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Background Following the emergency approval of the coronavirus disease 2019 (COVID-19) vaccines, research into its vaccination hesitancy saw a substantial increase. However, the psychological behaviors associated with this hesitancy are still not completely understood. This study assessed the psychological antecedents associated with COVID-19 vaccination in the Arab population. Methodology The validated Arabic version of the 5C questionnaire was distributed online across various social media platforms in Arabic-speaking countries. The questionnaire had three sections, namely, socio-demographics, COVID-19 related infection and vaccination, and the 5C scale of vaccine psychological antecedents of confidence, complacency, constraints, calculation, and collective responsibility. Results In total, 4,474 participants with a mean age of 32.48 ± 10.76 from 13 Arab countries made up the final sample, 40.8% of whom were male. Around 26.7% of the participants were found to be confident about the COVID-19 vaccination, 10.7% indicated complacency, 96.5% indicated they had no constraints, 48.8% had a preference for calculation and 40.4% indicated they had collective responsibility. The 5C antecedents varied across the studied countries with the confidence and collective responsibility being the highest in the United Arab Emirates (59.0% and 58.0%, respectively), complacency and constraints in Morocco (21.0% and 7.0%, respectively) and calculation in Sudan (60.0%). The regression analyses revealed that sex, age, educational degrees, being a health care professional, history of COVID-19 infection and having a relative infected or died from COVID-19 significantly predicted the 5C psychological antecedents by different degrees. Conclusion There are wide psychological antecedent variations between Arab countries, and different determinants can have a profound effect on the COVID-19 vaccine's psychological antecedents.

Maternal tobacco use is a global public health problem. In the literature, the focus was mainly on cigarette smoking, minimally on waterpipe use, and totally ignored dual use among pregnant women. We estimated the prevalence of current maternal tobacco use by tobacco product (cigarette, waterpipe, and dual use) over a period of ten years (2007 to 2017), and examined the socio-demographic patterning of maternal tobacco use. A secondary analysis of Jordan DHS four data waves was conducted for women who reported to be pregnant at the time of the survey. Current cigarette and waterpipe tobacco use were investigated. Prevalence estimates for cigarette-only, waterpipe-only, and dual use, as well as for cigarette, regardless of waterpipe, and waterpipe, regardless of cigarette, were reported. The effect of independent variables on cigarette smoking, waterpipe use, and dual use was assessed. Logistic regression models assessed the adjusted effects of socio-demographic variables on cigarette smoking, waterpipe use, and on dual use. For each outcome variable, a time-adjusted and a time-unadjusted logistic models were conducted. Over the last decade, the prevalence estimates of current cigarette-only smoking slightly decreased. The prevalence estimates of current waterpipe-only use exceeded those for cigarette-only after 2007 and showed a steady overall increase. Current dual use showed a continuous rise especially after 2009. Gradual increase in cigarette smoking (4.1%, in 2007, and 5.7% in 2017) and in waterpipe use (2.5% to 6.4%) were detected. Education showed an inverse relationship with cigarette and waterpipe smoking. Household wealth demonstrated a positive association with cigarette and waterpipe smoking. Tobacco use epidemic is expanding its roots among pregnant women in Jordan through not only waterpipe use but also dual cigarette-waterpipe smoking. Maternal and child services should consider tobacco counseling and cessation.

Scientists in biomedical and psychosocial research need to deal with skewed data all the time. In the case of comparing means from two groups, the log transformation is commonly used as a traditional technique to normalize skewed data before utilizing the two-group t-test. An alternative method that does not assume normality is the generalized linear model (GLM) combined with an appropriate link function. In this work, the two techniques are compared using Monte Carlo simulations; each consists of many iterations that simulate two groups of skewed data for three different sampling distributions: gamma, exponential, and beta. Afterward, both methods are compared regarding Type I error rates, power rates and the estimates of the mean differences. We conclude that the t-test with log transformation had superior performance over the GLM method for any data that are not normal and follow beta or gamma distributions. Alternatively, for exponentially distributed data, the GLM method had superior performance over the t-test with log transformation.

Azraq Syrian refugee camp, located in Jordan, is where the challenges of managing the COVID-19 epidemic meet the vulnerabilities of displaced people. This study aimed to investigate the epidemiological characteristics, incidence, risk factors, and outcomes of COVID-19 among Azraq camp residents. COVID-19 data from Azraq camp were collected by International Medical Corps clinics and analyzed retrospectively from August 1, 2020, to August 31, 2022. Data included demographics, risk factors, testing history, contact tracing, and vaccination profiles. We estimated COVID-19 incidence and analyzed risk factors using Poisson and multilevel logistic regression. A total of 2,468 confirmed COVID-19 cases were identified, with a prevalence of 5.6 per 100 residents. The camp's monthly incidence rate was more than 50% lower than the national rate, with a 1.7% monthly decrease. Females had a higher incidence than males (6.4% vs. 4.9%, p < 0.001), while the elderly bore the greatest disease burden. Home-based isolation was the main strategy, except during the second wave. Vaccination coverage reached 31.6%, primarily with Pfizer (49.8%). Symptomatic cases made up 44.0% of confirmed cases, with 10.4% requiring hospitalization. Factors independently associated with hospitalization included age, comorbidity, and vaccination status. The study highlights the need for robust surveillance, targeted healthcare interventions, equitable resource allocation, and vaccination campaigns to manage COVID-19 and future epidemics in refugee camps.

Background Different risk factors affect the intensive care unit (ICU) stay after cardiac surgery. This study aimed to evaluate these risk factors. Patients and methods A retrospective analysis was conducted on clinical, operative, and outcome data from 1070 patients (mean age: 59 ± 9.8 years) who underwent isolated coronary bypass grafting CABG surgery with cardiopulmonary bypass. The outcome variable was prolonged length of stay LOS in the CICU stay (> 3 nights after CABG). Results Univariate predictors of prolonged ICU stays included a left atrial diameter of > 4 cm ( P  < 0.001),chronic obstructive airway disease COPD ( P  = 0.005), hypertension ( P  = 0.006), diabetes mellitus ( P  = 0.009), having coronary stents ( P  = 0.006), B-blockers use before surgery (either because the surgery was done on urgent or emergency basis or the patients have contraindication to B-blockers use) ( P  = 0.005), receiving blood transfusion during surgery ( P  = 0.001), post-operative acute kidney injury (AKI) ( P  < 0.001), prolonged inotropic support of > 12 h ( P  < 0.001), and ventilation support of > 12 h ( P  < 0.001), post-operative sepsis or pneumonia ( P  < 0.001), post-operative stroke/TIA ( P  = 0.001), sternal wound infection ( P  = 0.002), and postoperative atrial fibrillation POAF ( P  < 0.001). Multivariate regression revealed that patients with anleft atrial LA diameter of > 4 cm (AOR 2.531, P  = 0.003), patients who did not take B-blockers before surgery (AOR 1.1 P  = 0.011), patients on ventilation support > 12 h (AOR 3.931, P  =  < 0.001), patients who developed pneumonia (AOR 20.363, P  =  < 0.001), and patients who developed post-operative atrial fibrillation (AOR 30.683, P  =  < 0.001) were more likely to stay in the ICU for > 3 nights after CABG. Conclusion Our results showed that LA diameter > 4 cm, patients who did not take beta-blockers before surgery, on ventilation support > 12 h, developed pneumonia post-operatively, and developed POAF were more likely to have stays lasting > 3 nights. Efforts should be directed toward reducing these postoperative complications to shorten the duration of CICU stay, thereby reducing costs and improving bed availability.

Despite under-reporting, health workers (HWs) accounted for 2 to 30% of the reported COVID-19 cases worldwide. In line with data from other countries, Jordan recorded multiple case surges among HWs. Based on the standardized WHO UNITY case-control study protocol on assessing risk factors for SARS-CoV-2 infection in HWs, HWs with confirmed COVID-19 were recruited as cases from eight hospitals in Jordan. HWs exposed to COVID-19 patients in the same setting but without infection were recruited as controls. The study lasted approximately two months (from early January to early March 2021). Regression models were used to analyse exposure risk factors for SARS-CoV-2 infection in HWs; conditional logistic regressions were utilized to estimate odds ratios (ORs) adjusted for the confounding variables. A total of 358 (102 cases and 256 controls) participants were included in the analysis. The multivariate analysis showed that being exposed to COVID-19 patients within 1 metre for more than 15 minutes increased three-fold the odds of infection (OR 2.92, 95% CI 1.25-6.86). Following IPC standard precautions when in contact with patients was a significant protective factor. The multivariate analysis showed that suboptimal adherence to hand hygiene increased the odds of infection by three times (OR 3.18; 95% CI 1.25-8.08). Study findings confirmed the role of hand hygiene as one of the most cost-effective measures to combat the spreading of viral infections. Future studies based on the same protocol will enable additional interpretations and confirmation of the Jordan experience.

Background: Enlargement of the left atrium has been thoroughly studied in many clinical situations, especially its association with mortality and morbidity. Patients and Methods: The study cohort included patients with rheumatic valve pathology such as stenosis and regurgitation. All patients underwent valvular surgical procedures including mitral valve replacement (MVR), aortic valve replacement (AVR), AVR with coronary artery bypass grafting (CABG), MVR with CABG, or AVR and MVR with or without CABG. This study included patients who underwent surgery between 2002 and 2017. Results: Three hundred and forty-six patients were included in this study. The mean patient age was 51.6[+ or -]16.1 years; 37% of the patients underwent AVR, 28% underwent MVR, and 13% underwent a combination of MVR with AVR, AVR with CABG in 6%, and MVR with CABG in 10%. The operative mortality rate was 5.8% (n=20). Univariate analysis revealed that the predictors of mortality included age (P < 0.001), body mass index (BMI) (P = 0.003), type of surgery performed (P = 0.007), hypertension (P = 0.005), emergent surgeries (P = 0.018), left atrial diameter (P = 0.003), cross-clamp time greater than 90 minutes (P = 0.007), postoperative acute kidney injury (AKI) (P = 0.044), postoperative stroke (P = 0.049), and surgical site infection (P = 0.047). Multivariate analysis revealed that predictors of mortality included age (P = 0.028, AOR=10.6), BMI (P = 0.003, AOR=3.12), re-exploration (P = 0.006, AOR=8.38), length of intensive care unit stay (P [less than or equal to] 0.002, AOR=4.55), and left atrial diameter (P = 0.003, AOR=10.64). Conclusion: Enlargement of the left atrium has been studied extensively as a predictor of mortality and morbidity in different clinical situations, to the extent that some authors suggest adding it to risk stratification models. In this study, left atrial size >4 cm was found to strongly predict mortality after rheumatic heart valve surgery. Keywords: valve surgery, mortality, mitral, aortic, left atrial size

Precision oncology and pharmacogenomics (PGx) intersect in their overarching goal to institute the right treatment for the right patient. However, the translation of these innovations into clinical practice is still lagging behind. Therefore, this study aimed to analyze the current state of research and to predict the future directions of applied PGx in the field of precision oncology as represented by the targeted therapy class of tyrosine kinase inhibitors (TKIs). Advanced bibliometric and scientometric analyses of the literature were performed. The Scopus database was used for the search, and articles published between 2001 and 2023 were extracted. Information about productivity, citations, cluster analysis, keyword co-occurrence, trend topics, and thematic evolution were generated. A total of 448 research articles were included in this analysis. A burst of scholarly activity in the field was noted by the year 2005, peaking in 2017, followed by a remarkable decline to date. Research in the field was hallmarked by consistent and impactful international collaboration, with the US leading in terms of most prolific country, institutions, and total link strength. Thematic evolution in the field points in the direction of more specialized studies on applied pharmacokinetics of available and novel TKIs, particularly for the treatment of lung and breast cancers. Our results delineate a significant advancement in the field of PGx in precision oncology. Notwithstanding the practical challenges to these applications at the point of care, further research, standardization, infrastructure development, and informed policymaking are urgently needed to ensure widespread adoption of PGx.

Type 2 diabetes mellitus (T2DM) and thyroid disorders are common endocrine disorders. This case-control study aims to determine the prevalence and predictors of thyroid disorders in T2DM patients. A total of 998 T2DM patients attending a tertiary hospital were included and underwent investigations for thyroid function: thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3); and glycated hemoglobin (HbA1c). They were compared with 343 non-diabetic subjects as controls. A total of 1341 participants were included in the study. The mean age ± SD was 60.14 ± 12.21, and 47.9% were females. Among T2DM patients, 140 (14%) were known to have thyroid disorders; and as a direct result of screening, 126 (12.6%) new cases of thyroid disorder were diagnosed. Thus, the overall prevalence of thyroid disorders was found to be 26.7% in T2DM patients which significantly higher than the controls (13.7%), ( ˂0.001). Subclinical hypothyroidism was the most common one. Using logistic regression, after adjusting for age, gender, obesity, smoking, anemia, presence of goiter, disease duration, and poorly controlled, the risk factors for thyroid dysfunction among T2DM patients were an age of ≥50 years with an adjusted OR of 3.895 (95% CI 2.151-7.052, <0.001); female gender (OR 1.757, 95% CI 1.123-2.747, =0.013); goiter (OR 2.904, 95% CI 1.118-7.547, =0.029), and HbA1c>7% (OR 2.553, 95% CI 1.472-4.429, =0.001). However, there were no significant associations between thyroid disorders and complications or duration of diabetes ( >0.050). A high prevalence of thyroid disorders was reported in T2DM patients. Therefore, we suggest that diabetic patients should be routinely screened for thyroid dysfunction. Old age, female gender, goiter, and poorly controlled diabetes found to be risk factors for thyroid dysfunction among T2DM patients. Consequently, appropriate management and control of diabetes may lower the risk of thyroid dysfunction and vice versa.

From the beginning of 2020, COVID-19 infection has changed our lives in many aspects and introduced limitations in the way people interact and communicate. In this paper, we are evaluating the effect of non-pharmaceutical interventions (NPI) in limiting the spread of the Severe Acute Respiratory Syndrome Coronavirus 2 pandemic during a wedding ceremony from Irbid, Northern Jordan. Agent-based modeling was used in a real wedding event that occurred at the beginning of the spread of the pandemic in Jordan. Two infected nationals of Jordan, who arrived in Jordan about a week before the event, initiated the spread of the pandemic within the contact community. In this work, a strict national NPI that the government implemented is developed by using an abstract model with certain characteristics similar to the Jordanian community. Thus, the Jordanian community is represented in terms of ages, occupations, and population movements. After that, the extent of the impact of the NPI measures on the local community is measured. We observed the deterioration of the state of society while the epidemic is spreading among individuals in the absence of preventive measures. Also, the results show that the herd immunity case was an epidemic, with a high level of spread among the community with 918 cases during a short interval of time. On the other hand, the preventive measures scenario shows a totally controlled spread with only 74 cases applied on the same interval of time. Furthermore, a convergence in the actual results of the real system with the hypothetical system were detected in the case of applying the strict NPI measures. Finally, strict NPI at the community level following social gatherings seem to be effective measures to control the spread of the COVID- 19 pandemic.