An investigation into religious awareness as a crucial factor in adherence to COVID-19 medical directives in Palestine.

BACKGROUND: Coping with the pandemic caused by the SARS-COV- 2 has been a global challenge. To this end, several measures have been adopted to control the transmission of the disease and to ensure public safety. One factor that has greatly affected the community's behaviors, attitudes, and practices in Palestine has been religious beliefs. AIM: This study aims to investigate the role of religion as a factor in adherence to the COVID-19 medical directives in Palestine. METHODS: A descriptive cross-sectional study was performed from August to October 2021. In this study, 1,353 participants were asked to complete a questionnaire that consisted of 20 items that measured the impact of religious beliefs and the role played by religious scholars in the promotion and application of medically-approved health directives and the rectification of COVID-19 related information. The data were analyzed by using SPSS version 22 software. RESULTS: More than 50% of the participants agreed that religion has a positive impact on community adherence to the health instructions in the majority of studied items. The responses were significantly variable based on the age and place of residence in most of the questions (p-value < 0.05). However, gender and to a lesser extent, the level of education affected the responses to many research aspects less significantly. CONCLUSIONS: Religion could be an effective tool in dealing with challenging health issues such as COVID-19. Intervention programs can be developed based on the community's religious beliefs, attitudes, and practices, to dispel myths regarding the disease and to encourage community commitment and adherence to health directives.

Breaching the Bridge: An Investigation into Doctor-Patient Miscommunication as a Significant Factor in the Violence against Healthcare Workers in Palestine.

BACKGROUND: Workplace violence is a common issue worldwide that strikes all professions, and healthcare is one of the most susceptible ones. Verbal and nonverbal miscommunications between healthcare workers and patients are major inducers for violent attacks. AIM: To study the potential impact of verbal and nonverbal miscommunications between the patients and healthcare workers upon workplace violence from the patients' perspectives. METHODS: A descriptive cross-sectional study was performed from November to December 2020. Patients and previously hospitalized patients were asked to complete a self-reported questionnaire that involved items of verbal and nonverbal miscommunication. With the use of a suitable available sample composed of 550 participants, 505 had completed the questionnaire and were included in the study. The data were analyzed by using SPSS version 22 software. RESULTS: 7.2% of the study population reported participating in nonverbal violence and 19.6% participated in verbal violence against healthcare workers. The nonverbal and verbal violence was characteristically displayed by the patients who are male, younger than 30 years old, and bachelor's degree holders. The results of the study demonstrated that the verbal and nonverbal miscommunications between the patients and healthcare workers were the major factors in provoking violent responses from patients. Factors, such as age, gender, and level of education, were significant indicators of the type of patients who were more likely to respond with violence. CONCLUSION: Workplace violence, either verbal or nonverbal, in the health sector is a public health concern in Palestine. The verbal and nonverbal communication skills of healthcare workers should be developed well enough to overcome the effect of miscommunication provoking violent acts from patients and their relatives as well.

Comparison between Smoking and Nonsmoking Palestinian Medical Students in the Health-Promoting Behaviors and Lifestyle Characteristics.

OBJECTIVES: This study was aimed at comparing the predictors of health-promoting lifestyle behaviors between smoking and nonsmoking medical students at An-Najah National University located in Palestine. METHODS: A descriptive cross-sectional study was performed during the academic year 2017/2018. Medical students were asked to complete a self-reported questionnaire that involved the predictors of Health-Promoting Lifestyle Profile-II. With the use of a suitable available sample composed of a total of 430 medical students, 400 had successfully completed the questionnaire and were included in the study. The data was analyzed by using SPSS version 24 software. RESULTS: The sample included 400 medical students with a mean age of 18.7 years, 311 (77.7%) were females, and 89 (22.3%) were males. The prevalence of smokers in the sample was 110 (27.5%). For the health status of over half the students, 211 (52.8%) were excellent. The total HPLP-II score for smoking students resulted to be significantly lower in comparison to nonsmoking students (131.2 versus 135.7). This significant difference was clear in the interpersonal relation subscale (25.6 versus 26.8) for smoking and nonsmoking students, respectively. The score differences in other subscales were generally lower in smoking students. However, these differences were not consistent with statistical significance. CONCLUSION: The significant lower total Health-Promoting Lifestyle Profile-II score in smoking students necessitates the urgent need for awareness programs, not only towards smoking but also on how to enhance student health-promoting lifestyle behaviors.

Role of CD44 in breast cancer.

Breast cancer (BC) is among the most prevalent type of malignancy affecting females worldwide. BC is classified into different types according to the status of the expression of receptors such as estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2), and progesterone receptor (PR). Androgen receptor (AR) appears to be a promising therapeutic target of BC. Binding of 5α-dihydrotestosterone (DHT) to AR controls the expression of microRNA (miRNA) molecules in BC, consequently, affecting protein expression. One of these proteins is the transmembrane glycoprotein cluster of differentiation 44 (CD44). Remarkably, CD44 is a common marker of cancer stem cells in BC. It functions as a co-receptor for a broad diversity of extracellular matrix ligands. Several ligands, primarily hyaluronic acid (HA), can interact with CD44 and mediate its functions. CD44 promotes a variety of functions independently or in cooperation with other cell-surface receptors through activation of varied signaling pathways like Rho GTPases, Ras-MAPK, and PI3K/AKT pathways to regulate cell adhesion, migration, survival, invasion, and epithelial-mesenchymal transition. In this review, we present the relations between AR, miRNA, and CD44 and their roles in BC.

Role of androgen and microRNA in triple-negative breast cancer.

Breast cancer (BC) is the most frequent type of malignancy affecting females worldwide. Molecular-based studies resulted in an identification of at least four subtypes of breast carcinoma, including luminal A and luminal B, Human growth factor receptor (HER-2)-enriched and triple-negative tumors (basal-like and normal breast-like). A proportion of BC cases are of the triple-negative breast cancer (TNBC) type. TNBC lacks the expression of estrogen receptor (ER), progesterone receptor (PR), and HER-2, and is known to express androgen receptor (AR) at considerable levels. AR has been shown to promote the progression of TNBC. However, the exact mechanisms have yet to be unraveled. One of these mechanisms could be through regulating the expression of microRNA (miRNA) molecules, which play an important regulatory role in BC through post-transcriptional gene silencing. Activation of AR controls the expression of miRNA molecules, which target selective mRNAs, consequently, affecting protein expression. In this review we attempt to elucidate the relations between AR and miRNA in TNBC.

Dihydrotestosterone regulates expression of CD44 via miR-328-3p in triple-negative breast cancer cells.

Triple-negative breast cancer (TNBC) is an aggressive subtype that lacks effective targeted therapeutics strategy and has poor prognosis. Targeting androgen receptor (AR) in TNBC is thought to be a promising approach. We hypothesized that AR, functioning as a transcription factor, controls cell behavior via regulating the expression of microRNA molecules (miRNAs). The expression of 84 breast cancer-specific miRNAs in MDA-MB-231 cells, a highly invasive TNBC model system, was investigated using PCR arrays following treatment of cells with 5α-dihydrotestosterone (DHT). The expression of 33 miRNAs was changed by more than 2 folds including miR-328-3p, which was up-regulated by 13 folds. Transfection of cells with either miR-328-3p mimic or anti-sense molecules decreased cell motility. DHT-mediated effect on the expression and function of CD44, a target of miR-328-3p, was investigated. CD44 expression and cell adhesion to hyaluronic acid (HA) were down-regulated when cells were treated with DHT or transfection with a miR-328-3p mimic. On the other hand, the AR antagonist, bicalutamide, or transfection of cells with miR-328-3p anti-sense molecules had the opposite effect. Cells transfected with miR-328-3p anti-sense molecules reduced the negative effect of DHT on CD44 expression and cell adhesion to HA. In addition, DHT further reduced the expression of CD44 and cell adhesion to HA in cells transfected with miR-328-3p mimic. These results strongly suggest that miRNAs can mediate AR regulation of breast cancer cells and that AR controls the expression of CD44 via miRNA-dependent and independent mechanisms.