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.

Quality of life and its health and occupational determinants among hospital-based nurses during the COVID-19 pandemic.

BACKGROUND: Nurses worldwide were exposed to increased levels of occupational stress during the COVID-19 pandemic which could have hindered their level of health-related quality of life (HRQoL). OBJECTIVES: This project investigated HRQoL level in nurses during the COVID-19 pandemic and its health and occupational predictors. METHODS: A cross-sectional design was adopted and targeted full-time nurses in Jordan. Study collected data included demographics, 12-item Short Form health survey (SF-12) to measure HRQoL, Nordic Musculoskeletal Questionnaire (NMQ), nurses' evaluation of work conditions during COVID-19, and Depression Anxiety Stress Scale (DASS21). Data was analyzed descriptively to summarize main outcome measures and using multiple linear regression model to identify factors significantly associated with HRQoL. RESULTS: In total 245 nurses successfully completed the survey, 39.6% were males with a mean age of 35±6 years. Participant SF-12 scores were 65.94±17.85 for physical component and 50.09±19.36 mental component. The statistical model significantly explained 53.2% of variance in HRQoL (r2 = 0.534, F = 57.849, p < 0.001). Better sleep quality self-evaluation was significantly associated with higher HRQoL levels, while increased levels of depression, musculoskeletal pain, and financial burden on family were significantly associated with worse HRQoL level. CONCLUSION: Jordanian nurses' HRQoL level was relatively low during COVID-19. Sleep quality, mental health status, musculoskeletal health status, and financial status were identified as factors possibly influenced HRQoL among nurses during the COVID-19 pandemic. Nurses' quality of life along with their mental and physical health should be considered by healthcare administrators in the remaining period of COVID-19 and in future similar emergencies.

Physicians' Health-Related Quality of Life and Its Associated Factors During COVID-19 Pandemic in Jordan: A Cross-Sectional Study.

Healthcare workers worldwide have been exposed to extraordinary stress during COVID-19 pandemic. This study aimed to investigate health-related quality of life (HRQoL) level and its health and occupational associated factors among Jordanian physicians during COVID-19 pandemic. A cross-sectional design using an online survey was adopted targeting physicians at different Jordanian hospitals. The study survey included demographics, HRQoL measured by 12-item Short Form health survey (SF-12) mental and physical components, physicians' evaluation of work conditions during COVID-19, Neck Disability Index (NDI), Depression Anxiety Stress Scale (DASS 21), and International Physical Activity Questionnaire (IPAQ). Descriptive analyses were conducted to summarize primary data. Factors associated with HRQoL were determined using a multiple variable regression analysis. In total, 326 physicians successfully completed the survey, 44.2% were males with mean age of 32.08 (±6.93). SF-12 mental component mean was 52.13 (±20.84) and physical component mean was 69.24 (±18.1). Physicians HRQoL level was significantly associated with levels of stress (ß = -0.23, 95% CI -1.05 to -0.27), depression (ß = -0.22, 95% CI -1.09 to -0.28), neck disability (ß = -0.30, 95% CI -1.08 to -0.57), health self-evaluation (ß = 0.14, 95% CI 1.66-7.87), sleep self-evaluation (ß = 0.09, 95% CI 0.16-3.58), and physical activity level (ß = 0.09, 95% CI 0.00-0.001). Jordanian physicians' level of HRQoL was relatively low during COVID-19. Healthcare facilities administrators should take into consideration factors associated with physicians' HRQoL level when planning for future healthcare emergencies.

Regional Pericarditis Mimicking Inferior Myocardial Infarction following Abdominal Surgery.

Acute pericarditis is common but illusive, often mimicking acute coronary syndrome in its clinical and electrocardiographic presentation. Regional pericarditis, though rare, presents further challenge with a paucity of published diagnostic criteria. We present a case of postoperative regional pericarditis and discuss helpful electrocardiographic findings. A 66-year-old male with history of open drainage of a liver abscess presented with abdominal pain and tenderness. CT of the abdomen was concerning for pneumatosis intestinalis of the distal descending colon. He underwent lysis of liver adhesions; exploration revealed only severe colonic impaction, for which he had manual disimpaction and peritoneal irrigation. Postoperatively, he developed sharp chest pain. Electrocardiogram revealed inferior ST elevation. Echocardiogram revealed normal left and right ventricular dimensions and systolic function without wall motion abnormalities. Emergent coronary angiography did not identify a culprit lesion, and left ventriculogram showed normal systolic function without wall motion abnormalities. He received no intervention, and the diagnosis of regional pericarditis was entertained. His cardiac troponin was 0.04 ng/dL and remained unchanged, with resolution of the ECG abnormalities in the following morning. Review of his preangiography ECG revealed PR depression, downsloping baseline between QRS complexes, and reciprocal changes in the anterior leads, suggestive of regional pericarditis.

Triple therapy greatly increases myocardial salvage during ischemia/reperfusion in the in situ rat heart.

BACKGROUND: Cangrelor, a P2Y12 receptor blocker, administered just prior to reperfusion reduced but did not eliminate myocardial infarction in rabbits. Combining cangrelor with ischemic postconditioning offered no additional protection suggesting they protected by a similar mechanism. To determine if cangrelor's protection might be additive to other cardioprotective interventions we tested cangrelor in combination with ischemic preconditioning, cariporide, a sodium-hydrogen exchange blocker, and mild hypothermia. METHODS: Open-chest rats underwent 30-min coronary occlusion/2-h reperfusion. RESULTS: Cangrelor, administered as a bolus (60 µg/kg) 10 min before reperfusion and continued as an infusion (6 µg/kg/min) for the duration of the experiment, decreased infarction from 45.3 % of risk zone in control hearts to 25.0 %. Combining cangrelor and ischemic preconditioning offered no additional protection. Mild hypothermia (32-33 °C) instituted by peritoneal lavage with cold saline just prior to coronary occlusion resulted in 25.2 % infarction, and combining cangrelor and hypothermia nearly halved infarction to 14.1 % of risk zone. Cariporide (0.5 mg/kg) just prior to occlusion resulted in 27.2 % infarction and 15.8 % when combined with cangrelor. Combining cangrelor, hypothermia and cariporide further halved infarction to only 6.3 %. We also tested another P2Y12 inhibitor ticagrelor which is chemically similar to cangrelor. Ticagrelor (20 mg/kg) fed 1 h prior to surgery reduced infarct size by an amount similar to that obtained with cangrelor (25.6 % infarction), and this protective effect was abolished by chelerythrine and wortmannin, thus implicating participation of PKC and PI3-kinase, resp., in signaling. CONCLUSIONS: Cardioprotection from a P2Y12 receptor antagonist can be combined with at least 2 other strategies to magnify the protection. Combining multiple interventions that use different cardioprotective mechanisms could provide powerful protection against infarction in patients with acute coronary thrombosis.