p = 0.048). Furthermore, younger age group (below 30 years) were significantly able to list at least one correct stroke consequence compared to the older age groups (p = 0.025). Moreover, a significantly higher number of smokers compared to non-smokers correctly identified at least one stroke consequence (p = 0.019). The study revealed that there is a relatively weak understanding of the preventable nature of stroke among Syrian population. The overall awareness is still inadequate and varies depending on lifestyle factors and employment status.

Cannabis and cancer: unveiling the potential of a green ally in breast, colorectal, and prostate cancer.

Cancer comes in second place on the list of causes of death worldwide. In 2018, the 5-year prevalence of breast cancer (BC), prostate cancer (PC), and colorectal cancer (CRC) were 30%, 12.3%, and 10.9%, respectively. Cannabinoids are chemicals derived from the Cannabis sativa plant; the most investigated cannabinoids are cannabinol, delta 9-tetrahydrocannabinol (Δ9-THC), and cannabidiol. In humans, the endogenous endocannabinoid system consists of endocannabinoids, cannabinoids receptors (CBs), and enzymes that degrade the endocannabinoids. In this review, we will review the most recent literature for evidence that discusses the role of cannabis in the treatment of the three types of neoplasms mentioned. Studies have proved that BC cells express CB receptors; many in-vivo studies showed that cannabinoids cause apoptosis and inhibit proliferation and migration. Also, researchers found that treating BC mice with THC and JWH-133 (CB2 receptor agonist) slowed the tumor growth. Regarding CRC, cannabidiol was found to decrease the viability of chemotherapy-resistant CRC cells and inhibit metastasis by antagonizing the G-protein-coupled receptor 55 (GPR55; a novel cannabinoid receptor) necessary for metastasis. Moreover, cannabidiol had anti-angiogenetic effects by reducing the expression of vascular endothelial growth factor (VEGF) in addition to anti-inflammatory effects. Finally, studies demonstrated that PC cells highly express CB1 and CB2 receptors and that cannabinoids are capable of inhibiting the release of exosomes and microvesicles related to cancer progression. Cannabinoids also have antiproliferative, anti-invasive, anti-fibroblastic, cell cycle arrest, and proapoptotic effects on PC cells.

The Antimicrobial Activity of Combination of Vitamin D3 and Omega-3 against Pathogenic Microorganisms.

BACKGROUND: Food supplements such as vitamin D3 and omega-3 have a significant role in activating the immune system and impacting the diversity of gut microbiota; thus, controlling the growth of invading pathogens indirectly. OBJECTIVE: This study aims to evaluate the direct antimicrobial activity of vitamin D3 and omega- 3 individually, combined together, and combined with low concentrations of gentamicin or amphotericin B against selected pathogenic microorganisms. In addition, this study hypothesizes the potential antimicrobial mechanism and recommends suitable studies to be conducted. METHOD: Minimum inhibitory concentration of different serial dilutions of vitamin D3 [0.7µg/mL-83.3µg/mL] or omega-3 [0.7mg/mL-100mg/mL] or combined [vitamin D3:1.3µg/mL-83.3µg/mL and omega-3:1.56mg/mL-100mg/mL] with/without antibiotic have been investigated on Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans using check board technique. RESULTS: The highest concentration of vitamin D3 [83.3 µg/mL] demonstrated a complete eradication of the tested microorganisms. Conversely, omega-3 had a lower effect on them. The highest concentration of combining vitamin D3 and omega-3 with/without gentamicin resulted in a complete eradication of the S. aureus, E. coli and P. aeruginosa with a 6.8 to 7 log reduction. On the other hand, C. albicans was inhibited when using vitamin D3 [83.3 µg/mL] or when this concentration is combined with 100mg/mL of omega-3. However, when these two concentrations were added to amphotericin B the log reduction dropped to 0.45 suggesting antagonistic effect. CONCLUSION: These findings suggested that, unlike omega 3, vitamin D3 possesses good antimicrobial effects against pathogenic microorganisms. The combination of the studied food supplement showed enhanced microbial inhibition at high concentration, while they had antagonistic effect when combined with amphotericin B and applied on C. albicans combined. Further studies on the exact antimicrobial mechanism are still required to understand the measured data here.

Stroke awareness and knowledge in Sudan: a cross-sectional analysis of public perceptions and understanding.

Introduction: Stroke, a leading cause of morbidity and mortality globally, demands heightened awareness and knowledge for effective preventive strategies and tailored response. Sudan is classified as a low income country with a low rate of literacy, lack of knowledge, and awareness about diseases. Thus, this study aimed to assess stroke awareness and knowledge among Sudanese population, and identify the associated factors influencing awareness. Methods: A cross-sectional study conducted between October and November 2022 through a self-administered online survey distributed via various social media platforms. The study involved adults aged 18 years and above through snow-ball sampling technique. The survey covered general awareness and knowledge concerning stroke risk factors, consequences, and the appropriate responses taken during acute stroke attacks. Results: A total of 410 participants were enrolled in the study, majority (93.4%) were from urban area and had university degree (92.4%). Furthermore, 92.2% were aware about stroke and 74.9% were able to recognize the symptoms of stroke. Only 40.2% identified all correct answers, 96.3, 92.3, and 95.1% recognized at least one risk factor, early symptom, and consequences, respectively. Females were significantly more than males able to identify at least one risk factor. Almost all participants (99.5%) perceived stroke as a serious disease (99.5%). Notably, 86.3% would promptly transport a suspected stroke patient to the hospital. The multivariable analysis showed that females versus males and patients with depression versus without depression had significantly higher odds to identify at least one risk factor (OR of 14.716 [95% CI 1.901; 113.908] and 0.241 [95% CI 0.059; 0.984], respectively). Conclusion: The study concluded that stroke knowledge and awareness among Sudanese population is suboptimal. Furthermore, early stroke recognition and intake of the appropriate management strategies are lacking which highlights the need for targeted education and awareness campaigns.

Antimicrobial Resistance: Stewardship and One Health in the Eastern Mediterranean Region.

Antimicrobial resistance (AMR) is a major threat in the Eastern Mediterranean region (EMR) due to factors such as the high prevalence of infectious diseases, weak health systems, and the misuse of antimicrobials. This paper aims to discuss how interdisciplinary action and collaboration, specifically through antimicrobial stewardship (AMS) and the One Health approach, can effectively address AMR in the EMR. The review focuses on successful AMS initiatives and the adoption of the One Health approach in countries within the EMR, including the Gulf Cooperation Countries (GCC), Egypt, Iran, Jordan, and Pakistan. The goal is to highlight the potential for progress in combating AMR and identify challenges and opportunities for strengthening interdisciplinary collaboration. The results showcase successful AMS programs and One Health initiatives in various EMR countries, demonstrating their potential to address AMR challenges. The paper also discusses the challenges faced by these nations, such as limited resources, fragmented health systems, and knowledge gaps. Additionally, opportunities for enhancing interdisciplinary action through regional cooperation, international partnerships, and research and innovation are outlined. In conclusion, this paper emphasizes the importance of a comprehensive and collaborative response to combat AMR in the EMR. It advocates for the One Health approach as a crucial framework to guide these efforts, promoting coordinated action, improved surveillance, responsible antimicrobial use, and enhanced interdisciplinary collaboration to effectively mitigate the threat of AMR.

Assessment of Academic Resilience and Its Associated Factors Among Pharmacy Students in Twelve Countries.

OBJECTIVE: Academic resilience, a critical determinant of academic achievement, is affected by various factors. There is a paucity of large-scale international assessments of academic resilience among pharmacy students. Therefore, this study aimed to assess academic resilience among pharmacy students in 12 countries and to evaluate factors associated with their academic resilience levels. METHODS: A cross-sectional online survey-based study was conducted among randomly selected pharmacy students in 12 countries: Egypt, Türkiye, Indonesia, Pakistan, Bangladesh, Iraq, Jordan, Nigeria, Malaysia, Saudi Arabia, Sudan, and the United Arab Emirates. After pilot testing, the validated 30-item academic resilience scale (ARS) was used for the assessment. The data were collected between November 1, 2022 and April 15, 2023. Descriptive and inferential statistics were performed, as appropriate. RESULTS: A total of 3950 were received from the 12 participating countries. The mean age was 21.68 ± 2.62 years. About two-thirds of the responses were from female participants and those studying for Bachelor of Pharmacy degrees. Overall, the findings show moderate academic resilience, which varied across countries. The median (IQR) of the total ARS-30 was 114 (103-124). Females exhibited lower negative affective and emotional response subscale levels than males. There were significant cross-country variations in the ARS-30 and all subscales. The highest overall levels were reported for Sudan, Pakistan, and Nigeria and the lowest were reported for Indonesia and Türkiye. Students in private universities tended to have higher overall ARS levels than public university students. Higher academic performance was significantly associated with ARS levels, whereas those with excellent performance exhibited the highest ARS levels. Students with exercise routines had higher ARS levels than those without exercise routines. Finally, students who were engaged in extracurricular activities had higher ARS levels than those who did not participate in these activities. CONCLUSION: The study offers insights into the factors affecting academic resilience in pharmacy students across several countries. The findings could guide interventions and support activities to improve resilience and academic outcomes.

Assessment of burnout, resilience, and thriving among academic health professionals: findings from an international study.

Introduction: Burnout, resilience, and thriving significantly impact academics, particularly in health professions, where responsibilities are extensive. This study aimed to explore these constructs among academic health professionals, examining sociodemographic and work-related factors influencing these outcomes. Methods: A cross-sectional study was conducted among academic health professionals via web-based professional networks from August 2022 to February 2023. Validated tools were used, and descriptive and inferential statistics were applied. Results: 505 participants were included, predominantly female (63%), with a mean age of 38.15 ± 9.6 years. High burnout was reported by 10.9%, 13.7% experienced exhaustion, and 6.3% were disengaged. Resilience and thriving were moderate at 59.2 and 51.9%, respectively. Age correlated negatively with burnout (r = -0.131, p = 0.003) but positively with resilience (r = 0.178, p < 0.001). Females reported higher exhaustion (p = 0.014), while males showed greater resilience (p = 0.016). Instructors exhibited lower resilience compared to assistant professors (p < 0.001) and associate professors (p < 0.001). Those at public universities reported higher exhaustion than those at private universities (p < 0.001). Conclusion: Variable levels of burnout, resilience, and thriving were observed among academic health professionals, influenced by sociodemographic and work-related factors. Interventions targeting resilience and thriving may mitigate burnout risk and enhance engagement among academics in health professions.

Beyond the counter: Navigating the landscape of Deanxit® dispensing - Insights from Jordanian community pharmacies.

Background: This study investigates the dispensing patterns and knowledge of community pharmacists regarding Deanxit®, a combination of melitracen and flupentixol approved for the treatment of depression and anxiety in Jordan. Methods: This study employed a mixed-methods approach, involving 75 randomly selected pharmacies in two Jordanian governorates (Amman and Irbid). The investigation involved simulated patient scenarios and structured interviews employing a validated tool. Results: The analysis revealed that 70.6% of pharmacists were willing to dispense Deanxit® based on simulated scenarios, indicating malpractice. The mean practice score was 0.5867 out of 18, underlining a substantial level of malpractice. Pharmacists demonstrated poor knowledge, with a median score of 2.0 out of 15, reflecting a lack of awareness about Deanxit's labeled indications. Furthermore, 96% reported dispensing without prescriptions, and 62.1% acknowledged encountering cases of improper Deanxit® use. Conclusion: This study provides valuable insights into the current landscape of Deanxit® dispensing patterns, pharmacists' poor knowledge levels, and malpractices in Jordan. By identifying areas for improvement and offering recommendations for intervention, this study contributes to enhancing pharmacy practice and patient care outcomes in the region.

Evaluation of immunomodulatory potential of probiotic conditioned medium on murine macrophages.

Probiotics are a mixture of beneficial live bacteria and/or yeasts that naturally exist in our bodies. Recently, numerous studies have focused on the immunostimulatory effects of single-species or killed multi-species probiotic conditioned mediums on macrophages. This study investigates the immunostimulatory effect of commercially available active, multi-species probiotic conditioned medium (CM) on RAW264.7 murine macrophages. The probiotic CM was prepared by culturing the commercially available probiotic in a cell-culture medium overnight at 37 °C, followed by centrifugation and filter-sterilization to be tested on macrophages. The immunostimulatory effect of different dilution percentages (50%, 75%, 100%) of CM was examined using the MTT assay, proinflammatory cytokine (tumor necrosis factor TNF-alpha) production in macrophages, migration, and phagocytosis assays. For all the examined CM ratios, the percentages of cell viability were > 80%. Regarding the migration scratch, TNF-alpha and phagocytosis assays, CM demonstrated a concentration-dependent immunostimulatory effect. However, the undiluted CM (100%) showed a significant (p-value < 0.05) stimulatory effect compared to the positive and negative controls. The findings suggest that the secretions and products of probiotics, as measured in the CM, may be closely associated with their immune-boosting effects. Understanding this relationship between probiotic secretions and immune function is crucial for further exploring the potential benefits of probiotics in enhancing overall health and well-being.

An evaluation of pharmacists' general attitudes, knowledge, and phobias regarding medications that include corticosteroids: a cross-sectional study.

BACKGROUND: Corticosteroid-containing medications are widely accessible in various forms, including topical, injectable, and inhaled formulations. Due to uncertain safety profiles, healthcare providers, including pharmacists, often express apprehension when dispensing these drugs. This cross-sectional study assesses the knowledge, attitudes, and phobia of Jordanian pharmacists regarding corticosteroid-containing medications. METHODS: Conducted through a self-administered online questionnaire. RESULTS: the study reveals that dermatological conditions and respiratory disorders are the primary indications for prescribing corticosteroid-containing drugs. The most reported side effects among pharmacists' patients include increased appetite, diabetes, and skin thinning. Pharmacists generally exhibit acceptable knowledge, with a median score of 9.0 out of 11.0 (IQR = 3.0). Over two-thirds of pharmacists (69.9%) achieve a high knowledge score (Bloom's cut-off point ≥ 8.8). However, only 55.7% are aware that corticosteroids may induce mood changes. High phobia scores, particularly concerning increased blood pressure and osteoporosis risks, indicate pharmacist reservations in corticosteroid dispensing. Interestingly, pharmacists in rural areas display lower knowledge scores, while those working outside community pharmacies exhibit lower phobia scores compared to their counterparts in urban areas and community pharmacies, respectively. CONCLUSION: Despite generally good knowledge levels, the study underscores high phobia scores among Jordanian pharmacists regarding corticosteroid dispensing, particularly due to concerns about blood pressure elevation and osteoporosis risks. This suggests a potential need for targeted educational interventions and support systems to enhance pharmacist confidence and optimize corticosteroid usage while minimizing associated risks.

Mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students.

OBJECTIVES: This study examined the mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students. METHODS: A total of 769 female participants enrolled in this cross-sectional study (mean age 21.58 ± 3.20 years). A self-administered questionnaire was distributed among university female students. The questionnaire consisted of Mindful Eating Behaviors Scale, ORTO-R, Depression Anxiety Stress Scale, and Arabic version of Academic Self-Efficacy Scale. RESULTS: The results showed that psychological distress fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less psychological distress (ß= -0.31, p =.05), with more psychological distress significantly associated with lower academic self-efficacy (ß= -0.32, p =.09). Focused eating fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less focused eating (ß=-0.09, p =.04), with more focused eating significantly associated with better academic self-efficacy (ß = 1.40, p =.10). Orthorexia nervosa was not directly associated with academic self-efficacy in both models. CONCLUSION: This study shed light on important connections between orthorexia nervosa, psychological distress, mindful eating behaviors, and academic self-efficacy within the Lebanese context. The findings will have practical implications for both educational institutions and healthcare providers striving to support young female adults' overall well-being and academic success.

Molecular mechanisms underlying the regulation of tumour suppressor genes in lung cancer.

Tumour suppressor genes play a cardinal role in the development of a large array of human cancers, including lung cancer, which is one of the most frequently diagnosed cancers worldwide. Therefore, extensive studies have been committed to deciphering the underlying mechanisms of alterations of tumour suppressor genes in governing tumourigenesis, as well as resistance to cancer therapies. In spite of the encouraging clinical outcomes demonstrated by lung cancer patients on initial treatment, the subsequent unresponsiveness to first-line treatments manifested by virtually all the patients is inherently a contentious issue. In light of the aforementioned concerns, this review compiles the current knowledge on the molecular mechanisms of some of the tumour suppressor genes implicated in lung cancer that are either frequently mutated and/or are located on the chromosomal arms having high LOH rates (1p, 3p, 9p, 10q, 13q, and 17p). Our study identifies specific genomic loci prone to LOH, revealing a recurrent pattern in lung cancer cases. These loci, including 3p14.2 (FHIT), 9p21.3 (p16INK4a), 10q23 (PTEN), 17p13 (TP53), exhibit a higher susceptibility to LOH due to environmental factors such as exposure to DNA-damaging agents (carcinogens in cigarette smoke) and genetic factors such as chromosomal instability, genetic mutations, DNA replication errors, and genetic predisposition. Furthermore, this review summarizes the current treatment landscape and advancements for lung cancers, including the challenges and endeavours to overcome it. This review envisages inspired researchers to embark on a journey of discovery to add to the list of what was known in hopes of prompting the development of effective therapeutic strategies for lung cancer.

Treatment-related problems in neonates receiving parenteral nutrition: risk factors and implications for practice.

OBJECTIVES: Parenteral nutrition (PN) can be associated with several treatment-related problems (TRPs) and complications in neonatal settings. Thus, understanding the extent and type of these problems and related factors is pivotal to prevent negative consequences of these preparations. Thus, the aim of this study is to assess factors affecting TRPs in neonatal patients receiving PN. METHODS: This was a retrospective chart review of neonates receiving PN in NICU and other wards. We collected their demographics, and laboratory workup. TRPs related to PN preparations as well as their pharmacotherapy were the primary outcomes. RESULTS: Medical charts of 96 neonate were reviewed. The most encountered TRPs related to patients' pharmacotherapy were the lack of frequent monitoring (34.2%) and low dose (17.5%). For PN-related TPRs, a mismatch between patients' nutritional needs and PN composition was observed in third of the patients. Statistically significant positive correlations between number of medications during hospital stay and number of reported TRPs [(r = 0.275, p < 0.01) and (r = 0.532, p < 0.001)] were observed. CONCLUSION: In neonates who receive parenteral nutrition (PN), TRPs are often observed. These problems primarily arise from issues in patients' pharmacotherapy, namely monitoring and dosing. Identifying the risk factors for these TRPs emphasizes the full and effective integration of clinical pharmacists into the healthcare team, which can serve as a potential preventive strategy to lower the occurrence of TRPs.

A multinational study on the factors influencing university students' attitudes and usage of ChatGPT.

Artificial intelligence models, like ChatGPT, have the potential to revolutionize higher education when implemented properly. This study aimed to investigate the factors influencing university students' attitudes and usage of ChatGPT in Arab countries. The survey instrument "TAME-ChatGPT" was administered to 2240 participants from Iraq, Kuwait, Egypt, Lebanon, and Jordan. Of those, 46.8% heard of ChatGPT, and 52.6% used it before the study. The results indicated that a positive attitude and usage of ChatGPT were determined by factors like ease of use, positive attitude towards technology, social influence, perceived usefulness, behavioral/cognitive influences, low perceived risks, and low anxiety. Confirmatory factor analysis indicated the adequacy of the "TAME-ChatGPT" constructs. Multivariate analysis demonstrated that the attitude towards ChatGPT usage was significantly influenced by country of residence, age, university type, and recent academic performance. This study validated "TAME-ChatGPT" as a useful tool for assessing ChatGPT adoption among university students. The successful integration of ChatGPT in higher education relies on the perceived ease of use, perceived usefulness, positive attitude towards technology, social influence, behavioral/cognitive elements, low anxiety, and minimal perceived risks. Policies for ChatGPT adoption in higher education should be tailored to individual contexts, considering the variations in student attitudes observed in this study.

A Preliminary Checklist (METRICS) to Standardize the Design and Reporting of Studies on Generative Artificial Intelligence-Based Models in Health Care Education and Practice: Development Study Involving a Literature Review.

BACKGROUND: Adherence to evidence-based practice is indispensable in health care. Recently, the utility of generative artificial intelligence (AI) models in health care has been evaluated extensively. However, the lack of consensus guidelines on the design and reporting of findings of these studies poses a challenge for the interpretation and synthesis of evidence. OBJECTIVE: This study aimed to develop a preliminary checklist to standardize the reporting of generative AI-based studies in health care education and practice. METHODS: A literature review was conducted in Scopus, PubMed, and Google Scholar. Published records with "ChatGPT," "Bing," or "Bard" in the title were retrieved. Careful examination of the methodologies employed in the included records was conducted to identify the common pertinent themes and the possible gaps in reporting. A panel discussion was held to establish a unified and thorough checklist for the reporting of AI studies in health care. The finalized checklist was used to evaluate the included records by 2 independent raters. Cohen κ was used as the method to evaluate the interrater reliability. RESULTS: The final data set that formed the basis for pertinent theme identification and analysis comprised a total of 34 records. The finalized checklist included 9 pertinent themes collectively referred to as METRICS (Model, Evaluation, Timing, Range/Randomization, Individual factors, Count, and Specificity of prompts and language). Their details are as follows: (1) Model used and its exact settings; (2) Evaluation approach for the generated content; (3) Timing of testing the model; (4) Transparency of the data source; (5) Range of tested topics; (6) Randomization of selecting the queries; (7) Individual factors in selecting the queries and interrater reliability; (8) Count of queries executed to test the model; and (9) Specificity of the prompts and language used. The overall mean METRICS score was 3.0 (SD 0.58). The tested METRICS score was acceptable, with the range of Cohen κ of 0.558 to 0.962 (P<.001 for the 9 tested items). With classification per item, the highest average METRICS score was recorded for the "Model" item, followed by the "Specificity" item, while the lowest scores were recorded for the "Randomization" item (classified as suboptimal) and "Individual factors" item (classified as satisfactory). CONCLUSIONS: The METRICS checklist can facilitate the design of studies guiding researchers toward best practices in reporting results. The findings highlight the need for standardized reporting algorithms for generative AI-based studies in health care, considering the variability observed in methodologies and reporting. The proposed METRICS checklist could be a preliminary helpful base to establish a universally accepted approach to standardize the design and reporting of generative AI-based studies in health care, which is a swiftly evolving research topic.