Objectives The aim of this research is to examine the developmental stages of acquiring stress in the speech of Ammani Arabic-speaking children (henceforth AASC). Methods Elicited and spontaneous speech productions of 48 typically developing children were transcribed and coded with the primary stress. Words were also analyzed according to their metrical shapes. The children were divided into four age groups: (1; 0–1; 6), (1; 7–2; 0), (2; 1–2; 6), and (2; 7–3; 0). Data were collected through spontaneous speech samples and picture-naming tasks. Results Acquisition of stress goes through the four developmental stages until they become adult-like at the age of 3. Children misplace stress in the first two age stages, using an iambic foot in forms having a trochic shape. Thus, they place stress on a syllable with a geminate irrespective of the weight of other syllables. The stress shift stopped when children reached 30 months. Results support the neutral-start hypothesis which shows that children have no bias for any stress type; instead they use both trochaic and iambic feet at the outset of speaking. Conclusion It was shown that adult weak forms are more likely to be omitted in children's production, and stressed and final ones are often preserved. This conforms with the widely accepted Perceptual Salience.
This paper develops a cooperative federated reinforcement learning (RL) strategy that enables two unmanned aerial vehicles (UAVs) to cooperate in learning and predicting the movements of an intelligent deceptive target in a given search area. The proposed strategy allows the UAVs to autonomously cooperate, through information exchange of the gained experience to maximize the target detection performance and accelerate the learning speed while maintaining privacy. Specifically, we consider a monitoring model that includes a search area, a charging station, two cooperative UAVs, an intelligent deceptive uncertain moving target, and a fake (false) target. Each UAV is equipped with a limited-capacity rechargeable battery and a communication unit for exchanging the gained experience. The problem of maximizing the detection probability of the uncertain deceptive target using cooperative UAVs is mathematically modeled as a search-benefit maximization problem, which is then reformulated as a Markov decision process (MDP) due to the uncertainty nature of the problem. Because there is no prior information on the targets’ movement, a cooperative RL, is utilized to tackle the problem. The proposed cooperative RL-based algorithm is a distributed collaborative mechanism that enables the two UAVs, i.e., agents, to individually interact with the operating environment and maximize their cumulative rewards by converging to a shared policy while achieving privacy. Simulation results indicate that a cooperative RL-based dual UAV system can noticeably improve the target detection probability, reduce the detection performance, and accelerate the learning speed.
Objectives: Acute kidney injury (AKI) is a severe complication that is associated with significant morbidity and mortality in hospitalized cirrhotic patients. Data about AKI incidence and outcomes in patients with cirrhosis is scarce in the Middle East region. This study explored the incidence and impact of AKI on clinical and economic outcomes in cirrhosis. Methods: This was a retrospective cohort study of cirrhosis patients admitted to an educational hospital in Jordan during the years 2012-2022. Demographics, clinical and biochemical information, and charges were retrieved from medical electronic records. Logistic regression models were conducted to evaluate predictors of AKI and mortality in cirrhosis adjusting for covariates. Hospital charges were also described. Results: A total of 380 cirrhosis patients were included with an AKI incidence of 27.9%. Male sex, elevated baseline serum creatinine, presence of spontaneous bacterial peritonitis, and higher comorbidity score were independently associated with AKI development (P < 0.05). The hospital mortality rate was markedly higher for patients with AKI versus those without AKI (51.9% vs. 6.2%, respectively; P < 0.001). AKI was associated independently with higher odds of hospital death (OR = 5.83, P < 0.001), prolongation of the median hospital stays by 5 days (P < 0.001), more clinical complications, and increased total hospital charges per admission by $2500. Conclusion: AKI is prevalent in cirrhosis patients, and it is associated with increased mortality, hospitalization, and cost. This burden in cirrhosis emphasizes the need for early identification of patients at high risk of AKI and applying prompt and effective management approaches, aiming at improving outcomes.
Aim: The aim of the study was to explore the perceived self-reported competence of nurses who worked in Kuwaiti hospitals and the predictors influencing the level of competence. Background: Competence in nursing is found to affect patient safety and the quality of care provided to patients. The vast majority of nurses working in the health system are non-Kuwaitis. Thus, it is of the utmost importance to assess nurses' competences as the first step toward ensuring the best quality of care. Methods: A cross-sectional, descriptive, correlational design was used. A non-random convenience sample of 220 practicing expatriate nurses working in public hospitals completed the NPC-35 scale and a demographic form. Data collection was done over a period of three weeks from January 26th, 2020 to February 16th, 2020. Results: The findings of the study showed that nurses perceived their competence as good. The results also showed that years of experience, enrollment in a traditional program of study, exposure to training programs, working in accredited hospitals and nationality explained 56% of the variation in the level of Nursing Professional Competence (NPC). Conclusion: The results indicate that nurse leaders and policy makers need to improve nursing orientation and training programs so that they are competence based. The results of the study also point to the importance of revisiting the nursing recruitment policy and managing expatriate nurses while making better investment in educating and producing Kuwaiti national nurses.
Background Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods. Methods A multi-country online survey collected data from caregivers of children in 2020–21 about children’s use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors). Results A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother’s education and area of residence ( P < 0.05). In addition, children from low income countries had significantly lower odds of using mouthwashes and dental floss than those from high income countries (AOR = 0.55, 95% CI 0.31, 0.98 and AOR = 0.34, 95% CI 0.12, 0.97) whereas children from the European region had higher odds of using mouthwash (AOR = 2.82, 95% CI 1.27, 6.26) and those from the region of the Americas had higher odds of using dental floss (AOR = 3.84, 95% CI 1.28, 11.52) than those from the Eastern Mediterranean region. Conclusions The use of various oral hygiene methods is associated with individual, familial and country-level factors. Oral health promotion programs should be developed taking into account these influences.
The prevalence of needy-students who cannot afford their university fees has become a phenomenon in countries like Jordan. Thus, supporting such students by establishing a reliable cloud-based platform for collecting donations from wealthy people is a very noble action. Such donations will enable needy-students to continue their education to up their development, reduce their poverty, improve their health, scale-up their gender equality, promote peace across their communities, enhance stability in their societies, and enrich the field of cloud-based services development. This paper proposes a new cloud-based platform that aims at connecting donors with needy-students in a very discrete way that preserves and honors the privacy and confidentiality of their information. We claim that our proposed cloud-based platform depicts a unique novelty that can be easily anticipated from the perspectives of its status as a cloud-based donations and financial support services platform; its ability to interconnect its users privately and confidentially; and its ability to easily verify the credentials of its users and confirm their eligibility to receive financial support.
Computed tomography (CT) scan contributes to about 10% of the total medical radiographic examinations conducted worldwide. Noticeably, various studies have raised concern regarding the high radiation dose exposure of patients during this technique of imaging. The study assesses the dose of radiation to which patients undergoing different CT examinations in Jordanian hospitals are exposed and measures the national diagnostic reference levels (DRLs). This retrospective observational study of all CT examinations performed in almost 300 plus CT examination centers in Jordan. A random sample of the top 28 hospitals in Jordan was taken for the study, which was conducted between May 2019 and December 2020. We quantified the national DRL by calculating the 75th percentile and the percentage difference of volume CT dose index (CTDIv) and dose length product (DLP) for both pediatric and adult populations and different CT examinations, including brain, sinus, chest, abdomen & pelvis, knee, neck, lumbar‐spine, cervical‐spine, and shoulder. A total of 242 pediatric patients and 304 adult patients underwent various CT examinations during the study period. The national DRLs (the 75th percentiles of CTDIv and DLP) for the pediatric population were highest for the brain (81 mGy and 1425 mGy.cm, respectively) and lowest for the shoulder (7 mGy and 181 mGy.cm, respectively). Similarly, the 75th percentiles of CTDIv for the adults were highest for the brain examination (68 mGy) and lowest for the shoulder (8 mGy). The national DRLs for CT scans conducted in Jordan hospitals were found to be higher than those quantified in other countries, with larger CTDIv and DLP variations.
Background Gabapentinoids are often administered preoperatively, as they have been shown to reduce postoperative opioid consumption and pain scores however sedation has always been a concern because of sedative side effect. Objective This study was intended to compare oral gabapentin versus oral pregabalin sedative effects and complications in patients undergoing lumbar spine surgery under general anaesthesia. Methods This study was a true experimental randomised, placebo-controlled, prospective study, conducted at Rafedia Government Surgical Hospital in Nablus, Palestine. The sample consisted of 60 male and female patients undergoing elective lumbar spine surgeries in the department of neurology and aged from 18 to 70 years. The patients were divided into three groups (20 patients each): The pregabalin 150mg group, the gabapentin group and the placebo group. Findings Nearly 51.7% of the participants reported that they experienced a feeling of nausea or vomiting after the operation. There were statistically significant differences (p-value = 0.008) between the groups in how often complications happen after surgery. Conclusions Preemptive pregabalin (150mg) was established to have a more sedative effect and lowered complications than gabapentin (300mg).
Unmanned aerial vehicles (UAVs) play an important role in the future of 5G and 6G communication networks. UAV-assisted communication offers the benefits of improved network capacity and coverage. A typical communication setup is for UAVs to connect users to the core network via a backhaul channel. Some of the challenges in such a setup include user-UAV association and management of the backhaul channel. These two challenges are greatly impacted by the positioning of the UAVs in the network. In this article, we address these challenges by considering a joint UAV placement and user association problem under data rate, signal to interference and noise ratio, and bandwidth constraints. To overcome this problem, a hybrid PSO-K-means clustering algorithm is used in two stages. In the first stage, we use a K-means algorithm to cluster users and determine their horizontal locations. In the second stage, we use particle swarm optimization (PSO) to find the efficient 3D position of UAVs to maximize various network designs, namely, the network-centric approach and the user-centric approach. The performance of the proposed solution is verified using simulation results.
Acinetobacter baumannii is one of the most successful pathogens that can cause difficult-to-treat nosocomial infections. Outbreaks and infections caused by multi-drug resistant A. baumannii are prevalent worldwide, with only a few antibiotics are currently available for treatments. Plasmids represent an ideal vehicle for acquiring and transferring resistance genes in A. baumannii. Five extensively drug-resistant A. baumannii clinical isolates from three major Jordanian hospitals were fully sequenced. Whole-Genome Sequences (WGS) were used to study the antimicrobial resistance and virulence genes, sequence types, and phylogenetic relationship of the isolates. Plasmids were characterized In-silico, followed by conjugation, and plasmid curing experiments. Eight plasmids were recovered; resistance plasmids carrying either aminoglycosides or sulfonamide genes were detected. Chromosomal resistance genes included bla OXA-66 , bla OXA-91 , and bla OXA-23, and the detected virulence factors were involved in biofilm formation, adhesion, and many other mechanisms. Conjugation and plasmid curing experiments resulted in the transfer or loss of several resistance phenotypes. Plasmid profiling along with phylogenetic analyses revealed high similarities between two A. baumannii isolates recovered from two different intensive care units (ICU). The high similarities between the isolates of the study, especially the two ICU isolates, suggest that there is a common A. baumannii strain prevailing in different ICU wards in Jordanian hospitals. Three resistance genes were plasmid-borne, and the transfer of the resistance phenotype emphasizes the role and importance of conjugative plasmids in spreading resistance among A. baumannii clinical strains.
Curcumin (diferuloylmethane) is a natural polyphenolic compound that targets multiple signaling molecules and helps in supporting health benefits as it aids in the management of oxidative and inflammatory conditions. However, curcumin by itself has poor absorption, rapid metabolism, and fast elimination, which makes its bioavailability very low. Therefore, curcumin is more active when combined with piperine to provide major health benefits. Several studies indicated that curcumin has powerful effects on post-surgical outcomes such as in ischemia-related surgeries, it improves postoperative pain and fatigue following laparoscopic cholecystectomy. Also, it is effective against traumatic brain injury outcomes through several molecular signaling pathways that include oxidative stress, inflammation, apoptosis, and autophagy. Finally, it has topical applications that improve granulation tissue formation, deposition of collagen, wound contraction, and remodeling of the tissue. In conclusion, curcumin has been shown to have strong antioxidant and anti-inflammatory effects that could result in improved post-surgical outcomes.
Aim: Bladder cancer is the second most common urological malignancy after prostate cancer. Increase in the post-void residual (PVR) volume may result in an increase in the risk of cancer recurrence. Methods: Patient demographic data, tumor stage and grade, PVR volume and 2 years follow-up data for recurrence were obtained and evaluated. Results: One-hundred-and-nineteen patients were subdivided into three groups according to PVR urine volume. The increase of PVR volume was related to short recurrence-free survival (RFS) especially for patients with PVR volume of 60 ml or more. Conclusion: Low PVR volume in patients with non-muscle invasive bladder cancer may play a role in reducing cancer recurrence. However further research is needed in this field.
Background Poor medication adherence is a concern among patients with hypertension. However, few studies have assessed the effect of health literacy on medication adherence among refugee patients. Aim The aim was to examine the effect of health literacy and associated factors in explaining medication adherence among Syrian refugee patients with hypertension. Methods A cross‐sectional study was used, recruiting 150 Syrian refugees with hypertension in February 2020. The Hill‐Bone scale and the Health Literacy Questionnaire were used to collect data, which were analysed using descriptive and inferential statistics. Results Participants had low levels of medication adherence and had low mean scores in eight of nine subscales of the health literacy scale, except in the appraisal of health information subscale. Factors including patient's age, marital status, the number of medications and co‐morbid diseases were significantly associated with medication adherence. Age, understanding written health information and ability to engage with healthcare providers were predictive of medication adherence. Conclusion To increase medication adherence among refugee patients with hypertension, nurses need to improve patients' health literacy and understanding of health information about their disease.
Classification of hand gestures from multichannel surface electromyography (sEMG) has been widely explored for the control of robotic prostheses. Several deep-learning algorithms have been utilized for this task with diverse levels of performance. A special type of genetic algorithm, Neuroevolution of Augmenting Topologies (NEAT), has favorable properties to be exploited for this task, especially the minimalistic initial structure and optimizing the topology along and weights of the evolved network. In this paper, we proposed a novel NEAT-based model that coherently evolves neural networks with Gated Recurrent Units and employed it for sEMG-based hand gesture classification. The algorithm was assessed in classifying 9 gestures from eight subjects (NinaPro Database 2) using eight independently trained networks using 150 ms non-overlapping decision windows. The trained networks yielded a mean classification accuracy of 88.76% (3.85%). Separate classification of gesture transition yielded an overall accuracy of 84% and transition class recall of 93.3%. The proposed algorithm was shown to utilize a small data set to evolve a classifier capable of expanding the number of independent control signals for real-time myoelectric control of powered upper limb prosthesis, translating the user’s intent into intuitive control of prosthesis with high degrees of freedom.
Background: During COVID-19 lockdown periods, several studies reported decreased numbers of myocardial infarction (MI) admissions. The lockdown impact has not yet been determined in developing countries. The aim of this study was to investigate the impact that of the lockdown measures might have had on the mean number of MI hospital admissions in Northern Jordan. Methodology: A single-center study examined consecutive admissions of MI patients during COVID-19 outbreak. Participants' data was abstracted from the medical records of King Abdullah University Hospital between 2018 and 2020. Mean and percentages of monthly admissions were compared by year and by lockdown status (pre-lockdown, lockdown, and post-lockdown time intervals). Results: A total of 1380 participants were admitted with acute MI symptoms: 59.2% of which were STEMI. A decrease in number of MI admissions was observed in 2020, from 43.1 (SD: 8.017) cases per month in 2019 to 40.59 (SD: 10.763) in 2020 (P < 0.0001) while an increase in the numbers during the lockdown was observed. The mean number during the pre-lockdown period was 40.51 (SD: 8.883), the lockdown period was 44.74 (SD: 5.689) and the post-lockdown was 34.66 (SD: 6.026) (P < 0.0001 for all comparisons). Similar patterns were observed when percentages of admissions were used. Conclusion: Upon comparing the lockdown period both to the pre- and post-lockdown periods separately, we found a significant increase in MI admissions during the lockdown period. This suggests that lockdown-related stress may have increased the risk of myocardial infarction.
COVID-19 is a severe acute respiratory syndrome that mainly affects the human respiratory system. Unhealthy nutritional habits and obesity are expected as consequences of protective measures including quarantine. Obesity, in its growing prevalence, is a worldwide health issue associated with worsening health conditions. This is a cross-sectional study to assess the impact of the COVID-19 pandemic on obesity among Jordanian adults and across epidemiological statuses. Participants were randomly selected, and the survey was distributed on social media networking sites. A total of 672 subjects were surveyed and participated in the study between March and June 2021 via Google Form questionnaire. The results indicated that 74.4% of participants reported that they did not do any physical activity, and 43.5% changed their lifestyle and eating habits for the worse. During the COVID-19 pandemic, almost half of the participants reported an increase in hunger, consuming 3–4 meals/day, and consuming <1 liter of water/day. Additionally, more than half of the participants reported no change in fat, cereals, and protein consumption, 46.4 % had no change in fruit and vegetable consumption, and 50.6% increased their consumption of sweets. Our results showed a significant increase in the self-reported BMI categories during the COVID-19 pandemic for all ages (p < 0.001). Change in weight and BMI was significantly associated with marital status, education level, living place, family size, family working members, and working status. Participants across all epidemiological statuses displayed a statistically significant increase in BMI. This study was conducted to observe the impacts of the COVID-19 pandemic on health behaviors and obesity among Jordanian adults and across epidemiological statuses. We found that there were significant negative changes in the lifestyle (physical activity) and eating behaviors of Jordanians during the COVID-19 quarantine which in turn increased their body weight and changed the obesity rate
Background To validate both models of Grobman nomogram (The antenatal and the intrapartum model) for predicting successful intended Vaginal Birth After Caesarean delivery (VBAC) in a Jordanian population. Methods A retrospective study has identified all live, singleton, term, cephalic pregnancies with a previous lower segment cesarean section who opted for a Trial Of Labour After Caesarean Section (TOLAC) between January 2014 to December 2020. Five variables were used for the antenatal model, while ten variables were used for the intrapartum model. Two sets of patients were created: one for the antenatal model and the other for the intrapartum model. The predicted probability for each woman was calculated and compared with the successful VBAC for each category. The predictive ability was assessed with a receiver operating characteristic, and the area under the curve (AUC) was determined. Results There were seven hundred and fourteen complete cases for the antenatal model and six hundred ninety-seven for the intrapartum model. Our population's overall number of VBAC is 83.89% for the antenatal group and 82.92% for the intrapartum group. The mean predicted probability for a successful intended VBAC using the antenatal and intrapartum models were 79.53 ± 13.47 and 78.64 ± 14.03, respectively. The antenatal and intrapartum predictive models ROC had an AUC of 65% (95% CI: 60%-71%) and 64% (95% CI: 58%-69%), respectively. Conclusions Both models are validated in the Jordanian population. Adapting the antenatal model as supporting evidence can lead to a higher rate of TOLAC.
This study aims to investigate sleep patterns and quality in patients who had SARS-CoV-2 (COVID-19) infection and to determine the sleep quality and pattern among patients. A cross-sectional design was used to assess sleeping patterns during the post-COVID-19 era for recovered individuals from April 1st, 2022, to June 1st, 2022. The participants had to meet the following requirements: both genders, ages 18 to 70, and previously infected with COVID-19. The prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was 834 (40.6%), and the prevalence of disturbance in sleep quality was 1308 (63.6%). Lower economic status and younger ages in twenties and thirties experienced more disturbances in sleep patterns than other older ages. Many predictors were determined the quality of sleep. These predictors were age (B = .105, P = .00), income (B = .05, P = .035) and educational level (B = .20, P = .006). To sum up, our study found that the prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was moderate, and the prevalence of disturbance in sleep quality was high. The predictors of quality of sleep were age, income, and educational level. Practitioners should be trained to evaluate and manage sleep disturbances, as this comprehensive approach has the potential to reduce mental distress and prevent the consequences of sleep disturbances.
Background and objectives: While the role of autologous stem cell transplant (ASCT) in the first line therapy for newly diagnosed multiple myeloma is well established, efficacy of ASCT for patients with relapsed refractory multiple myeloma (RRMM) in the era of novel therapeutic agents remains unknown. In this single center retrospective analysis, we evaluated and compared the efficacy and safety outcomes of patients with RRMM treated with daratumumab pomalidomide dexamethasone (DPd) alone versus (vs) DPd followed by ASCT. Methods: A total of 83 patients with RRMM who were treated with and achieved at least partial response (PR) with DPd were evaluated by electronic medical records. All patients who responded to DPd and were deemed eligible for ASCT proceeded with high dose melphalan followed by autologous stem cell infusion (DPd + ASCT group). Remaining patients continued DPd until disease progression or intolerable toxicities (DPd-alone group). Responses were evaluated using the International Myeloma Working Group response criteria and toxicities were graded using National Cancer Institute Common Terminology Criteria for Adverse Events. Patient and disease characteristics, as well as efficacy and safety outcomes were summarized using descriptive statistics. Kaplan-Meier analyses were used to estimate progression-free survival (PFS) and overall survival (OS). Results: A total of 21/83 (25%) patients with RRMM who achieved at least PR to DPd underwent ASCT (DPd + ASCT group) while the remaining 62/83 (75%) continued DPd without ASCT (DPd-alone group). For the entire patient population, median age was 66 years (42-81), 49 (59%) patients were male, 54 (65%) patients had IgG isotype, 21 (25%) patients had R-ISS stage III disease, 51 (61%) patients had high-risk cytogenetics, and 17 (20%) patients had extramedullary disease. Patient age, disease stage, cytogenetic risk profile were well balanced between two groups. A stringent complete response was seen in 10 (16%) and 12 (57%) patients in the DPd-alone and DPd + AST groups, respectively. Median PFS was 17.5 months in the DPd-alone vs 42.2 months (p=0.006) in the DPd + ASCT group. Median OS was 38.1 months in the DPd-alone group vs not reached in the DPD + ASCT group (p=0.009). The most common grade 3 or 4 treatment-related adverse events (TRAE) were myelosuppression and gastrointestinal toxicities, more commonly seen in the DPd + ASCT group. No treatment-related mortalities were observed in either group. Conclusion: Patients with RRMM who responded to DPd and underwent HDT-ASCT demonstrated superior depth and duration of remission compared to those who received DPd-alone. Although DPd followed by ASCT is associated with more cytopenias and gastrointestinal toxicities, this treatment appears to be overall safe for patients with RRMM.
Institution pages aggregate content on ResearchGate related to an institution. The members listed on this page have self-identified as being affiliated with this institution. Publications listed on this page were identified by our algorithms as relating to this institution. This page was not created or approved by the institution. If you represent an institution and have questions about these pages or wish to report inaccurate content, you can contact us here.