Exploring the impact of nano-Se and nano-clay feed supplements on interleukin genes, immunity and growth rate in European Sea Bass (Dicentrarchus labrax).

This study aimed to investigate the effects of adding Nano-Selenium (NSe) and Nano-clay (NC) as feed supplements on European Sea Bass (Dicentrarchus labrax). Two separate experiments were conducted, one with NC and the other with NSe. Each experiment consisted of four sub-groups with varying concentrations of NC or NSe. The expression levels of five immune-related genes (TNF-α, TNF-ß, IL-2, IL-6 and IL-12) were measured using Real-time Quantitative PCR (Rt-PCR) Assay. The results showed an increase in the expression of interleukins (IL-2, IL-6 and IL-12) and pro-inflammatory cytokines (TNF-α and TNF-ß) after exposure to NC and NSe. TNF-α gene expression was significantly higher with both 1 mg and 10 mg concentrations of NC and NSe. TNF-ß gene expression was highest with the 5 mg concentration of NC. The concentrations of 1 mg and 10 mg for NC, and 1 mg, 5 mg, and 10 mg for NSe, led to the highest (p < 0.05) levels of IL-2 expression compared to the control. Similar trends were observed for IL-6 and IL-12 gene expression. Understanding the impact of these concentrations on gene expression, growth rate, biochemical indices, and antioxidant status can provide valuable insights into the potential applications of NC and NSe supplements on European Sea Bass.

Hypnosis during Endovascular Abdominal Aortic Aneurysm Repair.

(1) Background: Endovascular abdominal aneurysm repair (EVAR) is associated with a reduction in early morbidity and mortality compared with open repair. Procedures performed under hypnosis might represent an alternative to further reduce the risks related to general anesthesia (GA). This study aimed to assess the feasibility and safety of hypnosis and local anesthesia during EVAR. (2) Methods: All consecutive patients who underwent EVAR or fenestrated/branched EVAR (f/bEVAR) under hypnosis and local anesthesia (n = 28) between 2017 and 2019 were retrospectively studied and matched to control patients who underwent the same interventions under GA. (3) Results: There was neither a significant difference in the length of ICU stay (p = 0.06), nor in the occurrence of endoleaks, reintervention, and 30-day mortality rate (p = 1.00, 0.73, and 0.24, respectively). The hypnosis group had lower use of norepinephrine (maximum dose 0.04 ± 0.1 vs. 1.2 ± 4.0 mg·h-1, p < 0.001), shorter procedure duration (181.2 ± 71.4 vs. 214.3 ± 79.6 h, p = 0.04), and shorter length of stay (5.4 ± 3.2 vs. 8.4 ± 5.9 days, p = 0.002). (4) Conclusions: In this pioneering study, hypnosis during EVAR appears feasible and safe. It is associated with lower intraoperative use of norepinephrine, as well as procedure duration and length of in-hospital stay.

Toxicity Evaluation, Oxidative, and Immune Responses of Mercury on Nile Tilapia: Modulatory Role of Dietary Nannochloropsis oculata.

The current study evaluated the potential ameliorative effect of a dietary immune modulator, Nannochloropsis oculata microalga, on the mercuric chloride (HgCl2)-induced toxicity of Nile tilapia. Nile tilapia (45-50 g) were fed a control diet or exposed to » LC50 of HgCl2 (0.3 mg/L) and fed on a medicated feed supplemented with N. oculata (5% and 10% (50 or 100 g/kg dry feed)) for 21 days. Growth and somatic indices, Hg2+ bioaccumulation in muscles, and serum acetylcholinesterase (AChE) activity were investigated. Antioxidant and stress-related gene expression analyses were carried out in gills and intestines. Histopathological examinations of gills and intestines were performed to monitor the traits associated with Hg2+ toxicity or refer to detoxification. Hg2+ toxicity led to significant musculature bioaccumulation, inhibited AChE activity, downregulated genes related to antioxidants and stress, and elicited histopathological changes in the gills and intestine. Supplementation with N. oculata at 10% was able to upregulate the anti-oxidative-related genes while downregulated the stress apoptotic genes in gills and intestines compared to the unexposed group. In addition, minor to no histopathological traits were detected in the gills and intestines of the N. oculata-supplemented diets. Our data showed the benefit of dietary N. oculata in suppressing Hg2+ toxicity, which might support its efficacy as therapeutic/preventive agent to overcome environmental heavy metal pollution in aquatic habitats.

Assessment of lifestyle and coping strategies among asthmatic patients during the Covid-19 crisis.

BACKGROUND: COVID-19 can cause an asthma attack by triggering asthma symptoms, such as wheezing, chest tightness, and difficulty breathing, which are distressing for patients and can cause anxiety. Additionally, it can progress to pneumonia or other severe lung diseases. OBJECTIVES: Therefore, this study aimed to assess the coping strategies and lifestyle modifications among patients with asthma during the COVID-19 crisis. METHODS: A descriptive comparative design was conducted on 300 adult patients with bronchial asthma at the Alexandria Main University Hospital's chest disease outpatient clinic. Three tools were used for data (including biosocio-demographic characteristics of patients with asthma, the effect of the COVID-19 crisis on the lifestyle of patients with asthma, and how patients with asthma cope with COVID-19) collection. RESULTS: This study revealed that more than two-thirds of patients with asthma did not have COVID-19, while more than one-quarter had COVID-19. More than two-thirds had reasonable asthma control, and more than half had neutral coping with their asthma and the COVID-19 crisis. Half of the studied patients had coped neutrally with their asthma during the COVID-19 crisis, and more than half coped neutrally with the COVID-19 crisis. CONCLUSION: These findings indicate that all stressors faced by patients with respiratory diseases during the COVID-19 crisis and psychological, social, and health support that should be provided to these patients during the pandemic require further investigation.

Effects of L-ascorbic acid on growth, non-specific immunity, antioxidant capacity, and intestinal and hepatopancreatic histology of red swamp crayfish, Procambarus clarkii.

This study investigated the dietary effects of coated L-ascorbic acid (LA) on growth, feed utilization, survival, serum biochemical indices, immunity, antioxidant capacity, and intestinal and hepatopancreatic histology of the pre-adult red swamp crayfish. Four isoproteinous and isolipidic diets were formulated to contain several LA levels as 0, 1300, 1600, and 1900 mg/kg and designated as control (LA0), LA13, LA16, and LA19, respectively. However, the analyzed LA concentrations in diets were 0.00, 199.57, 360.45, and 487.50 mg/kg in LA0, LA13, LA16, and LA19, respectively. Triplicate treatments of crayfish (21.60 ± 0.14 g) were fed the test diets and reared in fiberglass tanks with a density of 20 individuals per each for eight weeks. Results revealed that all LA treatments had significantly enhanced growth performance compared to the control. Of interest, the LA16 treatment recorded the highest final tank biomass, biomass gain, total feed intake, condition factor, and muscle yield among the other treatments. The tank feed conversion ratio was significantly decreased in LA treatments compared to the control. Moreover, dietary LA16 and LA19 had significantly higher survival rates (93.3%) compared to (85.0%) in the LA0 group. All dietary doses of LA significantly increased serum parameters (total protein, albumin, globulin, lysozyme activity) and respiratory burst activity compared to the LA0 treatment. Dietary LA16 significantly boosted the hepatopancreatic antioxidant capacity, manifested by decreased malondialdehyde concentrations, increased catalase, superoxide dismutase, and glutathione peroxidase enzyme activities, and reduced glutathione content compared to the LA-free diet. A normal histoarchitecture of the hepatopancreatic tubules was found in all LA treatments except with some minor degenerative changes in the tubular lumen, and hepatopancreatic cells associated with enlarged nuclei were found in the LA19. However, normal intestinal histoarchitecture was found in all treatments with no recorded intestinal lesions. Of interest, the polynomial regression performed on the analyzed LA concentrations suggested that 380 mg/kg would be suitable to provide maximal biomass gain for pre-adult crayfish. In conclusion, results revealed that coated LA could enhance the growth, immunity, and antioxidant capacity of pre-adult red swamp crayfish, suggesting its potential as a functional and necessary micronutrient for crayfish diets.

Effects of exogenous bile acids (BAs) on growth, lipid profile, digestive enzymes, and immune responses of thinlip mullet, Liza ramada.

An eight-week trial was designed to explore the dietary effects of commercially purchased exogenous bile acids (BAs) on growth, whole-body composition, lipid profile, intestinal digestive enzymes, liver function enzymes, oxidative stress biomarkers, and serum immunity of thinlip mullet, Liza ramada. Four triplicate groups (10.50 ± 0.05 g) were fed four soybean meal (SBM)-based diets supplied with several BAs levels at 0 (control), 50, 130, or 350 mg/kg feed. Results indicated that the growth was significantly increased in groups fed BAs-based diets, especially at 130 mg/kg feed. The body composition analysis showed that feeding fish on diets supplied with BAs up to 130 mg/kg decreased moisture (%) alongside increased crude protein (%). However, the body composition of fish fed a diet with 350 mg BAs/kg had the lowest moisture (%) and the highest crude protein (%). Moreover, there were significant increases in the intestinal (protease, α-amylase, and lipase) enzyme activities in the groups supplied with BAs up to 130 mg BAs/kg. Liver function enzymes (aspartate aminotransferase and alanine aminotransferase enzyme activities) were significantly decreased in BAs-supplemented groups compared to those fed the BAs-free group. On the other hand, the control group had higher total cholesterol, triglycerides, and low-density lipoprotein alongside the lower high-density lipoprotein than BAs-supplemented groups, especially at 350 mg BAs/kg feed. BAs significantly decreased hepatic malondialdehyde concentrations and increased the activity of hepatic catalase, superoxide dismutase, and total antioxidant capacity compared with those reared on the control diet. Serum lysozyme, respiratory burst, and alternative complement activities were significantly increased in BAs-supplied groups, particularly in the group supplied with 130 mg BAs/kg compared to those fed on the control diet. Accordingly, our findings recommend that including 130 mg BAs/kg in an SBM-based diet enhanced the growth, digestive enzyme activities, and liver functions, alleviated oxidative stress, boosted serum immunity, and lowered lipid metabolites in thinlip mullet. These findings will be beneficial for improving the quality of feed prepared for feeding mullets and an effective alternative strategy to support mullet farming.

Compulsive digital use among school-age children and association with escapism and feeling of loneliness: A call for action.

PURPOSE: This study aimed to investigate the relationship between Compulsive Digital Use (CDU), escapism, and loneliness among school-age children. DESIGN AND METHODS: A quantitative, non-experimental, descriptive correlational study was conducted at 16 governmental preparatory schools affiliated with the Ministry of Education in Alexandria, Egypt. A simple random sampling of 300 school-age children participated in the study after obtaining the informed consent from the parents/guardians and assent from children. RESULTS: The main study findings showed that 74% of school-age children had a subthreshold level of CDU, and 21.7% demonstrated a pathological/ addictive level. Compulsive digital use showed a significant positive correlation with both total escapism and loneliness scores (r = 0.689, p < 0.001 and r = 0.329, p = 0.005, respectively). CONCLUSION: Children spend more than the recommended daily duration online. They reported having sleeping problems, especially insomnia, and poor academic achievement due to internet overuse. Most children had subthreshold level of CDU and one-quarter of them reached the addictive level. They reported that internet use helped them escape from the world of reality, unpleasant and worrisome things, as well as problems and pressures. Children reported loneliness and felt that people were around but not with them. Female gender and the employment of both parents were significantly associated with developing CDU. Escapism and loneliness among children were positively correlated with CDU. PRACTICAL IMPLICATIONS: Awareness-raising campaigns regarding internet usage should be launched for school-age children and their parents to address its emerging psychosocial risks and challenges.

Association of health anxiety, fatalism and medication adherence among geriatric clients: An exploratory study.

OBJECTIVES: This study explored the relationship between health anxiety, fatalistic beliefs, and medication adherence among geriatric clients. Also, it determines the extent to which health anxiety and fatalism can predict the variance in medication adherence among the same population of geriatric clients. DESIGN: A cross-sectional analytical survey on 200 eligible participants using the Arabic Version of the Short Health Anxiety Inventory, Fatalism Scale, and Morisky Medication Adherence Scale-8 items. RESULTS: The study found a statistically significant negative relationship between the studied geriatric clients' fatalism and health anxiety and their medication adherence (r = -0.160, - 0.187, and P = 0.024, 0.008), respectively. CONCLUSION: This study highlights the importance of considering psychological factors such as health anxiety and fatalistic beliefs in addressing medication adherence among geriatric clients. By addressing these factors, healthcare providers can develop more effective strategies to improve medication adherence and ultimately improve the health outcomes of geriatric clients.

The efficacy and safety of vibrating capsules for functional constipation: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: Chronic constipation is a challenging functional gastrointestinal disorder that remains a global burden. Pharmacologic therapy, including laxatives and dietary fibers, are suggested as lines of treatment. Recent trials introduced an orally ingested vibrating capsule (VC) as an eligible option for chronic constipation management. METHODS: We conducted a literature search in English on electronic databases CENTRAL, PubMed, EMBASE, Scopus, and WOS until February 27th, 2023. RevMan was used to perform the meta-analysis. The results were reported as risk ratios (RRs), mean differences (MDs), and 95% confidence intervals (CIs). The study protocol was registered in PROSPERO with ID: (CRD42023409422). RESULTS: Three RCTs with a total of 601 patients were included in our analysis. There was no difference between the VC and placebo in responder rate (RR: 1.37 with 95% CI [0.82, 2.28], p = .22), CSBM change from baseline (MD: 0.21 with 95% CI [-0.26, 0.69], p = .38), SBM change from baseline (MD: 0.14 with 95% CI [-0.22, 0.49], p = .46), and the incidence of any adverse event (RR: 1.45 with a 95% CI of [0.79, 2.63], p = .23). However, VC was associated with increased vibration sensation (RR: 17.23, 95% CI [3.29, 90.20], p = .0008). CONCLUSIONS: VC was not effective to improve bowel movement in patients with functional constipation with no difference in response rate. However, evidence is still uncertain, with only three small RCTs that yielded heterogenous findings, mainly due to the different vibration protocols. Also, our findings suggest that VC is safe and well-tolerated, with no significant harmful effects observed. Therefore, more large-scale RCTs are needed to confirm the efficacy and safety of VC in patients with functional constipation, determining the most effective dose, frequency, and duration of treatment.

The role of antifreeze genes in the tolerance of cold stress in the Nile tilapia (Oreochromis niloticus).

BACKGROUND: Tilapia is one of the most essential farmed fishes in the world. It is a tropical and subtropical freshwater fish well adapted to warm water but sensitive to cold weather. Extreme cold weather could cause severe stress and mass mortalities in tilapia. The present study was carried out to investigate the effects of cold stress on the up-regulation of antifreeze protein (AFP) genes in Nile tilapia (Oreochromis niloticus). Two treatment groups of fish were investigated (5 replicates of 15 fish for each group in fibreglass tanks/70 L each): 1) a control group; the fish were acclimated to lab conditions for two weeks and the water temperature was maintained at 25 °C during the whole experimental period with feeding on a commercial diet (30% crude protein). 2) Cold stress group; the same conditions as the control group except for the temperature. Initially, the temperature was decreased by one degree every 12 h. The fish started showing death symptoms when the water temperature reached 6-8 °C. In this stage the tissue (muscle) samples were taken from both groups. The immune response of fish exposed to cold stress was detected and characterized using Differential Display-PCR (DD-PCR). RESULTS: The results indicated that nine different up-regulation genes were detected in the cold-stressed fish compared to the control group. These genes are Integrin-alpha-2 (ITGA-2), Gap junction gamma-1 protein-like (GJC1), WD repeat-containing protein 59 isoform X2 (WDRP59), NUAK family SNF1-like kinase, G-protein coupled receptor-176 (GPR-176), Actin cytoskeleton-regulatory complex protein pan1-like (PAN-1), Whirlin protein (WHRN), Suppressor of tumorigenicity 7 protein isoform X2 (ST7P) and ATP-binding cassette sub-family A member 1-like isoform X2 (ABCA1). The antifreeze gene type-II amplification using a specific PCR product of 600 bp, followed by cloning and sequencing analysis revealed that the identified gene is antifreeze type-II, with similarity ranging from 70 to 95%. The in-vitro transcribed gene induced an antifreeze protein with a molecular size of 22 kDa. The antifreeze gene, ITGA-2 and the WD repeat protein belong to the lectin family (sugar-protein). CONCLUSIONS: In conclusion, under cold stress, Nile tilapia express many defence genes, an antifreeze gene consisting of one open reading frame of approximately 0.6 kbp.

Nutritional and immunological evaluation of Nannochloropsis oculata as a potential Nile tilapia-aquafeed supplement.

Nannochloropsis oculata (N. oculata) is a marine microalga containing bioactive compounds and a high omega-3 polyunsaturated fatty acid (ω-3 PUFAs). Therefore, it is very promising for nutraceutical and the functional food industry applications. Three groups of Nile tilapia (forty-five fish/group) were fed on basal diets or diets containing 5% (N5) or 10% (N10) of the microalga N. oculata for seven weeks. Fish growth performance, proximate composition, and lipid (fatty acids/ FAs and lipoproteins) profile were estimated. In addition, the expression pattern of some lipid metabolism and immune-relevant genes were assessed. An enhancement in whole body crude protein and growth indices of Nile tilapia was observed on both the supplemented groups N5 and N10. Higher levels of high-density lipoproteins (HDL); and lower levels of the low-density lipoproteins (LDL) were evident in both supplemented groups, while the cholesterol and triglycerides (TG) levels were similar among groups. Ω-3 PUFAs were the significant FAs profile of tilapia fed on N. oculata-supplemented diets in terms of eicosapentaenoic acid, docosahexaenoic acid, and n3/n6 ratio. Concerning the gene expression pattern, heat-shock protein70, glutathione-S-transferase, glutathione peroxidase, and interleukin-1ß (IL-1ß) were elevated significantly in both supplemented groups. IL-10 is only upregulated in the N10 group. The lipid metabolism-related gene expression showed downregulation of only fatty acid synthase (FAS) in both supplemented groups, with no statistical changes in Peroxisome proliferator-activated receptor alpha (PPARα). Tumor necrosis factor-α (TNF-α), Transforming growth factor-ß1 (TGF-ß1), and the apoptotic related genes [caspase3 and Proliferating cell nuclear antigen (PCNA)] showed insignificant changes among groups. The histopathological examination of the intestine, liver, and spleen supports our findings and confirms the benefits and safeness of N. oculata dietary inclusion. Collectively, N. oculata is a very promising nutraceutical for improving fish health and sustainability of aquaculture production.

DNA barcoding of marine macroalgae as bioindicators of heavy metal pollution.

Metal pollution in the marine coastal environment is an important topical issue. In this study, the water quality in five locations along the Alexandria coast (Eastern Harbor, El-Tabia pumping station, El Mex Bay, Sidi Bishir, and Abu Talat) was assessed by measuring physicochemical parameters from water samples. Depending on the morphological classification of macroalgae, the collected morphotypes were related to Ulva fasciata, Ulva compressa, Corallina officinalis, Corallina elongata, and Petrocladia capillaceae. Corallina officinalis and Corallina elongata demonstrated a high capacity for Cd, Pb, and Ni accumulation, and the highest values of Fe, Cu, and Mn were reported in Ulva fasciata and Ulva compressa. Two standard markers were applied, and results showed that the morphological classification matched the molecular data. Moreover, the analysis of algae can only reflect the accumulation of metals. The conclusion is that Ulva compressa and Corallina officinalis are potentially suitable indicators of localized short-term heavy metal pollution.

Parents' perception of COVID-19 risk of infection and intention to vaccinate their children.

Background: Parent's perception of the COVID-19 vaccines is very important to protect themselves and their children and achieve maximum effect of vaccination programs. Objective: Evaluate the perception and attitude of parents towards COVID-19 risk of infection and intentions to vaccinate their children. Method: Cross-sectional study including 1032 participants who have children aged from 5 to 18 years using a structured questionnaire. Results: Overall, 65.0% of participants or their family members suffered from comorbidities that poses them at risk for COVID-19 infection such as hypertension (25.1%) and diabetes mellitus (16.1%). The prevalence of tobacco smoking in the studied families was 36.9%. Among participants, 40.6% had a family member with history of confirmed COVID-19 infection. Nearly one-half of studied parents (48.2%) reported COVID-19 as a serious infection and the majority were worried about getting a family member infected (86.8%). Among participants 62.0% of male parents and 57.8% of female parents agreed that vaccine information is reliable. Participants reporting safety of COVID-19 vaccination represented 45.3%. If vaccine is available, 40.1% of parents intended to vaccinate their children. The main factors associated with the willingness to vaccinate children were vaccine is not suitable for children under 18 years (OR = 11.508), concern about vaccination safety (OR = 8.678), doubts about reliability of vaccine information (OR = 7.811) and ability of vaccine to prevent infection (OR = 5.766). Conclusion: Our study provides a brief insight about how parents think about COVID-19 vaccines and acceptance to vaccinate their children.

Antecedentes: La percepción de los padres sobre las vacunas contra el COVID-19 es muy importante para protegerse a sí mismos y a sus hijos y lograr el máximo efecto de los programas de vacunación. Objetivo: Evaluar la percepción y actitud de los padres hacia el riesgo de infección por COVID-19 y las intenciones de vacunar a sus hijos. Método: Estudio transversal que incluyó a 1032 participantes que tenían hijos de 5 a 18 años mediante un cuestionario estructurado. Resultados: En general, el 65,0% de los participantes o sus familiares padecieron comorbilidades que los ponen en riesgo de infección por COVID-19, como hipertensión (25,1%) y diabetes mellitus (16,1%). La prevalencia de tabaquismo en las familias estudiadas fue del 36,9%. Entre los participantes, el 40,6% tenía un familiar con antecedentes de infección confirmada por COVID-19. Casi la mitad de los padres estudiados (48,2%) informaron que la COVID-19 era una infección grave y la mayoría estaba preocupada por la posibilidad de que un miembro de la familia se infectara (86,8%). Entre los participantes, el 62,0% de los padres varones y el 57,8% de las mujeres acordaron que la información sobre las vacunas es confiable. Los participantes que informaron sobre la seguridad de la vacunación contra la COVID-19 representaron el 45,3%. Si la vacuna está disponible, el 40,1% de los padres tenía la intención de vacunar a sus hijos. Los principales factores asociados al deseo de vacunar a los niños fueron la vacuna no apta para menores de 18 años (OR = 11.508), preocupación por la seguridad vacunal (OR = 8.678), dudas sobre la confiabilidad de la información vacunal (OR = 7.811) y capacidad de vacuna para prevenir la infección (OR = 5.766). Conclusión: Nuestro estudio proporciona una breve perspectiva sobre cómo piensan los padres sobre las vacunas contra el COVID-19 y la aceptación de vacunar a sus hijos.

Growth performance, antioxidant activities, and immunological responses of hapa-reared thinlip mullet (Liza ramada) juveniles fed on diets supplemented with spirulina (Arthrospiraplatensis).

Spirulina (Arthrospira platensis) (SP) has been utilized for a long time as a valued feed supplement because of its proteinous content and other beneficial phytochemical compounds. Herein, we investigated the influences of SP-supplemented diets on growth, body somatic indices, digestive enzymes, hepatic antioxidant activities, and immunological responses of hapa-reared thinlip mullet (Liza ramada) juveniles. Fish were assigned in six triplicate groups and were fed for consecutive 60 days on the prepared experimental diets containing varying SP levels as 0.0, 2.0, 4.0, 6.0, 8.0, and 10.0 g/kg diet and defined as control (CNT or SP0), SP2, SP4, SP6, SP8, and SP10 groups, respectively. The results indicated that dietary SP supplementation linearly and quadratically improved the fish growth performance, and the highest growth indices were found in the SP8 group. However, dietary SP supplementation did not significantly alter feed conversion ratio (FCR), survival rate (%), hepato-somatic index, and viscera-somatic index among all experimental groups. Meanwhile, digestive enzymes (lipase, α-amylase, and proteases) in the mid-intestine were also linearly and quadratically increased in all SP-fed groups, and their uppermost values were noted in the SP8 group. Hepatic antioxidants such as superoxide dismutase, catalase, and total antioxidant capacity in SP-supplemented groups were significantly elevated than the CNT group. Conversely, hepatic malondialdehyde contents were decreased significantly along with increasing dietary SP-supplementation levels. The immunological parameters such as lysozyme, respiratory burst, and alternative complement activities were significantly elevated in SP-fed groups than in the CNT group. These findings evoked that feeding SP-supplemented diets (especially at 8.0 g/kg diet) significantly promoted the growth, digestive enzymes, hepatic antioxidant status, and immunity of L. ramada juveniles.

Knowledge, attitudes, practices and perceived barriers towards research in undergraduate medical students of six Arab countries.

BACKGROUND: The involvement of the undergraduates in the research field requires a better view of their potential and the anticipated barriers facing them. This study aims to assess the undergraduates' knowledge, attitudes, practices and perceived barriers towards research in six Arab countries. METHODS: A cross sectional study included medical students from six Arab countries, where a self-administered five-section questionnaire was used to assess the students' demographics, knowledge, attitudes, practices and perceived barriers. The questionnaire was distributed in the online educational platforms of the participating medical schools in the six included countries. RESULTS: The total sample of recruited students was 2989, the majority of students (91.6%) showed poor level of knowledge regarding research. Generally high levels of positive attitudes towards research, research relevance and usefulness were found, with moderate levels of perception of research anxiety and difficulty. 33.7% (n = 1006) participated in an actual research project before with a mean of .5 publications per student. Cross-sectional studies were the most common type of studies conducted by students (38.6%), followed by case reports (23.9%). Lack of access to lab equipment for lab research (68.1%), the priority of education over research (66.8%), and lack of time because of educational tasks (66.1%) were generally the top perceived barriers towards research practice. CONCLUSION: In the current study, the participants showed a poor knowledge level with associated positive attitudes towards research. One third of the students participated in research projects that mostly were cross-sectional studies and case reports. Educational tasks and lack of support were the most prevalent barriers. The students' positive attitudes towards research need to be translated into better knowledge and appropriate practice, which can be done by development of better training systems and more structured mentoring.

Efficacy of dance for Parkinson's disease: a pooled analysis of 372 patients.

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder that presents with motor and nonmotor symptoms such as bradykinesia, resting tremor, postural instability, and cognitive and neuropsychiatric manifestations. Dance therapy or complex motor activity, besides pharmacological treatment, may have benefits in PD patients. OBJECTIVE: To assess the effect of dance in patients with PD. METHODS: We searched for clinical trials in PubMed, Scopus, and Web of Science, and Cochrane till April 2020 using relevant keywords. Data were extracted and pooled as mean difference (MD) with 95% confidence interval (CI) by Review Manager 5.3. RESULTS: Fourteen randomized controlled trials with 372 patients were included. Dance showed a significant improvement over the control group in term of the Unified Parkinson's Disease Rating Scale III (UPDRS III) after three (MD = - 4.49, 95% CI [- 6.78, - 2.21], p = 0.00001), six, (MD = - 5.96, 95% CI [- 8.89, - 3.02], p < 0.0001), and 12 months (MD = - 14.58, 95% CI [- 24.76, - 4.4], p = 0.005), and Mini-BES test after 12 months. Compared to exercise, dance showed a significant improvement in Timed Up and Go (TUG) test, Berg Balance Scale (BBS), and Mini-BES test. CONCLUSION: In comparison to other types of exercise or no activity, dance improves the symptoms and outcomes in patients with PD, especially motor symptoms. Dance also has positive effects on balance, functional mobility, and cognition.

Toxicity, inflammatory and antioxidant genes expression, and physiological changes of green synthesis silver nanoparticles on Nile tilapia (Oreochromis niloticus) fingerlings.

The rapid increase of incorporating silver nanoparticles (Ag-NPs) in different anthropogenic and industrial activities increased the discharge of these particles in the aquatic ecosystem. The environmental impact of Ag-NPs, especially the green synthesized is still not completely understood on fish. Therefore, this study aimed to investigate the effects of exposure to graded series of starch-mediated Ag-NPs at levels of 0, 3.31, 6.63, 13.25, and 26.50 mg L-1 representing 0, 6.25, 12.5, 25, and 50% of LC50 on Nile tilapia (O. niloticus), respectively. Fish with initial weight 37.63 ± 0.41 g were maintained in 70 L glass aquaria and exposed to starch-mediated Ag-NPs (average particle size 40 nm) for 28 days. The results revealed that starch-mediated Ag-NPs induced severe changes in the mRNA levels of toxicity (CYP1A and Hsp70) and inflammatory (TNF-α and TGF-ß) genes. The expression of antioxidant genes (SOD and CAT) was significantly suppressed, and the activities of their enzymes were inhibited significantly upon exposure. Simultaneously, the malondialdehyde level increased significantly with increasing the exposure levels of starch-mediated Ag-NPs. The red blood cells, hemoglobin, hematocrit and white blood cell values were decreased significantly with doses over 3.31 mg L-1 of Ag-NPs. In addition, the total protein and globulin decreased significantly with increasing Ag-NPs in a dose-dependent manner. The liver function enzymes and kidney function indicators revealed severe toxicity with Ag-NPs exposure. In conclusion, the effect of starch-mediated Ag-NPs in doses over 3.31 mg L-1 induced obvious toxicity in the molecular and proteomic levels in Nile tilapia fingerlings.

Perioperative Outcomes of Adjunctive Hypnotherapy Compared with Conscious Sedation Alone for Patients Undergoing Transfemoral Transcatheter Aortic Valve Implantation.

Transcatheter aortic valve implantation (TAVI) using a transfemoral approach under local anesthesia with conscious sedation (LACS) is becoming an increasingly common TAVI strategy. However, patients who are awake during the TAVI procedure can experience stress, anxiety, and pain, even when LACS is used. Clinical hypnotherapy is an anxiolytic intervention that can be beneficial for patients undergoing invasive surgery. This study aimed to assess the perioperative outcomes of adjunctive hypnotherapy undergoing transfemoral TAVI with LACS.Consecutive patients (n = 143) with symptomatic severe aortic stenosis who underwent transfemoral TAVI with LACS only (n = 107) or with LACS and hypnotherapy (n = 36) between January 2015 and April 2016 were retrospectively included in the study. The clinical outcomes were compared between the two groups. The LACS with hypnotherapy group had a significantly shorter length of stay in the intensive care unit (ICU; LACS only versus LACS with hypnotherapy: 4.0 (4.0-5.5) days versus 3.0 (3.0-5.0) days, P < 0.01). Moreover, the use of anesthetics (propofol and remifentanil) and norepinephrine was significantly lower in the LACS with hypnotherapy group (e.g., for propofol, LACS only versus LACS with hypnotherapy: 96.4 ± 104.7 mg versus 15.0 ± 31.8 mg, P < 0.001). The multiple regression analysis showed that being male, hypnotherapy, and the composite complication score were independently associated with the length of stay in the ICU.The adjunctive hypnotherapy on LACS among transfemoral TAVI patients may facilitate perioperative management. However, a prospective randomized study is necessary to confirm the efficacy of hypnotherapy among TAVI patients.