Evaluating the understanding of the ethical and moral challenges of Big Data and AI among Jordanian medical students, physicians in training, and senior practitioners: a cross-sectional study.

AIMS: To examine the understanding of the ethical dilemmas associated with Big Data and artificial intelligence (AI) among Jordanian medical students, physicians in training, and senior practitioners. METHODS: We implemented a literature-validated questionnaire to examine the knowledge, attitudes, and practices of the target population during the period between April and August 2023. Themes of ethical debate included privacy breaches, consent, ownership, augmented biases, epistemology, and accountability. Participants' responses were showcased using descriptive statistics and compared between groups using t-test or ANOVA. RESULTS: We included 466 participants. The greater majority of respondents were interns and residents (50.2%), followed by medical students (38.0%). Most participants were affiliated with university institutions (62.4%). In terms of privacy, participants acknowledged that Big Data and AI were susceptible to privacy breaches (39.3%); however, 59.0% found such breaches justifiable under certain conditions. For ethical debacles involving informed consent, 41.6% and 44.6% were aware that obtaining informed consent posed an ethical limitation in Big Data and AI applications and denounced the concept of "broad consent", respectively. In terms of ownership, 49.6% acknowledged that data cannot be owned yet accepted that institutions could hold a quasi-control of such data (59.0%). Less than 50% of participants were aware of Big Data and AI's abilities to augment or create new biases in healthcare. Furthermore, participants agreed that researchers, institutions, and legislative bodies were responsible for ensuring the ethical implementation of Big Data and AI. Finally, while demonstrating limited experience with using such technology, participants generally had positive views of the role of Big Data and AI in complementing healthcare. CONCLUSION: Jordanian medical students, physicians in training and senior practitioners have limited awareness of the ethical risks associated with Big Data and AI. Institutions are responsible for raising awareness, especially with the upsurge of such technology.

Central nervous system tumors in patients coming from areas of conflict in the Middle East/North Africa region: an experience from King Hussein Cancer Center.

Introduction: The global cancer burden has been disproportionately shifting towards low- and middle-income countries (LMICs). Limited availability and accessibility to screening, treatment and surveillance, increase in the prevalence and lack of control of risk factors, and underdeveloped healthcare infrastructures have greatly contributed to the disparity in the global cancer burden. Methods: A retrospective cohort study was conducted that included adult and pediatric patients with an established diagnosis of Central Nervous System (CNS) tumors including brain or spinal tumors of which different demographic, clinical characteristics, and financial burden were presented. Results: 749 patients were included stemming from various countries in the Middle East/North Africa (MENA) region including Libya (34.2%), Palestine (19.8%), Iraq (15.4%), Syria (14.6%) Yemen (14.5%), and Sudan (1.5%). Most patients were adults (66%) with a median age of 34-year-old. 104 patients had died (13.9%), 80 patients were still alive (10.7%) and most of the patients (n= 565, 75.5%) were lost to follow-up. The added cost of managing these patients is 10,172,935 Jordanian Dinars (JOD), with King Hussein Cancer Foundation (KHCF) covering around 34.3% of the total cost. Conclusion: Our study aimed at taking a closer look at patients coming from areas of conflict in the MENA region diagnosed and treated for CNS tumors at King Hussein Cancer Center (KHCC) over a 12-year period. It was found that even with the contributions of the Jordanian sources almost half of the patients were faced with the entire financial burden of treatment alone.

Quantum Mechanical Aspects in the Pathophysiology of Neuropathic Pain.

Neuropathic pain is a challenging complaint for patients and clinicians since there are no effective agents available to get satisfactory outcomes even though the pharmacological agents target reasonable pathophysiological mechanisms. This may indicate that other aspects in these mechanisms should be unveiled to comprehend the pathogenesis of neuropathic pain and thus find more effective treatments. Therefore, in the present study, several mechanisms are chosen to be reconsidered in the pathophysiology of neuropathic pain from a quantum mechanical perspective. The mathematical model of the ions quantum tunneling model is used to provide quantum aspects in the pathophysiology of neuropathic pain. Three major pathophysiological mechanisms are revisited in the context of the quantum tunneling model. These include: (1) the depolarized membrane potential of neurons; (2) the cross-talk or the ephaptic coupling between the neurons; and (3) the spontaneous neuronal activity and the emergence of ectopic action potentials. We will show mathematically that the quantum tunneling model can predict the occurrence of neuronal membrane depolarization attributed to the quantum tunneling current of sodium ions. Moreover, the probability of inducing an ectopic action potential in the axons of neurons will be calculated and will be shown to be significant and influential. These ectopic action potentials are generated due to the formation of quantum synapses which are assumed to be the mechanism behind the ephaptic transmission. Furthermore, the spontaneous neuronal activity and the emergence of ectopic action potentials independently from any adjacent stimulated neurons are predicted to occur according to the quantum tunneling model. All these quantum mechanical aspects contribute to the overall hyperexcitability of the neurons and to the pathogenesis of neuropathic pain. Additionally, providing a new perspective in the pathophysiology of neuropathic pain may improve our understanding of how the neuropathic pain is generated and maintained and may offer new effective agents that can improve the overall clinical outcomes of the patients.