King Abdullah University Hospital

Axial spondyloarthritis (AxSpA) is a chronic inflammatory condition of the spine and sacroiliac joints, associated with a considerable functional and psychosocial burden. This study aimed to investigate the interplay between disease activity and patient-reported outcomes, specifically focusing on how psychosocial factors and functional status serve as predictors of disease severity in Jordanian patients with AxSpA. We conducted a cross-sectional study at two tertiary hospitals in Jordan, including patients diagnosed according to the Assessment of SpondyloArthritis International Society (ASAS) criteria. A total of 79 patients were analyzed, with a mean age of 41.1 ± 11.9 years and a significant diagnostic delay of 5.7 ± 6.1 years. Sixty-seven were diagnosed with ankylosing spondylitis (AS), and twelve with non-radiographic AxSpA (nr-axSpA). Most patients were current smokers (53.2%), and more than half of the patients were retired or unemployed. Notable psychosocial burden was observed according to the Patient Health Questionnaire-9 (PHQ-9) questionnaire, with over half of the patients experiencing depressive symptoms and one-fifth screening positive for fibromyalgia according to the Fibromyalgia Rapid Screening Tool (FiRST). Using the Ankylosing Spondylitis Disease Activity Score (ASDAS), a majority of patients demonstrated high (51.9%) or very high (29.1%) disease activity. Male patients and those with higher ASQOL scores (worse quality of life) were significantly more likely to have very high disease activity. In patients receiving TNF inhibitors, NLR maintained the highest discriminatory ability, with an AUC of 0.676 (95% CI: 0.517–0.834). Significant diagnostic delays, smoking prevalence, work disability, and psychological burden were observed. Longitudinal studies remain essential to confirm these findings and better assess disease progression and treatment outcomes.

The Industrial Internet of Things (IIoT) has brought transformative changes to industrial sectors by enabling intelligent automation, real-time monitoring, and data-driven decision-making. However, this increased connectivity and system integration have expanded the cybersecurity threat landscape, exposing critical infrastructure to sophisticated cyberattacks. Traditional Intrusion Detection Systems (IDS), particularly those relying on static signature-based detection, have proven inadequate in addressing the dynamic, heterogeneous, and resource-constrained nature of IIoT environments. Motivated by these emerging challenges, this paper presents a comprehensive review of AI-based IDS solutions developed over the past decade, with a specific focus on IIoT contexts. In doing so, it addresses key limitations in prior literature, including an insufficient focus on industry-specific constraints, a lack of attention to explainability and adversarial robustness, and an absence of a structured, future-oriented research agenda. The primary objectives are to synthesize the evolution of IDS methodologies, provide a multidimensional taxonomy that incorporates learning paradigms, deployment layers, and resource constraints, and critically assess the suitability of available datasets and benchmarks. The review highlights significant shifts from conventional machine learning techniques toward more adaptive, lightweight, explainable, and federated learning approaches. Additionally, it proposes a structured research roadmap outlining short-, mid-, and long-term directions for enhancing IDS in IIoT, such as edge-based detection, the integration of explainable AI (XAI), and the development of resilient, self-adaptive intrusion detection architectures. This paper offers a unified, actionable reference for researchers, practitioners, and policymakers seeking to strengthen industrial cybersecurity in increasingly complex and intelligent IIoT systems.

Abstract This research examines file protection in cloud environments using the SHA-256 algorithm. It evaluates secure hash variants in file transfer systems, aiming to improve throughput while meeting security requirements. Data analysis involved gathering and cleaning datasets, measuring encryption times, and applying statistical and graphical methods. Results show SHA-256 as an effective base for encryption, with parallel processing increasing efficiency when real-time speed is essential. The study highlights the value of transformational techniques to boost performance and recommends hybrid systems that combine SHA-256 with other algorithms for stronger security. These outcomes support further work on cryptographic methods to strengthen the safety and reliability of cloud infrastructures.

Cocaine use disorder prevalence is around 2.2% for individuals age 12 and older, with higher rates reaching 6.2% in young adults ages 18-25. In 2021 around 23% of all US overdose deaths were related to cocaine. Cannabis use disorder is more prevalent than cocaine use disorder with prevalence reaching 14.7%. This study aims to evaluate the impact of cocaine and cannabis on clinical cardiovascular outcomes. Specifically, it investigates the incidence of new-onset cardiac arrhythmia between the cocaine and cannabis users, as well as the incidence of cardiac arrest events, major adverse cardiovascular events including myocardial infarction (MI) and stroke, and all-cause mortality. We did a retrospective cohort analysis using the TriNetX database of cocaine and cannabis users patients and created two cohorts: cocaine and cannabis. Propensity score matching was employed to reduce baseline disparities.The primary outcome was the incidence of new-onset cardiac arrhythmia. Secondary outcomes included cardiac arrest events, all cause mortality, and occurrence of major adverse cardiovascular events (MI and stroke). After matching, 248,769 patients were included in each cohort (cocaine and cannabis users). New-onset cardiac arrhythmia occurred more frequently in the cocaine group (0.2%) compared to the cannabis group (0.15%) (HR: 1.067; 95% CI: 1.022-1.115, P < 0.035). Cocaine use was also associated with higher rates of the secondary outcomes: cardiac arrest (HR: 1.442; 95% CI: 1.346-1.545, P < 0.001), all-cause mortality (HR: 1.215; 95% CI: 1.187-1.243, P < 0.013), and major adverse cardiovascular events (HR: 1.147; 95% CI: 1.116-1.178, P < 0.001). Cocaine users experience significantly higher rates of new-onset cardiac arrhythmias, cardiac arrest, and major adverse cardiovascular events (MI and stroke) compared to cannabis users. These findings highlight the differing outcomes associated with substance use. Future research should aim to validate our findings through prospective, multicenter studies with standardized diagnostic methods as well as longer-term follow-up to more accurately define the outcomes.

Introduction: Pediatric healthcare decision-making is influenced by intersecting and often conflicting factors. The coexistence of traditional parental beliefs and the modern digital landscape has altered this process and produced a novel paradigm which greatly impacts regions where cultural heritage guides medical practices and behaviors. This paper examines how parental attitudes built on traditional beliefs and social media affect healthcare decisions for pediatric patients aged twelve and below. Methods: The paper employs a structured 18-item questionnaire distributed to 200 Jordanian parents to gauge beliefs, digital health literacy, and online misinformation influence healthcare-seeking behavior. Results: The results indicated a considerable influence of traditional beliefs, as 48% of parents favored traditional remedies, and 35% consulted family elders before seeking professional advice. On the other hand, 62% stated they frequented social media for information on child healthcare, while 55% had followed online advice without medical consultation. Moreover, only 45% of the parents expressed confidence in their ability to distinguish credible information from misleading content. Discussion: The analysis through hypothesis testing indicated that lower education levels and higher social media usage rates significantly delayed medical consultations and were related to a reliance on unverified health advice. In contrast, high media literacy levels resulted in increased caution, leading to more professional-aligned decisions. Conclusions: The paper suggests enhancing the digital presence of pediatricians to increase the credibility of online information. The paper recommends the integration of evidence-based health messaging in popular platforms such as WhatsApp and Facebook.

PurposePatient confidentiality and privacy are foundational ethical principles in clinical practice. Evaluating how well future physicians understand and uphold these principles is critical for effective ethics education. This study assessed knowledge and self-reported practices regarding patient confidentiality and privacy among medical students in a Jordanian medical school, providing insights into broader regional trends.Material and MethodsA cross-sectional survey was conducted among 297 medical students (Years 4–6) using a structured questionnaire. A convenience sampling approach was used to invite all accessible students through class WhatsApp groups. The final sample exceeded the precision-based minimum of 273 participants. The instrument included demographics items and 17 questions across knowledge (10 questions) and practice (7 questions) domains, measured on a 5-point Likert scale. Descriptive statistics, t-tests, ANOVA, and multiple linear regression were applied to identify predictors of practice behavior.ResultsParticipants demonstrated good theoretical knowledge (Mean=4.18, SD=0.36) and reported good practices (Mean=4.06, SD=0.56). Reliability was moderate for knowledge (α=0.624) and good for practice (α=0.767) domains after reverse-scoring. Female students reported significantly better practices than males (p = 0.001). Practice scores also differed across academic years (p < 0.001), with 5th- and 6th-year students outperforming 4th-year students. In multivariate analysis, higher knowledge (β = 0.828, p < 0.001), female sex (β = −0.167, p = 0.001), and senior academic level (p < 0.05) independently predicted better practices.ConclusionDespite promising knowledge levels, practical challenges remain in upholding patient confidentiality and privacy among Jordanian medical students. Findings should be interpreted in light of the cross-sectional design and reliance on self-reported data. Targeted educational interventions that strengthen knowledge, address sex-specific needs and ensure early, continuous ethics education are essential to bridge the knowledge-practice gap and foster a culture of confidentiality in medical training.

Duodenal diverticular disease is a common finding in the general population and most individuals, in fact, remain asymptomatic. However, duodenal diverticular perforation is an occasional unfortunate endpoint that carries significant morbidity, and mortality rates and requires a particular attention and a wise judgement whether to liberally interfere surgically or to stay more conservative.In this writing, we describe a case of a 45-year-old male with a perforated duodenal diverticulum that presented in a stable general condition and was successfully managed conservatively, sparing the patient a particularly morbid surgical intervention. Perforated duodenal diverticula, though rare, can be managed conservatively in stable patients without signs of sepsis or generalized peritonitis. Conservative treatment, including intravenous antibiotics, bowel rest, and nasogastric suction, can be effective and avoid the morbidity associated with surgery. In our case, conservative management led to significant improvement, underscoring the importance of individualized treatment plans and close monitoring to decide on the necessity of surgical intervention.Conservative management of perforated duodenal diverticula should be considered in selected patients who fulfill the general settled criteria. Nevertheless, an individualized approach is recommended and escalating up the invasiveness of interventions may seem vital at any time during treatment.