Features

GENEVA — Microplastics contained in drinking water pose a “low” risk to human health at current levels, but more research is needed to reassure consumers, the World Health Organisation (WHO) said on Thursday.

Studies over the past year on plastic particles detected in tap and bottled water have sparked public concerns but the limited data appears reassuring, the UN agency said its first report on potential health risks associated with ingestion.

Microplastics enter drinking water sources mainly through run-off and wastewater effluent, the WHO said. Evidence shows that microplastics found in some bottled water seem to be at least partly due to the bottling process and/or packaging such as plastic caps, it said.

“The headline message is to reassure drinking water consumers around the world, that based on this assessment, our assessment of the risk is that it is low,” Bruce Gordon of the WHO’s department of public health, environmental and social determinants of health, told a briefing.

The WHO did not recommended routine monitoring for microplastics in drinking water. But research should focus on issues including what happens to chemical additives in the particles once they enter the gastrointestinal tract, it said.

The majority of plastic particles in water are larger than 150 micrometres in diameter and are excreted from the body, while “smaller particles are more likely to cross the gut wall and reach other tissues”, it said. 

Health concerns have centred around smaller particles, said Jennifer De France, a WHO technical expert and one of the report’s authors.

“For these smallest size particles, where there is really limited evidence, we need know more about what is being absorbed, the distribution and their impacts,” she said.

More research is needed into risks from microplastics exposure throughout the environment — “in our drinking water, air and food”, she added.

Alice Horton, a microplastics researcher at Britain’s National Oceanography Centre, said in a statement on the WHO’s findings: “There are no data available to show that microplastics pose a hazard to human health, however, this does not necessarily mean that they are harmless.”

 “It is important to put concerns about exposure to microplastics from drinking water into context: we are widely exposed to microplastics in our daily lives via a wide number of sources, of which drinking water is just one.”

Plastic pollution is so widespread in the environment that you may be ingesting five grams a week, the equivalent of eating a credit card, a study commissioned by the environmental charity WWF International said in June. That study said the largest source of plastic ingestion was drinking water, but another major source was shellfish.

The biggest overall health threat in water is from microbial pathogens — including from human and livestock waste entering water sources — that cause deadly diarrhoeal disease, especially in poor countries lacking water treatment systems, the WHO said.

Some 2 billion people drink water contaminated with faeces, causing nearly 1 million deaths annually, Gordon said, adding: “That has got to be the focus of regulators around the world.”

A far more dramatic and stylised car than the somewhat conservative model it replaces, the new eight generation Hyundai Sonata takes a distinctly sportier and edgier design direction.

Launched early this summer as a 2020 model and part the Korean brand’s more loosely and individualistic “Hyundai look” approach, the latest Sonata harks back to the eye-catching if somewhat controversial sixth generation model in the way it makes a statement.

However, the new Sonata backs this up with subtly yet meaningfully improved driving dynamics, new technologies and improved cabin design, comfort and materials.

Dramatic design

A design-led car very much informed by trendy so-called “four-door coupe” designs like the Audi A7, Mercedes-Benz CLS-Class and Volkswagen Arteon, Hyundai’s stated and ambitious goal for the new Sonata is to produce “the most beautiful sedan on the road”. 

Whether they have achieved this is a matter of personal taste, but it is indeed an attractive, low-slung and viscerally dramatic design. Longer, lower and wider than its predecessor, the new Sonata is built on a new platform with repositioned front strut towers for a lower bonnet, shorter front overhang and longer wheelbase.

A front-driven car with a similarly sporty profile as an upmarket rear-drive saloon in its overhang ratios and distance between wheel centre and A-pillar base, the new Sonata seemingly taking inspiration from marine life. At first sight it somewhat resembles a stingray, with its broad shoulders, wide stance, sharply creased lined and heavily ridged surfacing. 

However, its wide, almost frowning “cascading grille” design, protruding lower lip, prominent sills and long low and arcing — almost fastback — roofline and discrete rear light cluster fins instead lend it an almost barracuda-like sense of menace and drama.

Confident delivery

Available at launch with either 2- and 2.5-litre naturally-aspirated multipoint injection (MPI) engines mated to 6-speed automatic gearboxes for the Middle East, other Sonata versions available or expected for various markets include 8-speed gearboxes, and all four-cylinder direct injection, hybrid and more performance-oriented turbocharged “N” sub-brand variants.

Driven in 2.5-litre MPI guise and with similar output as its 2.4-litre predecessor, the Sonata develops 177BHP at 6,000rpm and 171lb/ft torque at 4,000rpm. Undisclosed, the Sonata’s estimated 1.5-tonnes or less weight is expected to be reasonably quick with around 9.5-second 0-100km/h acceleration and 210km/h top speed.

Responsive from standstill and smoothly progressive in delivery, the driven 2.5 MPI proved well suited to the Sonata’s size, segment and weight as driven in various routes in South Korea at launch. Well-refined and insulated, it pulled with confident versatility in mid-range and when cruising, while venturing towards the redline, it was willing and eager. 

Driving the front wheels through a standard 6-speed automatic gearbox, shifts had the right compromise between speed, response and smoothness for a medium to big comfortable family saloon, and feature push-button gear selection and manual mode steering-mounted paddle-shifters.

Dynamic improvements

Built on Hyundai’s new N3 platform with improved structural design for improved ride, handling and safety, and incorporating more sophisticated collision safety multiload paths, the new Sonata better reconciles its assertively sporty looks with improved dynamic capabilities. 

Stable and reassuring on highway and smooth and refined in its ride quality, the new Sonata is comfortable and well absorbs road imperfections, but can feel slightly firm over small jagged bumps, as driven with 235/45R18 optional low profile tyres. Through corners, lateral and roll control is improved and it feels more settled than before.

Similarly, it seems to have acquired firmer dampers and improved vertical body and rebound control on dips and crests, and feels more settled and buttoned down than its predecessor. 

Turning tidily into corners with light, quick and direct electric-assisted steering, the Sonata grips well front and rear, but is weighted with a slight bias for more predictable under-steer if entering a tight and narrow too aggressively, which can be controlled through its electronic stability controls or by easing slightly off the throttle. Meanwhile, a larger brake booster improves braking response and effectiveness.

Comfortably equipped

A significant improvement on the outgoing model in most respects, the new Sonata also receives a plusher and more pleasant interior, in addition to more advanced convenience and safety equipment. 

Said by Hyundai to be inspired by stealth aircraft the low-slung new Sonata’s cabin features a cleaner, less cluttered design with an emphasis on horizontal lines and creating a sense of width and space. 

This includes a narrower dash, unobstructive push-button shift-by-wire gear selector and a reduced button count, with most features accessed through a large and wide 12.3-inch touchscreen.

Classier looking and incorporating better materials and softer textures and touch points, the new Sonata is also well-equipped and includes numerous standard and optional features including Android Auto, text-to-speech Bluetooth, heated and ventilated seats and wireless phone charging.

It also has driver assistance features like lane keeping and following, blind spot, forward and rear cross-traffic collision avoidance assists and more.

Comfortable inside, it also features good cabin width, legroom and generous luggage volume. However, given its rakish new roofline, the Sonata could have done with slightly lower seat mounting points for taller occupants, especially in sunroof-equipped models.

TECHNICAL SPECIFICATIONS

• Engine: 2.5-litre, aluminium block/head, transverse 4-cylinders
• Bore x stroke: 88.5 x 101.5mm
• Valve-train: DOHC, 16-valve, continuously variable valve timing
• Gearbox: 6-speed automatic, front-wheel-drive
• Power, BHP (PS) [kW]: 177.5 (180) [132.4] @6,000rpm
• Specific power: 71BHP/litre
• Torque, lb/ft (Nm): 171 (232) @4,000rpm
• Specific torque: 92.9Nm/litre
• 0-100km/h: 9.5-seconds (est.)
• Top speed: 210km/h (est.)
• Length: 4,900mm
• Width: 1,859mm
• Height: 1,445mm
• Wheelbase: 2,840mm
• Headroom, F/R: 975/950mm
• Leg room, F/R: 1,171/884mm
• Shoulder room, F/R: 1,470/1,425mm
• Hip room, F/R: 1,386/1,381mm
• Doors/seats: 4/5
• Luggage volume: 453-litres
• Kerb weight: 1,450-1,500kg (est.)
• Steering: Electric-assisted rack and pinion
• Lock-to-lock: 2.6-turns
• Turning circle: 10.9-metres
• Suspension, F/R: MacPherson struts/multi-link
• Brakes F/R: Ventilated discs, 305mm/discs, 300mm 
• Tyres: 235/45R18

The False Daisy is a magical herb which looks like the white daisy. 

It is from the sunflower family with tapering lance-shaped leaves often making its way in August through the prairies of the world and native to my hometown India. Back home, it is used for making hair oil and is one of the main ingredients in hair dyes.

Clinical cure

Roots, seeds, seed oil and the whole plant are a known rejuvenator. Traditionally, the petals are used to address skin disorders, skin allergies and cracked heels. It is known to help improve liver metabolism and is used in the treatment of jaundice, fatty liver and hormonal imbalance. Commercially sold in health shops, it has shown to overcome the loss of appetite, acidity, heartburn and anaemia. 

The entire plant contains the alkaloids nicotine and is used in the treatment of diphtheria and other respiratory conditions.

Hair tonic

Growing up, our family always used a homemade concoction of herbs steeped in a mixture of oils for a week to make hair oil, then strained and bottled by my mama for a years’ supply. 

Here, the dried organic leaves of the False Daisy were the main ingredient, combined with rose petals, gooseberries and aromatic herbal oil. 

The extracts from the leaves and flowers add lustre to your locks. The pungent property of the plant is known to have positive effects on stimulating hair growth and its herbal property helps improve dry skin and avoid dandruff and split ends.

It has a cooling effect on the scalp and adds lustre to hair, serving as a perfect conditioner. The best way to infuse the herb is in oil form as it helps prevent hair fall, premature greying and split ends. 

There are no regularly reported problems but there is a chance of an allergic reaction on sensitive skin. It is also used as an astringent and often mixed with aromatic oils for spas.

Wonder herb

This magical herb is enriched with rich sources of iron, vitamin E, magnesium, steroids calcium, vitamin D and traces of protein. 

Moreover, it is known to be anti-bacterial, antiviral and analgesic properties. The paste of the leaves combined with milk cream and applied to the forehead has shown to relieve migraine pain. 

The juice of the leaves in small quantity mixed with buttermilk has reportedly cured jaundice within a few days. 

Lactating mothers and pregnant women should consult their doctor before using this powerful herb. In all cases, be sure to consult your doctor before trying any herbal remedies. 

Reprinted with permission from Family Flavours magazine

Celestial Bodies
Jokha Alharthi
Translated by Marilyn Booth
Scotland: Sandstone Press, 2018
Pp. 243 

Jokha Alharthi, a professor of Arabic at Sultan Qaboos University in Muscat, put Oman on the world literary map this year when her novel, “Celestial Bodies”, won the Man Booker International Prize.

This marks the first time an author from the Gulf region has even been nominated for the prestigious award, and the first time an Omani female novelist has been translated into English. Originally published in Arabic as “Sayyidat Al Qamar” (literally Ladies of the Moon), “Celestial Bodies” has been hailed as a novel reflecting transition in one of the most traditional Arab societies. The story is set in the village of Al Awafi, where “people were firm believers in the past; they did not look to the future”. (p. 141)

Yet, change they do, especially after the oil boom, though social change comes more slowly than economic development. From the author’s vivid descriptions, we learn of marriage and birthing customs, as well as landmarks in Oman’s history after Britain gained oil exploration rights and “imperialist greed lit the wick of war”, dividing Omanis into supporters of the British-backed Sultanate and the followers of the Iman. (p. 146)

If the title “Celestial Bodies” sounds ambiguous, evocative and even esoteric, Alharthi’s story is full of its mythical and earthier implications. Platonic, parental, passionate and conjugal love, as well as marriage, play a prominent role in the plot, but so do spirituality, superstition, memory and family history. Transition is a fairly common theme in modern Arabic literature, yet, Alharthi’s book stands out for her innovative scene depiction, tantalising characters and intricate story structure. Her storytelling relies on multiple points-of-view, an omniscient narrator as well as a first-person narrator, the interface of past and present, inclusion of poetry, and semi-supernatural or magical events, which are accepted as natural by the characters and sometimes embody their deepest desires.

“Celestial Bodies” focuses on three generations of prominent families in Al Awafi, who are connected by marriage or other relationships. Complicating the social structure, some still have slaves up until the 1980s, although slavery had been abolished decades before. The story opens with three sisters, emblematic of the second generation, who receive marriage proposals. Mayya, the oldest, is proposed to by Abdullah, the son of the village’s most successful merchant, and the only character to narrate the story, but she has given her heart to another.

The way Alharthi describes Mayya’s feelings is indicative of how she interweaves cosmic dimensions into an otherwise prosaic life: “She sent her spirit into the ether, detaching herself completely from the world. Her body convulsed and she could barely keep herself from collapsing as she telegraphed her whole self to him, transmitting it with every gram of energy she could find.” (p. 5)

However, Mayya receives no response to her monumental effort, so she agrees to marry Abdullah without any pretence of loving him. They do, however, come to share the adoration of their daughter who is incongruously named London, heralding the third generation in the novel, whose lifestyle is unfathomable to their ancestors. In a society that long avoided modern education, especially of girls, London becomes a doctor.

The marriages of Mayya’s sisters are quite different, proof that times are changing in a way that gives women more choice but does not necessarily guarantee happiness. Each marriage is somehow compared to the idea that God created every soul as a sphere and then split it and gave each half to a human body. “It is decreed that each body will meet the body that holds the other half of that rent soul… From one human being to the next, the effect of this union will vary, according to the delicacy of each person’s nature.” (p. 38)

From Abdullah’s narration, we learn much about the past, especially his severe father, Suleiman the merchant, representative of the first generation, who didn’t think the freeing of slaves affected his property. Abdullah’s great fear of his father and his terrible punishments seems to have partially paralysed his personality. Having begun with his father’s vast wealth gained by trading in dates and slaves, he is rich but his anxiety persists, now framed by global changes like the crash of the stock market. 

Though potentially in a position of power, he mainly reacts to personal and family events rather than taking the initiative. And sometimes he instinctively replicates his father’s authoritarian behaviour although he doesn’t mean to. From Abdullah’s reminiscing, we also learn of the family secrets —intimacy between masters and slaves, and why Zarifa, who raised him after his mother’s unexplained, premature death, had a special status.

Many of Abdullah’s memories are recounted as he is on an airplane. When London comments on how frequently he travels, he doesn’t tell her his real feelings that “when we are away from home, in new and strange places, we get to know ourselves better. And that is exactly the way it is with love”. (p. 25)

Here, Alharthi reveals something about herself, for she was educated in the UK and has said that she wouldn’t have been able to write about her own society if she hadn’t been able to view it from the vantage point of another country. 

Alharthi idealises neither the past nor the present; they just are, and she describes them well, especially male and female dreams and insecurities, and how they are changing. She has given us a unique window on Oman, dispelling any remaining notions that it is an isolated country.

Family caregivers for dementia patients don’t sleep as long or as well as other adults of the same age, a new study suggests. 

In an analysis of the combined data from 35 earlier studies, researchers found that dementia caregivers slept about three hours less per week than age-matched adults, according to the report published in JAMA Network Open. 

“Sleep debt is known to have cumulative associations with physical, mental and cognitive health,” the researchers, led by Chenlu Gao wrote. “Therefore, poor sleep quality in dementia caregivers should be recognised and addressed.” 

To take a closer look at the impact of caregiving on sleep, the Gao and her colleagues scoured the medical literature for research on the topic. 

The combined studies included information on 3,268 caregivers, 76.7 per cent of whom were women. When compared to age-matched non-caregiving adults, caregivers slept less — by an average of 2.42 hours to 3.5 hours per week — and had poorer sleep quality, including more difficulty falling asleep and disturbed sleep. 

Those studies showed that poor sleep could, indeed, be improved. 

Bad sleep can lead to a host of health problems, Stephen Smagula, an assistant professor of psychiatry and epidemiology at the University of Pittsburgh said. “If you’re losing a lot of sleep over a long period of time, you are at higher risk of heart disease, Alzheimer’s, dementia, diabetes.” 

The new study “was not at all surprising” to Katherine Ornstein, an assistant professor of geriatrics and palliative care medicine at the Icahn School of Medicine at Mount Sinai in New York City. “We know caregivers are doing so much,” she said. “They are caring for children, working, dealing with financial stress, their own health. So, of course sleep would be impacted in some way.” 

LOS ANGELES — Superhero Black Widow is a woman at the top of her game, and so is the actress who plays her — Scarlett Johansson is the world’s highest paid actress for the second year in a row, according to Forbes’s annual ranking published on Friday.

Johansson, 34, earned $15.5 million more than she did in 2018, primarily due to the immense global success of “Avengers: Endgame” — the final chapter of the saga — for which she earned $35 million.

The actress will take up the Black Widow mantle again in 2020 for an eponymous spinoff film.

But even though Johansson and her cohorts on the list all earned more than $20 million, pay inequality is alive and well in Hollywood. Johansson earned $56 million total over the past year, but that amount lands her at only eighth place for the combined list of highest-paid actors and actresses.

For comparison, Robert Downey Jr., Johansson’s “Avengers” costar, earned about $55 million for his turn as Iron Man in “Endgame”.

According to the Forbes ranking of highest-paid actors in the world, published on Wednesday, Downey Jr. comes in at third place with $66 million total, behind fellow Avenger Chris Hemsworth ($76.4 million) and Dwayne Johnson ($89.4 million).

For the women, second place goes to Sofia Vergara, an industry veteran but a newcomer to the list. The “Modern Family” sitcom star earned $44.1 million between June 1, 2018 and June 1, 2019.

She is followed by Reese Witherspoon ($35 million) and Nicole Kidman ($34 million), costars on the series “Big Little Lies”.

Jennifer Aniston, who came in third in 2018 mainly due to advertising campaigns for major brands, has been relegated to fifth place with a mere $28 million for the year. The former “Friends” star — a show which also featured a guest appearance from Witherspoon — stars in a new series for Apple’s on-demand web television service.

Other new list arrivals include Elisabeth Moss, boosted by the series “The Handmaid’s Tale”, and Australian actress Margot Robbie.

Angelina Jolie, who was number two on the list in 2018, did not make the cut this year, along with Julia Roberts, Cate Blanchett and Jennifer Lawrence.

The top 10 are Scarlett Johansson ($56 million), Sofia Vergara ($44.1 million), Reese Witherspoon ($35 million), Nicole Kidman ($34 million), Jennifer Aniston ($28 million), Kaley Cuoco ($25 million), Elisabeth Moss ($24 million), Margot Robbie ($23.5 million), Charlize Theron ($23 million) and Ellen Pompeo ($22 million).

PARIS — A cheap, once-a-day pill combining aspirin with drugs that lower blood pressure and cholesterol cuts cardiovascular disease as a whole by a third, and heart attacks by more than half, researchers said Friday.

In clinical trials, the so-called “polypill” was especially effective among people with no history of cardiovascular disease, reducing the number of severe events by 40 per cent, the researchers reported in The Lancet, a medical journal. 

For those with a history of heart problems and strokes, the drug combo was only half as effective compared to the control group, who received advice on healthy living but no drugs.

Among participants who took the pill as directed — at least 70 per cent of the time — heart attack incidence declined by 57 per cent.

The polypill concept was first proposed more than 20 years ago as a simpler, cost-effective approach to treating cardiovascular disease, which often requires taking several medications.

Currently, patients are typically prescribed one or more drugs to lower blood pressure along with a statin, which holds lipids such as fatty acids in check. Aspirin, an analgesic, has blood thinning properties.

“The more tablets people have to take, the less they comply in the long-term,” noted Kausik Ray, a professor in public health and Imperial College London not involved in the study.

“For chronic diseases, this is a challenge as you are asking people to take multiple medications every day for 30 or 40 years.”

About a third of patients stop taking their meds as early as 90 days after a heart attack, according to earlier research.

But despite its obvious potential, the polypill had yet to be tested on a large number of people over a long period of time.

Scientists led by Reza Malekzadeh from the Tehran University of Medical Sciences recruited nearly 7,000 men and women, aged 50 to 75, living in rural Golestan, a province in Iran.

About one in 10 had previously had heart attacks, strokes or other cardiovascular episodes.

The participants were divided into two groups of roughly the same size. One was given “lifestyle advice” only, while the other also got a daily polypill from 2011 to 2013.

Doctors monitored compliance with the drug regimen, and then tallied the number of strokes and heart attacks across each cohort over the next five years.

Crucially, adherence was significantly higher with the all-in-one pill.

“Drugs do not work if they are not taken,” noted Amitava Banerjee, a consultant cardiologist at University College London.

Compared with the lifestyle group, the polypill cohort had 34 per cent fewer adverse events. Results were similar for men and women.

Blood pressure did not differ much, but “bad” cholesterol levels were lower in the group taking meds. 

“Now we know that a fixed-dose polypill can achieve clinical benefits in practice,” Malekzadeh said in a statement.

“But the polypill is not an alternative to a healthy lifestyle and should be combined with physical activity, a healthy diet, and smoking cessation.” 

Other researchers not involved in the study said the findings could be a game changer, especially in developing nations.

“Given the polypill’s affordability, there is considerable potential to improve cardiovascular health and to prevent the world’s leading cause of death,” noted co-author Nizal Sarrafzadegan, a researcher at Isfahan University of Medical Sciences.

Healthy young people show signs of impaired blood vessel function after just a few puffs of an electronic cigarette, even without nicotine, new research shows. 

“We essentially found that using e-cigarettes is not equivalent to inhaling water vapor; in fact, it can exert acute, detrimental effects on [blood vessels] even when the liquid does not contain nicotine,” Dr Alessandra Caporale of the University of Pennsylvania Perelman School of Medicine in Philadelphia, the study’s first author, told Reuters Health in an email. 

Evidence is mounting that vaping, sometimes touted as a safer alternative to smoking, is not risk-free, Caporale and her colleagues note in Radiology. In a previous study, they found that vaping nicotine-free e-cigarettes increased signs of inflammation and a form of tissue damage known as oxidative stress, which returned to normal levels in one to three hours. 

Big US tobacco companies are all developing e-cigarettes. The battery-powered devices feature a glowing tip and a heating element that turns liquid nicotine and flavourings into a cloud of vapour that users inhale. 

In the new study, the authors used magnetic resonance imaging (MRI) to take several measurements of blood vessel function in 31 healthy adults who had never smoked, before and after they took 16 three-second puffs of an e-cigarette containing propylene glycol, glycerol and flavouring but no nicotine. 

After vaping, study participants showed several changes indicating that “vascular reactivity”, which is the ability of healthy blood vessels to widen when necessary, was “considerably and significantly impaired”, Caporale noted. 

These changes were temporary, but if repeated over a long period of time could cause inflammation and deterioration of blood vessel health, the researcher added. “We are far from suggesting that a single episode of vaping translates immediately into atherosclerosis.” 

With funding from the National Heart, Lung, and Blood Institute, which also supported the current research, Caporale and her team are planning a study that will look at inflammation, oxidative stress and circulatory changes in e-cigarette users, cigarette smokers and non-smokers over time. 

Dr Irfan Rahman, a professor at the University of Rochester Medical Centre who researches the effect of e-cigarettes on health, reviewed the study for Reuters Health. “The study is interesting and has some insights into long-term consequences of electronic cigarette vapours in cardioneurovascular disorders,” he told Reuters Health in a telephone interview. 

But the findings don’t confirm an association and shouldn’t be interpreted to mean that e-cigarette users will develop these health problems, he added. 

Regulating and controlling the Internet, in general, is no picnic – and online shopping is no exception. It is particularly difficult when the goods are imported from outside the country they are to be delivered to, for it disturbs the normal functioning of its tax and customs departments, two essential governmental institutions, as well as the balance of country’s internal commercial distribution outlets. This of course applies only if and when the volume of online imported shopping reaches a significant amount, a given threshold, which apparently is now the case in Jordan.

From Amazon to Alibaba and countless other sites, a non-negligible number of Jordanian consumers are hooked on online shopping from abroad, for all the (good) reasons that make it more attractive than traditional local shopping, in most cases. Though no numbers about the actual volume of these personal imports have been disclosed at this point by the authorities, the customs department has just released this week new rules for personal orders placed online this way.

In short, the rules make it mandatory to pre-declare the goods on a specific Jordan Customs Internet platform and to pay customs duties, taxes and service fees on the shipments. “Shipments valued under JD50 will be subject to [pay] JD5, and those valued between 51 and JD100 will be subject to [pay] JD10.” Moreover, and for these fees to apply, one given consumer (or account) must not exceed a total of JD500 orders per year. In all other cases, standard customs fees and clearing procedures will apply, the same as “for passengers’ luggage”.

Interestingly the above is true only for certain categories of goods: namely “apparel and clothing, shoes, children’s toys and food items”. All other items fall into the “passengers’ luggage” rules mentioned above. 

Regulating is understandable, but are the new rules fair enough to the population? Does protecting the local retail business justify these rules? For until now any personal single order entering the country and estimated at under JD100 was completely free of duties and taxes.

It is hard at this point in time to say what is really fair and what is not. The weight of online shopping in the world has reached gigantic proportions. It is perhaps worth remembering that Jeff Bezos, the boss of Amazon, the largest online shopping outlet of them all, is the richest man in the world, according to Forbes’ March 2019 edition.

Following in the footsteps of the giants abroad, the number of local outlets where you can place online orders is also increasing. For example, City Centre Computers, one of well-known suppliers of computers and IT goods of all kinds in Amman, takes online orders and will deliver them to your doorsteps. If your order is above JD100, the delivery will be done free-of-charge, what’s more.

A number of fast-food restaurants in Amman, as well as most large supermarkets, also offer online ordering service. Some even have their own, locally designed, mobile app to make using the service fast, easy and pleasant. The trend is slowly but surely reaching all types of retail businesses in the country. However, and for some time at least, the volume will remain insignificant compared to the size of shopping imports from Amazon and the like.

In any case, the new customs regulations for online shopping from abroad are now the talk of the town. Many are asking whether with time the rules will get tighter, or on the contrary, may be softened a bit.

Surgeons are no better at determining which patients might benefit from operations to treat torn knee cartilage than if they just flipped a coin, a new study suggests. 

Researchers surveyed 194 surgeons to see whether they would recommend surgery or exercise therapy in 20 test cases with middle-aged patients who had tears in the meniscus, the cartilage that works as a cushion between the shin and thigh bones. 

Researchers created test cases based on actual patients to see whether the surgeons could accurately predict who would benefit the most, or least, from surgery or from exercise therapy. 

Overall, surgeons correctly predicted which patients would benefit from operations only half of the time. And experienced knee surgeons were no better at guessing correctly than other orthopaedic surgeons. 

These findings offer one reason these knee operations remain common despite a growing body of evidence suggesting many patients don’t benefit, said Dr Victor van de Graaf, lead author of the study and a researcher at University Medical Centre, Utrecht, in The Netherlands. 

“Orthopaedic surgeons believe they are capable of identifying which patients may still benefit more from surgery,” van de Graff said by e-mail. “Therefore, our findings may help to further decrease the number of unnecessary performed surgeries.” 

During the operation, a surgeon makes a small incision in the knee and inserts a tiny camera called an arthroscope to view the inside of the joint, locate and diagnose the problem, and guide repairs. Sometimes surgeons remove all of the meniscus, and other times they only remove part of it. 

While the procedure is minimally invasive, it’s not risk-free. Patients receive anaesthesia, which in any surgery may lead to complications such as allergic reactions or breathing difficulties. In addition, this specific procedure might potentially damage the knee or trigger blood clots in the leg. 

To understand how accurately surgeons could predict patient outcomes, researchers asked a series of questions for each of the 20 patient cases. They asked whether patients should get surgery or physical therapy; what amount of improvement or deterioration would be expected in function after two years; and what level of function patients would have if they went with the treatment surgeons didn’t recommend. 

Surgeons were more likely to make correct predictions about who would benefit from knee operations or physical therapy, but more likely to be wrong about which patients would not benefit from the treatments. 

Among patients who didn’t respond to surgery, only 39 per cent of the surgeons correctly foresaw this outcome. And among patients who didn’t respond to exercise therapy, only 29 per cent of surgeons correctly predicted this outcome. 

For patients who did benefit from surgery, surgeons correctly predicted this outcome 60 per cent of the time. And for patients who benefitted from physical therapy, surgeons correctly chose this outcome in 72 per cent of cases. 

One limitation of the study is that the 20 sample cases presented to surgeons don’t reflect how surgeons would interact with patients and make treatment decisions in real life, the study team notes in the British Journal of Sports Medicine. 

Very few surgeons asked to participate in the study agreed to do so, and it’s possible the results don’t reflect what would happen with a larger group of surgeons. 

But given how poor the participating surgeons were at guessing who might benefit from surgery, it makes sense for patients to only consider this option when physical therapy doesn’t work, the study team writes. 

Another study concluding that it’s impossible to predict who might benefit from arthroscopic meniscus repair surgery. 

Kenneth Pihl of the University of Southern Denmark in Odense and his colleagues built a model based on the real-world outcomes after one year for 641 patients who had undergone the surgery. Out of 18 preoperative factors that surgeons and the medical literature consider predictive of who will benefit, none predicted the actual results for these patients, Pihl’s team found.