The Impact of the Increase of Crude Oil Prices on the Jordanian Public Debt for the Period 1998-2013

The study aimed to identify the impact of the increase of crude oil prices on the Jordanian Public debt for the period 1998-2013, as well as impact of the increase of crude oil prices on the internal and external debt in Jordan for the Period 1998-2013. So, the increase in the crude oil prices has a significant impact on the budget deficit in Jordan and therefore on indebtedness. The study found a number of results most notable was: a. The results explain that increase of the (crude oil prices) will lead to increase the (public debt) of Jordan for the Period 1998-2013. b. The results explain that increase of the (crude oil prices) will lead to increase the (internal debt) of Jordan for the Period 1998-2013. c. The results explain that increase of the (crude oil prices) will lead to decrease the (external debt) of Jordan for the Period 1998-2013. The study concluded that a number of recommendations and conclusions. Keywords: Crude oil prices, Public debt, Internal debt, External debt, Budget deficit, Jordan

Impact of the Public Debt on Deficit of the Public Budget in Jordan for the Period (1998-2014)

The study aimed to identify the impact of the public debt on deficit of the public budget in Jordan for the Period (1998-2014), as well as impact of the internal and external debt on the deficit of the public budget in Jordan. The study found a number of results most notable was: a. There exist a statistically significant impact at the significance level (α = 0.05), for the public debt on deficit of the public budget in Jordan for the Period (1998-2014). b. There exist a statistically significant impact at the significance level (α = 0.05), for the internal debt on deficit of the public budget in Jordan for the Period (1998-2014). c. There is no a statistically significant impact at the significance level (α = 0.05), for the external debt on deficit of the public budget in Jordan for the Period (1998-2014). The study concluded to a number of conclusions. Keywords: Public debt, Internal debt, External debt, Public Budget deficit, Jordan

Estimation the Reliability of the Productivity Machines and it's Availability for the Exponential Distribution A Case Study of AL-Qastal Factory for Producing Juice and Carbonated Soft Drinks in Jordan

This study aimed to apply the parametric methods in order to estimate the reliability of productivity machines and it's availability, also to estimate the failure rate function in AL-Qastal factory for producing juice and carbonated soft drinks in Jordan. To achieve the study objectives, the study depend on the machines work times and the repair times of the machines, during the period (1/10/2013 – 31/3/2014). The study findings a number of results, including: 1-     There exist a statistically significant (positive) relationship at the significance level (? = 0.05), between the estimated values of the reliability functions R^(t) for the productivity machines and it's availability A(t). 2-     There exist a statistically significant (negative) relationship at the significance level (? = 0.05), between the estimated values of the reliability functions R^(t) for the productivity machines and the estimated values of the failure rate function h^(t). 3-     There are no statistically significant differences at the significance level        (? = 0.05), between the estimated values of the reliability functions R^(t) for the productivity machines. Upon the foregoing results, the study reached to a number of conclusions and recommendations. Keywords: Exponential Distribution, Reliability, Availability, Failure Rate

Conclusions and results of colonoscopy at Tishreen University Hospital during 2018

Introduction: Colonoscopy is now considered a routine procedure in gastrointestinal practice, and the current gold standard in diagnosis and evaluation of colonic pathologies. It is the most accurate diagnostic tool of colonic mucosal lesions when suspected clinically or radiologically. Aim: This study will allow to assess the diagnostic outcome of colonoscopy at Tishreen University Hospital in 2018, evaluating the diagnostic yield of colonoscopy and the correlation between indications and outcome of colonoscopy, as well for unplanned events and its percentage. Methods: This is a hospital‑based observational descriptive study that has been carried out in Tishreen University Hospital, Lattakia, Syria between January, 2018 and December, 2018. All patients were approached before colonoscopy, detailed examination and questioning were carried out, followed by the colonoscopy procedure. All endoscopic findings were recorded, as well as endoscopic unplanned events, and total procedure time. Results: A total of 601 patients went colonoscopy (323 males, 278 females), the median age was 55 years with a range of 83 years. The indications for colonoscopy were abdominal pain (33.8%), iron deficiency anemia (26.3%), lower-gastrointestinal bleeding (22.8%), constipation (17.8%), diarrhea (16.3%), weight loss (12.1%), screening (4.3%), and other indication of 16.8% that included search for a primary tumor (4.5%), obstipation (3.7%), and assessment of parametrial invasion of the rectum in cervical cancer (1.5%) Despite the at least 10 major pathologies seen on colonoscopy, normal cases constituted the majority (36.3%). The most common endoscopic findings were hemorrhoids (24.1%), polyps (16.5%), inflammatory bowel disease IBD (11.3%), colorectal cancer CRC (10.3%); 85.5% of CRC were located in the left side of the colon. Diverticulosis were found in 5.5%, infectious colitis in 2.5%, and angiodysplasia in 1.8%.  The diagnostic yield was 63.7%. Pain was the most encountered unplanned event that has been seen in 90% of cases, mostly of mild intensity. Serious complications were encountered in 5 cases (0.83%), consisted of 3 post polypectomy bleeding (0.5%), 1 respiratory arrest (0.16%), and 1 perforation (0.16%); none of them ended in patients’ permanent harm or death. Total procedure time (TPT) for colonoscopy was 24.2 ± 12.3 minutes. Conclusion: In Syrian patients went colonoscopy at Tishreen University Hospital, Lattakia during 2018, the most prevalent indication was abdominal pain followed by anemia and lower GI bleeding. The most common finding was hemorrhoids, followed by benign polyps and IBD. CRC was found in 10.3% of cases. We detected a significant correlation between patients’ chief complaint and colonoscopic findings with regards to CRC and IBD. In general, colonoscopy was safe and few serious complications were recorded. المقدمة: يعدّ الآن تنظير الكولونات من الإجراءات الروتينية بالحقل الهضمي، ووسيلة الاستقصاء الذهبية لتشخيص ودراسة الموجودات المرضية في الكولون، وهو الوسيلة الأكثر دقة في تشخيص آفات مخاطية الكولون عند الشك بها سريريا أو شعاعيا. الهدف: ستسمح هذه الدراسة بمعرفة النتاج التشخيصي وطيف الإمراضيات الكولونية المنتشرة في منطقتنا الجغرافية متمثلة بمراجعي مشفى تشرين الجامعي خلال عام 2018، إضافة لدراسة العلاقة الترابطية بين استطباب تنظير الكولون والموجودات التنظيرية المرضية. كما ستسمح بدراسة الاختلاطات الحاصلة أثناء التنظير. المواد والطرائق: هذه الدراسة دراسة رصدية وصفية أجريت في مشفى تشرين الجامعي في اللاذقية بين كانون الثاني وحتى كانون الأول من عام 2018. تم مقاربة جميع المرضى قبيل البدء بالتنظير، أجري الفحص والاستجواب المفصّل عن الأعراض التي استطبت إجراء تنظير الكولون لهم، وسجلت الموجودات التنظيرية المرضية أو الطبيعية، كما سجلت الاختلاطات الحاصلة أثناء التنظير، بالإضافة لزمن التنظير الكامل. النتائج: اشتملت الدراسة على 601 مريضا (323 ذكرا، و278 أنثى) أجري لهم تنظير الكولون، بواســـط أعمــار 55 ســــنة مع مــدى 83 ســــنة. كــانت اســتطبابات تنظيـر الكـــــولـون هــــي الألــم البطنــــي (33.8%)، فقر الدم العوزي (26.3%)، النزف السفلي (22.8%)، الإمساك (17.8%)، الإسهال (16.3%)، نقص الوزن (12.1%)، والمسح الاستقصائي في 4.3%. كما كانت 16.8% من الحالات تابعة لاستطبابات أخرى أهمها البحث عن مصدر ورمي بدئي (4.5%)، انسداد الأمعاء (3.7%)، وتقييم ارتشاح ورمي إلى المستقيم من ورم عنق الرحم (1.5%). كان نتاج التنظير طبيعياً في 36.3%. أهم الموجودات التنظيرية المرضية كانت البواسير (24.1%)، البوليبات (16.5%)، الداء المعوي الالتهابي (11.3%)، سرطان الكولون والمستقيم (10.3%) كان منها 85.5% بالجهة اليسرى للكولون. وشوهد داء الرتوج (5.5%)، التهاب الكولون الانتاني (2.5%) والتشوهات الوعائية (1.8%). وكان النتاج التشخيصي diagnostic yield 63.7%. كان الألم هو أكثر الاختلاطات مشاهدة بنسبة 90% معظمه من الدرجة الخفيفة. أما الاختلاطات الهامة فشوهدت في 0.83% فقط وكانت عبارة عن 3 حالات نزف تالٍ لاستئصال بوليبات (0.5%)، وحالة تثبيط تنفسي واحدة (0.16%) وحالة انثقاب واحدة (0.16%)؛ لم يسفر أي من هذه الاختلاطات عن أذية دائمة أو وفاة للمريض. زمن التنظير الإجمالي 24.2±12.3 دقيقة. الخلاصة: لدى المرضى الذين أجري لهم تنظير الكولون في مشفى تشرين الجامعي كان الألم لبطني هو العرض الأكثر مشاهدة، متبوعا بفقر الدم العوزي والنزف السفلي. كانت البواسير هي أكثر الموجودات التنظيرية، تلتها البوليبات والداء المعوي الالتهابي. شوهدت أورام الكولون والمستقيم في 10.3% من التناظير، مع سيطرة لأن تكون بالجهة اليسرى للكولون. كما وجدنا علاقة ترابطية بين الاستطباب التنظيري ونتاج التنظير فيما يخص الداء المعوي الالتهابي وأورام الكولون والمستقيم. ويعدّ تنظير الكولون بشكل عام إجراء آمن، مع نسبة منخفضة جدا من الاختلاطات الهامة. إجمالي زمن تنظير الكولون المتوقع 24.2±12.3 دقيقة

A combined Blockchain and zero-knowledge model for healthcare B2B and B2C data sharing

The two main forms of healthcare data exchange among entities are business-to-business (B2B) and business-to-customer (B2C). The former uses the electronic data interchange (EDI) technology between healthcare institutions, while the latter is usually conducted by providing web-based interfaces for patients. This research argues that both forms have inherent security and privacy weaknesses. Furthermore, patients lack appropriate transparency and control over their own Personally Identifiable Information (PII). We explore the issues of medical record exchange, analyze them and suggest appropriate solutions in the form of a new model to mitigate them. The vulnerabilities, ranging from critical to minor, include the possibility of Man-in-The-Middle (MiTM) and supply chain attacks, weak cryptography, repudiable transactions, single points of failure (SPOF), and poor access controls. A novel model will be presented in this research for healthcare data sharing which applies the best security practices. The proposed unified model will counter the listed vulnerabilities. It automates the healthcare processes in decentralized architecture by utilizing the smart contracts for B2C transactions such as medicine purchase. The model is based on the Blockchain and zero-knowledge proofs. It is made with novel controls which represent the latest advancements in cybersecurity. It has the potential of setting a new cornerstone

A Flood Risk Management Program of Wadi Baysh Dam on the Downstream Area: An Integration of Hydrologic and Hydraulic Models, Jizan Region, KSA

For public safety, especially for people who dwell in the valley that is located downstream of a dam site, as well as the protection of economic and environmental resources, risk management programs are urgently required all over the world. Despite the high safety standards of dams because of improved engineering and excellent construction in recent times, a zero-risk guarantee is not possible, and accidents can happen, triggered by natural hazards, human actions, or just because the dam is aging. In addition to that is the impact of potential climate change, which may not have been taken into account in the original design. A flood risk management program, which is essential for protecting downstream dam areas, is required. Part of this program is to prepare an inundation map to simulate the impact of dam failure on the downstream areas. The Baysh dam has crucial importance both to protect the downstream areas against flooding, to provide drinking water to cities in the surrounding areas, and to use the excess water for irrigation of the agricultural areas located downstream of the dam. Recently, the Kingdom of Saudi Arabia (KSA) was affected by extraordinary rainstorm events causing many problems in many different areas. One of these events happened along the basin of the Baysh dam, which raised the alarm to the decision makers and to the public to take suitable action before dam failure occurs. The current study deals with a flood risk analysis of Wadi Baysh using an integration of hydrologic and hydraulic models. A detailed field investigation of the dam site and the downstream areas down to the Red Sea coast has been undertaken. Three scenarios were applied to check the dam and the reservoir functionality; the first scenario at 100-and 200-year return period rainfall events, the second scenario according to the Probable Maximum Precipitation (PMP), and the third scenario if the dam fails. Our findings indicated that the Baysh dam and reservoir at 100-and 200-year rainfall events are adequate, however, at the PMP the water will spill out from the spillway at ~8900 m3/s causing flooding to the downstream areas; thus, a well-designed channel along the downstream wadi portion up to the Red Sea coast is required. However, at dam failure, the inundation model indicated that a vast area of the section downstream of the dam will be utterly devastated, causing a significant loss of lives and destruction of urban areas and agricultural lands. Eventually, an effective warning system and flood hazard management system are imperative

Racial differences in serum prostate-specific antigen (PSA) doubling time, histopathological variables and long-term PSA recurrence between African-American and white American men undergoing radical prostatectomy for clinically localized prostate cancer

To determine if there are significant differences in biochemical characteristics, biopsy variables, histopathological data, and rates of prostate-specific antigen (PSA) recurrence between African-American (AA) and white American (WA) men undergoing radical prostatectomy (RP), as AA men are twice as likely to die from prostate cancer than their white counterparts. PATIENTS AND METHODS We established a cohort of 1058 patients (402 AA, 646 WA) who had RP and were followed for PSA recurrence. Age, race, serum PSA, biopsy Gleason score, clinical stage, pathological stage, and PSA recurrence data were available for the cohort. The chi-square test of proportions and t -tests were used to assess basic associations with race, and log-rank tests and Cox regression models for time to PSA recurrence. Forward stepwise variable selection was used to assess the effect on the risk of PSA recurrence for race, adjusted by the other variables added one at a time. RESULTS The AA men had higher baseline PSA levels, more high-grade prostatic intraepithelial neoplasia (HGPIN) in the biopsy, and more HGPIN in the pathology specimen than WA men. The AA men also had a shorter mean (sd) PSA doubling time before RP, at 4.2 (4.7) vs 5.2 (5.9) years. However, race was not an independent predictor of PSA recurrence ( P  = 0.225). Important predictors for PSA recurrence in a multivariable model were biopsy HGPIN ( P  < 0.014), unilateral vs bilateral cancer ( P  < 0.006), pathology Gleason score and positive margin status (both P  < 0.001). CONCLUSIONS This study indicates that while there are racial differences in baseline serum PSA and incidence of HGPIN, race is not an independent risk factor for PSA recurrence. Rather, other variables such as pathology Gleason score, bilateral cancers, HGPIN and margin positivity are independently associated with PSA recurrence. The PSA doubling time after recurrence may also be important, leading to the increased mortality of AA men with prostate cancer.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74706/1/j.1464-410X.2005.05561.x.pd

Access-Site Complications in Transfemoral Neuroendovascular Procedures: A Systematic Review of Incidence Rates and Management Strategies

BACKGROUND: The femoral artery is the most common access route for cerebral angiography and neurointerventional procedures. Complications of the transfemoral approach include groin hemorrhages and hematomas, retroperitoneal hematomas, pseudoaneurysms, arteriovenous fistulas, peripheral artery occlusions, femoral nerve injuries, and access-site infections. Incidence rates vary among different randomized and nonrandomized trials, and the literature lacks a comprehensive review of this subject. OBJECTIVE: To gather data from 16 randomized clinical trials (RCT) and 17 nonrandomized cohort studies regarding femoral access-site complications for a review paper. We also briefly discuss management strategies for these complications based on the most recent literature. METHODS: A PubMed indexed search for all neuroendovascular clinical trials, retrospective studies, and prospective studies that reported femoral artery access-site complications in neurointerventional procedures. RESULTS: The overall access-site complication rate in RCTs is 5.13%, while in in non-RCTs, the rate is 2.78%. The most common complication in both groups is groin hematoma followed by access-site hemorrhage and femoral pseudoaneurysm. On the other hand, wound infection was the least common complication. CONCLUSION: The transfemoral approach in neuroendovascular procedures holds risk for several complications. This review will allow further studies to compare access-site complications between the transfemoral approach and other alternative access sites, mainly the transradial approach, which is gaining a lot of interest nowadays

The Youngest Palestinian Case of Multisystem Inflammatory Syndrome in children (MIS-C)

The multisystem inflammatory syndrome in children (MIS-C) considers a post-infectious immunological response to coronavirus illness (COVID-19) that was originally identified in the United Kingdom and later identified in other countries.  A previously healthy 3-month-old boy was admitted to hospital context with -5-day history of fever, gastrointestinal symptoms [diarrhea, vomiting of normal gastric contents], hypoactivity, and poor oral intake, but so far no history of covid-19 active disease. The infant was dehydrated, with macular non-blanching skin rash everywhere over his body and widespread non-pitting edema. With supportive measures, methylprednisolone and IV immunoglobulin, the child improved, with his fever, skin rash, and laboratory tests returning to normal. On the seventh day of hospitalization, he was discharged. This is identified as the youngest reported case of MIS-C since the beginning of the COVID-19 pandemi

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London