Preparation and Evaluation of Phenol Formaldehyde-Montmorillonite and Its Utilization in the Adsorption of Lead Ions from Aqueous Solution.

In this study, phenol formaldehyde-montmorillonite (PF-MMT) was prepared and used for lead ion (Pb2+) adsorption. Batch adsorption experiments were conducted to determine the optimal conditions. The calculated adsorption equilibrium (q) revealed that pseudo-second-order (PSO) and Langmuir isotherm models best fit the experimental data, suggesting chemisorption as the main mechanism. An adsorption capacity (qmax) of 243.9 mg/g was achieved. Fourier transform infrared (FTIR) analysis showed new peaks in PF-MMT-Pb, indicating metal complexation. Scanning electron microscopy (SEM) imaging displayed distinct Pb2+ clusters on the adsorbent surface. Adsorption was rapid, attaining equilibrium within 90 min. Effects of time, dose, concentration, and pH were systematically investigated to optimize the process. Lead ion removal efficiency reached 98.33% under optimum conditions after 90 min. The adsorption process was chemisorption based on the Dubinin-Kaganer-Radushkevich model with a free energy of 14,850 J/mol. The substantial adsorption capacity, rapid kinetics, and high removal efficiency highlight PF-MMT's potential for effective Pb2+ removal from aqueous solution.

Decision-Making Preferences among Advanced Cancer Patients in a Palliative Setting in Jordan.

Understanding patients' decision-making preferences is crucial for enhancing patients' outcomes. The current study aims to identify Jordanian advanced cancer patients' preferred decision-making and to explore the associated variables of the passive decision-making preference. We used a cross-sectional survey design. Patients with advanced cancer referred to the palliative care clinic at a tertiary cancer center were recruited. We measured patients' decision-making preferences using the Control Preference Scale. Patients' satisfaction with decision-making was assessed with the Satisfaction with Decision Scale. Cohen's kappa statistic was used to assess the agreement between decision-control preferences and actual decision-making, and the bivariate analysis with 95% CI and the univariate and multivariate logistic regression were used to examine the association and predictors of the demographical and clinical characteristics of the participants and the participants' decision-control preferences, respectively. A total of 200 patients completed the survey. The patients' median age was 49.8 years, and 115 (57.5%) were female. Of them, 81 (40.5%) preferred passive decision control, and 70 (35%) and 49 (24.5%) preferred shared and active decision control, respectively. Less educated participants, females, and Muslim patients were found to have a statistically significant association with passive decision-control preferences. Univariate logistic regression analysis showed that, being a male (p = 0.003), highly educated (p = 0.018), and a Christian (p = 0.006) were statistically significant correlates of active decision-control preferences. Meanwhile, the multivariate logistic regression analysis showed that being a male or a Christian were the only statistically significant predictors of active participants' decision-control preferences. Around 168 (84%) of participants were satisfied with the way decisions were made, 164 (82%) of patients were satisfied with the actual decisions made, and 143 (71.5%) were satisfied with the shared information. The agreement level between decision-making preferences and actual decision practices was significant (ⱪ coefficient = 0.69; 95% CI = 0.59 to 0.79). The study's results demonstrate that a passive decision-control preference was prominent among patients with advanced cancer in Jordan. Further studies are needed to evaluate decision-control preference for additional variables, such as patients' psychosocial and spiritual factors, communication, and information sharing preferences, throughout the cancer trajectory so as to inform policies and improve practice.

Validation of the Arabic Version of the Edmonton Symptom Assessment System.

Quality cancer care is a team effort. In addition, patients' symptoms change over the course of treatment. As such, the Edmonton Symptom Assessment System (ESAS) is a simple tool designed to quickly monitor symptom change. Here, we present the results from a two-phase study aimed at validating the Arabic version of the ESAS (ESAS-A). Phase one involved the creation of two versions of the ESAS with both reverse and forward translations by bilingual, native Arabic speakers as well as evaluation by an expert panel. The reconciled version was then administered to 20 patients as a pilot from which to create the final version, which was then used with 244 patients. Phase two for the ESAS-involved an ESAS-based validation of 244 adults aged 18 years and older who were diagnosed with advanced cancer; then, further validation was completed in conjunction with two other symptom survey tools, the EORTC-Pal 15 and the HADS. The ESAS-A items possessed good internal consistency with an average Cronbach's alpha of 0.84, ranging from 0.82 to 0.85. Moreover, the results of ESAS-A showed good agreement with those of EORTC QLQ- 15 PAL (r = 0.36 to 0.69) and HADS (r = 0.60 and 0.57) regarding anxiety and depression. We found the ESAS-A to be responsive to symptom change and a median time to completion of 3.73 min. The results of our study demonstrate that the ESAS-A is a reliable, valid, and feasible tool for the purposes of monitoring symptom change over the course of cancer treatment.

Comparison of the Efficacy of Atorvastatin with Rosuvastatin in Preventing Cardiovascular Events Among Patients With Cardiovascular Disease: A Meta-Analysis.

The aim of this study was to assess and compare the efficacy of atorvastatin with rosuvastatin in preventing cardiovascular events among patients already diagnosed with cardiovascular disease (CVD). We performed this systematic review and meta-analysis as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Two investigators independently searched online databases, including PubMed, the Cochrane Library, and the Excerpta Medica database (Embase), from the inception of databases until November 2023. The primary outcome assessed in the meta-analysis included cardiovascular mortality and a composite of cardiovascular events. Other outcomes included myocardial infarction and stroke. A total of four studies were selected for our meta-analysis. A total of 7,378 patients were enrolled, including 3,721 in the atorvastatin group and 3,657 in the rosuvastatin group. Pooled analysis showed that the incidence of composite cardiovascular events was not significantly different in patients receiving atorvastatin and patients receiving rosuvastatin (risk ratio (RR): 0.93, 95% confidence interval (CI): 0.79 to 1.09, p-value: 0.38, I-square: 0%). Pooled analysis showed that the risk of cardiovascular mortality was not significantly different between the two study groups (RR: 0.96, 95% CI: 0.51 to 1.81, p-value: 0.93, I-square: 0%). In conclusion, our meta-analysis, based on four selected studies, found no significant disparities in composite cardiovascular events, cardiovascular mortality, myocardial infarction, or stroke between patients administered atorvastatin and those receiving rosuvastatin. This outcome underscores the comparable efficacy of these statins in mitigating cardiovascular risks, highlighting their clinical equipoise in the realm of secondary prevention.

Comparison of the Efficacy and Safety of Left Atrial Appendage Closure and Direct Oral Anticoagulants for Atrial Fibrillation: A Meta-Analysis of Randomized Control Trials and Observational Studies.

The aim of this study was to compare the efficacy and safety of left atrial appendage closure (LAAC) and direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF). This meta-analysis was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. Two investigators performed an online database search on PubMed, Web of Science, and Scopus databases from inception to October 31, 2023, without any language or time restrictions. Outcomes assessed in this meta-analysis included all-cause mortality, cardiovascular mortality, stroke, and major bleeding events. Eight studies were included in this meta-analysis, enrolling 7,629 participants with AF (4,287 in the DOAC group and 3,342 in the LAAC group). The pooled analysis showed that the risk of all-cause mortality was significantly higher in patients in the DOAC group compared to LAAC (relative risk (RR): 1.87, 95% confidence interval (CI): 1.50 to 2.34). The risk of cardiovascular mortality was 1.60 times higher in patients receiving DOACs compared to those receiving LAAC (RR: 1.60, 95% CI: 1.12 to 2.28). The risk of stroke was not significantly different between the two groups (RR: 1.15, 95% CI: 0.95 to 1.41). In conclusion, LAAC for AF patients proves to be safe and effective for stroke prevention, exhibiting a superior profile in terms of all-cause mortality, cardiovascular events, and major bleeding compared to oral anticoagulation (OAC). These findings prompt consideration of LAAC as a preferred treatment for cardiovascular event prevention in high-bleeding-risk patients.

Three-dimensional evaluation of root canal morphology of maxillary first premolars: Micro-computed tomographic study.

Aim: The aim of this in vitro study was to investigate the root and root canal morphology of maxillary first premolar teeth in a Kuwaiti population using micro-computed tomography (µ- CT). Materials and methods: A total of 100 maxillary first premolars were scanned in a micro- computed tomographic device. The external anatomy (number of roots, distance from cementoenamel junction to apex, and presence of a palatal groove) and internal anatomy (number of canals and presence of apical deltas, lateral canals, and isthmi) of teeth were analyzed using descriptive analysis. Results: The number of roots was one root (57 %), two roots (41 %), and three roots (2 %). The longest and shortest roots measured 17.7 and 11.2 mm, respectively. The palatal groove was present in 63.4 % of the teeth. According to Vertucci's classification, type IV configuration was the most prevalent (53 %), followed by type II. A new root canal configuration type (1-2-1-2-1) was detected. Apical deltas, lateral canals, and isthmi were present in 33 %, 48 %, and 21 % of teeth, respectively. Conclusion: Type IV canal configuration was the most common root canal configuration. A new root canal configuration type IX for (1-2-1-2-1) was proposed for Kuwaiti population. The µ-CT device could to be a better diagnostic tool for understanding the anatomy of the root canal system.

Exploring the Nexus Between E-Business Processes and Organizational Performance: Can Technological Opportunism Play Any Role?

The digitization of business processes has gained much scholarly and practical attention in the recent past. To understand their effectiveness, particularly in connection to organizational performance, the current study developed and tested a comprehensive framework. Through obtaining data from 350 manufacturing businesses, the study investigated using Smart PLS3 and found a significant influence of online procurement, channel management, and service delivery capabilities on organizational performance. Furthermore, the study also found the significant direct and moderating potential of technological opportunism to harness organizational performance. The study concludes that e-business processes serve as crucial resources and capabilities for businesses to achieve their goals and objectives. The study offers contributory implications for theory and practice indicating for strategic investment of e-business processes for businesses aiming to boost their performance.

Frequency and distribution of root filled teeth and apical periodontitis in a Jordanian subpopulation.

OBJECTIVE: The aim of this study was to evaluate the prevalence and distribution of apical periodontitis and endodontic treatment in a Jordanian subpopulation. STUDY DESIGN: Digital panoramic radiographs of 294 patients who were assessed at Caritas Association between January and September 2008 were evaluated. The coronal and periapical status of all visible teeth were evaluated according to the criteria proposed by de Moor et al. RESULTS: Of the 294 subjects assessed, 83.7% had apical periodontitis and 63.3% had endodontically treated teeth. Of the 7,390 teeth assessed, 11.6% had apical periodontitis and 5.7% were endodontically treated. A correlation was found between apical periodontal lesions and endodontically treated teeth. Endodontic treatment was inadequate in 72.4% of the endodontically treated teeth, of which 87.0% had apical periodontitis. No difference in the number of endodontically treated teeth or the presence of apical periodontitis was found between male and female subjects (P > .05). CONCLUSIONS: The results of this study indicate that there is a relatively higher prevalence of apical periodontitis compared with those of many other countries. High percentage of endodontically treated teeth was inadequate and associated with periapical pathosis, indicating a poor quality of endodontic treatment.

The effect of dental restoration type and material on periodontal health.

PURPOSE: To investigate the relationship between the type and material of dental restorations and periodontal health in a sample of Jordanians. MATERIALS AND METHODS: Patients attending the Dental Teaching Clinics of Jordan University of Science and Technology with restored teeth were examined. For every patient, the plaque index, gingival index, probing depth and clinical attachment level were recorded on restored and non-restored tooth surfaces. The restoration types were Classes II, III and V, in addition to crowns and bridge abutments. The restorative materials included amalgam, tooth-coloured materials (resin composite and glass ionomer), non-precious alloys, porcelain and acrylic. RESULTS: Class III restorations were associated with the lowest plaque index (0.62), gingival index (1.13), probing depth (1.62 mm) and clinical attachment level (0.31 mm). Class II restorations had the highest plaque index (0.99) and probing depth values (2.27 mm). Crowns and bridge abutments had the highest gingival index (1.65 and 1.61, respectively), high probing depth (2.01 and 2.15 mm), but a low plaque index (0.69 and 0.66). Class V restorations demonstrated the highest attachment loss (0.92 mm). Resin composite and glass ionomer restorative materials demonstrated the lowest gingival index (1.21) and probing depth (1.75 mm), whereas porcelain demonstrated the lowest plaque index (0.51) and clinical attachment level (0.14 mm). Amalgam was associated with the highest plaque index (1.01) and probing depth (2.29 mm). Non-precious alloys and acrylic covered castings demonstrated the highest gingival index (1.73 and 1.72, respectively) and clinical attachment level (1.00 and 0.88 mm). CONCLUSIONS: Crowns, bridge abutments (especially acrylic and non-precious metals) and Class II amalgam restorations appear to be associated with periodontal breakdown.

The radiographic outcomes of direct pulp-capping procedures performed by dental students: a retrospective study.

BACKGROUND: The decision between pulp capping and root canal therapy after pulp exposure is a clinical issue. The aim of the authors' study was to evaluate the outcome of direct pulp-capping procedures performed by dental students. METHODS: The authors followed the treatment outcomes of 193 patients with 204 pulp exposures with direct pulp capping. They determined the outcome of pulp capping radiographically using periapical radiographs taken at least three years after pulp exposure. The outcome was considered as successful if the tooth was present and not associated with periapical radiolucency or root canal treatment; otherwise, the outcome was considered as being a failure. RESULTS: Overall, the success rate of pulp capping was 59.3 percent. The success was associated more with mechanical exposure than with carious exposure (92.2 versus 33.3 percent) (P < .001), more with permanent restoration than with temporary restoration (80.8 versus 47.3 percent) (P < .001) and more with class I occlusal restoration (83.8 percent) than with proximal multiple surface restorations (Class II, 56.1 percent; Class III, 58.8 percent; mesial-occlusal-distal, 28.6 percent) (P = .009). Patients' age, sex, and tooth location and position had no significant effect on the outcome (P > .05). CONCLUSION: The success rate of direct pulp capping was 92.2 percent with mechanical exposure and 33.3 percent with carious exposure. CLINICAL IMPLICATIONS: Direct pulp capping is recommended after mechanical exposure with immediate placement of permanent restoration, while root canal therapy would be the choice of treatment if the exposure was due to caries.

Compliance with infection control programs in private dental clinics in Jordan.

The aim of this study was to assess the compliance of general dental practitioners (GDPs) in the private sector in North Jordan with infection control measures. A pilot-tested questionnaire about infection control measures was distributed in March 2004 to 120 private practices. The response rate was 91.66 percent. About 77 percent of dentists usually ask their patients about medical history, 36 percent were vaccinated against hepatitis B, 81.8 percent wear and change gloves during treatment and between patients, and 54.5 percent wear and change masks during treatment and between patients. Most dental practitioners (95.4 percent) reported that they changed extraction instruments and burs between patients. All dental practitioners reported that they changed saliva ejectors between patients, but only 41.8 percent changed handpieces between patients. Approximately 63 percent (69/110) used autoclaves for sterilization, 47.3 percent (52/110) used plastic bags to wrap sterilized instruments, and only 18 percent (20/110) disinfected impressions before sending them to dental labs. Fourteen percent used rubber dams in their clinics, and only 31.8 percent had special containers for sharps disposal. Based on these responses, approximately 14 percent of general dentists in this sample were considered to be compliant with an inventory of recommended infection control measures. In Jordan, there is a great need to provide formal and obligatory infection control courses and guidelines for private dentists by the Ministry of Health and the dental association in addition to distribution of standard infection control manuals that incorporate current infection control recommendations.

Rapid response to rituximab in a pediatric liver transplant recipient with post-transplant lymphoproliferative disease and maintenance with sirolimus monotherapy.

A 12-yr-old girl with end-stage renal disease secondary to primary hyperoxaluria type I received a living related (left lateral segment) liver transplant from her brother as the first step of a staged liver and kidney transplant. Renal transplantation was planned for a later date from the same donor. Nine weeks after transplantation she developed polymorphic PTLD of the tonsils and adenoids. Initial treatment with surgical resection and withdrawal of immunosuppression was insufficient as she developed recurrence of the PTLD lesion 1 wk after surgical resection and reduction of immunsuppression. Treatment with the chimeric monoclonal anti CD20 antibody, rituximab (Mabthera, Hoffman-La Roche AG, Grenzach-Whylen, Germany), resulted in quick response and complete recovery from PTLD within 2 wk, with no recurrence up to 8 months after treatment. Rejection prophylaxis was successfully achieved with Sirolimus (Rapamune, Wyeth Pharmaceuticals Inc., Philadelphia, PA, USA) monotherapy, with no episodes of acute rejection.

Uvulo-glosso-pharyngeal dimensions in subjects with beta-thalassaemia major.

The purpose of this study was to investigate cephalometrically the uvulo-glosso-pharyngeal dimensions in subjects with beta-thalassaemia major. The subjects were 15 thalassaemic patients (eight males, seven females) with a mean age of 14.13 +/- 1.06 years. The variables measured on the lateral cephalograms were tongue height and length, soft palate length and thickness, superior, middle and inferior pharyngeal airway space, and hyoid bone position. The thalassaemic group was compared with a normal control group matched for sex and age using a t-test. The results showed that thalassaemic patients had a smaller tongue size (length P < 0.05, height P < 0.001), shorter soft palate (P < 0.001), smaller upper (P < 0.001) and middle (P < 0.05) pharyngeal airway spaces, and a shorter vertical pharyngeal length (P < 0.05). The hyoid bone in thalassaemic patients was closer to the mandibular plane (P < 0.001).