Search

Introduction: This study investigates the dynamics of intranational intergroup contact between Arab and Jewish students in a higher education institution in Israel. Guided by the contact hypothesis, the research examines the gap between students' willingness for intergroup closeness and their reported actual intergroup interactions. Methods: Using a cross-sectional survey design, quantitative data were collected from a total of 733 Arab and Jewish students at two timepoints: in 2016 (n = 419) and in 2023 (n = 314). All students were studying to become physical education teachers. Results: The findings revealed both persistent challenges and encouraging trends in intergroup relationships. Despite reported willingness for meaningful connections, the students' reported actual intergroup interactions remained limited. A significant increase in willingness for academic and friendship relationships was observed from 2016 to 2023, suggesting the potential for constructive change. Arab students consistently reported higher willingness for closeness and more frequent interactions than their Jewish counterparts. Discussion: These findings underscore the importance of structured interventions in higher education settings to foster meaningful intergroup relations, amidst broader societal challenges. [ABSTRACT FROM AUTHOR]

Introduction: This study investigates the dynamics of intranational intergroup contact between Arab and Jewish students in a higher education institution in Israel. Guided by the contact hypothesis, the research examines the gap between students’ willingness for intergroup closeness and their reported actual intergroup interactions. Methods: Using a cross-sectional survey design, quantitative data were collected from a total of 733 Arab and Jewish students at two timepoints: in 2016 (n  =  419) and in 2023 (n  =  314). All students were studying to become physical education teachers. Results: The findings revealed both persistent challenges and encouraging trends in intergroup relationships. Despite reported willingness for meaningful connections, the students’ reported actual intergroup interactions remained limited. A significant increase in willingness for academic and friendship relationships was observed from 2016 to 2023, suggesting the potential for constructive change. Arab students consistently reported higher willingness for closeness and more frequent interactions than their Jewish counterparts. Discussion: These findings underscore the importance of structured interventions in higher education settings to foster meaningful intergroup relations, amidst broader societal challenges. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the prevalence and determine predictors of leg cramps among pregnant women in their third trimester. Methods: A sample of pregnant women in their third trimester who routinely visited local clinics in Jordan was recruited. Participants completed a socio-demographic and clinical characteristics questionnaire, the numeric pain rating scale (NPRS) for leg cramp pain intensity, the Arabic version of the Pregnant Physical Activity Questionnaire (PPAQ), the Nordic Musculoskeletal Questionnaire (NMQ), Short Form Health Survey (SF-12), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HADS). In addition, magnesium (Mg) and calcium (Ca) serum levels were examined. Logistic regression analyses were used to identify predictors of leg cramps occurrence. A linear regression model was used to investigate predictors of leg cramps pain intensity among pregnant women who reported leg cramps. Results: Two hundred and five (n=205) pregnant women completed the study. The estimated prevalence of leg cramps was 58%. Logistic regression results showed that not receiving assistance with housework (OR 0.46, p=0.025), progress in the number of gestational weeks (OR 1.10, p=0.021), the number of previous pregnancies (OR 1.21, p=0.049), having leg swelling (OR 2.28, p=0.019), and having gastrointestinal (GIT) problems (OR 2.12, P=0.046) were associated with a higher odds of leg cramps occurrence. In the subsample with pregnant women with leg cramps, linear regression results showed that pregnant women with high school education versus elementary school (β=0.70, p=0.012), number of working hours (β=0.11, p=0.010), using vitamins supplements (β=− 1.70, p=0.043), having diabetes after pregnancy (β=1.05, p=0.036), having sciatica (β=0.58, p=0.028), having hip pain (β =−.33, p=0.029), and higher PSQI total score (β=0.09, p=0.020) were the significant predictors of leg cramp pain intensity. Conclusion: Many health-related conditions, as well as work and home-related work characteristics, may be considered risk factors for the occurrence of leg cramps and increased leg cramps pain intensity in pregnancy. [ABSTRACT FROM AUTHOR]

Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

Premenstrual syndrome (PMS) has various symptoms that occur during the luteal phase of the menstrual cycle and subside after menstruation. Anxiety and depression are prevalent in women with PMS and may exacerbate the severity of PMS. Vitamin D and calcium deficiency may have a role in developing anxiety, depression, and musculoskeletal pain (MSP). The aim of this study was to evaluate selected premenstrual symptoms in relation to serum vitamin D levels, daily calcium consumption, and psychological symptoms among women with MSP. The study population consisted of 108 women with MSP and 108 healthy controls. Information about premenstrual symptoms and calcium consumption were collected. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Vitamin D was determined by electrochemiluminescence immunoassay. Women with MSP had lower serum vitamin D levels, lower daily calcium consumption, higher HADS scores for anxiety and depression, and higher frequency of severe premenstrual symptoms including fatigue, headache, irritability, mood swings, anxiety, depression, and social withdrawal compared to controls (P < 0.01). Abnormal HADS scores for anxiety and depression were associated with increased severity of premenstrual symptoms (P < 0.05). Deficient vitamin D and calcium consumption were associated with abnormal HADS scores for anxiety and depression (P < 0.05) and with increased severity of premenstrual headache, irritability, anxiety, and depression (P < 0.05). Low calcium consumption was associated with increased severity of premenstrual irritability, anxiety, depression, and social withdrawal (P < 0.05). The results suggest that vitamin D deficiency, low calcium consumption, psychological symptoms, and MSP could be interrelated and implicated in the etiology severe premenstrual symptoms. Further studies are necessary to assess whether vitamin D and calcium supplements can relieve MSP and premenstrual symptoms. [ABSTRACT FROM AUTHOR]

Background: Adverse birth outcomes, such as preterm birth and low birth weight (LBW), are leading causes of neonatal morbidity and mortality. In this study, we aimed to estimate the association between inter‐pregnancy interval (IPI) and the risks of adverse birth outcomes in a subsequent pregnancy. Methods: We conducted a retrospective analysis involving 630 mothers who delivered a singleton live infant at a leading tertiary hospital in northern Jordan from March to August 2021. Outcome variables were preterm birth (<37 weeks of gestation) and LBW (<2.5 kg). Using multivariable logistic regression, the association between IPI and these two adverse birth outcomes was investigated. Results: The rates of preterm birth and LBW were 12.4% and 16.8%, respectively. Compared with an optimal IPI (24–36 months), a short IPI (<24 months) was positively associated with preterm birth (aOR: 4.09; 95% CI: 1.48–6.55) and LBW (aOR: 3.58; 95% CI: 1.57–5.15). Infants conceived after a long IPI (≥ 60 months) had increased odds of preterm birth (aOR: 3.78; 95% CI: 1.12–5.78) and LBW (aOR: 2.65; 95% CI: 1.67–4.03). Preterm delivery was also significantly associated with the mother's age (aOR: 1.10; 95% CI: 1.04–1.17), history of multiple cesarean births (aOR: 2.67; 95% CI: 1.14–4.29), prolonged rupture of membranes (aOR: 2.46; 95% CI: 1.10–5.52), and perinatal death (aOR: 3.42; 95% CI: 1.10–5.49). A mother's history of prior LBW (aOR: 4.39; 95% CI: 1.08–6.80), hypertensive disorders (aOR: 1.95; 95% CI: 1.03–3.89), and multiple cesarean births (aOR: 4.35; 95% CI: 2.10–6.99) was associated with LBW. Conclusions: Both short and long IPIs were related to preterm delivery and LBW. Optimal birth spacing is recommended to improve birth outcomes and must be considered when designing effective family planning programs. [ABSTRACT FROM AUTHOR]

Both the IGF1 axis and hypovitaminosis D play a role in childhood obesity, either as a cause or a causality. While some studies suggest an interrelation between vitamin D status, IGF1, and obesity, this mechanism remains obscure. The aim of this study, therefore, was to explore associations between four genetic polymorphisms in the IGF1 axis in hypovitaminosis D-related obesity. The study included 116 pre-pubertal Israeli Arab children (52 girls), mean age 9.4 ± 2.6. Serum 25(OH)D was measured and anthropometric measures were obtained. Genomic DNA was extracted from peripheral EDTA-treated anti-coagulated blood using a standard protocol. Genotypes were determined using the Taqman allelic discrimination assay. The IGF genetic score was computed according to the additive genetic score model. A moderate-to-high negative correlation (r = 0.580, p < 0.05) was seen between the vitamin D status and body mass index (BMI) percentile of participants with high GS. Yet, no correlations were seen between vitamin D status and BMI percentile for participants with a low-to-moderate genetic score (GS) (GS ≤ 2). These results suggest that IGF1 genetic scores associated with elevated circulating IGF1 may indicate a tendency toward developing hypovitaminosis D-associated obesity. [ABSTRACT FROM AUTHOR]

To separate and purify organic contaminants, the employment of liquid membrane technology based on the Polymer Inclusion Membrane (PIM) technique is a major alternative. This technology has been extensively employed on an industrial, hospital, and academic laboratory scale. This work produced PIM membranes using dibenzyl ether, polyvinyl chloride, and copoly-eugenol divinyl benzene (Co-EDVB) 8%, respectively, as plasticizers, support polymers, and carriers. Also, the optimization test for phenol transport was conducted utilizing parameters for the impact of membrane thickness and transport duration. The plasticizer effect, different salt kinds, salt concentrations, repeated use, and longevity factors were used to assess the robustness and stability of the PIM membrane. The findings indicated that the type T54 membrane's thickness and a twenty-four hours transit period were the ideal conditions for phenol transport. The proportion of phenol concentration that was successfully delivered to the receiving phase under these ideal circumstances was 89.03 percent. Also, it was discovered that the PIM membrane's stability and durability were impacted by the use of plasticizers and salt. The membrane life was increased to up to thirty-four days by adding sodium nitrate salt to the source phase at a concentration of 0.01 M. [ABSTRACT FROM AUTHOR]

Aims: To describe the level of knowledge of undergraduate students in Jordan toward COVID‐19 in children in respect of the clinical signs of the disease, modes of transmission, protection measures against the disease and satisfaction with governmental measures. Design: A cross‐section was utilized in this study. Methods: An online survey questionnaire was utilized in this research study. All undergraduate students in Jordan were able to take part. The size of the sample was 799. Knowledge toward COVID‐19 among children was used to assess the participants' knowledge about COVID‐19. Results: The findings indicate that the students had a good understanding of the clinical signs, mode of transmission and protection measures and were satisfied with governmental measures. According to the students' responses, the resource they used the most was social media followed by news channels. Our study also found that medical specialty students had more knowledge toward COVID‐19 than non‐medical. [ABSTRACT FROM AUTHOR]

In this study, 271 pre- and in-service science teachers in Israel were surveyed on their level of awareness about green chemistry and sustainability, as well as attitudes toward environmental education. Of the total participants, 123 were in-service science teachers with different seniority levels teaching in elementary, middle, and high schools. The remaining participants were teacher candidates studying at different institutions. The main source of the data was derived from a 34-item questionnaire that assessed teachers' awareness of green chemistry and sustainability and attitudes toward environmental education. The findings illustrated that the teachers' sustainability and green chemistry awareness was low in general, although their views on environmental education were mostly positive. In-service science teachers were found to have more knowledge about green chemistry and sustainability than pre-service science teachers. Notably, in-service science teachers with more than 10 years of teaching experience were found to have more knowledge than those who have less experience. Teaching implications and possible future studies were presented as well. [ABSTRACT FROM AUTHOR]

Background: Obstetric Violence (OV) is a public health matter that affects women and their children with an incidence rate between 18.3–75.1% globally. The delivery institution of public and private sectors represents a potential factor contributing to OV. This study aimed to assess OV existence among sample of pregnant Jordanian women and its risk factors domains between public and private hospitals. Methodology: This is a case-control study including 259 recently delivered mothers from Al-Karak Public and Educational Hospital and The Islamic Private Hospital. A designated questionnaire including demographic variables and OV domains was used for data collection. Results: A significant difference was seen between patients delivering in the public sector compared to patients delivering the private sector in education level, occupation, monthly income, delivery supervision and overall satisfaction. Patients delivering in the private sector showed a significantly less physical abuse by the medical staff compared to patients delivering in the public sector, and patients delivering in a private room also showed a significantly less OV and risk of physical abuse compared to patients delivering in shared room. In public settings, medications information was lesser versus the private ones, additionally, there is significant association between performing episiotomy, physical abuse by staff and the delivery in shared rooms in private settings. Conclusion: This study showed that OV was less susceptible during childbirth in private settings compared to public settings. Educational status, low monthly income, occupation are risk factors for OV; also, features of disrespect and abuse like obtaining consent for episiotomy performance, delivery provision updates, care perception based on payment ability and medication information were reported. [ABSTRACT FROM AUTHOR]

This study aimed to examine the relationship between maternal health during pregnancy and low birth weight (LBW), as well as the impact of COVID-19 on the socio-economic status of pregnant women and its effect on LBW. The study was conducted in Amman, Jordan, and included 2260 mothers who visited Abu-Nusair comprehensive health center between January and December 2020. A matched case-control design was used with 72 cases and 148 controls selected for data collection through medical records and face-to-face interviews. Results showed that factors such as a monthly income of 400 JD or less, living with an extended family, exposure to passive smoking, maternal weight gain of 6-10 kg, maternal anemia, maternal hypertension, delivery by cesarean section, and previous history of LBW newborns were positively associated with an increased risk of LBW. Conversely, factors such as a monthly income above 700 JD, living with a core family, daily intake of iron, calcium, and vitamin D, prenatal visits, healthy food intake, and planning for pregnancy were associated with a lower risk of LBW. COVID-19 infection and its effects on work, family finances, antenatal care visits, and food supply were also positively linked with LBW. In conclusion, socioeconomic status, maternal health, COVID-19, and its impacts were significant risk factors for LBW. [ABSTRACT FROM AUTHOR]

Evidence from SDP programmes around the world illustrates that structured sports and recreational activities promote interaction between individuals from different cultural backgrounds that over time can lead to a more significant understanding of one another. Based on this evidence, the effects of a recreational activities programme on the attitudes of Arab and Jewish Israeli undergraduate students (average age, 23) studying at a college of physical education in Israel were examined. A pilot recreational activities programme was conducted once a week for six weeks. An average of 70 students participated in the first five meetings and approximately 200 students participated in the sixth meeting, a peak event of Israeli folk dancing. Students filled out pre- and post-programme questionnaires on their attitudes towards each other. Written student feedback on the programme and observations of activities were collected by one of the researchers. Findings indicated positive changes in attitudes on both sides [ABSTRACT FROM AUTHOR]

Additionally, the study aimed to evaluate the relation between dysmenorrhea and perceived stress and to explore whether different pain relief methods affected the severity of the symptoms. Keywords: premenstrual syndrome; premenstrual severity scale; perceived stress scale; medical students EN premenstrual syndrome premenstrual severity scale perceived stress scale medical students 777 785 9 07/07/22 20220601 NES 220601 Introduction Worldwide, around 1.8 billion women experience menstruation every month, which is regarded as a natural physiological process.[1] Currently, more recognition is being garnered regarding the fact that menstruation might have a negative effect on many individuals.[2] Premenstrual syndrome (PMS) is a common gynaecological disorder with a pooled prevalence of 47.8%.[3] It usually presents with a constellation of physical and psychological symptoms. The interquartile range was used to extract the cut-off point, where a score of <= 22 indicated mild symptoms, 23-36 indicated moderate symptoms, and >= 37 indicated severe symptoms. Although premenstrual symptoms per se are experienced by about 90% of women, only around 20% experience symptoms severe enough to cause substantial impairment of daily life activities.[5],[6] No consensus exists on how symptom severity should be assessed. [Extracted from the article]

Purpose. Oxytocin has been suggested to play a vital role in modulating maternal behavior and stress-related disorders. However, the relationship between antenatal oxytocin and postpartum depression is not well established. We aim to investigate the association between serum oxytocin level in the late third-trimester and early-onset postpartum depression symptoms. Materials and Methods. A total of 172 healthy pregnant women participated in this cross-sectional descriptive study. The serum oxytocin level was measured between 34 and 37 weeks. A validated Edinburgh Postnatal Depression Scale (EPDS) was used to assess symptoms of depression four to six weeks postpartum. Participants who scored more than 12 on the EPDS were considered having depressive symptoms. Independent sample t -test and Pearson r were used to examine differences in depression scores. The level of significance was set at α = 0.05. Results. 30.8% of the participants experienced depressive symptoms. There was no association between EPDS scores and oxytocin level r 170 = 0.10 , p = 0.23. The association also did not exist even among women with a lifetime history of depression r 43 = − 0.13 , p = 0.37. Participants with low education, low income, previous history of depression, positive family history of depression, positive family issues, and absent emotional family support have scored significantly higher on EPDS scores than their counterparts. The strongest association was with previous lifetime history of depression t 170 = − 4.40 , p < 0.001. Conclusions. Postpartum depression is a major public health problem in Jordan. Late trimester serum oxytocin level has no association with early-onset postpartum depression. [ABSTRACT FROM AUTHOR]

aimed to evaluate the association between perceived social support during pregnancy and levels of anxiety among postpartum women using an anxiety-specific screening instrument. Methods: Using a prospective cohort design, a two-stage methodology was conducted to collect data from women seeking maternal care at the King Abdullah University Hospital in northern Jordan. In the first stage, perceived social support was assessed among pregnant women using the Medical Outcomes Study Social Support Survey. During the first six months after childbirth, postpartum women were contacted to complete the second stage, wherein their perceptions of infant-focused anxieties were assessed using the Postpartum Specific Anxiety Scale. In our study, two types of infant-focused anxieties were investigated among a final sample of 419 mothers: infant safety and welfare anxieties and practical infant care anxieties. Results: The results of multivariate linear regression analysis indicated that providing pregnant women with high levels of emotional support from close social networks (β= − 0.08, p= 0.01) and perceiving informational support from health care providers (β= − 0.71, p< 0.01) were protective factors for reducing the levels of postpartum anxiety concerning infant safety and welfare. Our findings also demonstrated that pregnant mothers who perceived high informational support from health care providers had a lower level of postpartum anxiety about practical infant care (β= − 0.20, p< 0.01). In contrast, mothers who reported receiving high tangible support from close social networks during pregnancy had a significantly higher level of perceived anxiety concerning practical infant care after delivery (β= 0.13, p= 0.02). Conclusion: Our study suggests that postpartum anxiety would be reduced if effective informational support were readily available for pregnant women. There is a clear need for building bridges between women, their families, and providers to distinguish the specific type and amount of support that should be provided to mothers during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: Unusual setting of medical care. Background: A yolk sac tumor (YST) is a rare, malignant tumor of cells that line the yolk sac of the embryo. It most frequently occurs in the ovary (ovarian yolk sac tumor: OYST) in children and adolescents. Thus, fertility-preservation treatment is a concern. Case Report: A 24-year-old nulliparous woman visited us for infertility treatment and then right OYST was detected. A unilateral right salpingo-oophorectomy, infra-colic omentectomy, ipsilateral lymph node dissection, and peritoneal biopsies were performed. Histological examination confirmed the diagnosis of a stage IC OYST. Six cycles of bleomycin-etoposide-cisplatin chemotherapy were performed. She had no recurrence over the next 16 months. She conceived by in-vitro fertilization, and abdominally gave birth to a term infant. Both mother and baby had a smooth recovery. Conclusions: This case adds further evidence to the 5-year survival and progression-free survival following surgery and chemotherapy in OYSTs, while preserving fertility. [ABSTRACT FROM AUTHOR]

Background: Male infertility is a multifactorial syndrome with diverse phenotypic representations. MicroRNAs (miRNAs) are small, non‐coding RNAs that are involved in the post‐transcriptional regulation of gene expression. Altered abundance levels of ODF2 and UBQLN3 have been reported in patients with different spermatogenic impairments. However, the transcriptional regulation of these two genes by miR‐23a/b‐3p is still unclear. Objectives: To investigate experimentally whether miR‐23a/b‐3p targets the genes ODF2 and UBQLN3 and whether this targeting impacts abundance levels of ODF2 and UBQLN3 in patients with oligoasthenozoospermia. Materials and methods: A total of 92 men attending a fertility clinic were included in the study, including 46 oligoasthenozoospermic men and 46 age‐matched normozoospermic volunteers who served as controls. Reverse transcription‐quantitative PCR (RT‐qPCR), Western blot, and dual‐luciferase (Firefly‐Renilla) assays were used to validate the miRNAs and their target genes. Results: RT‐qPCR revealed that miR‐23a/b‐3p was more abundant and ODF2 and UBQLN3 targets were less abundant in men with impaired spermatogenesis. Besides, Western blot shows that ODF2 and UBQLN3 protein levels were reduced in men with impaired spermatogenesis. In silico prediction and dual‐luciferase assays revealed that potential links exist between the higher abundance level of miR‐23a/b‐3p and the lower abundance level of ODF2 and UBQLN3 targets. Mutations in the miR‐23a/b‐3p‐binding site within the 3ˊUTRs (3ˊuntranslated regions) of ODF2 and UBQLN3 genes resulted in abrogated responsiveness to miR‐23a/b‐3p. Correlation analysis showed that sperm count, motility, and morphology were negatively correlated with miR‐23a/b‐3p and positively correlated with the lower abundance level of UBQLN3, while ODF lower abundance level was positively correlated with sperm motility. Conclusion: Findings indicate that the higher abundance level of miR‐23a/b‐3p and the lower abundance level of ODF2 and UBQLN3 targets are associated with oligoasthenozoospermia and male subfertility. [ABSTRACT FROM AUTHOR]

Purpose: To find out whether couples with predominant female offspring have more chances to produce more female embryos during non-medical pre-implantation genetic diagnosis (PGD) for male sex selection. Methods: A total of 125 couples who had three or more female offspring and underwent non-medical PGD for male sex selection between 2015 and 2019 were included. Nuclear DNA was analyzed by fluorescent in situ hybridization (FISH). Two-chromosome (X, Y), 3-chromosome (21, X, Y), and 5-chromosome (13, 18, 21, X, Y) probes were used for FISH. The standard protocol was followed for sperm processing and embryo culture for IVF and PGD. Results: In 83.2% of the couples, the ratio of female embryos was higher than male embryos. Independent sample t-test showed that there is no significant difference between equal and unequal embryonic groups in patients' age, husbands' age, sperm count, sperm motility, total male embryos, total female embryos, normal male embryos, and normal female embryos. For patients with positive pregnancy outcome, 84.6% had unequal embryonic ratio while 15.4% had equal embryonic ratio. Similarly, patients who were treated by short protocol had 85% of unequal embryonic ratio and 15% had equal ratio. Conclusion: A greater variability in the female to male embryonic ratio is produced in couples having predominantly female offspring and seeking non-medical PGD for male sex selection. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of previous lower segment cesarean section on maternal and fetal outcomes of patients with non-adherent placenta previa Methods: This is a retrospective study of all patients who delivered at a tertiary referral university hospital by lower uterine cesarean section with non-adherent placenta previa, over a 10-year period. Data were obtained through hospital registry and medical records. The differences in demographic, obstetric characteristics, peripartum complications, and fetal outcome between patients with no previous cesarean and those with previous cesarean section were analyzed. Results: Ninety patients with non-adherent placenta previa were included, 54 patients with no previous cesarean and 36 patients with previous cesarean section. Patients with previous cesarean section were significantly more likely to incur inadvertent organ injury, transfusion of 4 or more units of packed red blood cells, transfusion of fresh frozen plasma, uterine brace compressive sutures, uterine artery ligation, and peripartum hysterectomy. Conclusion: There is a significant increase in the incidence of inadvertent neighboring viscus injury, transfusion of 4 units or more of packed red blood cells, transfusion of fresh frozen plasma, uterine brace compressive sutures, uterine artery ligation, and peripartum hysterectomy in patients with non-adherent placenta previa and previous cesarean section, compared to those with non-adherent placenta previa and no previous history of cesarean section, with no difference in perinatal outcome. [ABSTRACT FROM AUTHOR]

Background: Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods: This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents' health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher's exact test, Mann Whitney U test, and Cramer's V and r statistics as measures of effect sizes. Results: Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V =.124 "small effect" (95% CI;.017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 "small effect" (95% CI; 0.007–0.249), p =.044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V =.201 "small effect" (95% CI;.078–.313), p =.001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V =.158 "small effect" (95% CI;.032–.279), p =.012). Conclusion: The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations. [ABSTRACT FROM AUTHOR]

Objective: Poor ovarian response (POR) refers to a subnormal follicular response that leads to a decrease in the quality and quantity of the eggs retrieved after ovarian stimulation during assisted reproductive treatment (ART). The present study investigated the associations of multiple variants of the estrogen receptor 2 (ESR2) and follicle-stimulating hormone receptor (FSHR) genes with POR in infertile Jordanian women undergoing ART. Methods: Four polymorphisms, namely ESR2 rsl256049, ESR2 rs4986938, FSHR rs6165, and FSHR rs6166, were investigated in 60 infertile Jordanian women undergoing ART (the case group) and 60 age-matched fertile women (the control group), with a mean age of 33.60±6.34 years. Single-nucleotide polymorphisms (SNPs) were detected by restriction fragment length polymorphism and then validated using Sanger sequencing. Results: The p-value of the difference between the case and control groups regarding FSHR rs6166 was very close to 0.05 (p=0.054). However, no significant differences were observed between the two groups in terms of the other three SNPs, namely ESR2 rs1256049, ESR2 rs4986938, and FSHR rs6165 (p=0.561,p=0.433, and p=0.696, respectively). Conclusion: The association between FSHR rs6166 and POR was not statistically meaningful in the present study, but the near-significant result of this experiment suggests that statistical significance might be found in a future study with a larger number of patients. [ABSTRACT FROM AUTHOR]

Purpose: To review the indications and clinical profile of neonatal admissions at King Abdullah University Hospital in Jordan. Materials and Methods: We conducted a cross-sectional review of all neonates admitted to the neonatal intensive care unit between September 2016 and September 2018. Collected data include demographic characteristics, indications for admission, morbidities and mortality, and discharge outcomes. Findings were reported among term and preterm infants. Results: A total of 1444 infants were admitted during the study period of whom 1332 (92.2%) were inborn and 612 (42.4%) were term neonates. Of the 832 preterm infants, 545 were late preterm (34– 36 6/7 gestation) and 125 had very low birth weight (˂ 1500 grams); 925 (64%) were born by cesarean section. Respiratory failure of the newborn (41.2%) and prematurity (33.3%) were the main indications for admission among the whole cohort. Maternal prolonged premature rupture of membranes (PROM) was observed in nearly half the admissions of term infants. Hypoxic ischemic encephalopathy (3.2% vs 0.7%, p 0.01) and congenital anomalies (5% vs 1.2%, p 0.03) were more common in term infants. The rate of bronchopulmonary dysplasia was 39% among < 28-week and 28% among < 32-week premature infants. Sepsis was encountered in 59 infants. The overall mortality rate was 3.8%. Prematurity was the main predisposing factor for mortality (Adjusted OR: 9.9, 95% CI: 3.5, 27.6). Conclusion: The majority of neonatal admissions at our institution are term and late preterm infants delivered by cesarean section. Prematurity, respiratory failure of the newborn, and suspected sepsis due to maternal PROM are the leading causes of admission. The mortality rate is within WHO target to achieve Sustainable Development Goal 3. Population-based studies are needed to make better conclusions that represent the whole Jordanian population. A revisit for the indications of cesarean deliveries may help to improve the neonatal outcomes. [ABSTRACT FROM AUTHOR]

Objective: Rare co-existance of disease or pathology. Background: A complete mole with a living fetus in a form of twin pregnancy that is a rare obstetric event. The development of metastatic gestational trophoblastic disease is the most important and serious complication. It is debatable whether to terminate the pregnancy or to continue. Another point is the validity of the conservative treatment of this type of neoplasm, especially in developing countries. Case report: In this study, we report the first case of a twin pregnancy with complete mole and a living fetus in Jordan, which is a developing country. A 33-year-old woman presented with vaginal bleeding which was revealed to be due to a complete mole in the form of a twin pregnancy. A hystrostomy was performed with subsequent drop of β-hCG level. However, the b-hCG started to rise and the CT scan revealed multiple metastatic sites. Accordingly, she received 3 cycles of methotrexate, with a subsequent reduction in b-hCG level. Conclusions: This is the first case report of a complete mole in twin pregnancy in Jordan. To overcome the development of metastasis, close follow-up and immediate treatment are crucial when the conservative approach is being considered. This report highlights the importance of considering the diagnosis of complete mole for women with twin and vaginal bleeding. [ABSTRACT FROM AUTHOR]

Background. This prospective study compared the blood glucose concentration with spinal anesthesia or general anesthesia in patients undergoing elective cesarean section surgery. Methods. In total, 58 pregnant women who underwent elective cesarean section surgery were included in this prospective comparative study. Group S (n = 35) included patients who chose spinal anesthesia, and group G (n = 23) included patients who chose general anesthesia. The patients were allocated to the groups upon patients' preference. For the group G, the blood glucose concentration (BGC) was obtained 5 minutes before induction, T1, and 5 minutes after induction T2. For the group S, the BGC was obtained immediately before the injection of the local anesthetic agent T1 and 5 minutes after the complete block T2. For both groups, BGC was measured 5 minutes before the end of surgery T3 and 30 minutes after the end of surgery T4. For BGC measurements, we used a blood glucose monitoring system with a lancet device to prick the finger. Results. There was no statistically significant difference in the mean blood glucose concentration between the groups S and G in T1 (78.3 ± 18.2 vs. 74.3 ± 14.7, p>0.05) and T2 (79.2 ± 18.3 vs. 84.9 ± 23.7, p>0.05). The mean BGC was statistically significantly higher in group G in comparison to group S in the times 5 minutes before (80.2 ± 18.1 vs. 108.4 ± 16.7, p<0.05) and 30 minutes after the end of surgery (80.9 ± 17.7 vs. 121.1 ± 17.4, p<0.05). Conclusion. There is a much lower increase in blood glucose concentration under spinal anesthesia than under general anesthesia. It is reasonable to suggest that the blood sugar concentration must be intraoperatively monitored in patients undergoing general anesthesia. [ABSTRACT FROM AUTHOR]

Background: Newborn ovary homeobox (NOBOX) gene plays a critical role in the transcriptional regulation of oocyte-specific genes. Previous studies have demonstrated a pathogenic effect of NOBOX variants on premature ovarian insufficiency (POI) patients. Poor ovarian response (POR) is a risk factor for POI. Therefore, genetic variants in the NOBOX gene may also be studied as risk factors for POR development. Aims: The aim of the study is to investigate the association between seven known NOBOX single-nucleotide polymorphisms (SNPs) and POR in Jordanian females. Settings and Design: This was a case-control study of 60 females with POR for controlled ovarian hyperstimulation and 59 healthy females with no history of reproductive problems. Blood samples were collected from the participants and seven SNPs of NOBOX gene were screened. Subjects and Methods: DNA was extracted from blood samples. Polymerase chain reaction with primers specific for seven known SNPs in NOBOX gene was used to amplify the specified region within the gene followed by Sanger sequencing. Results: The seven SNPs investigated in this study, namely, rs77587352 (c.271G>T, p. Gly91Trp), rs7800847 (c.349C>T, p. Arg117Trp), rs193303102 (c.907C>T, p. Arg303X), rs193303103 (c.1025G>C, p. Ser342Thr), rs193303104 (c.1048G>T, p. Val350Leu), rs201947677 (c.1064G>A, p. Arg355His), and rs146227301 (c.1856C>T, p. Pro619Leu), only represent the wild-type allele in both females with POR and healthy participants. Conclusions: The results show that only monomorphic genotype of the NOBOX variants was found in Jordanian females studied. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of contact (C-SSG) and no-contact (NC-SSG) handball small-sided games (SSGs) on motion patterns and physiological responses of elite handball players. Twelve male handball players performed 10 C-SSG and 10 NC-SSG while being monitored through the heart rate (HR) and rate of perceived exertion (RPE) as physiological responses and time-motion activities profile using video-match analysis. Both game conditions resulted in similar HR responses (P > 0.05), but the NC-SSG led to a higher RPE scores. The time-motion activity analysis featured NC-SSG with a greater amount of walking (855.6 ± 25.1 vs. 690.6 ± 35.2 m) and backward movements (187.5 ± 12.3 vs. 142.5 ± 8.7 m) combined with fast running (232.3 ± 8.5 vs. 159.7 ± 5.7 m) and sprinting (79.5 ± 4.7 vs. 39.7 ± 3.7 m) activities (P < 0.001). Conversely, C-SSG had a higher percentage of jogging and sideway movements associated with greater frequency of jumping (0.87 ± 0.09 vs. 0.31 ± 0.06 nr) and physical contact (1.82 ± 0.55 vs. 0.25 ± 0.03 nr) events (P < 0.001). No between-regimen differences were found for the number of throws (P = 0.745). In addition, the RPE was significantly correlated with fast running relative distances (r = 0.909,P < 0.001) and sprinting relative distances (r = 0.939,P < 0.001). In conclusion, this investigation showed that both C-SSG and NC-SSG in team handball can effectively represent specifically oriented exercises, according to the sport-task and the performance demands. [ABSTRACT FROM AUTHOR]

The aim of the present study was to compare the effect of an increasing-distance, interval-training programme and a decreasing-distance, interval-training programme, matched for total distance, on aerobic and anaerobic physiological indices. Forty physical education students were randomly assigned to either the increasing- or decreasing-distance, interval-training group (ITG and DTG), and completed two similar relevant sets of tests before and after six weeks of training. One training programme consisted of increasing-distance interval-training (100-200-300-400-500 m) and the other decreasing-distance interval training (500-400-300-200-100 m). While both training programmes led to a significant improvement in VO2 max (ES = 0.83-1.25), the improvement in the DTG was significantly greater than in the ITG (14.5 ± 3.6 vs. 7.8 ± 3.2%, p < .05). In addition, while both training programmes led to a significant improvement in all anaerobic indices (ES = 0.83-1.63), the improvements in peak power (15.7 ± 7.8 vs. 8.9 ± 4.7), mean power (10.6 ± 5.4 vs. 6.8 ± 4.4), and fatigue index (18.2 ± 10.9 vs. 7.0 ± 14.2) were significantly greater in the DTG compared to the ITG (p < .05). The main finding of the present study was that beyond the significant positive effects of both training programmes on aerobic and anaerobic fitness, the DTG showed significant superiority over the ITG in improving aerobic and anaerobic performance capabilities. Coaches and athletes should therefore be aware that, in spite of identical total work, an interval-training programme might induce different physiological impacts if the order of intervals is not identical. [ABSTRACT FROM AUTHOR]

Repeated anaerobic conditions during athletic performance may cause general and local fatigue that result in postural balance deficit. Evidence suggests that improved postural balance during athletic training may decrease the risk for fallings and traumatic injuries among athletes. Twenty athletes (12 girls, 8 boys) and 20 controls (12 girls, 8 boys) ages 10-15 years participated in the current study. All athletes were active in an 8-month physical activity program, 3 times per week for 90 min., specific to basketball, soccer, or athletic training. The control children participated in physical education at school only, with no involvement in organized extracurricular sports. All participants were evaluated for postural balance in three assessments over one year (at 4-mo intervals); the Interactive Balance System machine (Tetrax device) was used to assess balance at three test times (pre-, post-, and 10 min) after a session of a repeated sprint anaerobic test, consisting of 12 x 20 m run starting every 20 sec. The athletes had better postural balance than controls. There were different group patterns of change over the sessions; a significant interaction of session and group indicated that postural balance of the groups differed. The contribution of low sway frequencies (F1) and high sway frequencies (F6) differed between the controls and the athletes group. Results suggested that although athletes had better postural balance, improvement should be encouraged during training over the sessions and seasons, with special awareness of the balance deficit that occurs immediately after anaerobic stress and at the end of the season, to decrease the risk of injuries. [ABSTRACT FROM AUTHOR]

Background: One of the major reproductive health challenges among disadvantaged populations is to provide pregnant women with the necessary antenatal care (ANC). In this study, we suggest applying an integrated conceptual framework aimed at ascertaining the extent to which attendance at ANC clinics may be attributed to individual determinants or to the quality of the care received. Methods: Using a cross-sectional design, data were collected from a sample of 831 women residing in nine sub-districts in three northern governorates of Jordan and designated according to national categorization as persistent poverty pockets. All of the sampled women were recruited from public maternal and child health centers and interviewed using a structured pre-tested survey. This tool covered certain predictors, ranging from the user's attributes, including predisposing, enabling, and need factors, to the essential components of the experience of care. These components assessed the quality of ANC in terms of five elements: woman–provider relations, technical management, information exchange, continuity of care, and appropriate constellation of services. Adequate ANC content was assessed in relation to the frequency of antenatal visits and the time of each visit. Results: The results of multivariate logistic regression analyses show that the use of ANC facilities is affected by various factors related to the quality of service delivery. These include receiving information and education on ANC during clinic visits (OR = 9.1; 95% CI = 4.9–16.9), providing pregnant women with opportunities for dialogue and health talks (OR = 7.2; 95% CI = 4.1–12.8), having scheduled follow-up appointments (OR = 6.5; 95% CI = 3.5–12.0), and offering dignified and respectful care (OR = 5.7; 95% CI = 2.5–13.1). At the individual level, our findings have identified a woman's education level (OR = 1.2; 95% CI = 1.1–1.3), desire for the pregnancy (OR = 1.7; 95% CI = 1.1–2.7), and living in a district served by an ANC clinic (OR = 4.3; 95% CI = 2.3–8.1) as determinants affecting ANC utilization. Conclusion: Taking women's experiences of ANC as a key metric for reporting the quality of the care is more likely to lead to increased utilization of ANC services by women in highly disadvantaged communities. Our findings suggest that the degree to which women feel that they are respected, informed, and engaged in their care has potential favorable implications for ANC. [ABSTRACT FROM AUTHOR]