Awareness, Knowledge, and Current Practice of Breast Cancer Among Surgeons in Jordan.

PURPOSE: Breast cancer (BC) is the most prevalent cancer in Jordan. De-escalation in treatment reflects a paradigm shift in BC treatment. More tailored strategies and the adoption of a multidisciplinary approach are essential to apply recent changes in management. In the era of breast surgery fellowship, adopting well-structured training is essential to apply recent therapeutic guidelines and meet patients' expectations. METHODS: A cross-sectional study using a customized, self-reported questionnaire was used. Data collection occurred anonymously using a link via WhatsApp in the period between February 2023 and April 2023. RESULTS: A total of 89 surgeons were involved in this study, and only 14 (15.7%) completed a subspecialty in breast surgery. About 58.4% considered the age of 40 years as the starting point for screening, and 84.3% reported that mammogram screening is associated with improved BC survival. Only 10.1% and 28.1% acknowledged the applicability of both tomosynthesis and breast magnetic resonance imaging in screening, respectively. A significant difference in the mean knowledge score about BC is observed between general surgeon and those with subspecialty. Varying levels of awareness concerning different risk factors and their correlation with the likelihood of BC occurrence observed. Although 56.2% of participants could offer breast conserving surgery and consider it oncological safe, only 48.3% defined it correctly. Of the participants, 61.8% and 76.4% stated that sentinel lymph node biopsy can be safely applied in clinically negative or suspicious axillary nodes, respectively, with <50% of surgeon performing it in their practice. CONCLUSION: More efforts are required to enhance the knowledge and practice of surgeons in the field of breast surgery. Adopting national guidelines can facilitate the acceptance and improvement of current practices among surgeons in Jordan.

Perceptions and Attitudes of Jordanian Medical Students on Using 3D Interactive Anatomy Dissection in Teaching and Learning Anatomy.

Background and Aims: This study evaluates the use of virtual anatomy dissection (Anatomage Table) in teaching anatomy for Jordanian medical students. The study also highlights any gender differences in students' perception on this method of teaching anatomy. Methods: This is a cross-sectional questionnaire-based study that was carried out on medical students enrolled in Al-Balqa Applied University, a Jordanian public university. A group of expert anatomists designed a questionnaire that investigates the students' perceptions and attitudes toward using virtual anatomy dissection. The questionnaire also investigated student's opinions and expectations on the impact of using this method on the academic achievement of students. Results: The findings of the study showed that most students agreed that Anatomage Table helped them better understand (64.3%) and memorize (64%) anatomy lectures. In addition, most students were interested in using this learning method in lab groups (72.3%). However, the didactic approach that combined anatomical models and the Anatomage Table was preferred over the unilateral approach that included only the Anatomage Table (80.5% vs 30.2%, p<0.001, r=0.9). Of note, there was a statistically significant difference between males and females in their preference for Anatomage Table (p<0.001), and in their perceptions on the impact of Anatomage Table on understanding of lectures (p<0.001) and memorization of anatomical structures (p=0.004). Conclusion: The Anatomage Table is a powerful teaching and learning method in undergraduate medical education. Its application to Al-Balqa Applied University has proven to be effective so far. It can be used to overcome the problems facing anatomical education in the college of medicine in Al-Balqa Applied University and perhaps other universities in Jordan, but this needs better cooperation between universities and stakeholders to provide adequate funding for this method.

Roles of the ACE/Ang II/AT1R pathway, cytokine release, and alteration of tight junctions in COVID-19 pathogenesis.

This paper shows how SARS-CoV-2 alters tight junctions (TJs) in human organs. The effect of SARS-CoV-2 on the ACE/Ang II/AT1R pathway and immune cells culminates in the release of numerous pro-inflammatory mediators, leading to the presence of certain symptoms in COVID-19, such as acute lung injury (ALI), pulmonary hypertension, and pulmonary fibrosis. Furthermore, the cytokines released alter different TJs components. The study shows how the irregular release of pro-inflammatory cytokines leads to claudin disruption in various tissues of the body, resulting in different symptoms, such as alveolar fibrosis, pulmonary edema, conjunctivitis, altered fertility in males, gastrointestinal symptoms, Covid toes, and others. SARS-CoV-2 also alters occludin expression in the endothelial and blood-testis barriers (BTB) resulting in edema and altered fertility. Viral disruption of JAM-A leads to activation of the RhoA GTPase, which leads to ALI. Taken together, these results define ACE/Ang II/AT1R pathway receptors and tight junctional components as potential therapeutic targets in COVID-19.

Determining Required Teaching Methods in Distance Undergraduate Medical Education Based on the Non-University Learning Methods Medical Students Used During Covid-19: An Exploratory Factor Analysis.

In order to improve the distance learning experience for undergraduate medical education, this study aims to evaluate the teaching methods used by universities in Jordan during the distance learning period and identify the best methods in this situation based on non-university educational avenues utilized by medical students during COVID-19. We conducted a survey of 195 medical students from universities across the country using a questionnaire that measures how dependent students are on educational resources provided by universities before and during the distance learning condition and looks into medical students' most used non-university learning methods in face-to-face and distance learning conditions, and the extent to which medical students used them. We found that the main methods used by medical students for non-university learning were non-university educational videos like YouTube videos (92.8%) and non-university textual explanations (i.e., explanations on websites and summaries of materials made by other students) (67.7%). Before the remote learning situation, there was a large reliance on non-university learning materials, which rose significantly during the distance learning situation (p<0.001, r=0.54). We conducted a polychoric correlations-based Exploratory Factor Analysis (EFA) on 10 items, 7 of which were retained in the final model that revealed 2 factors, to analyze the relationship between the universities' educational methods used in distance learning and the non-university methods medical students used. The first factor reflected the change in "students' use of non-university visualization learning methods in distance learning" (external videos, general dependence on non-university methods, and simulation apps had the highest significant loadings (>0.3)). The second factor reflected the change in "universities' use of visualization and interactive learning methods in distance learning" (deductive discussions, educational videos, and practical methods had significant loadings). A moderately negative correlation was detected between the two factors after applying a Promax rotation (r=-0.41), indicating that the decrease in universities' use of visualization and interactive learning aids in connection with insufficient visualization in the distance educational sessions increased students' use of the aforementioned visualized learning methods in distance learning. This study identifies the optimal visual teaching aids to improve distance undergraduate medical education.