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Yacoub A Yousef,1 Mona Mohammad,1 Ibrahim AlNawaiseh,1 Reem AlJabari,1 Mario Damiano Toro,2,3 Almutez Gharaibeh,4 Robert Rejdak,5 Katarzyna Nowomiejska,5 Sandrine Zweifel,3 Teresio Avitabile,6 Magdalena Rejdak,6 Rashed Nazzal2 1Department of Surgery (Ophthalmology), King Hussein Cancer Centre, Amman, Jordan; 2Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland; 3Department of Ophthalmology, University of Zürich, Zürich, Switzerland; 4School of Medicine, The University of Jordan, Amman, Jordan; 5Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland; 6Department of Ophthalmology, University of Catania, Catania, ItalyCorrespondence: Yacoub A YousefDepartment of Surgery (Ophthalmology), King Hussein Cancer Centre, Queen Rania St, Amman, 11941, JordanTel +96265355000Email yyousef@khcc.joMario Damiano ToroDepartment of Ophthalmology, University Hospital of Zürich, Raemistrasse 100, Zürich, 8091, SwitzerlandTel +39 3495158220Email toro.mario@email.itPurpose: Ciliary body (CB) and iris thicknesses may change with certain eye diseases as well as between different populations. Here, we report Ultrasound Biomicroscopy Measurements (UBM) of the normal thickness for the CB and the iris from a homogenous population in the Middle East.Patients and Methods: Sonomed 35-MHz (SONOMED, INC. New York, USA) images were obtained at 4 radial meridians, and the thickness was measured at 3 locations along the radial length of the iris and at the thickest part of the CB. Parameters included mean thickness, median thickness, range, and standard deviation.Results: Of 46 adult patients, 83 normal eyes were included in this analysis. The overall mean, median iris thicknesses at the iris root, midway along the radial length of the iris, and at the juxtapupillary margin in mm were 0.42, 0.41 ± 0.08, 0.52, 0.51± 0.08, and 0.72, 0.71± 0.1, respectively. The overall mean, median thicknesses of the CB and CB + ciliary processes in mm were 0.72, 0.71 ± 0.1, and 1.42, 1.37 ± 0.2 respectively. Gender, age, side, and height had no impact on iris and/or CB thickness (p> 0.05). However, the iris thickness was significantly thicker in the superior quadrant than inferiorly, and in the nasal quadrant than the temporal quadrant (p=0.04), and the CB thickness and the CB + ciliary processes thickness were significantly thicker in the superior quadrant than inferiorly (P = 0.04 and 0.02 consecutively).Conclusion: We measured in this study the normal thickness of the CB and the iris in normal eyes from homogenous population in the Middle East using ultrasound biomicroscopy. Our findings are essential for the ophthalmic community worldwide and in the Middle East region and can be used as a normative thickness data for the iris and CB in healthy eyes.Keywords: ultrasound biomicroscopy, iris, ciliary body

This study examined the independent contribution of morphological awareness and orthographic awareness in reading comprehension, controlling for working memory and reading fluency in Arabic-speaking children. Participants (N = 244) from grades four and five, were classified into typical comprehenders (n = 207) and poor comprehenders (n = 37). All the participants underwent reading comprehension tasks (sentence comprehension and reading maze), orthographic awareness tasks (word choice and parsing), morphological awareness test (root morpheme awareness), working memory test (listening sentence span), word reading fluency, and word reading accuracy and fluency (reading in one minute). The results indicated that morphological awareness and orthographic awareness contributed significantly to reading comprehension (composite scores) only in the typical comprehenders group. Although morphological awareness showed significant predictive relation with reading comprehension, orthographic awareness was a stronger predictor of reading comprehension while controlling for working memory and reading fluency. The findings are discussed, and future directions for research are suggested.

Mutasem Elfalah,1 Saif Aldeen AlRyalat,1 Mario Damiano Toro,2– 4 Robert Rejdak,4 Sandrine Zweifel,3 Rashed Nazzal,5 Mohammed Abu-Ameerh,1 Osama Ababneh,1 Almutez Gharaibeh,1 Zuhair Sharif,1 Jehad Meqbil,1 Mo’ath AlShawabkeh,1 Amal Alwreikat,6 Muawyah Al Bdour,1 Maysa Al-Hussaini,7 Yacoub A Yousef8 1Department of Special Surgery, Faculty of Medicine, The University of Jordan, Amman, Jordan; 2Faculty of Medical Sciences, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland; 3Department of Ophthalmology, University Hospital of Zürich, Zürich, Switzerland; 4Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland; 5Shami Eye Center, Amman, Jordan; 6Department of Ophthalmology, Royal Medical Services, Amman, Jordan; 7Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman, Jordan; 8Department of Surgery (Ophthalmology), King Hussein Cancer Center, Amman, JordanCorrespondence: Mutasem ElfalahDepartment of Special Surgery, Faculty of Medicine, The University of Jordan, Queen Rania St, Amman, 11941, JordanTel +96265355000Email mutasemrabie@hotmail.comMario Damiano ToroDepartment of Ophthalmology, University Hospital of Zürich, Raemistrasse 100, Zürich, 8091, SwitzerlandTel +39 3495158220Email toro.mario@email.itPurpose: To assess the impact of Jordanian’s Corona Virus Disease (COVID-19) lockdown on visual acuity and macular thickness in patients with macular edema receiving intravitreal injections, and to assess the ethical endeavor of lockdown among serious sight threatening conditions.Patients and Methods: This retrospective observational study included patients planned for intravitreal injections who did not complete the planned course before the lockdown (ie, before 20th of March 2020). Data included demographics, indication for the intravitreal injection, corrected distance visual acuity (CDVA), and central macular thickness on Optical Coherence Tomography (OCT) before and after the lockdown.Results: One-hundred and sixty-six eyes of 125 patients were studied, 68 (54.4%) patients were males, and the mean (± standard deviation, SD) age was 64.79 (± 9.41) years. Mean (±SD) duration of delay in the planned injection was 60.97 (± 24.35) days. The change in visual acuity was statistically significant for patients with diabetic macular edema (p= 0.045 improvement), patients with central retinal vein thrombosis (CRVO) (p= 0.05 deterioration), and patients with age-related macular degeneration (AMD) (p= 0.005 deterioration). Of interest, delay of more than 2 months and the previous need for 3 or more injections were significant poor prognostic factors for visual outcome for patients with diabetic macular edema (p=0.027 and 0.045).Conclusion: The impact of delay in the scheduled intravitreal injections resulted in variable outcomes depending on the indication. Triaging the urgency of patients should be based on the indication to support the equity principle of bioethics, where those in need are prioritized against others, depending on potential adverse outcome.Keywords: COVID-19 lockdown, COVID-19 pandemic, ethics, intravitreal injection, macular edema

BACKGROUND: The TROPiCS-02 study (NCT03901339) demonstrated that sacituzumab govitecan (SG) has superior clinical outcomes over treatment of physicians choice (TPC) chemotherapy in patients with hormone receptor-positive, human epidermal growth factor 2 receptor-negative (HR+/HER2-) metastatic breast cancer (mBC). Here, we present health-related quality of life (HRQoL) patient-reported outcome (PRO) findings from this study. PATIENTS AND METHODS: Eligible adults with HR+/HER2- mBC who previously received a taxane, endocrine-based therapy, a CDK4/6 inhibitor, and 2-4 lines of chemotherapy were randomized 1:1 to receive SG or TPC until progression or unacceptable toxicity. PROs were assessed at baseline and on day 1 of each cycle, using the European Organization for Research and Treatment of Cancer Quality-of-Life Core 30 (EORTC QLQ-C30), EQ-5D-5L, and PRO Common Terminology Criteria for Adverse Events (PRO-CTCAE). RESULTS: Compared to TPC, overall least square mean change from baseline was significantly better for SG for physical functioning and dyspnea, but worse for diarrhea. Time to first clinically meaningful worsening or death was significantly longer for SG in global health status/quality of life, physical functioning, fatigue, emotional functioning, dyspnea, insomnia, and financial difficulties of the EORTC QLQ-C30 and the EQ-VAS, but longer for TPC in diarrhea. Few patients in both arms reported experiencing any worsening to level 3 or 4 treatment-related symptomatic events during treatment, as assessed by 16 PRO-CTCAE items, except for diarrhea frequency and amount of hair loss, which favored TPC. CONCLUSIONS: SG was associated with an HRQoL benefit in most symptoms and functioning, compared with TPC. This supports the favorable profile of SG as a treatment option for patients with pretreated HR+/HER2- mBC.

BACKGROUND: Patient satisfaction is a paramount measure of the quality of healthcare system, particularly in the practice of family medicine. The study aimed to assess patients’ satisfaction with services provided by family physicians (FPs) at Comprehensive Healthcare Centers (CHCCs) in Northern Jordan. MATERIALS AND METHODS: A cross-sectional study was conducted at 11 CHCCs in Northern Jordan between July and October 2023. A convenient sample of 367 patients, both males and females over the age of 18 years, was selected. Participants were requested to complete the Arabic version of the Consultation Satisfaction Questionnaire (CSQ). Mean and standard deviation calculated for continuous variables, and frequencies and percentages for categorical variables. Multivariable logistic regression analysis yielded factors related to patients’ satisfaction with family physician. RESULTS: The mean score of patients’ satisfaction was 55.63 ± 12.15. The highest mean satisfaction scores were reported for the “professional care” provided by the FP (72.41 ± 15.9), followed by the “depth of relationship and the length of consultation” with the FP, respectively. Patients who had a reference health center if needed (P < 0.002), had health insurance (P < 0.05), patient’s privacy (P < 0.027), and waiting time < 20 min to see the FP (P < 0.001) were all positively associated with the status of patients’ satisfaction. Logistic regression final model included only two factors, waiting time < 20 minutes and having a reference health center. CONCLUSION: The study reveals moderate patient satisfaction with care provided by FP. The moderate satisfaction is attributed to good care provided by FP and the least to the length of consultation. The predictors of satisfaction are the waiting time to see FP and the availability of a reference health center. Study has implications for the health care system in Jordan, as regards the strengthening of the health information system to incorporate policies on appointments, quality of consultation times, and waiting times.

This paper examines the initiatives and policies implemented in the United Arab Emirates (UAE) to protect Children of Determination (COD) from abuse and neglect. Despite global efforts to address child abuse, children with disabilities, referred to here as children of determination, remain particularly vulnerable. This paper explores the social framework, legal protections, prevention strategies, challenges, and necessary measures to ensure that such children are safe and empowered to protect themselves from abuse. The paper also explores approaches to enhancing the efficacy of the caregivers engaged with these children so that they can predict, prevent, and deal with incidents of abuse. Drawing upon qualitative research and data analysis, the study assesses the effectiveness of existing programmes and proposes a model for a child advocacy centre that promotes and implements best practices. The study adopts a qualitative approach to collect the views of ten social workers and parents of children of determination through in-depth interviews, and to analyse data, legislation, and initiatives related to the target population in the UAE. In particular, this study highlights the critical importance of protecting girl children from abuse, given that international research indicates that girls are more vulnerable to abuse than boys. Keywords: Disability, Abuse, Prevention, Empowerment, Rehabilitation, Social Policy, Children of Determination, UAE, Child rights, Girls' rights, Introduction International Views on the Abuse and Protection of Girls and Boys with Disabilities People around the world often refer to individuals with disabilities as 'differently abled,' highlighting their unique [...]

Introduction Family is a vital organ in the establishment and maintenance of societies as it facilitates relations and aims for compatibility among individuals in the community and is where children [...], This study aimed to investigate the attitudes of university students in the United Arab Emirates towards the marriage of people with disabilities. To achieve this goal, a sample of 396 students, consisting of 222 women and 174 men, was selected. All participants were administered a scale of 15 items built according to the closed-ended Likert. The results indicated a high level of positive attitudes towards this type of marriage. Furthermore, the results showed no statistically significant differences in attitudes attributed to variables such as gender and academic year, while there were statistically significant differences favoring students in scientific colleges over those in humanities colleges regarding academic specialization. The study also reflects a wider gendered analysis based on the field of Arab women with disabilities studies. This might help us to understand how the cultural and societal nature of these norms could impact ways in which students view marriage amongst people with disabilities thus providing more insights into an intersection between gender and disability within UAE. The study concluded with several recommendations, including that the UAE law on the rights of persons with disabilities must emphasize the right to marriage for persons with disabilities. Keywords: Marriage of people with disabilities, University students, Gender variable, Academic specialization

November 2024 This special issue of the Journal of International Women's Studies takes a broad look at issues of disability within the Arab world. Half of the papers address issues [...]

Abstract Objective This cross-sectional observational study, conducted from 01/09/2023 to 01/11/2023, involved 200 warfarin-using patients outpatient clinics to assess the knowledge and understanding of warfarin among patients through face-to-face interviews. Results Almost 70% of participants displayed insufficient knowledge about their warfarin therapy, potentially linked to inadequate counseling or patient comprehension. The participants had an average weekly warfarin dose of 32.9 ± 11.2, and more than half had used warfarin for at least 2 years. Only one third of patients most recent INR level was within the target range. Thirty-seven percent of patients experienced a thromboembolic event, and most of them required hospitalization. One hundred and eight patients (54.0%) experienced bleeding (minor, or major, or both). Eighty-two percent of participants correctly answered Question 8 of the OAK questionnaire regarding warfarin's indication for treating blood clots and 78% of the participants knew what the INR was. Moreover, the research revealed a positive correlation between higher education and adequate knowledge, with university-educated individuals exhibiting superior understanding. Conversely, a prolonged warfarin duration correlated with diminished knowledge, possibly indicating decreased patient vigilance. Furthermore, maintaining INR within the target range showed an association with sufficient knowledge.

This study employs finite element analysis (FEA) and response surface methodology (RSM) to analyze the stress concentration factor (SCF) in a biaxially loaded isotropic plate with a central countersunk hole. A finite element model is built using ANSY and employed to generate stress concentration factor values. The finite element model was optimized in terms of mesh density and properties based on data from past literature. Five dimensionless parameters are studied: radius to width ratio, thickness to radius ratio, countersink to thickness ratio, σ_y to σ_x ratio and countersink angle. The effect of the different configurations was studied using RSM. Finally, a precise second order equation was produced to estimate the value of SCF with dimensionless parameters.

Abstract Background Turkey arthritis reovirus (TARV) causes arthritic lameness in market-age turkeys. Since 2011, highly pathogenic TARV strains have caused significant economic losses in the turkey industry due to increased culling, reduced market weights, and decreased carcass quality, necessitating more effective control measures. Autogenous vaccine prevention strategies have been inefficacious partly due to a limited understanding of age-related susceptibility of turkeys to TARV. This study investigated age-related host and gut microbiota responses to TARV infection in commercial turkeys derived from vaccinated breeder hens. Poults with known maternally derived antibody titers were orally challenged with TARV O’Neil strain at 1-, 3-, and 7- weeks of age (WOA) and monitored for cloacal virus shedding, gastrocnemius tendon viral tropism, tendon inflammation, weight gain, and changes in gut microbiota. Results A transient TARV-induced weight gain suppression was evident in poults infected at 1- and 3- WOA during the first 3 weeks post-infection. Age-dependent variations in cloacal viral shedding, virus isolation from tendons, and tendon inflammation severity were also observed. There was significant dissimilarity in ileal and cecal bacterial communities between mock and infected groups, but the effect of age of infection was unclear. Conclusions Age dependent host response was observed to TARV based on cloacal virus shedding, weight gain suppression and viral tendon tropism. Our study also indicates that maternally derived antibodies appeared insufficient to prevent virus translocation to the tendons and subsequent pathological changes. This study lays the groundwork for future investigations of better vaccines/vaccination strategies and alternative preventive measures. Importance Turkey arthritis reovirus (TARV) causes lameness due to arthritis and tenosynovitis, commonly in market-age turkeys, resulting in significant economic losses. As a control strategy, the turkey industry used autogenous vaccines, prepared from field TARV isolates in breeder hens, to protect the poults in the early stage of life through maternally derived antibodies (MDAs). This study establishes the level of protection provided by MDAs in young poults with age-based responses to TARV O’Neil reovirus strain. Additionally, this study reveals the dynamics of gut dysbiosis in infected poults at different timepoints, paving the way to ground-breaking investigations into gut microbiome modulation interventions that could potentially improve vaccine efficacy and reduce virus transmission and disease severity.

Background and Aim: Ovine mastitis, particularly subclinical mastitis caused by Staphylococcus aureus, poses significant economic and health challenges in livestock management. This study aimed to investigate the molecular characteristics and antimicrobial-resistance gene profiles of S. aureus isolated from subclinical mastitis in northern Jordan and assess the zoonotic potential of these isolates. Materials and Methods: A total of 283 milk samples from ovines and 24 nasal swabs from animal handlers across three northern Jordanian governorates were analyzed. Bacterial isolates were identified phenotypically and genotypically, with antimicrobial susceptibility tested using disk diffusion and minimum inhibitory concentration assays. The presence of antimicrobial-resistance genes (ARGs) was analyzed through polymerase chain reaction, and genetic relatedness was determined using pulse-field gel electrophoresis (PFGE) and spa typing. Results: S. aureus was detected in 16 (6%) ovine milk samples and four nasal swab samples from animal handlers. High resistance rates were observed for penicillin G, oxacillin, and cefoxitin (25% each). ARGs, including mecA, blaZ, aph(3′)-III, and ant(4′)-Ia, were detected in 25% of isolates. PFGE revealed a high genetic similarity among isolates, while spa typing identified three types, with t1534 predominating (81.25%). Limited cross-transmission between ovines and handlers was noted. Conclusion: The study highlights spa type t1534 as the dominant genotype in ovine mastitis in Jordan and underscores the low zoonotic transmission risk from ovines to animal handlers. The findings emphasize the importance of antimicrobial stewardship and enhanced mastitis management strategies.

Abstract The thermomagnetic, electronic, structural, and mechanical properties of the Fe2MnAs1−xSix (x = 0, 0.25, 0.5, 0.75, and 1.0) full Heusler alloys were investigated using Monte Carlo simulation (MCs) and density functional theory (DFT). Both the pure and doped structures exhibit the L21 prototype, and there is a noticeable decline in the lattice parameter as the Si concentration increases. Electronic analysis was performed using Wien2k and the calculations were conducted using the full-potential linearized augmented plane wave (FP-LAPW) method implementing various approximations including GGA-PBE, mBJ-GGA, GGA + U, and PBEsol (GGAsol). Studying exchange coupling parameters revealed that ferromagnetic states primarily arise from the interactions between Fe–Mn and Fe–Fe in both pure and doped structures. The resultant Curie temperature ranged from 215 to 490 K by investigating the magnetic properties. Additionally, different mechanical properties such as Poisson’s ratio, linear compressibility, anisotropy parameter, shear, bulk, and Young’s modulus were examined for all the structures.

Abstract Background This research investigates micro-credentialing as an approach to recognise learning achievements in health. Establishing international standards can ensure consistency, promote equity, and enhance quality of recognition systems. Achieving stakeholder consensus on the key topic areas is an important precursor to lead to relevant topics from which to build appropriate standards. This research supports the efforts by UN agency representatives and experts in qualification systems, medical education, the health and care sector, regulation, and accreditation, to build foundations from which to launch normative work on the application of micro-credentials to award learning achievements for health and care workers. Methods A modified Delphi study following methodological steps was conducted. From April to May 2021, a literature review investigated existing standards in continuing professional development and the use of micro-credentialing in health. Results from the review informed the initial draft of statements that were then refined through three iterative Delphi rounds between May to September 2021. The process culminated in a final workshop in March 2023. Results A total of 53 participants completed the Delphi, with results analysed by researchers using qualitative analysis. Consensus was achieved on the core principles to recognise learning achievements. The expert panel agreed on the need for standards that are competency-based, and require evidence of learning indicating what a learner can do. There was also consensus that the characteristics of a valid digital award or micro-credential should be portable, standardised, secure, interoperable, stackable and verifiable. Conclusions The growing body of literature on micro-credentialing highlights its potential as a method to recognise learning achievements. The interest in alternative pathways to award health practitioners, through short competency-based micro-learning opportunities, has spurred discussions on the practical application of micro-credentials. This research outlines the categories and principles for a proposed framework to implement micro-credentialing to recognise learning achievements within the health and care sector.

Abstract Background Timely diagnosis is a crucial factor in decreasing the death rate of patients with breast cancer. BI-RADS categories IVc and V indicate a strong suspicion of cancer. The categorisation of each group is determined by the characteristics of the lesion. Certain benign breast lesions might have radiological features indicative of malignancy; thus, biopsy is mandatory. This study aimed to identify the histopathological diagnosis of benign breast masses classified into BIRADS IVc and V subgroups, investigate the radiological characteristics of these masses, and identify ultrasound features that could lead to false positive results (benign lesions that mimic malignancy on imaging). Methods This was a retrospective cross-sectional study at a single facility. Breast lesions reported as BIRADS IVc and V that underwent needle core/stereotactic vacuum-assisted biopsy were reviewed. Patients with benign pathologic diagnoses were analysed, delineating pathological diagnoses. Radiological descriptors were compared to those of a matched control of 50 malignant cases with BIRADS IVc. Results A total of 828 breast lesions classified as BIRADS IVc or V were detected during the period spanning from 2015 to 2022. Forty-four lesions (44/828, 5.3%) were benign at initial biopsy, while 784 lesions (784/828, 94.7%) were malignant. After histopathological testing and repeat biopsy, 26/828 (3.14%) patients had discordant benign diagnosis. Half of the repeated biopsies (10/20, 50%) showed malignant pathology. Compared to that in the control group, the presence of an oval shape of the mass was significantly more common in patients with benign pathology (p = 0.035). Conversely, the presence of posterior shadowing was significantly less common (p = 0.050) in benign lesions. No significant differences were observed for the other radiological characteristics. The most common histopathological diagnosis was fibrocystic change. Conclusion This study highlights key findings regarding the sonographic imaging descriptors and histopathological diagnoses of benign breast lesions categorised as BIRADS IVc/V. The study recommends a correlation between clinical and radiological findings and encourages multidisciplinary decision-making among radiologists, pathologists, and clinicians to determine if a repeat biopsy is warranted. There is a need for continuous research to improve the diagnosis and treatment of breast lesions and reduce false-positive rates by incorporating other methodologies such as sonoelastography and incorporating deep learning and artificial intelligence in the decision-making to eliminate unnecessary procedures.

Abeer Alassaf,1 Lobna Gharaibeh,2 Fatima Alkubaisi,3 Majd Alkhawaldeh,3 Sohayla Dababseh,3 Rasha Odeh1 1Department of Pediatrics, The University of Jordan, Amman, Jordan; 2Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan; 3School of Medicine, The University of Jordan, Amman, JordanCorrespondence: Abeer Alassaf, Department of Pediatrics, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan, Tel +962 6 5353444 extn 2767, Fax +962 6 5356746, Email dr_abeerassaf@hotmail.comBackground: During COVID-19 pandemic in Jordan, a number of medical students participated in voluntary work. However, barriers and facilitators were unclear. Therefore, we aimed to evaluate their experience and attitudes towards volunteering during a pandemic and the factors affecting that.Methods: A cross-sectional questionnaire-based study, using paper and online questionnaire which were distributed to final-year medical students at the University of Jordan from August 2021 to October 2021, about their experience and attitudes towards voluntary work during pandemics.Results: A total of 375 of final year medical students responded to the questionnaire. The number of male and female respondents were equal. Past voluntary work experience prior to COVID-19 pandemic in 44.8% of students, while 79.2% of them did not volunteer during the COVID-19 pandemic. Around 60% of students were willing to participate in future voluntary work that does not involve patients infected with COVID-19, while 29.3% of them were willing to do so depending on the type of pandemic and the availability of vaccines. There were 86.1% of students who thought that participating in voluntary work involving infected patients during pandemics, should be optional; where 10.1% suggested that it should be compulsory if vaccines were available.Conclusion: The majority of medical students did not volunteer during the COVID 19 pandemic. However, many of them expressed willingness to take part in future pandemics. Providing sufficient protection aids and adequate training, would affect positively the willingness of medical students to participate in voluntary work during a pandemic.Keywords: volunteering, pandemic, medical students, Jordan

Computer-supported collaborative learning (CSCL) pedagogies, platforms, and tools are prevalent in higher education due to their pervasive capabilities to enhance students' engagement, communication, and learning. However, it is reported that CSCL tools, media, and platforms may not yield the desired results if not planned, utilized, and managed strategically. Facilitating students' learning through CSCL may require a non-hierarchical approach, such as peer mentoring, for sustainably valuable outcomes. Using this approach successfully will also require contextual diagnostic analysis and exploration. This study was, therefore, conducted to explore the means to effectively deploy peer mentoring to enhance CSCL involving 227 undergraduate students in an Emirati university. Data were collected using a questionnaire with quantitative and qualitative elements. Data analyses were done using descriptive statistics and thematic coding. Findings show that students are well-disposed to peer mentoring as a measure for enhancing CSCL regardless of their demographic characteristics, as they could learn from each other and develop transferrable skills. However, students indicated that the process could be challenging with language barriers, technological issues, and distractions. Even so, the findings show that peer mentoring in CSCL could be enhanced with students' participation in the exercise made voluntary and the availability of different CSCL platforms, among others.

The categorization of benign and malignant patterns in digital mammography is a critical step in the diagnosis of breast cancer, facilitating early detection and potentially saving many lives. Diverse breast tissue architectures often obscure and conceal breast issues. Classifying worrying regions (benign and malignant patterns) in digital mammograms is a significant challenge for radiologists. Even for specialists, the first visual indicators are nuanced and irregular, complicating identification. Therefore, radiologists want an advanced classifier to assist in identifying breast cancer and categorizing regions of concern. This study presents an enhanced technique for the classification of breast cancer using mammography images. The collection comprises real-world data from King Abdullah University Hospital (KAUH) at Jordan University of Science and Technology, consisting of 7,205 photographs from 5,000 patients aged 18–75. After being classified as benign or malignant, the pictures underwent preprocessing by rescaling, normalization, and augmentation. Multi-fusion approaches, such as high-boost filtering and contrast-limited adaptive histogram equalization (CLAHE), were used to improve picture quality. We created a unique Residual Depth-wise Network (RDN) to enhance the precision of breast cancer detection. The suggested RDN model was compared with many prominent models, including MobileNetV2, VGG16, VGG19, ResNet50, InceptionV3, Xception, and DenseNet121. The RDN model exhibited superior performance, achieving an accuracy of 97.82%, precision of 96.55%, recall of 99.19%, specificity of 96.45%, F1 score of 97.85%, and validation accuracy of 96.20%. The findings indicate that the proposed RDN model is an excellent instrument for early diagnosis using mammography images and significantly improves breast cancer detection when integrated with multi-fusion and efficient preprocessing approaches.

The Internet of Things (IoT) has expanded into a realm of cutting-edge integrated solutions across numerous applications, following three stages of development: communication, authentication, and computing. However, each layer inside the three tier IoT architecture faces a spectrum of security concerns due to the IoT’s openness, scope, and resource limits. Therefore, developing a secure IoT system is vital, shielding against attackers leveraging IoT devices to obtain network access and maintaining data security during transmission between these devices. Despite developments in Intrusion Detection Systems, identifying Denial-of-Service (DoS) and Distributed Denial-of-Service (DDoS) attacks in real-time remains a significant issue, especially in the environment of IoT devices, which are diverse and resource restricted. This study provides a Convolutional Neural Network-Support Vector Machine (CNN-SVM) hybrid technique, targeted at overcoming these limits by enhancing detection speed and accuracy, thus addressing this substantial gap in the area. This research offers a hybrid model that combines CNN for feature extraction with SVM as a classifier. This model employs a CNN to extract essential elements from the data and classifies attacks as either DDoS or benign. Our results highlight the potential performance of our model, which was trained on the real Canadian institute for cybersecurity (CIC) IoT dataset in 2023. Notably, our hybrid model outperformed classic machine learning (ML) alternatives such as CNN, SVM, K-nearest neighbors, Naïve Bayes, and Logistic Regression. During testing, our model attained a remarkable accuracy rate of 99% and an F1-score of 99%, outperforming the highest-performing SVM ML model with an accuracy of 98% and the other ML methods.

Abstract This study is to investigate the relationship between the intestinal microbiota and urine levels of the ellagic acid-derived polyphenols, the urolithins, in a cohort of subjects following a three-week walnut dietary intervention. We longitudinally collected fecal and urine samples from 39 subjects before and after walnut consumption (2 oz per day for 21 days). 16S RNA gene sequencing was performed on fecal DNA to study the association between microbiota composition and the levels of nine urolithin metabolites, which were measured using UHPLC/Q-TOF–MS/MS. Fecal microbial composition was found to be significantly different between pre- and post-walnut intervention (beta diversity, FDR-p = 0.018; alpha diversity, p = 0.018). Roseburia, Rothia, Parasutterella, Lachnospiraceae UCG-004, Butyricicoccus, Bilophila, Eubacterium eligens, Lachnospiraceae UCG-001, Gordonibacter, Paraprevotella, Lachnospira, Ruminococcus torques, and Sutterella were identified as the 13 most significantly enriched genera after daily intake of walnuts. We observed 26 genera that were significantly associated with 7 urolithin metabolites, with 22 genera positively correlating after walnut supplementation (FDR-p ≤ 0.05). PICRUSt analysis showed that several inferred KEGG orthologs were associated with 4 urolithin metabolites after walnut intake. In this study, we found that walnut supplementation altered urolithin metabolites, which associates with specific changes in bacterial taxa and inferred functional contents.

Abstract Early childhood is crucial in building and shaping the personalities of children with disabilities, where employees dealing with such children face a lot of challenges. This study aimed to identify problems and challenges faced during early intervention programs in Jordan from employees’ perspectives. We conducted a questionnaire-based study on 350 from a population of 4000 employees working in early intervention programs from Jordan’s North, Central, and South territories. Participants responded to the problem and challenges scale, containing 32 items distributed over five dimensions. The findings of this study showed that employees at special education centers in Jordan who work in early intervention programs said they typically faced moderate issues and difficulties. The most significant issues and difficulties that Jordan’s early intervention programs faced were the absence of interactive cooperation among employees and the flexibility of the programs. Factor analysis of the studied items showed that, apart from the social dimension, the items of all other dimensions of the research instrument were influenced by a diverse set of underlying factors. There were no statistically significant differences in the challenges and problems facing early intervention programs in Jordan due to the employees’ gender, academic qualification, and experience. Finally, this study offered suggestions and recommendations for enhancing early intervention services and programs, putting additional rehabilitation into place, and implementing ongoing training for professionals in this sector.

Badera Al Mohammad,1 Monther A Gharaibeh2 1Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan; 2Department of Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa, 13133, JordanCorrespondence: Badera Al Mohammad, Radiology Technology, Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, 22110, Jordan, Email bmalmohammad@just.edu.joAbstract: The Anterior Cruciate Ligament (ACL) is considered the most commonly injured ligament of the knee. Magnetic Resonance Imaging (MRI) has become an indispensable imaging tool and modality of choice for assessing and managing knee conditions. This article outlines an effective MRI imaging technique that improves the diagnostic accuracy of ACL injuries of the knee, covering the appropriate pulse sequences and optimal imaging planes. Furthermore, the article provides a comprehensive review of the appearance of complete and partial ACL tears on MRI in the acute and chronic phases. In addition, it identifies and illustrates the primary MRI signs (signs related to the absence or abnormal visualization of the ACL fibers) and secondary MRI signs (signs related to the mechanism of injury or associated knee injuries) of ACL injury.Keywords: anterior cruciate ligament, magnetic resonance imaging, partial ACL tear, complete ACL tear

The recruitment life stage, including germination and early seedling establishment, is the most vulnerable life stage of plants and has cascading effects on plant performance at later life stages. However, surprisingly little is known on the eco-evolutionary processes that determine the success of biological invasions at this life stage. We performed germination experiments with and without simulated drought stress and monitored early seedling growth in diploid and tetraploid Centaurea stoebe. While diploids are the major cytotype in the native European range, only tetraploids became invasive in North America. Thus, C. stoebe is an excellent model species to simultaneously study both, pre-adaptive differences in the native range (diploids vs. tetraploids) and post-introduction evolution in the non-native range (native tetraploids vs. non-native tetraploids). To account for broad spatial-environmental variation within cytotypes and ranges, we germinated 23,928 seeds from 208 widely distributed populations. Tetraploids germinated better than diploids. Within tetraploids, invasive populations outperformed native populations in germination. However, these differences were not evident under simulated drought stress. Seedlings of invasive tetraploids had a higher biomass and developed the first true leaf earlier than those from the native range, while the native cytotypes did not differ in these early seedling traits. Our results suggest that a combination of pre-adaptation related to superior performance of polyploids (greater and faster germination) and post-introduction evolution towards higher performance in the invasive range (greater and faster germination, greater and faster accumulation of seedling biomass) may have contributed to the invasion success of tetraploid C. stoebe in North America.

This study aimed to determine the knowledge level of primary school teachers regarding their gender-based variations and the obstacles they face with using Assistive Technologies (ATs) for students suffering from dyslexia and dysgraphia in Abu Dhabi, UAE. For this purpose, a three-point Likert scale questionnaire was used to get teachers' responses. The study's main findings revealed that teachers have a high degree of knowledge about some of these technologies, such as highlighters, pen grips, voice recorders, and specific software applications. It also reveals significant gender differences in teachers' knowledge of some of these technologies, with male teachers being more familiar with voice-based tools and female teachers being more familiar with visual and tactile tools. The most significant challenge was the short class timings, followed by the teachers' lack of knowledge and training about the relevant ATs. This prevented primary school teachers from knowing ATs for students with dyslexia and dysgraphia. The findings contributed to the limited literature on gender knowledge levels and obstacles faced by teachers in using ATs for students with dyslexia and dysgraphia. Further, future directions for research are suggested.

Special education teachers' attitudes to teaching students with disabilities in the regular classroom were investigated alongside demographic characteristics. They had positive attitudes to inclusive teaching, with males, expatriates and Cycle. Two teachers being more positive. Attitudes towards inclusion were not, however, significantly correlated with age, place of residence, education, teaching experience or specialty. These findings offer the Ministry of Education important evidence on teacher attitudes to inclusive education, for the promotion of collaboration, respect and equality. Through inclusion, students with disabilities can form positive relationships with peers and grow to become fully participating members of the learning community.

Objectives The widespread use of proton pump inhibitors (PPIs) raised concerns on the safety of long-term use of these drugs. Community pharmacists have great responsibility of educating patients on these drugs which requires having adequate knowledge. The aim of this study was to assess the practices and knowledge of community pharmacists regarding PPIs.Design This was a cross-sectional study conducted by filling in a questionnaire. The questionnaire was developed after a comprehensive literature review and assessed knowledge and practices.Settings Community pharmacists with at least 1 year of experience working in a community pharmacy were enrolled in the study.Participants Community pharmacists with at least 1 year of experience working in a community pharmacy were enrolled in the study.Primary outcome measures The knowledge, attitudes, and practices of community pharmacists towards PPIs dispensing.Results A total of 459 community pharmacists were approached for participation in the study, 451 (98.3%) community pharmacists agreed to be enrolled. The most dispensed PPIs in Jordan were lansoprazole and the most commonly treated medical condition with PPIs was gastric ulcer. PPIs were dispensed by the pharmacists very frequently and one-fourth of the participants did not review instructions with patients to ensure their proper use of PPIs. Participants had an average knowledge of 6.1±1.7 (the highest knowledge score is 12). More than one-third of participants (180, 39.9%) had inadequate knowledge (a score of less than 6). Being a PharmD graduate was the only significant factor that predicted adequate knowledge in the logistic regression model, with an adjusted OR of 5.671, p=0.002.Conclusion To provide adequate pharmaceutical care services, community pharmacists must possess appropriate knowledge on different aspects of PPIs concerning administration, efficacy and long-term and short-term side effects.

AimTo explore the perceptions of Jordanian primipara and para 1 women regarding Cesarean section delivery and provide insights for clinical practice, policy development, and future research to optimize maternity care practices and outcomes in Jordan and similar contexts.BackgroundGlobal Cesarean section (CS) rates have risen steadily over recent decades. Jordan has witnessed a significant increase in CS rates. This trend has sparked interest in understanding the underlying factors behind this phenomenon and the perceptions surrounding CS delivery. Understanding these factors is essential for informing healthcare practices and promoting optimal maternal and neonatal health outcomes.MethodsForty-one primipara and para 1 women were interviewed within seven focus groups. The analysis was conducted using interpretative phenomenological analysis with the assistance of the NVivo 12 software program.ResultsThree main themes were identified: The Foundation of Women's Knowledge and Cognitive Structures; The Influential Parties in Shaping Women's Perceptions; and Transforming Perception into Action.DiscussionTo offer empathetic, comprehensive, and patient-centered care, healthcare professionals should discuss delivery options with pregnant mothers and factor in maternal preferences and perceptions. This study underscores the importance of supportive dialogue and informed decision-making in maternity care, advocating for a more individualized approach to childbirth.

Electrochemical migration is a critical factor contributing to failures in electronics due to humidity. When moisture accumulates on conductor-dielectric-conductor systems under bias voltage, electrochemical processes can be triggered, leading to the growth of metallic dendrites that may ultimately result in system failure. Despite its significance, many aspects of electrochemical migration remain unresolved, particularly regarding the physical characteristics of liquid buildup that facilitate dendrite growth and short circuit currents. While there are a few techniques that can measure water adsorption on the nanoscale, most conventional methods focus on water droplets within the size range of visible light wavelengths. In this study, we implemented a combined electrical-optical-ellipsometric measurement on FR-4 printed circuit boards featuring Sn surface finishes. Our experimental setup allowed for the measurement of water condensation across a wide range of thicknesses, while simultaneously monitoring the solder mask and metal electrodes during cooling. The ambient temperature of 25∘C and a relative humidity of 60% were constant during the measurement. By employing this approach, we elucidated the mechanisms of dendrite formation and short circuit currents, demonstrating that the water film remains continuous between droplets on the solder mask surface. Compared to Sn the nucleation was delayed on the solder mask with a larger surface coverage at smaller thicknesses. This comprehensive methodology provides crucial insights into the electrochemical migration process, enhancing our understanding of the underlying phenomena that contribute to electronic failures due to humidity. Our work highlighted the complementary nature of ellipsometry and optical imaging.