Search

Despite English teachers' acknowledgement of the plurality of English and the emergence of different varieties of the language, the actual manifestations of this plurality and the associated principles do not seem to be equally embraced in their classroom approach. Against this background, this study investigated Iranian English teachers' conceptions of English as an International Language (EIL) and their corresponding instructional practices through semistructured interviews and non-participant classroom observations. Drawing upon the theory of planned behavior (TPB), as the theoretical/analytical framework, the researchers explored the participant teachers' behavioral, normative, and control beliefs underlying their intentions and actual classroom practices with regard to EIL. Findings revealed that although the teachers acknowledged the importance of raising learners' awareness of EIL in different aspects of their language use, they still leaned towards standard American or British English in their actual instructional practices. Such propensity was informed by their attitudes toward the inclusion of EIL principles, their perceptions of the existing social pressures, and their perceived difficulty of adopting an EIL-aware pedagogy. Moreover, the participant teachers' actual classroom instructions were found to be incongruent with their beliefs about the importance of raising students' awareness regarding different English varieties. Implications for language teacher education are discussed.

Baharudin Abdullah,1 Kar Chai Koh,2 Mohazmi Mohamed,3 Vincent Eng Soon Tan,4 Nurashikin Mohammad,5 Zamberi Sekawi,6 Petrick Periyasamy,7 Anitha Ramadas,8 Martin Duerden9 1School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia; 2Kepong Baru Polyclinic, Kuala Lumpur, Malaysia; 3Department of Primary Care Medicine, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia; 4KPJ Klang Specialist Centre, Klang, Selangor, Malaysia; 5KPJ Ampang Puteri Specialist Hospital, Selangor, Malaysia; 6Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 7Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; 8Department of Pharmacy, Hospital Kuala Lumpur, Ministry of Health, Kuala Lumpur, Malaysia; 9Centre for Medical Education, Cardiff University, Cardiff, UKCorrespondence: Baharudin Abdullah, Department of Otorhinolaryngology – Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia, Tel +6097676416, Email profbaha@gmail.comIntroduction: Using antibiotics in the treatment of acute sore throats has been linked with antimicrobial resistance (AMR) and needs to be addressed. The consensus sought to improve diagnostic accuracy, decrease unwarranted antibiotic prescriptions and enhance patient outcomes.Methods: A multidisciplinary panel of nine experts reviewed published literature and discussed current practices in managing sore throat. Ten evidence-based statements on sore throat and AMR, diagnostic accuracy and antibiotic prescribing, and symptomatic therapy were developed. A modified Delphi exercise was then carried out. A consensus was reached if at least 70% of the group agreed with the statement.Results: All 10 statements for managing acute sore throat achieved consensus. The major concern of AMR caused by improper antibiotic prescribing, particularly in cases of viral sore throat, was recognized. This underscores the need for improved diagnostic tools, such as the McIsaac score, to reduce needless antibiotic prescriptions. To improve patient satisfaction, effective pain management using non-antibiotic alternatives such as paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and flurbiprofen throat lozenges was recommended. Pain and inflammation can be adequately managed with low-dose NSAIDs. The potential benefits of topical NSAIDs were acknowledged for their milder safety profile than oral formulations.Conclusion: A consensus was achieved on the use of a clinical diagnostic tool, prudent use of antibiotics, and symptomatic therapy in acute sore throat management. The McIsaac score and point-of-care testing (POCT) for the presence of group A beta-hemolytic Streptococcus (GABHS) can aid in the decision-making process for antibiotic use, reducing needless prescriptions. The mainstay of therapy is symptomatic treatment, which includes the use of NSAIDs.Keywords: antibiotic, antimicrobial resistance, diagnosis, sore throat, symptomatic treatment

Polyurethane/hydroxyapatite (PU/HA) composites are well-known for various biomedical applications. This study reports a chemical approach to improve the interaction between HA and PU matrix. HA was surface-modified with 1,6-hexamethylene diisocyanate (HMDI). First, an isocyanate-modified HA (IHA) was synthesized by hydro-thermal method. Second, IHA was incorporated into a separately synthesized thermoplastic PU by a solvent casting technique. A series of PU/IHA composites was prepared by varying PU᾿s soft and hard segments. The IHA was added to PU (5 and 10 %). The FTIR spectra exhibited characteristic bands of urethane and HA, confirming the synthesis of the composites. XRD study showed the crystallite size of IHA (20 Å) with hexagonal geometry and an amorphous to semicrystalline nature of composites. SEM showed that composites displayed porous and granular morphology. The TGA thermograms of the composites revealed the thermal stability up to 400 °C. The IHA addition considerably improved hydrophilicity and degradation of the composites in simulated body fluid (SBF). MTT assay revealed improved cytocompatibility (> 80 %) of the composites. These results demonstrated an appreciable improvement in structure, morphology, hydrophilicity, degradation, and cytocompatibility of PU/IHA composites by chemical modification of HA. Hence, these composites possess remarkable potential for biomedical applications such as tissue regeneration.

Developing L2 learners' emotional balance through adaptive regulation is a significant determinant of successful learning. Despite the recent surge of interest in emotion regulation (ER) programs, research on L2 learners' ER strategies is surprisingly underdeveloped. To address this gap, the current qualitative study explored ten L2 learners' understanding of achievement emotions and ER strategies throughout a longitudinal ER-oriented training course. Data were collected from four rounds of semi-structured interviews and diaries at different junctures of time. Data analysis revealed that the most frequent ER strategies in the pre-training phase were distraction and suppression, which showed a gradual decrease in the post-training phases. However, the use of self-regulated learning strategies and reassurance had the lowest frequency, showing a great improvement during the post-training phases. Additionally, the students grew in regulating their emotions across four major areas: (a) sufficient perceived control over negative emotions in high-stakes situations, (b) use of explicit ER strategies, (c) efficient use of competency-oriented strategies, and (d) decreased distraction as a function of negative simulators. The study provides implications for employing ER-based training to transform students' negative emotional experiences into positive emotions.

When researching socioscientific topics, particularly on the Internet, readers face multiple texts that they must integrate into a coherent mental model. Previous research in monolingual settings has found that comprehension is biased toward readers' prior beliefs (text-belief consistency effect). Considering that the Internet is multilingual, this experiment focused on the influence of document language on the text-belief consistency effect. Assuming differences in epistemic prestige among languages, we hypothesized that document language would act as a credibility cue and moderate the text-belief consistency effect. Seventy-four German university students read two conflicting texts either in their L2 English (higher epistemic prestige) or in their L1 German (lower epistemic prestige). Participants constructed stronger situation models for the belief-consistent text than for the belief-inconsistent text only when they read the texts in German. These results indicate that document language can act as a source characteristic that may reduce belief biases in comprehension.

The recent pandemic has forced the educational sector to unwillingly reform its strategies by compelling it to embrace technology as the savior of the educational process. COVID-19 has adversely affected this sector by forcing a halt to all face-to-face learning in educational institutes, which led to dependence solely on online education and adopting strategies fit solely to distant learning. Thus, this paper has focused on the English language learning strategies adopted during COVID-19. Moreover, this research aims to provide the latest information about online teaching strategies adopted during the COVID-19 pandemic by English language instructors in Asia, especially in Middle Eastern countries. This study is qualitative in nature and utilizes the systematic literature review approach. The data for this research was gathered from renowned databases to maintain reliability. The results highlighted that among many strategies, three are most important in teaching the English language during COVID-19, first is collaborative learning (i.e., breakout classes, cloud-based collaboration), the second is flipped classroom, and the final is scaffolding. In the end, the study concluded with the recommendation as the findings of this research can help policymakers and educationists in developing effective or efficient strategies for tackling tough situations or pandemics.

Abstract Background We conducted this updated systematic review to assess the effects of corticosteroids vs. placebo or no treatment for improving patient-relevant outcomes in hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome. Methods CENTRAL, MEDLINE/PubMed, Web of Science, and Scopus, from the date of inception of the databases to February 3, 2024 were searched. Reference lists of included studies and systematic reviews were thoroughly searched. We included RCTs that enrolled women with HELLP syndrome, whether antepartum or postpartum, to receive any corticosteroid versus placebo or no treatment. No language or publication date restrictions were made. We used a dual independent approach for screening titles and abstracts, full text screening, and data extraction. Risk of bias was assessed in the included studies using Cochrane’s RoB 2 tool. Pairwise meta-analyses were conducted, where two or more studies met methodological criteria for inclusion. GRADE approach was used to assess certainty of evidence for the pre-specified outcomes. Results Fifteen trials (821 women) compared corticosteroids with placebo or no treatment. The effect of corticosteroids is uncertain for the primary outcome i.e., maternal death (risk ratio [RR] 0.77, 95% confidence interval [CI] 0.25 to 2.38, very low certainty evidence). Out of 6 studies reporting maternal death, 5 were judged overall to have “low risk” of bias. The effect of corticosteroids is also uncertain for other important outcomes including pulmonary edema (RR 0.70, 95% CI 0.23 to 2.09), dialysis (RR 3, 95% CI 0.13 to 70.78), liver morbidity (hematoma, rupture, and failure; RR 0.22, 95% CI 0.03 to 1.83), or perinatal death (0.64, 95% CI 0.21 to 1.97) because of very low certainty evidence. Low certainty evidence suggests that corticosteroids have little or no effect on the need for platelet transfusion (RR 0.98, 95% CI 0.60 to 1.60) and may result in a slight reduction in acute renal failure (RR 0.67, 95% CI 0.40 to 1.12). Subgroup and sensitivity analyses showed results that were similar to the primary synthesis. Conclusions In women with HELLP syndrome, the effect of corticosteroids vs. placebo or no treatment is uncertain for patient-relevant outcomes including maternal death, maternal morbidity, and perinatal death. These uncertainties regarding this critical question should be addressed by adequately powered rigorous trials. Systematic review registration Center for Open Science, osf.io/yzku5.

Abstract Introduction The wrist joint is a complex anatomical structure, and various radiographic parameters are utilized to assess its normal alignment and orientation. Among these parameters are carpal height ratio (CHR) and ulnar variance (UV). Previous literature has indicated that factors such as age and gender may influence these parameters; However, there is a lack of studies investigating these differences specifically in the Middle East or Jordan. Additionally, no prior research has explored the relationship between UV and CHR. Therefore, the objective of this study is to investigate these critical radiological parameters and their associations. Methodology A cross-sectional study design was employed, wherein a total of 385 normal wrist X-rays were reviewed, and CHR and UV were measured. Intra-observer and inter-observer reliability assessments were conducted to ensure the consistency and accuracy of measurements. Additionally, the association between UV and CHR was measured and plotted for further analysis. Results In our study, the mean CHR was 0.5 (range: 0.4 to 1.5), and the mean UV was − 0.3 mm (range: -5.8 mm to 4.1 mm). We found a significant negative correlation between CHR and age (p

Abstract Hip fractures are common orthopedic injuries that have significant impacts on patients and healthcare systems. Previous studies have shown varying outcomes for hip fracture management in different settings, with diverse postoperative outcomes and complications. While teaching hospital settings have been investigated, no studies have specifically examined hip fracture outcomes in teaching hospitals in Jordan or the broader Middle East region. Therefore, the aim of this study was to investigate this important outcome. A cohort comprising 1268 patients who underwent hip fracture fixation from 2017 to 2020 was analyzed for nine distinct outcomes. These outcomes encompassed time to surgery, ICU admissions, perioperative hemoglobin levels, length of hospital stay, readmission rates, revision procedures, and mortality rates at three time points: in-hospital, at 6-months, and at 1-year post-surgery. The analysis of 1268 patients (616 in teaching hospitals, 652 in non-teaching hospitals) showed shorter mean time to surgery in teaching hospitals (2.2 days vs. 3.6 days, p

Grazing management strategies in arid ecosystems are of critical importance to regulate plant regeneration, improve forage quality, and ensure sustainable utilization of rangelands. This study examines the impacts of controlled grazing management on vegetation dynamics (gain/loss) and land cover changes over a 17-year period (2006-2022) at the Royal Botanic Garden, Jordan. Climatic factors, including precipitation and temperature, were analyzed alongside the Normalized Difference Vegetation Index (NDVI) to assess vegetation health and greenness. Autoregression models were used to investigate annual temporal trends between vegetation biodiversity indices and climatic factors. To assess controlled grazing's impact on vegetation biodiversity, the study period was divided into four periods: the initial period (period0: 2006-2007) which represented the pre-dating-controlled grazing period, followed by three subsequent periods: period1 (2008-2012), period2 (2013-2017), and period3 (2018-2022). Land cover analysis using yearly averaged NDVI values was assessed, including five distinct classes: water body, barren soil, herbaceous and shrub, open forest, and closed forest. The study identifies short-term changes during period1 and long-term changes during periods 2and3. The results revealed a significant annual temporal trend only in the NDVI index (P

Oral health is a very critical component of individuals' physical and psychological well-being. The present study aimed to investigate the dental health knowledge, attitude, and practice among schoolchildren in Abha. A cross-sectional epidemiological study was conducted. Each student completed a questionnaire regarding oral health. The participants were 800 students: 54.8% were male and 45.2% were female. Knowledge scores showed that -59.1% of the participants have fair knowledge. Statistically significant results were found between the age, school type, and students' educational level with the knowledge of oral health care (p < 0.05). More than half of the participants had positive attitudes (57.2%) and less than half demonstrated satisfactory oral health habits (45.3%). Students' educational level was significantly associated with attitudes and practices (p < 0.05). It can be concluded that the average knowledge, attitude, and practice level was 53.9%, which is not a positive indicator and needs to be strengthened.

The current study aimed to reveal the educational implications of distance learning within the coronavirus pandemic (COVID-19) according to university students' point of view and some variables. The study sample consisted of 3,584 male and female students. The results showed that there are educational effects of high degree distance learning on the total score of the fields of the study tool arranged as follows: possession of skills to deal with smart devices (phones and computers), social growth, academic performance, management of self-learning and motivation to learn, mental growth, development of thinking and research and emotional growth. The most prominent positive effects of distance learning were increasing students' experience in using smart devices and applications in the learning process and their optimal use of them; forming positive trends towards studying, enriching students' knowledge side; informing students about the latest reports and research in their field of specialisation; ease of access for students' information and their search for it; students' perseverance to excel in the study and obtain high rates; students' continuous follow-up to lectures; reliance on self-learning; optimal use of time and effort; and active participation in lectures.

The heat transfer improvement by using CuO/water nanofluid (NF) in a wavy channel is evaluated numerically using the turbulent two-phase mixture and the κ - ε models. The numerical work is a 2-dimensional model created and analyzed in Gambit and Ansys Fluent software, respectively. The flow Reynolds (Re) numbers of 8000 – 40,000, wavelength ranging from 0 – 0.4 m, and solid volume fraction (SVF) of 0 % to 4 % are investigated. In all cases, a constant heat flux of q′′=5000 W/m2 is applied on the outer surface of the heat exchanger. The heat transfer and fluid flow were analyzed by the flow visualization method and heat transfer evaluation indexes. The results show that by increasing the Re number, the vortices increase and more turbulence are generated in the vicinity of the waves near the channel inlet. As the amplitude of the channel waves increased, the velocity at the top of the wave increased, and the resulting pressure gradient behind the wave is intensified and the reverse flow is generated. The improving effect of using NF is more prominent where the effect of other enhancing factors is weak. For wall amplitude of 0.1 m, by increasing the SVF from 1 – 4 % the average Nu number (Nuavg) increased by 35 % and 22 % in Re = 8,000 and 40,000, respectively.

Background: Glioblastoma multiforme (GBM) is a very aggressive primary central nervous system (CNS) tumor with limited therapeutic options and poor prognosis. This study aimed to analyze the association between single nucleotide polymorphisms (SNPs), including IDH1 rs121913500C > T, IDH2 rs11540478G > A, and EGFR rs1468727C > T, and their association on the risk and overall survival of GBM patients in Jordan. Methods: Using a case-control study design involving 63 GBM patients and 226 healthy controls was conducted at King Abdullah University Hospital in Jordan. DNA extraction was performed using formalin-fixed and paraffin-embedded tissue for GBM samples and blood samples for controls. SNPs analysis was performed using the Sequenom iPLEX assay sequencing technique. Survival outcomes were assessed using Cox models and hazard ratios (HR), and single-cell RNA (scRNA) analysis was performed from GSE70630. Results: The study showed a significant association between genotype frequency in GBM cases and controls for specific SNPs, including IDH1 rs121913500C > T, and EGFR rs1468727C > T. The G/G genotype of rs11540478 (IDH2) was associated with better prognostic outcomes in GBM patients. The scRNA analysis demonstrated the differential expression of IDH1, IDH2, and EGFR in GBM, with enrichment in central carbon metabolism in cancer. Conclusion: Our findings suggest that SNPs, particularly in IDH1 and IDH2 genes and EGFR, may serve as diagnostic and prognostic biomarkers for GBM. While the study underscores the clinical relevance of these genetic variants, further investigations with larger and more diverse populations are essential to validate and extend these associations.