Pediatric cardiomyopathies are mostly attributed to variants in sarcomere-related genes. Unfortunately, the genetic architecture of pediatric cardiomyopathies has never been previously studied in Jordan. We sought to uncover the genetic landscape of 14 patients from nine families with several subtypes of pediatric cardiomyopathies in Jordan using Exome sequencing (ES). Our investigation identified pathogenic and likely pathogenic variants in seven out of nine families (77.8%), clustering in sarcomere-related genes. Surprisingly, phenocopies of sarcomere-related hypertrophic cardiomyopathies were evident in probands with glycogen storage disorder and mitochondrial-related disease. Our study underscored the significance of streamlining ES or expanding cardiomyopathy-related gene panels to identify plausible phenocopies of sarcomere-related cardiomyopathies. Our findings also pointed out the need for genetic testing in patients with cardiomyopathy and their at-risk family members. This can potentially lead to better management strategies, enabling early interventions, and ultimately enhancing their prognosis. Finally, our findings provide an initial contribution to the currently absent knowledge about the molecular underpinnings of cardiomyopathies in Jordan.

BACKGROUND: Previous evidence suggests an individual variation in the preferred oral processing behavior. Individuals can be classified as firm processing(FPL) or soft processing likers(SPL). FPL(crunchers and chewers) prefer using their teeth while SPL(smooshers and suckers) prefer using the tongue and the palate when processing different food items. Variation in the preferred oral processing behavior has been associated with differences in food texture preference and eating time. Time is one of the factors directly related to the development of dental caries(tooth decay). Oral retention and eating times are associated with greater caries experience. This study aims to explore if a relationship exists between the preferred oral processing behavior and the individual\'s caries experience.
METHODS: This was a cross-sectional, dental center-based study conducted at Jordan University of Science and Technology. Five hundred participants consented to fill out the preferred oral processing behavior(POPB) questionnaire. Anthropometric measurements (including weight, height, and waist circumference) were recorded. A single trained and calibrated dentist registered each participant\'s caries experience and plaque levels using the DMFS index and plaque index of Silness and Loe.
RESULTS: A total of 351(70.2%) and 149(29.8%) participants were typed as FPL and SPL, respectively. SPL demonstrated higher levels of dental caries experience compared to FPL. The mean DMFS score for SPL was 28.8(±25.43) while for FPL was 18.71(± 18.34). This difference remained significant after adjustment for confounders(P<0.001). SPL exhibited a significantly higher mean score for the \"M\" component(P <0.001) while no significant difference in the mean score of the \"D\"(P = 0.076) and \"F\"(P = 0.272) components was observed when compared to FPL.
CONCLUSIONS: The current findings provide new insight into a possible relationship between the preferred oral processing behavior and an individual\'s caries experience. A relationship in which the preferred oral processing behavior can potentially affect and/or be affected by the dental caries experience.

UNASSIGNED: Healthcare providers must possess the necessary knowledge and skills to perform effective cardiopulmonary resuscitation (CPR). In the event of cardiopulmonary arrest, basic life support (BLS) is the initial step in the life-saving process before the advanced CPR team arrives. BLS simulation training using manikins has become an essential teaching methodology in nursing education, enhancing newly employed nurses\' knowledge and skills and empowering them to provide adequate resuscitation.
UNASSIGNED: This study aimed to evaluate the potential effect of BLS simulation training on knowledge and practice scores among newly employed nurses in Jordanian government hospitals.
UNASSIGNED: A total of 102 newly employed nurses were randomly assigned to two groups: the control group (n = 51) received standard training, and the experimental group (n = 51) received one full day of BLS simulation training. The training program used the American Heart Association (AHA)-BLS-2020 guidelines and integrated theoretical models such as Miller\'s Pyramid and Kolb\'s Cycle. Both groups were homogeneous in inclusion characteristics and pretest results. Knowledge and practice scores were assessed using 23 multiple-choice questions (MCQs). Data were analyzed using one-way repeated measures ANOVA.
UNASSIGNED: The results indicated significant differences in knowledge scores, F(2, 182) = 58.514, p <0.001, and practice scores, F(2, 182) = 20.134, p <0.001, between the control and experimental groups at all measurement times: pretest, posttest 1, and posttest 2. Moreover, Cohen\'s d reflected the effectiveness of BLS simulation training as an educational module, showing a large effect (Cohen\'s d = 1.568) on participants\' knowledge levels and a medium effect (Cohen\'s d = 0.749) on participants\' practice levels.
UNASSIGNED: The study concludes that BLS simulation training using the AHA-BLS-2020 guidelines and integrating theoretical models such as Miller\'s Pyramid and Kolb\'s Cycle significantly improves knowledge and practice scores among newly employed nurses, proving highly effective in enhancing their competencies in performing CPR. Implementing BLS simulation training in nursing education programs can significantly elevate the proficiency of newly employed nurses, ultimately improving patient outcomes during cardiopulmonary arrest situations. This training approach should be integrated into standard nursing curricula to ensure nurses are well-prepared for real-life emergencies.
UNASSIGNED: NCT06001879.

BACKGROUND: High blood pressure, also known as hypertension (HTN), is a complicated disorder that is controlled by a complex network of physiological processes. Untreated hypertension is associated with increased death incidence, rise the need for understanding the genetic basis affecting hypertension susceptibility and development. The current study sought to identify the genetic association between twelve single nucleotide polymorphisms (SNPs) within seven candidate genes (NOS3, NOS1AP, REN, PLA2G4A, TCF7L, ADRB1, and PTPRD).
METHODS: The current study included 200 Jordanian individuals diagnosed with hypertension, compared to 224 healthy controls. Whole blood samples were drawn from each individual for DNA isolation and genotyping. The SNPStats tool was used to assess haplotype, genotype, and allele frequencies by the mean of chi-square (χ2).
RESULTS: Except for rs10739150 of PTPRD (P = 0.0003), the genotypic and allelic distribution of the SNP was identical between patients and controls. The prevalence of the G/G genotype in healthy controls (45.5%) was lower than in hypertension patients (64.3%), suggesting that it might be a risk factor for the disease. PTPRD TTC genetic haplotypes were strongly linked with hypertension (P = 0.003, OR = 4.03).
CONCLUSIONS: This study provides a comprehensive understanding of the involvement of rs10739150 within the PTPRD gene in hypertension. This new knowledge could potentially transform the way we approach hypertension diagnosis, providing an accurate diagnostic tool for classifying individuals who are at a higher risk of developing this condition.

The current study was designed to uncover the chemistry and bioactivity potentials of Bupleurum lancifolium growing wild in Jordan. In this context, the fresh aerial parts obtained from the plant material were subjected to hydrodistillation followed by GC/MS analysis. The main components of the HDEO were γ-patchoulene (23.79%), β-dihydro agarofuran (23.50%), α-guaiene (14.11%), and valencene (13.28%). Moreover, the crude thanolic extract was partitioned to afford two main major fractions, the aqueous methanol (BLM) and butanol (BLB). Phytochemical investigation of both fractions, using conventional chromatographic techniques followed by careful inspection of the spectral data for the isolated compounds (NMR, IR, and UV-Vis), resulted in the characterization of five known compounds, including α-spinasteryl (M1), ethyl arachidate (M2), ethyl myristate (M3), quercetin-3-O-β-d-glucopyranosyl-(1-4\")-α-L-rhamnopyranosyl (B1), and isorhamnetin-3-O-β-d-glucopyranosyl-(1-4\")-α-L-rhamnopyranosyl (B2). The TPC, TFC, and antioxidant activity testing of both fractions and HDEO revealed an interesting ABTS scavenging potential of the BLB fraction compared to the employed positive controls, which is in total agreement with its high TP and TF contents. Cytotoxic evaluation tests revealed that BLM had interesting cytotoxic effects on the normal breast cell line MDA-MB-231 (ATCC-HTB-26) and the normal dermal fibroblast (ATCC® PCS-201-012) and normal African green monkey kidney Vero (ATCC-CCL-81) cell lines. Despite both the BLB and BLM fractions showing interesting AChE inhibition activities (IC50 = 217.9 ± 5.3 µg/mL and 139.1 ± 5.6 µg/mL, respectively), the HDEO revealed an interestingly high AChE inhibition power (43.8 ± 2.7 µg/mL) that far exceeds the one observed for galanthamine (91.4 ± 5.2 µg/mL). The HDEO, BLM, and BLB exhbitied no interesting antimicrobial activity against Bacillus cereus, Bacillus subtilis, Staphylococcus aureus, Escherichia coli, or Pseudomonas aeruginosa.

BACKGROUND: Triage nurses\' pivotal role in initial assessment makes their competence crucial. However, the specific impact on Acute Coronary Syndrome (ACS) recognition and outcomes remains unclear in Jordanian healthcare. Understanding this relationship could enhance ACS management and patient outcomes in Jordanian Emergency Departments (EDs).
OBJECTIVE: To assess how triage nurses\' recognition of ACS diagnosis affects patient outcomes in Jordan.
METHODS: This retrospective study examined records of 150 ACS patients admitted to the coronary care unit (CCU). Data extraction assessed triage nurses\' accuracy in recognizing ACS symptoms and the timelines for diagnosis procedures (e.g., electrocardiogram [ECG]) and treatment provision (e.g., thrombolytic) based on triage decisions. It also evaluated the impact on treatment outcomes, including length of stay in the ED and hospital. Multiple linear regression analyses quantified the influence of under-triage on treatment outcomes.
RESULTS: The sample comprised 150 patients. Most were female (78.7%), aged 45-59.9 years (37.3%). ACS classifications: unstable angina (52.0%), STEMI (38.0%), NSTEMI (10.0%). The study included a cohort of ACS patients, with findings indicating varying degrees of under-triage by triage nurses. Analysis of timelines revealed significant delays in diagnosis and treatment initiation for patients subjected to under-triage. Multiple linear regression analyses demonstrated a robust association between under-triage and prolonged time to essential treatment outcomes, including delays in physician assessment, ECG performance, thrombolytic administration, and extended ED length of stay.
CONCLUSIONS: Triage nurses\' knowledge and competency are crucial determinants of accurate ACS recognition and subsequent clinical outcomes for patients presenting to the ED in Jordan. Investing in ongoing education and training programs for triage nurses may lead to improved ACS recognition rates and better patient outcomes in Jordanian healthcare settings.

UNASSIGNED: To quantify the economic burden associated with tobacco smoking among smokers aged 30-69 years, and second-hand smokers (SHS) aged 15-69 years in Jordan.
UNASSIGNED: A prevalence-based analysis was conducted in alignment with the Economics of Tobacco Toolkit developed by the WHO. The time-horizon of the analysis was one year (2019). Direct and indirect costs were estimated using data from the 2019 Global Burden of Diseases study. The analysis targeted the Jordanian population of smokers aged 30-69 years, and SHS aged 15-69 years. Adjustments were applied for age, gender, and smoking-related diseases. Direct costs were estimated using the smoking-attributable fraction (SAF) and national health expenditures. Indirect costs were divided into morbidity and mortality components. A discount rate of 3.0% and an annual productivity growth rate of 1.0% were assumed in modelling future economic losses. A sensitivity analysis was conducted on the lower and upper estimates of data used in this study.
UNASSIGNED: The cost of tobacco smoking and SHS exposure was estimated at US$2,108 million (95% confidence interval [CI] = US$2,003 million-US$2,245 million). This represents 4.7% (95%CI = 4.5%-5.0%) of national gross domestic product (GDP). Direct costs accounted for 3.1% of national GDP. Tobacco smoking accounted for 85.0% of total cost and SHS exposure accounted for 15.0% of total cost. Direct costs accounted for 67.0% of total cost, while indirect morbidity and mortality costs accounted for 9.0% and 24.0% of total cost, respectively. Non-communicable diseases accounted for 96.0% of total direct costs compared to communicable diseases (4.0% of total direct costs).
UNASSIGNED: Smoking cessation interventions such as raising taxes on cigarettes, protecting people from tobacco smoke, warning labels, plain packaging, and bans on advertising, are crucial for controlling national expenditures for treating smoking-related diseases and for averting future economic losses.
In this work, we aimed to calculate the annual economic impact of tobacco smoking in Jordan in 2019. We used the World Health Organization toolkit methodology to estimate both the direct and indirect costs associated with smoking nationally. Our focus was on Jordanian smokers aged 30-69 years and people exposed to second-hand smoke aged 15–69 years. Direct costs were calculated using epidemiological data on the proportion of health expenditures attributable to smoking and the national health expenditures. Indirect costs were divided into two components: morbidity and mortality. We also projected future economic losses, assuming a 3.0% discount rate and a 1.0% annual growth rate of productivity. Our study estimated that the cost of smoking and exposure to second-hand smoke was US$2,108 million (US$2,003 million-US$2,245 million), which accounted for 4.7% (4.5%-5.0) of Jordan’s gross domestic product. The majority of the cost (85.0%) was due to direct smoking, while 15.0% was due to exposure to second-hand smoke. Direct costs made up 67.0% of the total cost, while the costs related to morbidity and mortality accounted for 9.0% and 24.0% of the total cost, respectively. In conclusion, our study emphasized that tobacco smoking has a significant economic impact on Jordan. Therefore, it is crucial to implement effective smoking cessation programs, such as enforcing existing anti-tobacco policies and raising taxes. These measures can help control national expenditures for treating smoking-related diseases and prevent future economic losses.

BACKGROUND: This study investigates how congenital heart diseases (CHD) characteristics and interventions affect cognitive and verbal skills in Arab children, while also uncovering previously unexplored connections between these skills and the quality of life (QoL) scores as perceived by both children and parents.
METHODS: A cross-sectional study was conducted in Jordan, involving 62 children with CHD aged 6-16. Data were collected through standardized intelligence tests (namely The Raven\'s Progressive Matrices Test and The Wechsler Intelligence Scale for Children) and QoL assessments.
RESULTS: Sex, disease severity, cyanosis, CHD defect status, conducted operations, and types of interventions did not significantly influence cognitive scores. However, a significant difference was observed in Wechsler\'s scores between cyanotic and non-cyanotic children (p < .01) and between severe and moderate cases (p = .01). Further, a significant positive correlation was identified between Wechsler\'s Scores and QoL reported by parents (r = 0.33, p < .01). This correlation was particularly pronounced in the social and school functioning dimensions of QoL.
CONCLUSIONS: This study highlights the need for personalized care approaches for children with CHDs based on their individual characteristics. While cognitive abilities did not directly correlate with children\'s QoL reports, a significant positive correlation between verbal skills and QoL reported by parents underscores the importance of effective communication in assessing a child\'s overall well-being. Future research should further examine the cognitive development in this population, employing neurocognitive investigations and longitudinal studies to gain a deeper understanding of their cognitive profiles and trajectories.

OBJECTIVE: To assess the oral health status and related factors among hearing impaired schoolchildren.
METHODS: A cross-sectional study among 115 hearing impaired schoolchildren enrolled at the School of the Deaf in Jordan. The World Health Organization (WHO) methodology and criteria were applied to collect data on caries, gingival bleeding. The WHO classification modified by Andreasen et al. was used to record traumatic dental injuries (TDIs). Sociodemographic data, oral health practices, and oral health related quality of life information were collected using a structured questionnaire.
RESULTS: The prevalence of caries among the study sample was 84.3%, the dominating component was untreated dental caries. Mean decayed, missing, filled primary teeth (dmft) was 8 in the primary dentition and 3.62 in the mixed dentition, mean Decayed, Missing, Filled permanent Teeth (DMFT) was 1.38 in the mixed dentition and 2.87 in the permanent. The overall mean of gingival bleeding percentage among the whole study sample was 70.38%. the prevalence of TDIs was of 11.3% and mostly caused by falls.
CONCLUSIONS: The prevalence of dental caries and caries experience, rate of gingival bleeding and dental trauma in children with hearing impaired individuals are high compared to figures observed in studies conducted among Jordanian schoolchildren with normal hearing. Dental diseases impact the quality of life of these individuals.

Hypertension is one of the most common and complicated disorders associated with genetic and environmental risk factors. The angiotensin-converting enzyme (ACE) is important in the renin-angiotensin-system pathway. The gene expression of ACE has been investigated as a possible hypertension marker. This study investigates the association between polymorphisms within the ACE1 and ACE2 genes and hypertension susceptibility in a Jordanian population. The study comprised a total of 200 hypertensive patients and 180 healthy controls. A polymerase chain reaction (PCR) was performed to genotype the candidate polymorphism (rs4646994) of the ACE1gene. The Luminex DNA array technique was used for genotyping SNPs (rs4359, rs4344, rs4341, rs4343, and rs2106809) of the ACE1 and ACE2 genes. Our findings suggest no association between SNPs and hypertension regarding allelic and genotypic frequencies. However, rs4359 was significantly associated with diet (pP = 0.049), know HTN (P = 0.042), and number of years DM (P = 0.003). rs4341 was associated with diet (P = 0.032), peripheral vascular disease (P = 0.005), and chronic kidney disease (p = 0.049). While rs4343 was associated with diet (P = 0.031), diabetes mellitus (P = 0.032), and other medication (P = 0.025). Furthermore, the haplotypes of four SNPs of the ACE1 gene showed no significant association with HTN patients and healthy controls. Our findings indicate no association between the polymorphisms in the ACE gene and the risk of hypertension development in the Jordanian adult population.