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Background:. Rectus abdominis flap coverage of high-risk perineal wounds following extirpative pelvic procedures can result in improved perineal outcomes. However, rectus abdominis flap harvest has morbidity associated with the donor site, including hernia or bulge development. The risk–benefit profile of mesh use in this scenario is not well-defined in the literature. Methods:. We performed a retrospective chart review of all patients who underwent rectus abdominis flap coverage of pelvic defects at our institution during July 2012–January 2021. Patient characteristics and postoperative outcomes were assessed. Patients were stratified into groups based on whether mesh was used and whether primary fascial closure was achieved. Donor site outcomes were analyzed between groups. Results:. One hundred consecutive patients were included. When considering all patients in whom primary fascial closure was achieved, the use of mesh did not significantly decrease rates of hernia development. Mesh use in this setting was associated with significantly greater rates of infection, requiring procedural intervention (12% versus 0%, P = 0.044). When considering all patients in whom mesh was used, primary fascial closure was associated with decreased rates of hernia development, and this trended toward significance (16.1% versus 0.0%, P = 0.058). Conclusions:. When closing a pedicled rectus abdominis flap donor site, if primary fascial closure is achievable, the addition of mesh to reinforce the repair does not have an added benefit. Mesh use in this setting was not shown to prevent hernia or bulge development, and was found to be associated with significantly greater rates of infection, requiring procedural intervention.

Background:. In nipple-sparing mastectomy, adequate perfusion to the nipple-areolar complex (NAC) during reconstruction is paramount to avoiding unwanted outcomes. Previous studies have suggested that periareolar incisions may result in higher rates of NAC complications. However, studies to date have not specifically investigated this in prepectoral reconstruction. The purpose of this study is to evaluate the impact of incision location on NAC complications in patients undergoing prepectoral breast reconstruction. Methods:. We performed a retrospective review of all patients who underwent immediate two-stage prepectoral breast reconstruction following nipple-sparing mastectomy between 2015 and 2018 at a single institution. We identified two types of incisions utilized: superior periareolar or inframammary fold (IMF). Patient demographics, comorbidities, and surgical details were compared between incision types, as were NAC complications. Results:. A total of 181 consecutive prepectoral breast reconstructions were included for analysis. A superior periareolar incision was used in 113 reconstructions (62%), and an IMF incision was used in 68 reconstructions (38%). There were 33 (18%) total NAC complications in our series. The periareolar incision group had a higher rate of any NAC complication (25% versus 7.4%; P < 0.01), as well as a higher rate of nipple necrosis requiring debridement (9.7% versus 1.5%; P = 0.03). Conclusions:. In patients undergoing immediate two-stage prepectoral breast reconstruction following nipple-sparing mastectomy, periareolar incisions are associated with an increased risk of NAC complications compared with IMF incisions. For patients who are candidates for either an IMF or periareolar incision, a periareolar incision should be avoided.

Summary: Perturbations in the transcriptional programs specifying epidermal differentiation cause diverse skin pathologies ranging from impaired barrier function to inflammatory skin disease. However, the global scope and organization of this complex cellular program remain undefined. Here we report single-cell RNA sequencing profiles of 92,889 human epidermal cells from 9 normal and 3 inflamed skin samples. Transcriptomics-derived keratinocyte subpopulations reflect classic epidermal strata but also sharply compartmentalize epithelial functions such as cell-cell communication, inflammation, and WNT pathway modulation. In keratinocytes, ∼12% of assessed transcript expression varies in coordinate patterns, revealing undescribed gene expression programs governing epidermal homeostasis. We also identify molecular fingerprints of inflammatory skin states, including S100 activation in the interfollicular epidermis of normal scalp, enrichment of a CD1C+CD301A+ myeloid dendritic cell population in psoriatic epidermis, and IL1βhiCCL3hiCD14+ monocyte-derived macrophages enriched in foreskin. This compendium of RNA profiles provides a critical step toward elucidating epidermal diseases of development, differentiation, and inflammation. : Cheng et al. report single-cell RNA sequencing of normal and inflamed human epidermis, revealing a discrete set of specialized keratinocytes that exhibit a distinct composition at different anatomic sites. Myeloid dendritic cells and macrophages also vary sharply with epidermal anatomic site and inflammation, indicating dynamic programming of antigen-presenting cells. Keywords: epidermis, single-cell RNA-seq, keratinocyte, skin

Summary: Investigation of human muscle regeneration requires robust methods to purify and transplant muscle stem and progenitor cells that collectively constitute the human satellite cell (HuSC) pool. Existing approaches have yet to make HuSCs widely accessible for researchers, and as a result human muscle stem cell research has advanced slowly. Here, we describe a robust and predictable HuSC purification process that is effective for each human skeletal muscle tested and the development of storage protocols and transplantation models in dystrophin-deficient and wild-type recipients. Enzymatic digestion, magnetic column depletion, and 6-marker flow-cytometric purification enable separation of 104 highly enriched HuSCs per gram of muscle. Cryostorage of HuSCs preserves viability, phenotype, and transplantation potential. Development of enhanced and species-specific transplantation protocols enabled serial HuSC xenotransplantation and recovery. These protocols and models provide an accessible system for basic and translational investigation and clinical development of HuSCs. : Garcia and colleagues report methods for efficient purification of satellite cells from human skeletal muscle. They use their approaches to demonstrate stem cell functions of endogenous satellite cells and to make human satellite cells accessible for sharing among researchers. Keywords: human satellite cell purification, serial transplantation, satellite cell cryopreservation

Background Advances in medicine and surgery have allowed patients, who in the past would have required more aggressive amputations, to maintain longer stump lengths. Microvascular free tissue transfer has become increasingly popular to preserve limb length and optimize functionality. We present our experience using microvascular free flap reconstruction to preserve lower extremity limb length in the setting of high-energy trauma. Methods We conducted an Institutional Review Board-approved retrospective review of patients at three San Francisco hospitals who underwent free flap reconstruction after high-energy trauma between 2003 and 2015. We included all patients who underwent free flap reconstruction for lower extremity limb length preservation. We reviewed patient demographics, preoperative variables, intraoperative details, and postoperative outcomes, including complications, functional status, reoperation rates, and need for revision amputation. Results Twelve patients underwent microvascular free tissue transfer for limb length preservation. Overall, the patients had similar preoperative comorbidities and a mean age of 44. Six patients had postoperative complications: three minor complications and three major complications. Seven patients had additional surgeries to improve the contour of the flap. One patient required revision amputation, while the remaining 11 patients preserved their original limb length. The majority of patients were fully ambulatory, and four used a prosthesis. Conclusion Microvascular free tissue transfer can be used to effectively maintain lower extremity stump length following trauma. Although these patients often require multiple surgeries and face lengthy hospital courses, this technique enables preservation of a functional extremity that would otherwise require a more proximal amputation.

Identification of human satellite cells that fulfill muscle stem cell criteria is an unmet need in regenerative medicine. This hurdle limits understanding how closely muscle stem cell properties are conserved among mice and humans and hampers translational efforts in muscle regeneration. Here, we report that PAX7 satellite cells exist at a consistent frequency of 2–4 cells/mm of fiber in muscles of the human trunk, limbs, and head. Xenotransplantation into mice of 50–70 fiber-associated, or 1,000–5,000 FACS-enriched CD56+/CD29+ human satellite cells led to stable engraftment and formation of human-derived myofibers. Human cells with characteristic PAX7, CD56, and CD29 expression patterns populated the satellite cell niche beneath the basal lamina on the periphery of regenerated fibers. After additional injury, transplanted satellite cells robustly regenerated to form hundreds of human-derived fibers. Together, these findings conclusively delineate a source of bona-fide endogenous human muscle stem cells that will aid development of clinical applications.

Introduction: One of the biggest challenges to public health is increasing knowledge of the early warning signs (EWS) of bipolar disorder recurrence. The recurrence incidence is still high despite multiple attempts to improve the awareness level. The awareness level is still ambiguous and insufficient., Objective: The purpose of this study was to assess the degree of awareness of EWS of bipolar disorder recurrence among patients and their main caregivers in Jordan., Methods: A descriptive cross-sectional design was used to recruit 275 patients and their main caregivers to fill out the adapted version of the Awareness of the EWS of Relapse Questionnaire., Results: The analysis showed that patients and their main caregivers' awareness of the EWS of bipolar disorder recurrence was low and inadequate (patients, mean = 2.61 (SD = 2.6); main caregivers, mean = 3.84 (SD = 2.2); scores range from 0 to 10)., Conclusion: According to the study, the awareness level of these signs is still vague and inadequate. This means that ensuring long-term positive results for patients and their main caregivers requires a high degree of awareness regarding the warning signs and symptoms of bipolar disorder recurrence. To engage in standard practice, EWS of bipolar disorder recurrence awareness necessitate adequate resources, support, and an empowered and well-communicated multidisciplinary team., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Pressure Injuries are a prevalent and concerning issue in critical care settings, impacting patient well-being and healthcare systems., Purpose: Measure the point prevalence of acquired pressure injuries in Omani critical care units and assess the adequacy of preventive measures., Methods: A multicenter cross-sectional survey was conducted in four major Omani hospitals, encompassing various geographical regions and health sectors. A convenient sample of 156 adult patients in critical care units was examined using the European Pressure Ulcer Advisory Panel methodology. Data on prevalence, risk assessment, and prevention measures were collected and analyzed., Results: The study revealed a prevalence rate of 21.8 % for hospital-acquired pressure injuries (including stage I) and 19.2 % (excluding stage I) in Omani critical care units. The sacrum was the most affected area, with stage II being predominant. Alarmingly, some at-risk patients did not receive appropriate preventive equipment, while low-risk patients received unnecessary measures. Approximately 73.3 % of at-risk patients received adequate prevention., Conclusion: This pioneering study in Oman addresses the prevalence of Pressure Injuries, revealing rates that are higher than international norms. Additionally, the research underscores deficiencies in preventive measures, such as inadequate prevention for at-risk patients and unnecessary measures for low-risk individuals., Competing Interests: Declaration of interest We submit our manuscript, "Hospital Acquired Pressure Injuries Prevalence and Preventive Measures in Omani Critical Care Units: A Multicenter Cross-Sectional Study," for your consideration. No conflicts of interest exist, and the manuscript is not under review elsewhere., (Copyright © 2024 Tissue Viability Society / Society of Tissue Viability. Published by Elsevier Ltd. All rights reserved.)

Introduction: Post-neurosurgery patients often experience pain and anxiety. Handheld finger-grip relaxation helps the body, mind, and spirit to achieve relaxation., Objective: This study investigated the effect of a handheld finger-grip relaxation technique on pain and anxiety in post-neurosurgery patients., Method: A quasi-experimental study of 160 patients was randomly assigned to either the intervention group (received the handheld finger-grip relaxation technique) or the control group (received standard care). The intervention group received the handheld finger-grip relaxation technique for 15 min twice daily for 3 days. The control group received standard care. Pain and anxiety were assessed using a visual analog scale and a Spielberger State-Trait Anxiety Inventory, respectively., Results: The results showed that the intervention group had a highly statistically significant difference between pre and post-phase ( p  < .0000) regarding the severity of pain and anxiety level. Meanwhile, there was a statistically significant difference ( p  < .05) between pre and post-phase among the control group., Conclusion: It is suggested that the handheld finger-grip relaxation technique may be an effective intervention for reducing pain and anxiety in post-neurosurgery patients., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Spiritual Care is integral to holistic nursing; however, it often remains underprovided due to a lack of education., Objective: This study examined perceptions of spirituality and predictors of competence in spiritual care among nursing students in Middle Eastern countries., Design: A cross-sectional survey was used., Participant/setting: Nursing students (n = 785) from five universities in Middle Eastern countries were included., Methods: Participants completed the Spiritual Care-Giving Scale-Arabic and Spiritual Care Competency Scale. Multiple linear regression analysis was used to identify the predictors of perceived competence in spiritual care., Results: Nursing students showed positive attitudes towards spirituality, with a mean score of 5.1 (SD = 0.60) on the Spiritual Care-Giving Scale-Arabic. However, their perceived competence in providing spiritual care was low to moderate with a mean score of 79.0 (SD = 32.0) on the Spiritual Care Competency Scale. The bivariate analysis indicated significant relationships between students' spiritual care competence and gender, previous exposure to spirituality education, willingness to undergo spirituality training, and total spirituality score. Finally, significant predictors of higher competence included regular admission status, prior spiritual education, willingness to undergo spiritual care training, and higher personal spirituality scores., Conclusion: Nursing students in the Middle East have positive attitudes towards spirituality, but low to moderate competence in providing spiritual care. The influence of personal spirituality on competence underscores the importance of fostering a supportive environment for students to reflect on their beliefs. Comprehensive curriculum revisions and training programs, along with the recognition of the impact of personal spirituality, are essential to prepare future nurses for holistic people's care., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Providing care for people with dementia incorporates a level of burden which can affect quality of life for both the caregiver and the recipient of care. This study measures the level of burden experienced by Jordanian caregivers for people with dementia and explore related predictors., Methods: Through a cross-sectional survey, participants were invited through convenience sampling to participate in a structured interview., Results: A total of 406 participants completed the survey. According to Zarit Burden Interview, the mean burden score of the sample was 26.2 (SD = 16.2). This score falls under the mild to moderate burden level. Older age of the patient, severe dementia, lower number of caregivers, if the caregiving negatively affected family relations, and if the caregiving negatively affected jobs, were significant predictors of burden., Conclusion: Caregivers in the current study reported no burden to a minimum burden. This result does not mean that these caregivers have no or minimal stress or that they do not have psychological needs; on the contrary, these results call for more attention to providing extra psychological and emotional support to caregivers of patients with dementia in order to decrease the burden level and maintain their efforts in caregiving. Future studies are required to discern the shape and context of unmet caregiver needs, assessment, and support., (© 2024 Japanese Psychogeriatric Society.)

Background: Determining the clinical neurological state of the patient is essential for making decisions and forecasting results. The Glasgow Coma Scale and the Full Outline of Unresponsiveness (FOUR) Scale are commonly used tools for measuring behavioral consciousness. This study aims to compare scales among patients with neurological disorders in intensive care units (ICUs) in the West Bank., Methods: A prospective cross-sectional design was employed. All patients admitted to ICUs who met inclusion criteria were involved in this study. Data were collected from from An-Najah National University, Al-Watani, and Rafedia Hospital. Both tools were used to collect data., Results: A total of 84 patients were assessed, 69.0% of the patients were male, and the average length of stay was 6.4 days. The mean score on the Glasgow Coma scale was 11.2 on admission 11.6 after 48 hours, and 12.2 on discharge. The mean FOUR Scale score was 12.2 on admission, 12.4 after 48 hours, and 12.5 at discharge., Conclusions: This study indicates that both the Glasgow Coma Scale and the FOUR scale are effective in predicting outcomes for neurologically deteriorated critically ill patients. However, the FOUR scale proved to be more reliable when assessing outcomes in ICU patients.

Introduction: Hypertension is a serious public health issue. It is a significant but controllable factor in the emergence of cardiovascular disease. Controlling hypertension is a main target for individuals to prevent further illness., Objective: This study aims to explore the level of self-care behaviors, motivation, and self-efficacy among individuals with hypertension., Methods: A cross-sectional, descriptive, correlational design was used to recruit ( n  = 121) participants utilizing the Hypertension Self-Care Profile (HTN-SCP) questionnaire., Results: The analysis revealed that the mean score of self-care behavior was 49.7 ( SD  = 10.0) out of 20-80, which indicates that they are likely to have good self-care behavior. The mean score of motivation for self-care was 59.7 ( SD  = 11.8) out of 20-80, reflecting that individuals with hypertension have a good level of motivation for self-care, and the mean score of self-efficacy was 70.0 ( SD  = 9.8) out of 20-80, which means that individuals with hypertension have a high level of self-efficacy. Also, there was a significant positive correlation between self-care behavior and motivation for self-care ( r  = .527, p  < .001), between motivation for self-care and self-efficacy ( r  = .554, p  < .001), and between self-efficacy and self-care behavior ( r  = .572, p  < .001)., Conclusion: The study revealed that Jordanian patients with hypertension have good self-care practices, motivation, and high self-efficacy. Patients should therefore be strongly recommended to be compliant with self-care practices. The government should prioritize hypertensive patients by making it easier for them to receive information about self-management practices to improve their quality of care., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Pain is the most common symptom experienced by both cancer and non-cancer patients. A wide variety of barriers may hinder the optimal treatment of cancer and noncancer pain that are related to the health care system, health care providers, and patients., Purpose: To explore the barriers to pain management as perceived by patients with cancer and noncancer chronic diseases., Method: A descriptive, cross-sectional correlational design was employed to recruit a sample of 200 patients (n = 100 patients with cancer, n= 100 patients with noncancer) from two hospitals in Jordan. Patients filled out an Arabic version of Barriers Questionnaire II (ABQ-II)., Results: Harmful effects of medications were the greatest barrier to effective pain management, while fatalism had the lowest mean scores. Age was negatively correlated with physiological effects (r = -0.287, p < .01), communication (r = -0.263, p < .01), harmful effects (r = -0.284, p < .01), and the overall barrier score (r = -0.326, p < .01) among noncancer patients with chronic disease and (p > .05) for patients with cancer. Patients with cancer had higher mean scores (M = 2.12, SD = 0.78) in the fatalism subscale than those with noncancer chronic disease (M = 1.91, SD = 0.68), while patients with noncancer chronic disease had significantly higher mean scores (M = 2.78, SD = 0.78) in the communication subscale than patients with cancer (M = 2.49, SD = 0.65), (t = -2.899, p = .005)., Conclusion: To improve the quality of care for patients who are in pain, it is recommended to address pain management barriers as they arise., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Introduction: The training of nursing staff to deliver extracorporeal membrane oxygenation in Lebanon has recently attracted attention. It is important to comprehend the background of nurses who take on this new duty., Objectives: The main objectives of this study were to (1) explore the experiences of intensive care unit nursing staff who work with extracorporeal membrane oxygenation, (2) identify the psychological and physiological challenges experienced by intensive care unit nurses while managing patients with extracorporeal membrane oxygenation, and (3) determine the roles assumed by intensive care unit nurses while managing patients utilizing extracorporeal membrane oxygenation., Methods: A qualitative phenomenological design utilizing semistructured interviews utilizing a purposive sampling of 15 intensive care unit nurses using extracorporeal membrane oxygenation devices. Interviews were audio recorded, verbatim transcribed, and thematically analyzed., Results: Three themes emerged, namely (1) nurses' role in extracorporeal membrane oxygenation, (2) skills and training, and (3) challenges faced by extracorporeal membrane oxygenation nurses., Conclusion: This study demonstrates that nurses play a crucial role in providing extracorporeal membrane oxygenation patient care, placing them under significant occupational stress due to the intensive care unit's routine workload and the demands of extracorporeal membrane oxygenation. Additionally, role confusion brought on by a lack of professional practice norms and emotional exhaustion made occupational pressure worse., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Healthcare is one of the sectors where artificial intelligence (AI) is currently viewed as a crucial driving factor. Patient care, medical research, and clinical trial enrollment could all significantly improve due to AI's incorporation into electronic health records (EHRs). This short communication highlights how AI may improve the recruitment process regarding speed, accuracy, and overall cancer clinical trial efficiency. AI can automate this procedure by utilizing machine learning (ML) algorithms, identifying potential trial participants quickly and precisely. Many challenges could be addressed due to this integration, including data privacy and security that can be resolved through cutting-edge encryption techniques and differential privacy algorithms that ensure data anonymization. Another significant obstacle is the lack of common EHR formats and interoperability that can be addressed by creating a standardized structured layout. Automating and improving recruitment processes with AI may speed up research, increase the effectiveness of clinical trials, and open the door to more specialized cancer treatments., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Background: Post-laparoscopic shoulder pain is very common after laparoscopy. One method to reduce postoperative shoulder pain is the pulmonary recruitment maneuver. It is used to reduce post-laparoscopic shoulder pain. This study utilizes a truly experimental, double-blinded, prospective randomized design to assess the effect of pulmonary recruitment maneuvers on post-laparoscopic shoulder pain after laparoscopic cholecystectomy., Methods: Sixty patients were allocated randomly into two groups. The intervention group received five manual pulmonary inflations for 5 s at a maximum pressure of 25 cm H 2 O. The control group included patients whose residual CO 2 gas was evacuated from the abdominal cavity using passive exsufflation as the routine method at the end of surgery by abdominal massage. Gentle abdominal pressure was applied to facilitate CO 2 gas removal., Results: When Ramsay's Sedation Score's results were compared between the two groups after the operation, there was no statistically significant difference between the two groups during the first and (p value = 0.20) second (p value = 0.61) hours. A repeated measures ANOVA revealed that the pulmonary recruitment maneuver is significant (p-value 0.001) and had a high effect size (0.527) in reducing shoulder pain among laparoscopic cholecystectomy patients after controlling the effect of other covariate patient characteristics., Conclusion: Utilizing a pulmonary recruitment maneuver at the end of laparoscopic surgery reduces shoulder pain., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Nurses' job satisfaction is a crucial component of a safe and efficient healthcare environment., Aim: To understand the level of job satisfaction among migrant nurses working in intensive and critical care in Saudi Arabia., Method: This study used a quantitative descriptive design. A total of 421 migrant nurses working in intensive and critical care units in two teaching hospitals in Saudi Arabia completed a questionnaire based on the McCloskey/Mueller Satisfaction Scale., Findings: Participating migrant nurses had moderate levels of job satisfaction overall, except for salary, holiday allowance and maternity leave, which attracted low satisfaction scores, and nursing peers, which attracted a high satisfaction score. There were no statistically significant differences in job satisfaction scores according to demographic variables except marital status, with a significantly higher job satisfaction among married respondents., Conclusion: Promoting job satisfaction among nurses could improve the efficiency and quality of nursing care. There is a range of strategies that can be used to enhance nurses' job satisfaction, including improving working conditions and promoting career development., Competing Interests: None declared, (©2023 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Background: This study aims to assess healthy lifestyle behaviors among undergraduate students and determine the association between electronic health literacy with lifestyle behavior among undergraduate Jordanian university students., Methods: A descriptive cross-sectional design was used. The study recruited 404 participants utilizing undergraduate students from public and private universities. The e-Health literacy scale was used to assess the level of health information literacy among university students., Results: Data were collected from 404 participants who reported very good health status, the majority of the participants were female 57.2% with an average age of 19.3 years. The results showed that participants had good health behavior in terms of exercise, taking breakfast, smoking status, and sleeping status. The results have shown an inadequate level of e-Health literacy 16.61 (SD = 4.10) out of 40. The vast majority of students, in terms of their attitudes toward the Internet, thought that Internet health information was very useful/useful (95.8%). Also, they thought that online health information was very important /important (97.3%). The results showed that students who were attending public universities had higher e-Health literacy scores rather than those who were attending private universities, t (402) = 1.81, p  = .014. The mean e-Health literacy score for nonmedical students was higher than those for medical students ( p  = .022)., Conclusion: The study's findings provide important insights into the health behaviors and electronic health literacy of undergraduate students in Jordanian universities, and offer valuable guidance for future health education programs and policies aimed at promoting healthy lifestyles in this population., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: Diabetes is an endocrine chronic condition with a high prevalence rate among the population that needs a complex management process. However, many advanced health care technologies were evolving to help patients achieve their centered care and self-management using real-time proactive techniques through interactive systems to detect early complications and prevent them. The purpose of the current review is to assess the findings of literature reviews of the main interventions that used a real-time partially automated interactive systems to interpret patient's data including biological information, exercise, and dietary content calculated from a message sent by the patient and respond with actionable findings, helping patients to achieve diabetes self-management., Methods: PubMed\ MEDLINE, CINAHL, Google Scholar, and Research Gate were used to search the literature for studies published between the periods 2015 to 2021., Results: Eleven articles were included in the literature review. The retrieved studies approved the significant effect of achieving diabetic self-management by utilizing Information Technology (IT) with the Natural Language Processing (NLP) methods by sending a real-time, partially automated interactive system to interpret patient's biological information, physical activity, and dietary content calculated using a message sent by patients to achieve their self-management., Conclusion: Improved blood glucose levels, glycemic control, better readings of blood pressure, and lifestyle improvement including dietary intake and physical activity were offered using continuous real-time messages to improve their health outcomes., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aim: The study aimed to assess the level of practice of nursing leadership characteristics during the implementation of electronic health records as perceived by nurses., Method: A cross-sectional survey design was used in this study. The study recruited 213 nurses from five hospitals which had recently implemented electronic health solution. Data was collocated using self-administrated questionnaire composed of three sub-domains. The study was granted from the Ethics Committees of the investigators universities and the Jordanian Ministry of Health. Descriptive and correctional statistics were used for data analysis., Results: Data were collected from 213 nurses, the majority of participants (72.3%) were female. Of them, 45% reported receiving full support from their leaders in using electronic health records. Classroom-based training was the most frequently used teaching method during the implementation of electronic health records (59.6%)., Conclusion: The study demonstrated that diverse leadership styles were practiced during the implementation process of the electronic health records: setting directions, developing people, and redesigning their organizations. The most commonly practiced item was clarifying the reasons for using electronic health records. Such information could enhance the effective adoption of electronic health records by nurses.

Purpose: The aim of the current study was to determine the incidence, clinical characteristics, and risk factors associated with the recurrence of first unprovoked seizure in children., Methods: A retrospective, observational study was conducted at King Abdullah University Hospital in Jordan. Children aged from 1 month to 16 years old who attended the hospital between January 2013 to December 2017 were evaluated on the basis of medical records, from the first visit and for a 1-year follow-up period., Results: During the study period, a total of 290 cases with first unprovoked seizure were included. The incidence of first unprovoked seizure was 441 cases per 100 000 patient visits to the pediatric clinic. More than half of the cases developed a second attack (55.3%). Children with parental consanguinity were almost 3 times more likely to develop a second attack of seizure compared to those without parental consanguinity (odds ratio [OR] = 2.785, 95% confidence interval [CI] = 1.216-6.378, P = .015) and patients who had a history of focal type of seizure were almost twice as likely to develop seizure recurrence (OR = 1.798, 95% CI = 1.013-3.193, P = .045)., Conclusions: The current results showed a high incidence of first unprovoked seizure among children in Jordan. Parental consanguinity and focal seizure were associated with the increased risk of recurrent attack. This finding highlights the need for public education regarding the outcomes of parental consanguinity to improve the patient's quality of life.

Since its introduction in 1960, The Wada test has been considered the gold standard for language lateralization prior to ablative brain surgery. Due to the invasive nature of The Wada test several non-invasive techniques have been alternatively adopted. Recently, it has been suggested that the tongue deviates toward the language dominant cerebral hemisphere on full protraction. This suggestion is based on the important role the tongue plays in articulation and on the close anatomical relationship between the cortical tongue motor area and the motor speech area. It was proposed that this phenomenon could serve as a reliable and simple method for language brain lateralization. However, this hypothesis is still open for verification. In an attempt to correlate tongue deviation and language cerebral dominance we present and discuss in this paper the results of a study conducted on 339 free adult Jordanian volunteers. Tongue deviation and handedness were determined and statistically correlated. Our results showed that 62% of test subjects did not show any tongue deviation on full protrusion. Additionally, 9% of test subjects showed left-sided tongue deviation on full protraction in spite of 90% right handedness with presumed left language dominant cerebral hemisphere. We conclude that, at least in Jordanians, tongue deviation cannot be considered as a reliable indicator for language lateralization., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objective: To investigate the role of water-soluble extract of Salvia fruticosa (Greek sage) (S. fruticosa) leaves in reducing both intrinsic cellular and H2O2-induced DNA oxidation in cultured human embryonic kidney 293 cells. S. fruticosa, native to the Eastern-Mediterranean basin, is widely used as a medicinal herb for treatment of various diseases., Methods: Dried leaves of S. fruticosa were extracted in phosphate buffer saline and purified using both vacuum and high pressure filtrations. Each mL of the preparation contained (7.1±1.0) mg of extract. HEK-293 cells were incubated in one set with S. fruticosa extract in the presence of 0.1 mmol/L H2O2, and in the other set with the addition of the extract alone. The DNA oxidation was measured using fluorescence upon fluorescein isothiocyanate derivatization of 8-oxoguanine moieties. The fluorescence was measured using flow cytometry technique., Results: Cells incubated 3 h with 150 µL extract and exposed to 0.1 mmol/L H2O2 showed lower intensity of fluorescence, and thus lower DNA oxidation. Moreover, cells incubated 3 h with 100 µL of the extract showed lower intensity of fluorescence, and thus lower intrinsic cellular DNA oxidation compared to control (without S. fruticosa)., Conclusions: The results from this study suggest that the water-soluble extract of S. fruticosa leaves protects against both H2O2-induced and intrinsic cellular DNA oxidation in human embryonic kidney 293 cells.