Acidosis and its associated pathologies predispose patients to develop cardiac arrhythmias and even cardiac arrest. These arrhythmias are assumed to be the result of membrane depolarization, however, the exact mechanism of depolarization during acidosis is not well defined. In our study, the model of quantum tunneling of protons is used to explain the membrane depolarization that occurs during acidosis. It is found that protons can tunnel through closed activation and inactivation gates of voltage-gated sodium channels Nav1.5 that are present in the membrane of cardiac cells. The quantum tunneling of protons results in quantum conductance, which is evaluated to assess its effect on membrane potential. The quantum conductance of extracellular protons is higher than that of intracellular protons. This predicts an inward quantum current of protons through the closed sodium channels. Additionally, the values of quantum conductance are influential and can depolarize the membrane potential according to the quantum version of the GHK equation. The quantum mechanism of depolarization is distinct from other mechanisms because the quantum model suggests that protons can directly depolarize the membrane potential, and not only through indirect effects as proposed by other mechanisms in the literature. Understanding the pathophysiology of arrhythmias mediated by depolarization during acidosis is crucial to treat and control them and to improve the overall clinical outcomes of patients.

Body-contouring surgeries are known to improve the quality of life and body image of patients undergoing bariatric surgery. However, only a small number of patients choose to undergo body-contouring surgeries. This study evaluated the prevalence of body-contouring surgeries among patients who underwent bariatric surgery in Jordan, and identified the limitations encountered. This study is an observational multicentric cross-sectional study. A validated questionnaire was distributed to patients who had undergone bariatric surgeries between July 2017 and June 2021 at the University of Jordan Hospital and a bariatric surgery private center in Amman, Jordan. Inclusion criteria were based on the type of bariatric surgery (Sleeve Gastrectomy or Roux-En-Y gastric bypass) and the surgery date falling within the study period, with participation requiring the completion of an online questionnaire. Collected data was analyzed using various statistical tests, with a predetermined alpha level of 0.05 to determine statistical significance. Of 451 eligible participants, a total of 305 patients completed the validated questionnaire. Of these, 11 responses were excluded due to incomplete data. The analysis focused on remaining 294 participants who underwent bariatric surgery between July 2017 and June 2021, with only 7 participants (2.4%) electing to undergo body-contouring surgeries. The primary barriers to body-contouring surgeries reported by participants were cost (62.7%) and fear of postoperative complications (31.8%). Females exhibited a significantly greater desire for body-contouring surgeries (P = .000), which was also related to the percentage of total weight loss following bariatric surgery (P = .025). However, no significant associations were observed between desiring body-contouring surgeries and marital status (P = .734) or employment status (P = .319). The low rate of body-contouring surgeries in Jordan reflects the importance of strengthening the patient-physician relationship through targeted education efforts that emphasize the expected consequences of bariatric surgery and the available solutions to address them. Additionally, encouraging collaboration among caregivers, healthcare authorities, and insurance providers is necessary to develop more inclusive treatment plans that are tailored to meet the diverse needs and socioeconomic backgrounds of patients.