BackgroundThe coronavirus disease 2019 (COVID-19) pandemic mandated the change from face-to-face learning to distance learning. As a result, the quality of distance learning worldwide is questionable. Objectives and aimsThe aim of this study is to investigate the quality of distance learning among university students at the University of Jordan, as well as its determinants and obstacles. MethodsA questionnaire-based cross-sectional study was conducted among undergraduate students at the University of Jordan from May 29 to July 11, 2021. Using a quantitative approach, students' attitudes toward and perceptions of online and distance education were analyzed. The Distance Education Learning Environments Survey (DELES) tool was used to evaluate the quality of distance learning during COVID-19 pandemic. IBM SPSS Version 25 was used for data analysis. ResultsThe total number of participants was 486, and the mean total DELES score was 61.6 ± 24.6. The lowest mean of DELES score components was for the active learning component (6.9 ± 2.9). Moreover, 65.9% of the students were very dissatisfied or dissatisfied with the quality of distance learning. The quality of distance learning derived by the total DELES score was determined by several general demographics, and students' perceptions and attitudes. ConclusionsThe present study showed a low quality of distance learning and high levels of dissatisfaction among students at the University of Jordan. Thus, improvement of distance learning quality by filling its infrastructural defects and the implementation of its adjunct tools are required. In addition, we recommend collaboration with regional and international educational institutions to improve the quality of distance learning.

Objective Previous studies investigated the effect of pericardial fat on cardiovascular diseases. However, until now there was no systematic review and meta‐analysis investigated this association, thus we conducted this article to assess the relationship between pericardial fat and cardiovascular diseases. Methods We searched PubMed, The Cochrane Library, Scopus, Google Scholar and Clinicaltrials.gov to select observational studies reported the relationship between pericardial fat and cardiovascular diseases including coronary artery disease (CAD), ventricular dysfunction, heart failure (HF), atrial fibrillation (AF), major adverse cardiac events (MACE), coronary artery calcifications (CAC), arrhythmias other than atrial fibrillation, and cardiovascular events prediction scores. Meta XL 5.3 was used for data analysis. Results A total of 83 articles that included 73,934 patients were included in our analysis. The results showed that pericardial fat was significantly associated with CAD (OR = 1.38; 95% CI: 1.28–1.50), ventricular dysfunction (OR = 1.53 per 1 mm3; 95% CI: 1.17–2.01), HF (OR = 1.32 per 1 mm3; 95% CI: 1.23–1.41), AF (OR = 1.16 per 1 mm3; 95% CI: 1.09–1.24), MACE (OR = 1.39 per 1 mm3; 95% CI: 1.22–1.57), and CAC (OR = 1.15 per 1 mm3; 95% CI: 1.05–1.27). On the other hand, there was no enough data about the relationship between pericardial fat with arrhythmias other than atrial fibrillation or cardiovascular risk scores. Conclusion The analysis demonstrated that the relationship between pericardial fat volume and cardiovascular diseases was significant. Since pericardial fat is a good predictor of obesity, it suggests investigating its relationship and adds on effect to previously established risk factor to evaluate the possibility of incorporating it with cardiovascular risk scores.