Search

Background: Many nurses perceive that the Electronic Medical Record (EMR) reduces the workload, improves the quality of documentation, and improves safety and patient care. However, other nurses reported that the system and environment of healthcare might impede EMR documentation at the bedside. Objective: The study aimed to describe the nurses' views of the use, quality, and satisfaction with EMR in daily practice in outpatient settings. Furthermore, the relationships among the use, quality, and user’s satisfaction of EMR were assessed in the study. Methods: The proposed study employed a cross-sectional, descriptive correlational design. Inclusion criteria were nurses willing to participate in the study, fluent in the English language, and have been working in the Outpatient Department for more than three months until the time of study implementation. A self-reported questionnaire with strong validity and reliability was used to assess nurses’ views of use, quality and satisfaction of EMR. Results: The response rate was 77.2% (170 out of 220), 91.2% of the participants were females. Results about the use of EMR have shown positive views ranging from 51.2% to 84.7%, with the lowest scores reported when to write nurse care worksheets (Kardex). For the quality of EMR, the results have shown positive views ranging from 70% to 87.6% with the lowest scores reported related to the EMR system problems and crashes, and for the user’s satisfaction, the results have shown positive views ranging from 76.5% to 87.1%. There were significant positive correlations between the three elements use, quality, and user’s satisfaction of EMR. Conclusion: Participants reported positive views in the domain of use, quality, and satisfaction with EMR. Furthermore, positive correlations were reported between the use, quality, and satisfaction domains of EMR.

With increasing energy prices, nuclear energy concerns, climate changes, and electrical grid losses, the demand to rely on more renewable energy is growing. The majority of people currently prefer to live and work in smart environments, such as smart cities and smart institutions with an integrated smart microgrid. Energy management is a complex topic because a large amount of these smart microgrid systems rely on hybrid energy sources. As a result, a smart energy management controller needs to be created. The current research provides a new energy management control technique for a smart DC-microgrid based on a combined fuzzy logic controller (FLC) and high order sliding mode (HSMC) methods. The hybrid energy provider integrated into the DC-microgrid is made up of a battery bank, wind energy, photovoltaic (PV) energy, and tidal energy source. The new proposed intelligent control is intended to regulate source-side converters (SSCs) in order to capture the maximum energy from hybrid renewable energy sources (wind, tidal and PV) while also improving power quality in the DC-microgrid. To keep the microgrid as cost-effective as feasible, renewable energy sources are prioritized. The suggested controller offers a steady output power and sustained service. From the present simulation results under Matlab/Simulink and the comparative analysis, the proposed controller produces +1.02% wind power, +10% PV power, +100% tidal power, and +8.48% load power over intelligent fractional-order proportional–integral–derivative (PID) and more when compared to the super twisting fractional-order and PID controls. In addition, the suggested controller assures smooth output power and uninterrupted service.

Background The ongoing Coronavirus Infectious Disease (COVID-19) pandemic is a global health crisis that has had a magnanimous worldwide impact on all aspects of people's lives. Several observational studies investigated the relationship between Proton Pump Inhibitors use and the risk of COVID-19 development and mortality. Aim of the Study The aim of this meta-analysis is to investigate the association between current PPIs use and the development of COVID-19 as well as its mortality. Methods Pubmed, Google Scholar, ScienceDirect and medRxiv were searched until November 21, 2020 using the following keywords: proton pump inhibitors and COVID-19 as well as their related MESH terms. The studies considered in the meta-analysis were either cohort or case-control in design and adjusted for confounding factors. The quality of the studies included in this meta-analysis was assessed using the Newcastle-Ottawa Scale. In addition, a random-effects model was used to calculate the pooled Odds Ratio (ORs) and the corresponding confidence interval (95% CI). Heterogeneity was evaluated using The Cochran's Q heterogeneity test and I2 statistic. Results Six observational studies with 195,230 participants were included. In this meta-analysis, current use of PPIs increased risk of COVID-19 development (OR = 1.19; 95% CI: 0.62-2.28) and mortality (OR = 1.67; 95% CI: 1.41-1.97). Conclusions Our meta-analysis indicates that current PPIs use significantly increased the risk of COVID-19 mortality, but it did not reach a significant threshold in regards to the risk of COVID-19 development.

Hidradenitis suppurativa (HS) is a chronic skin disease primarily affecting the sweat glands apocrine zone of the body and what starts initially as an abscess progresses to nodules, sinus tracts, with cicatrisation fistula formation and ulcers. It is common to see all the stages of clinical spectrum viz multiple solitary abscess to nodules with sinus, fistulas with ulceration and cicatrisation in chronic patients. This chronic illness takes a toll on the psyche of these individuals as the need to avoid foul smell and the constant need for dressing dictate their social life. The patients are notoriously know for follow up for years. A low self-esteem and depression are companions of hidradenitis suppurativa (HS) individuals. Early involvement of the surgeon can substantially improve the progress and evolution of this chronic skin condition and could obviate the development of SCC the end stage of all Chronic neglected Hidradenitis suppurativa (HS) cases especially in the hi risk older age group of individuals

The Internet of Things (IoT) has been rapidly evolving towards making a greater impact on everyday life to large industrial systems. Unfortunately, this has attracted the attention of cybercriminals who made IoT a target of malicious activities, opening the door to a possible attack on the end nodes. To this end, Numerous IoT intrusion detection Systems (IDS) have been proposed in the literature to tackle attacks on the IoT ecosystem, which can be broadly classified based on detection technique, validation strategy, and deployment strategy. This survey paper presents a comprehensive review of contemporary IoT IDS and an overview of techniques, deployment Strategy, validation strategy and datasets that are commonly applied for building IDS. We also review how existing IoT IDS detect intrusive attacks and secure communications on the IoT. It also presents the classification of IoT attacks and discusses future research challenges to counter such IoT attacks to make IoT more secure. These purposes help IoT security researchers by uniting, contrasting, and compiling scattered research efforts. Consequently, we provide a unique IoT IDS taxonomy, which sheds light on IoT IDS techniques, their advantages and disadvantages, IoT attacks that exploit IoT communication systems, corresponding advanced IDS and detection capabilities to detect IoT attacks.

Global environmental changes, nuclear power risks, losses in the electricity grid, and rising energy costs are increasing the desire to rely on more renewable energy for electricity generation. Recently, most people prefer to live and work in smart places like smart cities and smart universities which integrating smart grid systems. The large part of these smart grid systems is based on hybrid energy sources which make the energy management a challenging task. Thus, the design of an intelligent energy management controller is required. The present paper proposes an intelligent energy management controller based on combined fuzzy logic and fractional-order proportional-integral-derivative (FO-PID) controller methods for a smart DC-microgrid. The hybrid energy sources integrated into the DC-microgrid are constituted by a battery bank, wind energy, and photovoltaic (PV) energy source. The source-side converters (SSCs) are controller by the new intelligent fractional order PID strategy to extract the maximum power from the renewable energy sources (wind and PV) and improve the power quality supplied to the DC-microgrid. To make the microgrid as cost-effective, the (wind and PV) energy sources are prioritized. The proposed controller ensures smooth output power and service continuity. Simulation results of the proposed control schema under Matlab/Simulink are presented and compared with the super twisting fractional-order controller.

Objectives The study purpose was to examine peri-implant bone alternations around osseointegrated implants caused solely by abutment screw preload stress using different tightening torque values. Materials and methods Twenty 20- to 22-week-old Japanese white rabbits received two implants each in right and left femurs. Implants were randomly assigned to one of three tightening torque groups or the control (Cont) group. After 8 weeks, 35 Ncm torque was delivered to abutment screws in the recommended torque (RT) group (n = 16). Other screws received 70 Ncm torque as the high torque (HT) group (n = 16). Temporary tightening (TT) groups (n = 8) received only 70 Ncm torque without preload stress as screws were untightened immediately. Cont group (n = 40) remained in situ. Animals were euthanized at 4, 6, 8, and 10 weeks after torque application. Micro-CT images were then taken, and undecalcified ground sections were stained with toluidine blue. Results Cross-sections of cortical bone showed remodeling activities adjacent to the implant in all groups. While bone marrow spaces appearance was relatively small in Cont and TT groups, RT and HT groups showed large bone marrow spaces and extensive remodeling activity. Bone-to-implant contact was significantly less in RT and HT groups compared with Cont and TT groups at different time points (p ˂ .05). Furthermore, RT and HT groups showed significantly less bone volume and area (p ˂ .05). Conclusion Results suggested that preload stress without any occlusal loading might negatively affect peri-implant bone stability and initiate bone remodeling. This could alter bone mechanical properties, subsequently influencing long-term implant success.

Opioid availability and accessibility represent major challenges to cancer patients, particularly in low- and middle-income countries. When palliative care service is available, referrals mostly oc...

Breast cancer is one of the most prevalent cancers in women. The improvement in breast cancer treatment has significantly increased the proportion of survival rate for women with breast cancer. Despite the advancement in breast cancer treatment, a great proportion of survivors suffer from co-occurring psychoneurological symptoms which impact their quality of life. The most frequently reported psychoneurological symptoms among women with breast cancer are depressive symptoms, anxiety, fatigue, sleep disturbances, and pain. These symptoms usually appear as a cluster. Inflammatory activation and serum metabolic alterations have been associated with the etiology of cancer and with various chronic neurocognitive disorders. However, to date, no studies considered the combined effects of inflammatory markers and metabolites in the development of psychoneurological symptoms in women with breast cancer especially those who were treated with chemotherapy. Further clarification of the relationships between the inflammatory markers, serum metabolic alterations, and psychoneurological symptoms in women with breast cancer should be pursued.

The pandemic of COVID-19 has globally interrupted the education systems. Many countries includingJordan forcefully moved to online education. This study is designed to build an innovative Framework toovercome the concerns and challenges of online clinical teaching.A cyclical module of the Online Clinical Training Pathway (OCTP) was created to provide an opportunity forstudents to document their learning, in the form of a reflection guide. Each module aims to attain the intendedlearning outcomes through a set of four integrated learning activities. OCTP success was assessed by regularevaluation parallel with semi-structured interview targeted faculty members and students across courses andstudent levels. The results emerged a new framework of the teaching and learning of synchronous distancelearning among participants. Technical limitations were also observed with regards to internet-connectionspeed and reliability. Quality indicators of the synchronous and asynchronous online environment wereissues that need to be addressed. Creating opportunities to enhance online engagement through the use ofnew framework methodology provides a promising direction to bring experiential education into the onlinecontext.

Objective This meta-analysis aims to estimate the pooled prevalence of mental disorders among COVID-19 survivors. Methods The databases Pubmed, Google Scholar, ScienceDirect, and medRxiv have been searched up to 1 August 2021 using COVID-19, survivors, mental disorders, and their related MeSH terms. The included studies were either cross-sectional, cohort, or case-control in design. Those studies included COVID-19 survivors after 14 or more days from their COVID-19 recovery and used validated questionnaires to assess their mental health outcomes. The random-effects model was used to pool the data from the incorporated studies. The heterogeneity was assessed using Cochran's Q heterogeneity test and I2 statistic. Results Twenty-seven studies were included in the data synthesis with a total sample size of 9605 COVID-19 survivors. The prevalence rates for Post-Traumatic Stress Disorder (PTSD), anxiety, psychological distress, depression, and sleeping disorders were 20% (95% CI = 16-24%), 22% (95% CI = 18-27%), 36% (95% CI = 22-51%), 21% (95% CI = 16-28%), and 35% (95% CI = 29-41%), respectively. Conclusions Although we found high heterogeneity across the included studies, our meta-analysis provides evidence that there are psychological sequelae in COVID-19 survivors that require medical assiduity as well as further research on the matter.KEY POINTSIncreased prevalence of psychological sequelae among COVID-19 survivors.The prevalence of PTSD was 20% (95% CI = 16-24%) and of anxiety was 22% (95% CI = 18-27%) among COVID-19 survivors.The prevalence of psychological distress was 36% (95% CI = 22-51%), of depression was 21% (95% CI = 16-28%), and of sleep disorders was 35% (95% CI = 29-41%) among COVID-19 survivors.Future researches are recommended to search for effective and safe methods to mitigate the psychological sequelae in COVID-19 patients.

Introduction The eye is the second most common organ affected by trauma after hands and feet. Eye trauma is a common cause of visual morbidity and may result in irreversible visual impairment and blindness. Ocular and facial trauma contribute to significant proportions of visual deficits among young children. This study aimed to explore the changes in trend including the pattern and outcomes of ocular and facial trauma among children between the last twenty years. Methodology A retrospective study was conducted between January 2020 and April 2021. The medical records of the patients who attended the Royal Medical Services (RMS) military hospital between January 1999 and December 2019 suffering from eye trauma which required hospitalization were enrolled in the study and reviewed regarding age, gender, mechanism of trauma, the severity of the trauma, eye structures involved, and visual outcome. The patients were divided into three groups based on the time of trauma: Group A for injuries in the period (January 1, 1999 to December 31, 2005), Group B for the period (January 1, 2006 to December 31, 2012), and Group C for the period (January 1, 2013 to December 31, 2019). The collected data was analyzed and compared to explore whether there is any change in the pattern and visual morbidity of eye injuries over time. The most frequent finding of eye injury was corneal wound in Groups A and B patients, while in Group C the most common ocular injury was ecchymosis or sub-conjunctival hemorrhage. Results Three-thousand one-hundred and thirty only patients (3130 eyes) aged between 2 and 14 years (mean 7.11 ± 3.13) were included in the study. The male to female ratio was 2:1. 1864 patients (56.6%) were at five years of age or younger. The most common place of injury in the three groups was on the street. This ratio decreased from 64.0% in Group A to 48.8% in Group C. Stone was the commonest etiology of injury in Group A (38.0%) while wood and fall were the commonest in Group B (28.5%) and Group C (37.1%) respectively. Open globe injuries constituted 67.0% of patients in Group A, 64.7% of patients in Group B, and 51.2% of patients in Group C. Normal or mild visual impairment was noted in patients of Group C (43.9%) as compared to the patients in Groups A (7.5%) and B (8.3%) at presentation. The final vision of normal or mild visual impairment was reported in 37.1%, 38.5%, and 77.5% of patients in Groups A, B, and C respectively. Conclusion The current study is a retrospective analysis of twenty years in Jordan and has comprehensively explored the trends and patient outcomes with respect to ocular and facial trauma among children. We revealed that over time, such injuries became less frequent and less serious than before with better patient outcomes. Furthermore, higher rates of closed globe injuries were reported in recent years. There was a dramatic increase in the rate of indoor injuries compared with outdoor ones which were mostly caused by falls with better initial and final visual outcomes. These injuries are preventable with the implementation of adequate safety measures which would significantly reduce the burden of visual impairment and cosmetic disfigurement among youngsters.

This paper designs an intelligent energy management control for a stand alone smart DC- micro-grid using super twisting fractional order method. Based on mathematical model of the micro-grid, controllers are derived for the source side converters such as photovoltaic (PV),wind, AC grid and battery management system, and load side converters. Based on the available measured input and consumed output power, an intelligent energy management algorithm decides the appropriate mode of operation for the source and load side converters controller. All DC loads connected to the micro-grid are treated as essential loads and no load shedding can be allowed by the energy management unit. The energy management unit prioritizes the renewable energy sources (PV and wind) in order to make the micro-grid as cost effective. The performance of the proposed control scheme is compared with the integer order controller and the system is simulated in MATLAB/SIMULINK environment for different test cases.

in this paper we designed microstrip patch antenna by using metamaterial to improve antenna bandwidth. We inserted Complementary Split Ring Resonator (CSRR) structure between the ground and patch in the substrate. We compared our design with the conventional microstrip patch antenna in point of bandwidth. We obtained bandwidth improvement by 800MHz. Simulation was obtained by using HFSS simulator

Background: Spirituality has been recognised as an essential aspect of patient care. Aim: To assess the greatest facilitators that would help to provide spirituality for paediatric end of life. Methods: Two hundred and fifty oncology nurses were surveyed using a spirituality and spiritual care rating questionnaire. Findings: The greatest facilitators perceived by nurses were: believe in spirituality as a unifying force that enables one to be at peace with oneself and the world; listening and allowing patients time to discuss and explore their fears; and using art, creativity and self-expression; respect for privacy, dignity and religious and cultural beliefs of a patient. Conclusions: Many nursing-related facilitators to spirituality care were found. They need to be addressed and supported through education and training.

Cyber-attacks are becoming more sophisticated and thereby presenting increasing challenges in accurately detecting intrusions. Failure to prevent the intrusions could degrade the credibility of security services, e.g. data confidentiality, integrity, and availability. Numerous intrusion detection methods have been proposed in the literature to tackle computer security threats, which can be broadly classified into Signature-based Intrusion Detection Systems (SIDS) and Anomaly-based Intrusion Detection Systems (AIDS). This survey paper presents a taxonomy of contemporary IDS, a comprehensive review of notable recent works, and an overview of the datasets commonly used for evaluation purposes. It also presents evasion techniques used by attackers to avoid detection and discusses future research challenges to counter such techniques so as to make computer systems more secure.

Recently, despite the development of cancer pain treatment, many cancer patients still suffer from pain.This review aimed to explore the patients-related barriers to pain management among cancer patients.The electronic searching was conducted in a different database: Google Scholar, CINAHL and PubMed.According to previous studies barriers can classified into patients/family- related barriers, health careprovided-related barriers, and institutional-related barriers. Patient-related barriers were reluctant to reportpain, fear from tolerance, addiction, and side effect, and culture. This review provides summary data aboutthe patient-barriers to effective cancer pain control.

In this paper we designed system for smart university building based on artificial intelligence (AI) and internet of things (IOT). Our idea can be summarized in smart security system that has different sensors to detect the surrounding environment of the class room in campus which keep everyone and everything on campus safer. By using (IOT), (AI) technologies and applications and by using microcontroller programming we can make the university building safer, secure and more energy saves.

The emergence of Coronavirus disease 2019 (COVID-19) has affected health-care workers’ psychological and mental health. Few studies have been conducted examining the psychological effect of COVID-19 on health-care worker psychological health in Jordan. Therefore, the present study aims to assess the respective levels of fear, anxiety, depression, stress, social support, and the associated factors, experienced by Jordanian health-care workers during the COVID-19 Pandemic. This study adopted a cross-sectional, correlational design to collect data from 365 health-care workers in Amman, Jordan, from August 16th to 23rd, 2020. Along with collecting sociodemographic characteristics, the Fear of COVID-19 Scale, the Depression, Anxiety, Stress Scale, and the Multidimensional Scale of Perceived Social Support electronically administered to participants. The majority of the participants (69.3%) were registered nurses. The mean overall score for the Fear of COVID-19 scale was 23.64 (SD + 6.85) which again exceeded the mid-point for the total score range (21), indicating elevated level fear of the COVID-19 pandemic. Participants had displayed extremely severe depression 40%, extremely severe anxiety 60%, and 35% severely distressed. Scores for depression (21.30 ± 10.86), anxiety (20.37 ± 10.80), stress (23.33 ± 10.87) were also high. Factors determined to be associated with psychological distress were being male, married, aged 40 years and older, and having more clinical experience. Assessment of social support indicated moderate-to-high levels of perceived support for all dimensions (significant other: 5.17 ± 1.28, family: 5.03 ± 1.30, friends: 5.05 ± 1.30). Weak significant correlations were found between social support and the other study variables (r < 0.22), indicating a weak association with fear, depression, anxiety, and stress, respectively. Overall, Jordanian health-care workers sample reported fear, depression, anxiety, and stress. The associated factors were being male, married, aged 40 years and older, and having more clinical experience. Regarding social support, participants primarily relied on support from their families, followed by support from friends.

Aim: This research aimed to survey a sample of nursing students and PharmD students in Jordan about their knowledge of pediatric palliative care (PPC) in the context of treating terminally ill children.Method: A descriptive, cross-sectional, correlational design was used to fulfill the goal of this research. A convenience sample of nursing and PharmD students currently studying in Jordan University of Science and Technology in Jordan was recruited to complete a survey that contained 20 statements about issues on and around the subject of PPC Results: The results showed that there a significant difference in PPC between nurses and PharmD students. Mother’s education (t= 2.158, p= .032) and being a nursing or PharmD student ( t=1.969, p=.050) were associated with knowledge toward PPC. Other listed factors such as gender, working ward, and age were not associated with knowledge toward PPC.Conclusion: this was the first study in Jordan to survey a sample of nursing students and PharmD students in Jordan about their knowledge of PPC. The current study found that knowledge of nursing and PharmD students regarding PPC was satisfactory according to the scale used.

Background Pain assessment and management are imperative parts of nursing care and considered as one of the most fundamental patient rights. The role of pain management education is well established in improving knowledge and attitude among nurses. Objectives This study aims to evaluate the impact of pain management educational program on the knowledge and attitudes of intensive care unit (ICU) staff nurses toward pain assessment and management. The baseline score of pain assessment and management knowledge and attitude of ICU nurses has been identified in a previous research, and the result showed immense lack of knowledge and poor attitudes among ICU nurses toward pain assessment and management when dealing with ICU patients. Methods This is a pretest-posttest experimental study, utilizing a self-reporting questionnaire tool to obtain information about nurses' knowledge and attitudes toward pain assessment and management after implementation of new pain management educational program for critical care nurses. Data were collected using the Knowledge and Attitudes Survey Regarding Pain tool that measures knowledge with 22 question items and measures attitude with 17 question items. Paper-based questionnaire was distributed to nurses for data collection. Results and conclusion The results showed significant improvement in knowledge and attitudes about pain assessment and management among ICU nurses; it was evident after delivering pain management education program. At baseline, 204 ICU nurses gave consent and completed the questionnaire and thus included in baseline measurement before implementing the intervention. In the postintervention measurement, the questionnaire was distributed to the same participants included in the baseline phase from which 181 participants completed the questionnaire for the second time, with a response rate of 89%; the deficits and preconception in pain assessment and management can be improved through implementing pain management educational programs.

Security personnel are the first ones who attend the scene in the case of out-of-hospital cardiac arrest (OHCA) at malls. Cardiopulmonary resuscitation (CPR) is not enough for those patients; they need an automated external defibrillator (AED) to bring the heart to function normally. This study aimed to assess the current status of CPR and AED knowledge and availability in Saudi malls by security personnel. Using a descriptive design, a study was conducted at seven malls located in the Eastern Province of Saudi Arabia. Two hundred and fifty participants were surveyed using the American Heart Association (AHA) 2015 guidelines to assess CPR and AED knowledge and availability in Saudi malls. The sample mean age was 32.60 years (SD = 10.02), and 87% of participants were working as security personnel. The majority of the participants had not received training about CPR and AED (75.8% and 95.2%, respectively). Common misconceptions are fallen into all categories of CPR and AED knowledge. Correctly answered statements ranged from 7.2% in the compression rate to 24.2% in hand placement. The study results indicated a poor training knowledge of CPR and AED in public settings. Integrating high-quality CPR and AED knowledge within the school and college curricula is a vital need. However, in order to maximize the survival rate, it is important to set laws and legislation adopted by stakeholders and decision makers to advocate the people who try to help, mandate AED installation in crowded places, and mandate teaching hands-only CPR and AED together as a package.

In any pharmaceutical packaging process, error rates must be kept very low to prevent defective or incorrect medicine from reaching the consumer. Published articles include a focus on the inspectio...

In this study a qualitative description of the occurrence of shear bands produced by a sudden impact on an axisymmetric specimen made of medium carbon steel 0.45% C is given. A simple experiment was developed aimed at producing a pinch shear stress in the front side of the test sample in order to visualize shear bands in 3-D. Curve fitting using MATLAB was employed based on the points taken from the images of the front section of the test sample. The predictions of the curve fitting suggests a hyperbolic section leading to the conclusion that within the sample there is a double cone region of material where the shear band region is located on its outer surface. The formation of the shear band is explained by the fact that the interaction of the stress wave front with the free surface of the test sample produces reflection waves that attenuate the incoming stress wave inwards leading to a stress gradient in the plane of the front side of the specimen that causes shear localization. Also, the progressively increasing cross sectional area of the test sample causes the expansion of the wave front, which also results in a stress gradient in the normal direction of the front side of the specimen. So the formation of shear bands depends not only on the impact momentum and strain rates but also on the sample's geometry. © 2015 The Authors

Background: Nurses are the heart of the palliative care team who provide high standards of care since they spend the longest time with patients. However, lack of adequate knowledge of palliative care is considered as one of the main obstacles to palliative care improvement. Aim: A survey was conducted to assess Saudi nursing students’ knowledge about palliative care. Methods: Using a descriptive design, 154 students who enrolled in first year and who will graduate within 1 year were surveyed in a nursing college located in Riyadh, the capital of Saudi Arabia. The Palliative Care Quiz for Nursing (PCQN) was used to assess students’ knowledge. Results: The sample mean age was 22.1 (standard deviation (SD): 2.2), and most of the students were predominately female (93; 60.4%) and the majority were senior students who will be graduated within the current academic year (105; 68.2%). The total mean score of palliative care knowledge was low at 7.30 (SD: 0.56; range: 0-13), and the number of correctly answered statements ranged from 16 (10.4%, statement no. 7) to 91 (59.1%, statement no. 18). Eleven misconceptions about palliative care among participants are conceptually categorized into 3categories: principle and philosophy of palliative care, pain and symptom management, and psychological and spiritual care. Conclusion: Integrating palliative care education within the nursing programs is the backbone to improve nursing students’ knowledge, namely, in principles of palliative care and symptom management.

Estimation of age-at-death is an integral part of the identification process of individuals in many forensic odontology cases where their identity cannot be determined by visualization or other ways. Dental age estimation in the adult is more challenging as most of the dentition is completely developed by 18 years of age. This study employs a mesio-distal (MD) pulp-to-tooth ratio taken at the neck of lower third molars (LM3) to provide an estimation of age at the time of radiographic imaging based on the well-known fact that pulp volume tends to decrease with advancing age due to continued apposition of secondary dentine throughout adulthood. A total of 155 Cone-beam computed tomography (CBCT) radiographs of LM3s for a random sample of 155 Jordanian Arabs (80 females, 75 males; age range= 18-58 years, mean age= 28.2 years, SD =10.0 years) were used. Both pulp and tooth MD diameters were measured at the neck. MD pulp-to-tooth ratios for LM3s were linearly regressed against age. Statistically significant negative association was found between an individual's age at the time of imaging and the MD pulp-to-tooth ratio taken at the neck. Specifically, the strength of the association is r= -0.361, which means only 13.0 % of the variation in age can be explained by the MD pulp-to-tooth ratio taken at the neck. Therefore, it was concluded that MD pulp-to-tooth ratio taken at the neck of LM3s is not a reliable predictor of chronological age in adults, possibly due to the large variation in the timing of LM3 development.

Dental implant abutments can be made of different materials including titanium, gold, zirconia, alumina, and polymeric materials. Polyetheretherketone (PEEK) is a high performance thermoplastic polymer that can be used as a dental implant abutment material. It has an elastic modulus comparable to bone and can reduce stress shielding. PEEK is a radiolucent material that can allow better radiographic imaging of peri-implant tissues and can be veneered with composite materials or bonded to ceramics. PEEK is widely used in orthopedic and spinal surgeries, and it possesses mechanical and biological characteristics that encourage its use as dental implant abutments. This article will review the use of PEEK in dentistry and in particular as a dental implant abutment and over implant framework. Clinical reports will be presented to suggest some uses of PEEK materials in implant dentistry.

New born babies could suffer from multiple craniofacial abnormalities, such as Pierre Robin syndrome, which consists of micrognathia and relative macroglossia with or without cleft palate. Although Pierre Robin syndrome is well described in literature, only a few have mentioned its occurrence in identical twins. This paper presents a rare incident of full-term twin babies born with the sequence of Pierre Robin syndrome, which consists of micrognathia, cleft palate, and glossoptosis. Although it is a rare coincidence, Pierre Robin syndrome still can occur in identical twin babies. The treatment is a step-by-step approach, but all procedures are mainly directed to widening the pharyngeal space.

Cyberttacks are becoming increasingly sophisticated, necessitating the efficient intrusion detection mechanisms to monitor computer resources and generate reports on anomalous or suspicious activities. Many Intrusion Detection Systems (IDSs) use a single classifier for identifying intrusions. Single classifier IDSs are unable to achieve high accuracy and low false alarm rates due to polymorphic, metamorphic, and zero-day behaviors of malware. In this paper, a Hybrid IDS (HIDS) is proposed by combining the C5 decision tree classifier and One Class Support Vector Machine (OC-SVM). HIDS combines the strengths of SIDS) and Anomaly-based Intrusion Detection System (AIDS). The SIDS was developed based on the C5.0 Decision tree classifier and AIDS was developed based on the one-class Support Vector Machine (SVM). This framework aims to identify both the well-known intrusions and zero-day attacks with high detection accuracy and low false-alarm rates. The proposed HIDS is evaluated using the benchmark datasets, namely, Network Security Laboratory-Knowledge Discovery in Databases (NSL-KDD) and Australian Defence Force Academy (ADFA) datasets. Studies show that the performance of HIDS is enhanced, compared to SIDS and AIDS in terms of detection rate and low false-alarm rates.

Objectives: The study aimed at assessing the stressors among hemodialysis (HD) patients and finding out whether there is any relation between these stressors and patients' characteristics in the North of the West Bank. Methods: A quantitative, cross-sectional, descriptive–analytical study was carried out. Data collection took place at three governmental hospitals and one private hospital where 120 HD patients responded to the HD stress scale. Results: Hemodialysis patients were mildly to moderately stressed, the greatest perceived sources of stress appeared to be “physiological stressors” (mean = 2.655), but the item with the highest percentage was 'limitation on time and place for vacation' (84.2%) which belong to psychosocial stress subscale, and the item stress with the least percentage was “dependency on nurses and technicians”(45%). Conclusions: There was significant difference between the psychosocial stressors and duration of treatment. The study concluded that HD patients are in need for continuous support, and it is recommended different contributions to improve the quality of their life.

Introduction: End-of-life care is a critical issue for pediatric population with terminal illness to ensure the best possible quality of care for them and their families. A survey was conducted to identify the barriers and facilitators to provide pediatric end-of-life care. Methods: A descriptive cross-sectional study was conducted at three tertiary centers providing end-of-life care in Jordan. Two hundred critical care nurses were surveyed (response rate 93%). Results: Nurses reported moderate level of experience in all areas of delivering pediatric end-of-life care. The highest scoring of barriers respectively were patients-families barriers having deal with angry family member; health-care professional barriers multiple physicians, involved with one patient, who differ in opinion about the direction care, and where plan of care should go; and organizational barriers not available support person for the family. The highest scoring of facilitators respectively were of patients families facilitators having family members accept that the patient is dying; health-care professional-facilitators having a physician agrees about the direction of care, and organizational facilitators providing family members adequate time to be alone with the pediatric after he or she has died. Conclusion: Nurses perceived that patient-family, health-care professionals, and organizational related barriers and facilitators were had the most influence in providing of pediatric end-of-life care. Findings highlighted the need for additional education and support for pediatric staff, across professions, in providing pediatric end-of-life care. A pediatric end-of-life care team should be developed to assist in improving patients' quality of care and increasing the awareness for the need for a standardized tool to evaluate the nursing competency level concerning pediatric end-of-life care.

Objectives: To assess the knowledge of Jordanian dentists toward phase down of dental amalgam as recommended by the Minamata Convention, and their training and competency in placing posterior composites. Methods: This study was conducted through structured questionnaire interviews with randomly selected cohort of dentists in Jordan between March 2015 and June 2015. Out of 230 dentists who were invited, 196 (85.2%) agreed to participate. Dentists were asked if they know about the Minamata Convention. They were also asked about their training in placement of posterior composite. Results: Out of the 196 interviewed, only 13.8% know about Minamata Convention and 17% had an undergraduate training in favor of placing composites in posterior teeth. Approximately 50% of those dentists were not trained in using rubber dam when placing posterior composites, while only 38.3% had training in sectional matrix placement. Undergraduate training did not influence ( p =0.00) the dentists’ decision to remove old amalgam based on patient’s demands. Only 28.1% were of the opinion of discontinuing the use of amalgam due to its alleged health and environmental hazards. There was no general agreement on the type of composite, liner, and bonding strategy when placing posterior composites. Conclusion: Dentists are not well informed on the Minamata Convention and the phase down of amalgam. Training in posterior composite placement should be given more room in undergraduate curriculum and continuous dental education. Saudi Med J 2016; Vol. 37 (12): 1381-1386 doi: 10.15537/smj.2016.12.16163

Outpatient palliative care clinics are essential for early symptom management in patients with advanced cancer. Few outpatient programs are available in the Middle East. In this prospective study, we examined the symptom changes among cancer patients seen at a palliative care clinic in Jordan. Patients with advanced cancer who had an outpatient palliative care consultation and not delirious were enrolled. The Edmonton Symptom Assessment System (ESAS), Karnofsky Performance Scale (KPS), and Memorial Delirium Assessment Scale (MDAS) were collected at consultation and follow up visit 14–34 days later. We compared symptom changes using paired t test. Among the 182 enrolled patients, the average age was 53 years, 47 % were females, and 95 % had stage IV cancer. The median duration between the two clinic visits was 21 days (interquartile range 15–28). KPS decreased between visits (mean 68 vs. 66 %, P = 0.004). ESAS pain (5.9 vs. 5.1, P = 0.004) and sleep (4.6 vs. 4.1, P = 0.007) improved significantly over time. The remaining ESAS symptoms decreased in intensity, albeit not statistically significant. Among patients who presented with moderate to severe symptom intensity, pain (7 vs. 6, P

Many organizations are interested in analyzing and evaluating the web data for their websites because websites are a very important platform to carry out their business. However, website evaluations face many challenges in using analytics, especially with the huge amount of data that the websites are collecting from various sources. This explosive growth in data requires a complex tool for analyzing and automatically convert the data into valuable information. However, without using a proper analysis tool, it is very difficult to understand the user’s behaviour, user’s interaction patterns on the website and how users involve in the site. This paper explains methods to examine, understand and visualize the huge amounts of stored data collected from the websites. In this paper, a framework is developed for identifying user’s behaviours on websites. Firstly, the attributes are extracted from different websites using Google Analytics and other API tools. Secondly, data mining techniques such as clustering, classification and information gain are applied to build this framework. The findings of these study can be used to evaluate the website and provide some guidelines for the web team to increase user engagement on the website and understand the influence of user behaviour. In addition, this framework is able to identify which behaviour features influence user decisions. Our proposed framework for identifying user’s behaviours on websites is tested on a large dataset that contains a variety of individual users from different websites.

The aim of this study was to report the satisfaction of fifth year undergraduate students on the clinical use of rotary endodontic preparation compared with stainless steel standard technique and to evaluate the impact of rotary nickel-titanium instruments on undergraduate teaching. This study was carried out by the fifth year undergraduate students attending peer review sessions as a part of their training program using a questionnaire to assess their satisfaction with these two techniques. The overall results indicated a statistically significant satisfaction of the undergraduate students with the use of the nickel-titanium system (P

Due to increase in intrusion activities over internet, many intrusion detection systems are proposed to detect abnormal activities, but most of these detection systems suffer a common problem which is producing a high number of alerts and a huge number of false positives. As a result, normal activities could be classified as intrusion activities. This paper examines different data mining techniques that could minimize both the number of false negatives and false positives. C5 classifier’s effectiveness is examined and compared with other classifiers. Results should that false negatives are reduced and intrusion detection has been improved significantly. A consequence of minimizing the false positives has resulted in reduction in the amount of the false alerts as well. In this study, multiple classifiers have been compared with C5 decision tree classifier using NSL_KDD dataset and results have shown that C5 has achieved high accuracy and low false alarms as an intrusion detection system.

This study investigated the prevalence of temporomandibular disorder (TMD) among patients before and after orthognathic surgery and assessed the effect of orthognathic surgery on each of the TMD symptoms (clicking, pain, crepitus, and MRI findings). A sample of 100 consecutive patients undergoing bimaxillary surgery for correction of craniofacial deformities (31 male and 69 female), with ages ranging between 17 and 58 years (mean age: 27.7 ± 9.3 years), were interviewed and examined regarding signs and symptoms of TMD. Clinical examination and X-ray and magnetic resonance imaging of the temporomandibular junction were performed at the time of surgery and 1 year thereafter. The prevalence of TMD preoperatively and postoperatively was 35% and 27%, respectively. A high frequency of relief was found in the patients with TMD symptoms (74.3%; 19 (70.3%) of patients had reduced clicking, 7 (87.5%) patients had reduced pain, 4 (100%) patients had reduced crepitus, and 4 (57.1%) patients showed changes in MRI findings), 12 patients who were asymptomatic before surgery developed clicking in TMJ after surgery, 3 developed pain, and 3 developed crepitus. TMD problems can occur in a variety of patients, including those who have facial deformities, and require orthognathic surgery. However, orthognathic surgery may not predictably treat or reduce the symptoms of TMD.

Ultra-wideband (UWB) is one of the recent topics that received a great concern from academia and industry. However, UWB found many difficulties to be standardized due to the overlay working that made UWB an important potential interference source to many licensed and unlicensed spectrum throughout the band 3.1 to 10.6 GHz. This paper demonstrates the design of integrated triple band notched for UWB Microstrip antenna. We simulated UWB short range systems which require low power and these are built using inexpensive digital components. We proposed a compact triple band notched CPW (Co-planar Waveguide) fed Micro strip Antenna (MSA) for UWB. This band-notched antenna has rejection characteristics at 3.2 GHz (for Wi-MAX band 3.16 to 3.32 GHz), at 5.5 GHz (for WLAN 2 band—5.3 to 5.72 GHz) and at 7.9 GHz (for ITU band 7.72 GHz to 8.13 GHz). The simulation was done using IE3D simulator.

Introduction: Central neurocytomas (CNCs) appear as a rare benign intraventricular lesions involving

Purpose – The purpose of this paper is to mitigate vulnerabilities in web applications, security detection and prevention are the most important mechanisms for security. However, most existing research focuses on how to prevent an attack at the web application layer, with less work dedicated to setting up a response action if a possible attack happened. Design/methodology/approach – A combination of a Signature-based Intrusion Detection System (SIDS) and an Anomaly-based Intrusion Detection System (AIDS), namely, the Intelligent Intrusion Detection and Prevention System (IIDPS). Findings – After evaluating the new system, a better result was generated in line with detection efficiency and the false alarm rate. This demonstrates the value of direct response action in an intrusion detection system. Research limitations/implications – Data limitation. Originality/value – The contributions of this paper are to first address the problem of web application vulnerabilities. Second, to propose a combination of an SIDS and an AIDS, namely, the IIDPS. Third, this paper presents a novel approach by connecting the IIDPS with a response action using fuzzy logic. Fourth, use the risk assessment to determine an appropriate response action against each attack event. Combining the system provides a better performance for the Intrusion Detection System, and makes the detection and prevention more effective.

The aim of this study was to investigate the technical quality of root canal treatment provided by the undergraduate students as their first experience in molar endodontics using nickel-titanium (NiTi) files in a crown-down approach compared with stainless steel standard technique. This study was carried out by the fifth year undergraduate students attending peer review sessions as a part of their training programme, using two different questionnaires to assess the overall technical quality and potential problems regarding endodontic complications after root canal preparation with these two techniques. The overall results indicated a statistically significant difference in the performance of the two instrument techniques in difficult cases showing better performance of the NiTi system and mean rotary preparation time (P

To describe lagophthalmos and eyelid closure abnormality after external dacryocystorhinostomy (DCR). A retrospective review of medical records and postoperative photographs of 79 patients who underwent external DCR for nasolacrimal duct obstruction and developed eyelid closure abnormality and lagophthalmos with or without exposure keratopathy was conducted. Collected data included age, sex, indication for surgery, laterality, length and type of incision, length of follow-up duration, presence of punctate epithelial keratopathy, and time for resolution of eyelid closure abnormalities. Twenty-seven patients with 28 external dacryocystorhinostomy had postoperative eyelid closure abnormalities. Male to female ratio was 1:6. The mean age was 40.1 years (range 9-80 years). All surgeries were performed through diagonal skin incision. Lagophthalmos involving the medial third of the palpebral fissure was noticed in 28.6 % of cases. All patients had hypometric blink mainly of the upper eyelid. One patient had punctate epithelial keratopathy. Resolution of lagophthalmos was noticed over a period of 1-5 weeks with an average of 3 weeks. None of the patients continued to have residual hypometric blink or punctate keratopathy at the last follow-up time. The mean follow-up period was 4.2 months (range 3-6 months). Eyelid closure abnormality and lagophthalmos after external DCR are underestimated problems. Spontaneous resolution is seen in all cases weeks to months after surgery.

This paper aims to examine the opportunities for possible improvement of the systems of pattern design and manufacturing, as well as the processes of casting design and technology in steel foundries. Solving these problems will improve the casting quality, and it will also standardize the work in one of the major bottlenecks in the production of steel casting. One big Jordanian foundry is selected as a case study. The foundry is referred to as GAZAL throughout this paper. A detailed flow process chart for the pattern making process with standardized times is developed, then possible improvements to the process are proposed. Several important milestones were developed and documented, among that; the development of a complexity classification and coding scheme of 6 levels to classify the products that GAZAL produced based on several criteria’s; the development of a mathematical model that relate the production time of the pattern with the complexity level. Finally conclusions are presented at the end of the paper.

The Internet of Things (IoT) has been rapidly evolving towards making a greater impact on everyday life to large industrial systems. Unfortunately, this has attracted the attention of cybercriminals who made IoT a target of malicious activities, opening the door to a possible attack to the end nodes. Due to the large number and diverse types of IoT devices, it is a challenging task to protect the IoT infrastructure using a traditional intrusion detection system. To protect IoT devices, a novel ensemble Hybrid Intrusion Detection System (HIDS) is proposed by combining a C5 classifier and One Class Support Vector Machine classifier. HIDS combines the advantages of Signature Intrusion Detection System (SIDS) and Anomaly-based Intrusion Detection System (AIDS). The aim of this framework is to detect both the well-known intrusions and zero-day attacks with high detection accuracy and low false-alarm rates. The proposed HIDS is evaluated using the Bot-IoT dataset, which includes legitimate IoT network traffic and several types of attacks. Experiments show that the proposed hybrid IDS provide higher detection rate and lower false positive rate compared to the SIDS and AIDS techniques.

Background : The success of penetrating keratoplasty (PKP) is determined by the duration of graft survival, which is the time to graft failure. Our study aims to identify various indications of corneal graft among our Jordanian population, their success rate as well as spotting the light on cases of re-grafting. Methods: In this study, we analyzed data for patients who had PKP as well as re-do PKP in the period from January 2014 to June 2017. For each study eye, we identified pre-operative visual acuity as well as visual acuity at six months and one year. We also focused on the specific indication for PKP, the surgical procedure and graft clarity at one year post-op. On SPSS statistical analysis software, we used repeated measure ANOVA, Pearson correlations, and Fischer’s exact test to analyze our study’s variables. Results: We included a total of 230 patients in this study with a mean age of 34.22 (±19.32). They were 112 (48.7%) males and 118 (±51.3%) females. We found a significant difference in mean age and outcome (p< 0.001), as the mean age for patients with successful PKP was 31.55 (±16.55) compared to 44.1 (±25.1) for patients with failed PKP. the success rate for patients with KC as an indication was 96.7% compared to only 58.3% for other indications. We found that failure rate in redo surgeries was significantly higher than first time surgeries. Conclusion: Among the Jordanian population, we found that Keratoconus was the main indication for PKP in our population, where we also found that it was associated with the best prognosis.