Unveiling the Chemical Composition, Bioactive Profile and Antioxidant Capacity of Dried Egyptian Jew's Mallow Stems as a Promising Anticancer Agent.

Phytochemicals from waste materials generated by agricultural and industrial processes have become globally significant due to their accessibility and potential effectiveness with few side effects. These compounds have essential implications in both medicine and the economy. Therefore, a quantitative analysis of the phytochemical profile, sugar types, and water-soluble vitamins of dried Corchorus olitorius L."DJMS" extract (dried Jew's mallow stem) was carried out with HPLC. In addition, the chemical composition, TPC, chlorophyll a and b, beta-carotene, and antioxidant effect using DPPH were investigated. Furthermore, the anticancer activity of the DJMS was evaluated by SRB assay using Huh-7 and MDA-MB-231 cell lines. In the quantitative study, DJMS extract showed a high antioxidant potential (67%) due to its content of bioactive compounds such as TPC (276.37 mg 100 g-1) and chlorophyll a and b (20.31, 12.02 mg 100 g-1, respectively), as well as some vitamins and minerals such as B-complex (B12; 146.8 mg 100 g-1 and vitamin C 6.49 mg 100 g-1) and selenium (<0.2 µg kg-1). Moreover, the main sugar types found were sucrose and stachyose, which recorded 9.23 and 6.25 mg 100 g-1, respectively. Identifying phenolic and flavonoids showed that the major components were ellagic acid (4905.26 µg kg-1), ferulic acid (3628.29 µg kg-1), chlorogenic acid (3757.08 µg kg-1), luteolin-7-O-glucoside (4314.48 µg kg-1), naringin (4296.94 µg kg-1) and apigenin-6-rhamnose-8 glucoside (3078.87 µg kg-1). The dried stem extract showed significant MDA-MB-231 inhibition activity and reached 80% at a concentration of 1000 µg/mL of DJMS extract, related to the content of phytochemical components such as isoflavones like genistein (34.96 µg kg-1), which had a tremendous anticancer effect. Hence, the stem of Jew's mallow (which is edible and characterized by its viability and low production cost) possesses the capacity to serve as a pharmaceutical agent for combating cancer owing to its abundance of bioactive components.

Commelina benghalensis (Wandering Jew) Linn exhibits abortifacient potentials and hepatotoxicity in pregnant Wistar rats via elevating indicators of oxidative stress and activating proinflammatory cytokines.

ETHNOPHARMACOLOGICAL RELEVANCE: Commelina benghalensis Linn is a perennial plant with upright stems reaching a height of 1 m. Its stem is commonly used to induce abortion in traditional medicine. However, there are insignificant scientific data to evaluate such a claim. AIM OF THE STUDY: The study was conducted to determine the abortifacient and toxicological potential of ethanol extract of Commelina benghalensis Linn stem (EECBS) via selected proinflammatory and oxidative stress biomarkers in pregnant Wistar rats. MATERIALS AND METHODS: To determine the phytochemicals responsible for EECBS's toxicity and abortifacient effects, high-performance liquid chromatography-photodiode array detection (HPLC-PDA) and gas chromatography-mass spectrometry (GC-MS) was used. The abortion rate was determined by monitoring the markers of reproductive system failure in the experimental model. To assess rat hepatotoxicity, biochemical markers and immunohistopathological parameters were used. RESULTS: Results demonstrated the presence of isomeric benzene-mesitylene compounds in EECBS. Also, EECBS significantly altered the markers of liver function and oxidative damage while eliciting a significantly reduced (P < 0.05) number of live fetuses, number of corpora lutea, progesterone, estradiol, and luteinizing hormone, whereas the number of dead fetuses percentage vaginal opening, and post-implantation loss increased significantly (P < 0.05). Estrogenicity studies indicated a significant (P < 0.05) increase in uterine weight, uterine glucose, and ALP dose-dependently. Moreover, EECBS also caused a vaginal hemorrhage preceding the parturition. Also, EECBS treatment significantly increased levels of interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and significantly elevated the expression of COX-2 protein in the liver. CONCLUSION: The current investigation established Commelina benghalensis Linn stem's abortifacient activity. Continuous use, on the other hand, may cause liver damage in pregnant rats by disrupting antioxidant defense mechanisms, promoting the production of pro-inflammatory cytokines, and increasing COX-2 expression. Hence, caution should be excised while consuming this plant's stem for medication purposes, especially during the gestational period.

Review of the Cardiovascular Implications of the Social and Religious Practices Associated with Donning Phylacteries.

We previously published a manuscript suggesting that use of phylacteries, ritual straps worn during Jewish prayer services, affects cardiovascular and inflammatory function (Owens et al., Am J Physiol-Heart Circ Physiol, 315(6):H1748-H1758, 2018). Observed physiologic changes were associated with improved cardiac outcomes, though a direct link between phylactery use and improved cardiovascular outcomes is difficult to prove as there are a number of associated religious and spiritual practices that may confound the observed effects. In this review, we assess the scientific literature regarding religious and spiritual practices associated with phylactery in order to better understand the cardiovascular implications of the practice of donning phylacteries. We focus on key aspects traditionally associated with donning phylacteries including gathering in groups, meditation and prayer.

Considering the Subjective Well-Being of Israeli Jews during the COVID-19 Pandemic: Messaging Insights from Religiosity and Spirituality as Coping Mechanisms.

Consistent with Terror Management Theory (TMT), COVID-19 has made us question our mortality and past studies have indicated the importance of religiosity to enhance subjective well-being (SWB), however, studies on spirituality's impact are incomplete. The pandemic has created an environment where both religiosity and spirituality may play a vital role. Israel was selected due to the emergence of Jewish spirituality, a phenomenon that is growing in importance but understudied. In response to these caveats, the current study examines the mediating role played by spirituality on the SWB of the religious during the pandemic. Participants from Israel (n = 138) were recruited via Qualtrics' online panels. Findings showed Jews' religiosity was important to enhance their SWB, i.e., religious beliefs bring certainty and happiness to one's life, especially, during the COVID-19 pandemic. More importantly, spirituality mediated the effect of religiosity on SWB, specifically, spirituality was important to enhance the well-being of low religious Jews. Implications for health messaging during a global pandemic are discussed.

[Jewish spirituality in the face of illness, suffering and care]. / La spiritualité juive à l'épreuve de la maladie, de la souffrance et des soins.

Jewish spirituality in its principles, its means and its practice offers the possibilities to cope with sickness, suffering and more broadly with the human condition.

Spiritual Interventions Used by Jewish Women to Facilitate the Family Continuum: A Qualitative Study.

Introduction: Spiritual interventions (SI) are used by patients and their families as a means to promote health. The family continuum (FC), which includes finding a partner/spouse, getting married, becoming pregnant, and having a safe pregnancy/birth, is an important concept for the Jewish culture as well as other cultures that have a traditional family-centered approach. There is a dearth of professional literature pertaining to SI to promote the FC. Although patients may use SI, this information is not routinely collected in a health history. The purpose of the study was to describe the experience of Jewish women's use of SI to promote the FC. Methods: This ethnographic study included interviews of Jewish women pertaining to FC, a text review, and field study. Coding of the text, site visits, and interviews were performed and reviewed to identify categories and themes and were refined until saturation was achieved. Results: Fifty-three observant and non-observant Jewish women participated in the study. Women expressed that SI were the means for them playing an active role in fulfilling the FC, and included intermediaries to God, self-improvement, and folk/spiritual remedies. The examples of SI included: visits to holy sites and spiritual leaders for blessings and advice, prayers, psalms, doing good deeds, eating special foods, wearing amulets, and performing certain SI with predesignated repetitions. Women attributed these SI to attaining an FC. Women who achieved each FC milestone without difficulty tended to use less SI, whereas women's SI usage increased the longer a milestone was not achieved. Conclusions: Jewish women are using many SI to promote the FC. Health care should be delivered in a culturally competent manner, which includes the incorporation of safe cultural practices. Obtaining a cultural assessment as part of the medical history could assist the health care professional in integrating safe SI into patient care.

Childhood Sexual Abuse, Spirituality/Religion, Anxiety and Depression in a Jewish Community Sample: the Mediating Role of Religious Coping.

Childhood sexual abuse (CSA) is a pervasive problem impacting a broad range of mental health outcomes. Previous research has shown that spiritual and religious (S/R) factors both positively and negatively relate to mental health issues among survivors of CSA, but mediating mechanisms of effect are unclear. The present study examined CSA, anxiety, depression, and positive/negative religious coping among 372 Jewish community members with and without CSA histories. Individuals who experienced CSA endorsed significantly higher anxiety and depression as well as negative religious coping than those without CSA. Negative religious coping mediated the relationship between CSA and anxiety and depression. We discuss clinical and social implications of these findings, including the need to address S/R factors in treatment of CSA, especially within religious communities. Further research examining abuser identity, survivors' disclosure experience, and other S/R mediators of effect is warranted.

Implicit/Explicit Beliefs About God, Uncertainty, and Anxiety.

ABSTRACT: Intolerance of uncertainty (IU) refers to the incapacity to cope with a perceived lack of information sustained by negative perceptions about uncertainty and its implications. Previous research regarding the role of religion and spirituality (R/S) in coping with uncertainty is unclear. The current research assessed if implicit and explicit beliefs about God are related to these discrepancies. Participants completed an explicit task, an implicit association task, the Intolerance of Uncertainty Scale, and the Hospital Anxiety and Depression Scale. Results indicated that explicit and implicit beliefs independently correlated with IU and anxiety. Regression analyses suggested that these correlations were primarily due to the relationship between negative beliefs of God and IU and that IU partially mediated the relationship between R/S and anxiety. The current findings add to the growing literature on IU and suggest the need to address R/S as a possible correlate of IU.

Relationship between patient ethnicity and prevalence of anemia during pregnancy and the puerperium period and compliance with healthcare recommendations - implications for targeted health policy.

BACKGROUND: Anemia is common during pregnancy and the puerperium. The association of ethnicity as well as other characteristics with anemia and compliance with healthcare recommendations has not been studied sufficiently and needs to be explored in order to implement a targeted health policy. We examined the association between ethnicity and the risk for prenatal and puerperium anemia and the compliance with healthcare recommendations. This effort aims to guide reforms in policies and practices that will assist in decreasing anemia prevalence in Israel. METHODS: This study was a secondary analysis of a prospective cohort study database including 1558 women who delivered vaginally at Emek Medical Center. Anemia was assessed before delivery by obtaining a complete blood count (CBC). After delivery, CBCs were taken in cases of postpartum hemorrhage, symptoms consistent with anemia, prenatal anemia or other clinical indications. The study population was divided according to their ethnicity (Jews and Arabs). The primary outcomes were anemia before delivery, anemia in the immediate postpartum and 6 weeks postpartum, and compliance with healthcare recommendations, which was defined as the rate of women who performed a routine CBC test 6-weeks-postpartum. RESULTS: The rates of anemia before delivery and in the puerperium period were similar between Jews and Arabs (before delivery: 88 (11%) versus 98 (14%); 6 weeks postpartum: 55 (21%) vs 68 (28%), respectively;p > 0.05). Iron supplementation was high in both groups during pregnancy (~ 90%) and lower during the postpartum for Jews compared to Arabs (72% vs 83%,respectively; P < .0001). Only one third of the patients performed a CBC 6-weeks-postpartum regardless of ethnicity. CONCLUSION: Overall compliance with health recommendation was high during pregnancy but low postpartum and was reflected in anemia persistence regardless of ethnicity. Because of the adverse long term impact of anemia on patient's health, new policies need to be developed to improve patient's compliance postpartum. A possible strategy is to combine the follow-up of the mother with the one of the newborn in the family health stations (Tipat Halav) and the community clinics similarly to the close follow-up during pregnancy. Additional methods may include active summoning for CBC test and assuring iron supplement consumption.

Ethnic disparities in receiving benefits for disability following postpartum mental illness during first two years after delivery: an Israeli nationwide study.

BACKGROUND: Despite relatively high rates of Postpartum Depression (PPD), little is known about the granting of social security benefits to women who are disabled as a result of PPD or of other postpartum mood and anxiety disorders (PMAD). This study aims to identify populations at risk for underutilization of social security benefits due to PMAD among Israeli women, with a focus on ethnic minorities. METHODS: This retrospective cohort study is based on the National Insurance Institute (NII) database. The study population included a simple 10% random sample of 79,391 female Israeli citizens who gave birth during 2008-2016 (these women delivered a total of 143,871 infants during the study period), and who had not been eligible for NII mental health disability benefits before 2008. The dependent variable was receipt of Benefit Entitlement (BE) due to mental illness within 2 years following childbirth. Maternal age at delivery, population group, Socio-Economic Status (SES), family status, employment status of the mother and her spouse, and infant mortality were the independent variables. Left truncation COX proportional hazard model with time-dependent variables was used, and birth number served as a time discrete variable. RESULTS: Bedouin and Arab women had significantly lower likelihood of BE (2.6 times lower and twice lower) compared with other ethnic groups (HR = 0.38; 95% CI: 0.26-0.56; HR = 0.47; 95% CI: 0.37-0.60 respectively). The probability of divorced or widowed women for BE was significantly higher compared to those living with a spouse (HR = 3.64; 95% CI: 2.49-5.33). Lack of employment was associated with higher likelihood of BE (HR = 1.54; 95% CI: 1.30-1.82). Income had a dose-response relationship with BE in multivariable analysis: lower income was associated with the nearly four-fold greater probability compared to the highest income quartile (HR = 3.83; 95% CI: 2.89-5.07). CONCLUSIONS: Despite the exceptionally high prevalence of PMAD among ethnic minorities, Bedouins and Arabs had lowest likelihood of Benefit Entitlement. In addition to developing programs for early identification of postpartum emotional disorders among unprivileged ethnic groups, awareness regarding entitlement to a mental health disability allowance among ethnic minorities should be improved.

Age at Onset of Parkinson's Disease Among Ashkenazi Jewish Patients: Contribution of Environmental Factors, LRRK2 p.G2019S and GBA p.N370S Mutations.

BACKGROUND: Both genetic and environmental factors contribute to Parkinson's disease (PD) risk. OBJECTIVE: We investigated the potential association of several relevant variables with PD age at onset (AAO), focusing on LRRK2 p.G2019S and GBA p.N370S mutations. METHODS: Ashkenazi Jewish (AJ) PD patients, screened for LRRK2 and GBA mutations, underwent an interview regarding exposure to the following environmental and lifestyle factors: cigarette smoking, consumption of coffee, tea and alcohol, head injury and rural living. Multivariate linear regression (adjusted for sex) was used to examine the association with AAO, and models included LRRK2 p.G2019S and GBA p.N370S mutation status (carrier/non-carriers), single environmental variable and their interactions terms, as independent variables. RESULTS: 225 Israeli AJ PD patients were enrolled: 65 LRRK2 p.G2019S mutation carriers, 60 GBA p.N370S carriers and 100 non-carries of these mutations. In the dichotomized exposure/non-exposure analyses, positive LRRK2 p.G2019S status was associated with younger AAO in all models, at nominal or near significant levels (p = 0.033-0.082). Smoking was associated with older AAO (p = 0.032), and the interaction between GBA p.N370S and history of head injury was associated with younger AAO (p = 0.049), both at nominal significance. There was no indication of a consistent main effect for GBA p.N370S status or significant LRRK2 p.G2019S-environmental factor interaction. In the dose-dependent analyses, increased coffee and tea consumption levels were associated with older AAO (p = 0.001 and p = 0.002, respectively). CONCLUSIONS: Our results suggest that genetic and environmental factors may affect AAO in PD patients, but validation in additional samples is required.

Go in Peace: Brain Death, Reasonable Accommodation and Jewish Mourning Rituals.

Religious objections to brain death are common among Orthodox Jews. These objections often lead to conflicts between families of patients who are diagnosed with brain death, and physicians and hospitals. Israel, New York and New Jersey (among other jurisdictions) include accommodation clauses in their regulations or laws regarding the determination of death by brain-death criteria. The purpose of these clauses is to allow families an opportunity to oppose or even veto (in the case of Israel and New Jersey) determinations of brain death. In New York, the extent and duration of this accommodation period are generally left to the discretion of individual institutions. Jewish tradition has embraced cultural and psychological mechanisms to help families cope with death and loss through a structured process that includes quick separation from the physical body of the dead and a gradual transition through phases of mourning (Aninut,Kriah, timely burial, Shiva, Shloshim, first year of mourning). This process is meant to help achieve closure, acceptance, support for the bereaved, commemoration, faith in the afterlife and affirmation of life for the survivors. We argue that the open-ended period of contention of brain death under the reasonable accommodation laws may undermine the deep psychological wisdom that informs the Jewish tradition. By promoting dispute and conflict, the process of inevitable separation and acceptance is delayed and the comforting rituals of mourning are deferred at the expense of the bereft family. Solutions to this problem may include separating discussions of organ donation from those concerning the diagnosis of brain death per se, allowing a period of no escalation of life-sustaining interventions rather than unilateral withdrawal of mechanical ventilation, engagement of rabbinical leaders in individual cases and policy formulations that prioritize emotional support for families.

Social relations between students from two groups in conflict: Differences in stereotypes and perceived social distance between Jewish and Arab nursing students.

BACKGROUND: The heterogeneous nature of the nursing profession generates encounters between members of different groups. Thus, nursing education should include programs focusing on cultural sensitivity to enhance cultural competence. Due to the ongoing conflict between Arabs and Jews, Israel is an appropriate setting for examining cultural sensitivity programs. AIM: This study explores how Jewish-Israeli and Arab-Israeli nursing students studying together perceive their social relations by examining attribution of stereotypes (positive and negative) to members of the other group and willingness to engage in social interactions with individuals from the other group. SETTING: The Department of Nursing at the Max Stern Yezreel Valley College. PARTICIPANTS: 180 Jewish and Arab nursing students at two different points in their studies, beginning students and those at more advanced stages. METHODS: The students completed questionnaires examining their perceptions of the social relations between the two groups. The questionnaires measured stereotypes and perceptions of social distance regarding members of the other social group. RESULTS: More positive stereotypes and fewer negative stereotypes were found among the Jewish students than among the Arab students. Nevertheless, the Jewish students exhibited less willingness to reduce social distance. No differences were found between beginning students and advanced students with respect to stereotypes, though advanced students expressed greater willingness to reduce social distance than did beginning students. CONCLUSIONS: The findings show that perceptions of social relations are influenced by two different contexts: the students' specific context (joint studies and joint work in the future) and the broader general context of relations between the groups. The findings indicate that programs aimed at developing cultural sensitivity and improving relations in a divided society should provide differential responses for each group and should focus on willingness to cooperate and reduce social distance rather than attempting to eliminate stereotypes.

Ethnopharmacological study of Sephardic remedies in the 19th century: The "Livro de Milizinas".

ETHNOPHARMACOLOGICAL RELEVANCE: The Sephardic or Judeo-Spanish communities kept a cultural heritage extremely relevant which is recognizable through the peculiar form of their language and practices. Medicine was one of the main professional activities among Jews of Spain before their expulsion in 1492. We expected to find ingredients and recipes in the Sephardic traditional medicine related to classical medicine and to modern ethnopharmacology of Spain, but also influenced by the host countries. Recipes for specific diseases could be compared with modern ethnopharmacology. Although the basic language of the recipes is Judeo-Spanish, it presents local variants and names which are not only dialectal Spanish, but also Turkish, Hebrew or Bosnian. METHODS: The main source of information for Sephardic folk medicine are the specimens of the "Livro de Milizinas" printed in Thessaloniki and Smyrna (Izmir) during the 19th century. Others are some documents on pharmacy conserved in Bosnia associated to the Papo family of Sephardic Aktars or Attars (Ottoman herbalists) and the oral tradition in the Sephardic communities of Asia, Europe and the Americas. In order to analyze these formularies, we have studied the recipes in eleven different sources systematized in an Excel® 2010 book. We focused on formulas that are not merely rituals instead contain specific ingredients and pathologies. Specific dictionaries were generated in Excel® 2010, to standardize names of ingredients and pathologies. RESULTS: In the 502 complete recipes and variants studied, 107 pathologies and 154 different ingredients appear. Among ingredients, 93 are plants, 38 animals and 23 mineral substances. The most common pathologies in the recipes correspond to infectious diseases, headache, epistaxis, parasites and the "espanto". These ingredients received 397 different vernacular names, being prevalent those in Spanish (303) followed by those in Turkish. Preparations recorded are simple, easily made at home, not requiring special tools or hardware. In studies dated 1845 in Bulgaria the forms of preparation and administration are similar. Topic preparations externally applied are prevalent in numbers doubling the oral administration on the contrary of modern ethnopharmacology studies in Thessaloniki where dominate internal uses over external ones. The books of medicines of Smyrna and Thessaloniki are very similar, if not almost identical. The "Livro de Milizinas" constitute a peculiar Sephardic text within the Ottoman style of medicine. The proximity in the analyses with Ottoman sources (Ottoman pharmacopoeias, Turkish Aktar shops and Medieval Cairo Jewish pharmacopoeia) is due to the high proportion of ingredients in common. After excluding animal and mineral ingredients of the analyses, modern ethnobotanical records from Greece and Turkey appear closer to the Sephardic main sources. The rest of Sephardic sources with notably smaller lists of ingredients represent fragments of mostly oral transmitted tradition and treat pathologies such as evil eye or "espanto". The recipes of the Sephardic of Bosnia comprise pathologies such as plague, cholera, typhus or gastroenteritis. Ingredients, largely of plant origin, to 93, are still in use in phytotherapy and/or local medical-pharmaceutical ethnobotany in Turkey or Greece. CONCLUSIONS: The Sephardic materia medica presented in the "Livro de Milizinas" is eclectic, adapted to an urban environment and to the prevalent pathologies of the second half of the 19th century, within the main cultural framework of the Ottoman Empire but with peculiarities characteristic of Sephardic Culture. These can be traced back to the period immediately after the expulsion of Sephardic from Spain. Their relationships with other modern sources are scarce, even in terms of pathologies.

The Jewish doctors involved in the development of health resorts in eastern Galicia at the late 19th and early 20th century (Central and Eastern Europe).

BACKGROUND: The involvement of Jewish doctors and scientists in the development of health resorts in eastern Galicia (part of the Austrian monarchy after 1772, and since 1918 as part of independent Poland, now part of Ukraine) is unquestionable; however, awareness of this fact is not that common. Meanwhile, also due to their work and activity, small borderland resorts became important medical, cultural and social centers of the region. The involvement of Jewish doctors in the development of Galician health resorts resulted from, among others, the rich and multi-layered tradition and integration of Judaism with the hygiene regulations and moral principles of the religion. The eastern Galicia health resort culture, architecture, style of how free time was spent, along with treatment and disease prevention, contributed to a European identity in the region. AIM: This article constitutes an attempt to restore the memory of places and people who created the phenomenon of Galician health resorts, an important social amenity and whose contribution to this process is completely forgotten or omitted. Most of the physicians mentioned in this article died in concentration camps or were murdered by the Nazis. METHODS: The article is based on the analysis of source texts drawn up in the German and Polish languages, including biographical archives, books, scientific articles, ego documents and press reports from the decades before WW I. RESULTS: On the European level, eastern Galicia resorts were new resorts and the development took place mainly around 1900. The Jewish community constitutively contributed to the medical, economic and cultural development of the resorts. Its role in creating a resort culture is related both to the activity of the Jewish intelligentsia and wealthy bourgeoisie, as well as local craftsmen, tavern owners or shopkeepers. It resulted from a wealthy and multi-layered Jewish tradition and the integration of Judaism with the orders of hygiene and moral principles of religion.

Spiritual Criminology: The Case of Jewish Criminology.

Throughout the ages and in most cultures, spiritual and religious thinking have dealt extensively with offending (person against person and person against the Divine), the response to offending, and rehabilitation of offenders. Although modern criminology has generally overlooked that body of knowledge and experience, the study of spirituality and its relation to criminology is currently growing. Frequently, though, it is conducted from the secular scientific perspective, thus reducing spiritual knowledge into what is already known. Our aim here is to present a complementary perspective; that is, spiritual criminology that emerges from the spiritual perspective. Following a description of the state-of-the-art in criminological research concerning spirituality and its impact upon individuals, we focus on Jewish criminology as an illustrative case study, and present a spiritual Jewish view on good and evil, including factors that lead to criminality, the issue of free choice, the aim of punishment and societal response, crime desistance, rehabilitation, and prevention. The proposed establishment of spiritual criminology can be further developed by including parallel schools of spirituality, to create an integrated field in criminology.

Israel transcutaneous bilirubin nomogram predicts significant hyperbilirubinemia.

OBJECTIVE: We constructed a transcutaneous bilirubin (TcB) nomogram to represent major sectors of the Israeli population. We studied the risk of hyperbilirubinemia, defined as meeting the requirements for phototherapy, per percentile risk category. STUDY DESIGN: Newborns ⩾36 weeks gestation were tested daily for TcB, using Drager JM-103 devices, during birth hospitalization. A nomogram was constructed and divided into four risk groups and validated by calculating the need for phototherapy for each group. RESULTS: A total of 3303 measurements were performed on 1059 consecutive newborns including Ashkenazi, Sephardic and mixed Ashkenazi/Sephardic Jews, Arab and Ethiopian Jewish. Phototherapy risk increased progressively and more than 100-fold, from 0/225 in the <40th percentile group through 27/120 (22.5%) for those >95th percentile (relative risk (95% confidence interval) 102 (6 to 1669) for those >95th percentile compared with those <40th percentile). The optimal risk for discriminating the need for phototherapy was >75th percentile (sensitivity 93.33, specificity 59.47). CONCLUSION: The risk of significant hyperbilirubinemia increased progressively with increasing percentile. Newborns >75th percentile groups are at high risk for phototherapy and should be closely monitored.

Contribution of Arabic Medicine and Pharmacy to the Development of Health Care Protection in Bosnia and Herzegovina - the First Part.

The time interval from the 9th to the 13th century remained known as the "Golden period of the Arab science", and a significant place among the taught sciences are occupied by Medicine and Pharmacy. In the history of medicine, Islamic medicine, also known as Arabic medicine, refers to the science of medicine developed in the Islamic Golden Age, and written in Arabic Arabs were able to use their cultural and natural resources and trade links to contribute to the strong development of pharmacy. After the collapse of the Arab rule, the Arab territorial expanses and cultural heritage were taken over by the Turks. Although scientific progress in the Turkish period slowed down due to numerous unfavorable political-economic and other circumstances, thanks to the Turks, Arab culture and useful Islamic principles expanded to the territory of our homeland of Bosnia and Herzegovina. Significant role in the transfer of Arabic medical and pharmaceutical knowledge was also attributed to the Sephardic Jews who, with their arrival, continued to perform their attar activities, which were largely based on Arab achievements. However, insufficiently elaborated, rich funds of oriental medical and pharmaceutical handwriting testify that Oriental science has nurtured in these areas as well, and that the Arab component in a specific way was intertwined with other cultures and traditions of Bosnia and Herzegovina.

Transcendental Spirituality and Acquaintance With the Activities of the Domestic National Transplant Center as Factors Shaping Attitudes Toward Organ Donation.

CONTEXT: Organ donation has been shown to be perceived as inappropriate by religiously observant individuals. The impact of spirituality level on attitudes toward organ donation has not been broadly explored. OBJECTIVE: To explore the contribution of ethnicity, spirituality, level of religious observance, and acquaintance with the activities of the Israel National Transplant Center (INTC) to forming attitudes toward organ donation among Jews and Muslim Arabs in Israel. DESIGN: A descriptive cross-sectional survey. PARTICIPANTS: Three hundred five (65.2%) Jewish and 163 (34.8%) Muslim Arab respondents living in Israel. RESULTS: Jewish respondents had more positive attitudes toward organ donation than Muslim Arabs. Muslim Arabs had a higher mean spirituality score than Jews. Gender, age, ethnicity, level of religious observance, education, 4 spirituality dimensions, and acquaintance with the activities of the INTC explained 41.5% of the variance in attitudes to organ donation. Transcendental spirituality, acquaintance with the activities of the INTC, and level of religious observance had the highest contribution to explaining attitudes to organ donation, while gender and age had a low contribution. Ethnicity, education, and the 3 other spirituality dimensions were not found to have a significant contribution. CONCLUSION: A multifaceted approach to improving attitudes toward organ donation among Jews and Muslim Arabs in Israel is important.

Multigene panels in Ashkenazi Jewish patients yield high rates of actionable mutations in multiple non-BRCA cancer-associated genes.

OBJECTIVE: To evaluate the results of multigene panel testing among Ashkenazi Jewish compared with non-Ashkenazi Jewish patients. METHODS: We reviewed the medical records for all patients who underwent multigene panel testing and targeted BRCA1/2 testing at a single institution between 6/2013-1/2015. Clinical actionability for identified pathogenic mutations was characterized based on the National Comprehensive Cancer Network (NCCN) guidelines and consensus statements and expert opinion for genes not addressed by these guidelines. RESULTS: Four hundred and fifty-four patients underwent multigene panel screening, including 138 Ashkenazi Jewish patients. The median patient age was fifty-two years. Three hundred and fifty-four patients (78%) had a personal history of cancer. Two hundred and fifty-one patients had breast cancer, 49, ovarian cancer, 26, uterine cancer and 20, colorectal cancer. We identified 62 mutations in 56 patients and 291 variants of uncertain significance in 196 patients. Among the 56 patients with mutations, 51 (91%) had actionable mutations. Twenty mutations were identified by multigene panels among Ashkenazi Jewish patients, 18 of which were in genes other than BRCA1/2. A review of targeted BRCA1/2 testing performed over the same study period included 103 patients and identified six mutations in BRCA1/2, all of which occurred in Ashkenazi Jewish patients. Among all Ashkenazi Jewish patients undergoing genetic testing, 25/183 (14%) had a mutation, 24/25 of which were actionable (96%) and 17/25 patients (68%) had mutations in non BRCA1/2 genes. CONCLUSIONS: With the rapid acceptance of multigene panels there is a pressing need to understand how this testing will affect patient management. While traditionally many Ashkenazi Jewish patients have undergone targeted BRCA1/2 testing, our data suggest consideration of multigene panels in this population as the majority of the results are clinically actionable and often in genes other than BRCA1/2.