The Fluid Diaspora: Palestinian Composers and the Diasporic Experience

Introduction Sickle Cell Disease (SCD), one of the common hemoglobinopathies, has a progressively increasing prevalence. Different genotypes of variants of SCD result in a spectrum of clinical manifestations. With SCD being a genetic disease, it is influenced by ethnicity and regional differences in its clinical course. There are recent advances in the management of SCD with newer therapies being introduced to the Western population. However, many of these treatments are yet to be used in the Arabic SCD population. It is important to understand the genetic variations of SCD regionally to anticipate the effectiveness of these newer modalities. This systematic review's main objective is to pool the available data on the genetic composition of SCD in the Arabic population. Methods We searched English language articles from PubMed, Scopus, and Google Scholar that reported genotypes of patients with SCD in countries of the Arab world. Demographics, prevalence, genotypes, clinical characteristics, management, and outcomes of patients were extracted and analyzed in the form of a systematic review. Descriptive and summary statistics were used to present the data and the mean (with standard deviation) and mode (with interquartile range) were reported as appropriate. Results Data for 44259 patients was extracted from 186 studies (case reports, case series, retrospective, and prospective observational studies). Male (49%) and female (51%) patients were equally reported wherever gender was available (N=13105). Most cases were reported from Saudi Arabia (>50%), and Bahrain (27.24%). The percentage of included cases was lower than 5% in Jordan, Egypt, Kuwait, and Tunisia, and less than 2% in the remaining Arab countries. Various SCD genotypes were reported in a total of 14482 patients, including Hb SS (76%) Hb Sβ0 (9.7%), and Hb Sβ+ (7.1%), while the rest of the genotypes, including HbSC, HbSD, HbSE, HbSO Arab, Hb S/α-Thal, Hb Sβ0 + α-Thal, and HBS Oman were individually reported in <4% of the cases. Major SCD complications in the Arab population included pain crises (48.25%) followed by neurological complications (33.46%), hepatobiliary complications (25.53%), musculoskeletal complications (24.73%), and hemolytic anemia (23.57%). The treatments reported for SCD included hydroxyurea (20%), blood transfusion (14.32%), and Deferasirox (3.03%). We did not find the use of stem cell transplantation or newer treatments such as L-Glutamine, Voxelotor, Crizanlizumab, or gene therapy reported in any of the studies included in our review. Conclusion SCD is a common hemoglobinopathy in the Arab population. Data with regards to its genotypic makeup in the region is scattered and is different from the other parts of the world. Many of the approved treatment modalities are yet to be reported in this patient population. This review highlights the genetic makeup of SCD in the Arab countries and common phenotypic manifestations. This data will help the direction of further research on SCD in this region, especially with respect to the upcoming era of genetic therapy. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Genetic disorders are not equally distributed over the geography of the Arab region. While a number of disorders have a wide geographical presence encompassing 10 or more Arab countries, almost half of these disorders occur in a single Arab country or population. Nearly, one-third of the genetic disorders in Arabs result from congenital malformations and chromosomal abnormalities, which are also responsible for a significant proportion of neonatal and perinatal deaths in Arab populations. Strikingly, about two-thirds of these diseases in Arab patients follow an autosomal recessive mode of inheritance. High fertility rates together with increased consanguineous marriages, generally noticed in Arab populations, tend to increase the rates of genetic and congenital abnormalities. Many of the nearly 500 genes studied in Arab people revealed striking spectra of heterogeneity with many novel and rare mutations causing large arrays of clinical outcomes. In this review we provided an overview of Arab gene geography, and various genetic abnormalities in Arab populations, including disorders of blood, metabolic, circulatory and neoplasm, and also discussed their associated molecules or genes responsible for the cause of these disorders. Although studying Arab-specific genetic disorders resulted in a high value knowledge base, approximately 35% of genetic diseases in Arabs do not have a defined molecular etiology. This is a clear indication that comprehensive research is required in this area to understand the molecular pathologies causing diseases in Arab populations.

Introduction Speech is a complex process requiring intellectual and physical capabilities. At times, this process can become compromised making the verbalization of thoughts difficult, therefore other methods of communication may be required. Alternative and augmentative forms of communication (often known as AAC) can help individuals with a wide range of speech and language such as Autism, Downs' Syndrome, Cerebral Palsy and Aphasia. Examples of alternative means of communication include the use of symbols to convey a message often with synthesized text to speech. This has proven to be an effective alternative and can allow people to hold conversations, participate (Light &amp; McNaughton, 2012) and enhance their quality of life (Hill, 2012). However, there have been some challenges in achieving this in the Arab region due to the lack of Arabic symbol inventories and reliance on Westernized symbols (Hock &amp; Lafi, 2011), and as a result, uptake and the positive outcomes of using AAC have been limited. The Arabic symbol dictionary research team has endeavored to create a new freely available resource that will be the first of its kind and is focused on creating culturally, environmentally, religiously and linguistically appropriate symbols for the Arab AAC community. Through engagement with AAC users, teachers, therapists and parents using a participatory approach, the team have found that current Westernized symbols are not appropriate for the region's culture and lifestyle. This paper aims to discuss what factors the team has taken into account to ensure the symbols are appropriate for the Arabic AAC population. Considerations to be discussed include; cultural adaptations, religious sensitivities, linguistic factors and suitable portrayal of the environment. Method At the outset of the project an expert group of advisors advised against the creation of a brand new symbol set and suggested the development of symbols that could complement existing symbol sets. As the research team adopted a participatory approach to solve design and developmental processes, a self-selecting AAC forum of teachers, therapists and parents was introduced to a choice of freely available symbol sets to compare to those they already used. Their choice would form the basis for the symbol dictionary development. The choice having been made, it was then essential to develop a set of criteria in collaboration with the AAC forum that would inform the adaptations made to any symbols that were felt to be culturally inappropriate or lacking in linguistic correctness. Criteria used to review the symbols included; flipping symbols especially those with arrows to follow Arabic sentence orientation from right to left, adapting dress to be modest and in line with Qatari and the modern general Arab dress code, adding darker physical features to characters, changing symbols which contained affection and/or mixing with the opposite gender, reducing greenery in the environment, consideration of social hierarchy, including nanny/maid in symbols related to the family unit, the inclusion of religious holidays and customs, local landmarks and food. Based on these criteria, the graphic designer would adapt the symbols and post them to the team's closed Google+ group for internal review. Once the symbol was reviewed by 3 team members, the symbol was uploaded to the Arabic Symbol Dictionary Symbol Manger where the AAC forum would later vote on a batch of adapted symbols. Symbols accepted as culturally suitable were then uploaded to the ‘Tawasol’ website for download for free by the public. Comments were analyzed and adaptations were made accordingly to the symbols that were voted as culturally inappropriate by the AAC forum and were re-voted on with the next batch of symbols. Results In the first round of voting where participants were asked to select their preferred symbol set, the ARASSAC symbol set was chosen. However only 3.4% of symbols were marked as ‘good’ due to the symbols being culturally sensitive. A number of symbols (‘batch 1’) were then adapted by the graphic designer and were voted on by 63 voters. The symbols' cultural acceptability increased to an average scoring of 4.14 out of 5 due to the cultural, religious, linguistic and environmental changes. 16.5% of comments were in relation to changes that needed to be made to the representation of culture (6.8%), religion (7.2%), language (2.4%) and environment (0.1%). A much smaller group of 21 voters voted on the second batch of newly developed symbols and the symbols' average cultural acceptability rating was 4.03 out of 5. 16.8% of comments were in relation to changes that needed to be made to the representation of culture (14%), religion (1.4%), language (1.4%) and environment (0%). The main comments regarding culture included ensuring women were wearing a black Abaya and Shayla and if they were in colored clothing that they did not “look like a maid”. There were mixed comments about whether children should be represented in the symbols as wearing traditional Qatari dress or non-traditional dress. Physical features also were commonly commented on with requests for darker skin tones and facial hair for older male Figs. (e.g. father). Concerns were also raised about some hand gestures used in the symbols that did not agree with the Qatari culture (e.g. hand over chest to indicate ‘thank you’ is not used in Qatari culture). Symbols with Qatari foods such as those with rice and meat/chicken needed to have whole joints of lamb/chicken on the rice rather than small pieces. In terms of religious feedback this included ensuring women's hair was covered, symbols related to eating showed the character eating with the right hand, the five daily prayers showed the correct position for the sun and that women's feet were covered during prayer. Linguistic feedback suggested that symbols for pronouns needed to include the dual form as well as including male and female versions of each symbol, both features of the Arabic language. Environmental feedback included reducing greenery. Discussion The results showed a steady improvement in voters' rating of the cultural appropriateness of the symbols. The majority of comments were related to the representation of attire in the symbols and this has been discussed in detail internally within the team and also with participants. Many therapists and teachers requested that characters should be dressed in traditional Qatari dress and many others suggested this would only serve the needs of the Arabic Gulf AAC users and would not appeal to the general Arab population. Through conducting a survey the team came to the conclusion that it was best to create symbols with general Arab clothing and traditional Qatari dress to serve the needs of the widest Arabic AAC population. The differences in results between voting session two and three could be attributed to a number of factors. In the third session, voters were strongly encouraged to provide detailed comments about the suitability of the symbols and this may have caused them to be more critical in their feedback. Furthermore, the second round of voting was primarily on symbols of nouns where their representation tended to be universally accepted compared to those voted on in the third round of voting, which were predominantly actions, interactions and concepts that were less concrete and difficult to convey. It is also possible that voters were more confident with the voting process in the third round of voting and this affected the way they voted, giving them the confidence to be open with their opinions. Conclusion The contribution of the AAC forum and AAC users to this project has yielded ample feedback that is essential to making the Arabic Symbol Dictionary relevant and useful. The Arabic Symbol Dictionary team has made an active effort to maintain open communication lines with participants to guarantee, where possible, that the symbols are culturally, religiously, linguistically and environmentally appropriate. It is for this reason, and the lack of freely available culturally appropriate symbols, that participants have requested access to these symbols much earlier than their official release date. Participants also regularly contact the team with lists of words which they require adapted symbols for, that do not exist in available symbols sets or are inappropriate for the Qatari setting. Any symbols that have been designed and voted on have been added to the Tawasol website on a share alike creative commons license (CC BY-SA 4.0 license)[1] so they can be used by the community and companies providing communication devices. The team is also concurrently seeking feedback from other GCC and Arabic speaking countries to ensure this resource is utilized and made available to a widespread audience. With the majority of Arab countries having between 4–5% of disabilities attributed to speech impairments and numerous Arab countries showing between 13 and 15% of all disabilities related to communication, (Disability in the Arab Region, 2014) the need for such a resource is becoming increasingly apparent. References Hill, K. (2010). Advances in augmentative and alternative communication as quality-of-life technology. Physical medicine and rehabilitation clinics of North America, 21(1), 43–58. Hock, B. S. &amp; Lafi, S., M. (2011). Assistive Communication Technologies for Augmentative Communication in Arab Countries: Research Issues. UNITAR e-Journal, 7(1), 57–66. Light, J., &amp; McNaughton, D. (2012). Supporting the communication, language, and literacy development of children with complex communication needs: State of the science and future research priorities. Assistive Technology, 24(1), 34–44. <ja

The protocol has been registered in the International Prospective Register of Systematic Reviews(PROSPERO):CRD42020218,666. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=218666.

Across the world, war and armed conflict continue to disrupt lives and have a profound impact on individuals. This is particularly evident in Arab countries, many of which have experienced repeated conflicts in recent decades. In these contexts, resilience and psychological adaptation are essential for maintaining well-being, yet social and cultural factors significantly shape how resilience manifests. Despite growing recognition of resilience’s importance, limited synthesis exists regarding the cultural and psychosocial factors that promote adaptation in Arab populations during wartime. This systematic integrative review provides a comprehensive overview of empirical findings on resilience, adaptation, and their associated factors during times of war in Arab countries. A screening was conducted following the PRISMA guidelines. Content and thematic analysis of 52 selected studies revealed five key themes: demographic factors, community resilience, personal resilience and growth, coping strategies, and religion and spirituality. The review highlights the effect of factors like religiosity, social support, and active coping strategies, among others, in promoting resilience and adaptation among Arab people exposed to war. The findings also suggest the value of leveraging existing cultural strengths, including strong social networks, communal practices, and religious beliefs, in interventions designed to promote resilience and adaptation during times of conflict.

Hearing loss (HL) is a heterogeneous condition that causes partial or complete hearing impairment. Hundreds of variants in more than 60 genes have been reported to be associated with Hereditary HL (HHL). The HHL prevalence is thought to be high in the Arab population; however, the genetic epidemiology of HHL among Arab populations is understudied. This study aimed to systematically analyze the genetic epidemiology of HHL in Arab countries. We searched four literature databases (PubMed, Scopus, Science Direct, and Web of Science) from the time of inception until January 2019 using broad search terms to capture all the reported epidemiological and genetic data related to Arab patients with HHL. A total of 2,600 citations were obtained; 96 studies met our inclusion criteria. Our search strategy yielded 121,276 individuals who were tested for HL over 52 years (1966-2018), of whom 8,099 were clinically diagnosed with HL and belonged to 16 Arab countries. A total of 5,394 patients and 61 families with HHL were genotyped, of whom 336 patients and 6 families carried 104 variants in 44 genes and were from 17/22 Arab countries. Of these variants, 72 (in 41 genes) were distinctive to Arab patients. Arab patients manifested distinctive clinical phenotypes. The incidence of HHL in the captured studies ranged from 1.20 to 18 per 1,000 births per year, and the prevalence was the highest in Iraq (76.3%) and the lowest in Jordan (1.5%). This is the first systematic review to capture the prevalence and spectrum of variants associated with HHL in an Arab population. There appears to be a distinctive clinical picture for Arab patients with HHL, and the range and distribution of variants among Arab patients differ from those noted in other affected ethnic groups.

As per the Global Cancer Observatory, the WHO Eastern Mediterranean region (which includes the Arabic countries) rankshighest for age-standardized mortality rate at 4 per 100,000, thus indicating a probable role of genetic associations. Identifying the genes associated with leukemia in the Arab population is crucial for effective preventive and treatment strategies. This scoping review aimed to determine the nature and extent of research available on the genes associated with the major types of leukemia among the Arab population. As per the scoping review guidelines, a comprehensive search was conducted in PUBMED and Google Scholar for articles published before 01/10/2023 and focused on leukemia-related genes among the Arab population. In total 119 studies, focusing on genes associated with leukemia met the inclusion criteria. On reviewing these studies, 27 genes were found to be associated with ALL, 33 genes with AML, seven genes with CLL, and 14 genes with CML. The majority of these genes were associated with an increased risk for the disease. Notably, the 119 studies covered only nine out of the 22 Arab countries, with 56 studies carried out in Egypt, exhibiting an imbalance in the regional distribution of the research landscape. Thus, indicating the inadequacy of research on leukemia genetics in the Arab region in comparison to the Western studies. This finding highlights the need for extensive research in the Middle Eastern region to gain geographically heterogeneous genetic information about the Arab population. In conclusion, this scoping study highlights the genes associated with the major types of leukemia among the Arab population and also indicates the need for comprehensive and regionally balanced research on leukemia genetics in Middle Eastern countries. Addressing this gap is essential to provide robust genetic data that can be used for targeted interventions to improve leukemia outcomes in the Middle East. Increased research efforts in all Middle Eastern countries will contribute to a greater understanding of genetic predisposition and help develop effective prevention strategies and treatments tailored to this population.

Breast cancer is the common malignant related disease of Women worldwide. In clinic, molecular classification of the disease is a key to setup therapeutic strategy for patients. To date, few reports describe the molecular basis of the disease, survival rate and therapeutic strategies that applied to encounter breast cancer in the Arab population. Nevertheless, advancement of medical research varied among Arab nations. This study reviews published data of breast cancer in the Arab World and integrate the available data to propose a model that describes the common molecular features of breast cancer in the Arab population. In conclusion, almost all of Arab nations share an early onset of breast cancer. Grade I cases accounted for ≤10% of the total cases, while grade III cases accounted for ≥40% of the total diagnosed cases. In general, breast tumor poor differentiation is associated with decrease in estrogen receptor (ER) and B-cell lymphoma 2 (Bcl2) expression and an increase of protein 53 (p53) protein expression. Human epidermal growth factor receptor 2 (HER2/neu) expression is varied, yet it is associated with poor differentiation. Most importantly ER expression level is relatively lower compared to the reported ER expression level in breast cancer cases detected in Western countries. This could be due to the fact that the majority of breast cancer cases detected in Arab population were grade II or III of cancer progression. The dominance of advanced form of the disease with early age of onset urge to screen samples to identify biomarkers associated with breast cancer onset in Arab population. In deed; identifying new biomarkers responsible of early onset of the disease might advance our understanding of disease progression and/ or discover new molecular therapeutic targets. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B64.

Background: Spirometric reference equations are essential for accurate interpretation of lung function tests. However, most globally used equations are derived from Western populations and may not reflect the physiological norms of Arab populations. Aim: To systematically evaluate the applicability of internationally adopted spirometric reference equations within Arab populations and to assess the availability of population-specific equations in the Arab world. Methodology: A systematic review was conducted using PubMed, Scopus, Google Scholar, and CORE databases for studies published up to July 2023. Studies were included if they developed, validated, or assessed spirometric reference equations in Arab populations. Out of 57 initially identified studies, 14 met the inclusion criteria. Results: Based on the 14 studies conducted, the majority of studies reported that predicted values for forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) in Arab populations were significantly lower than those predicted by equations derived from Western populations. This discrepancy suggests potential misclassification of respiratory diseases when non-local reference values are applied. Conclusion: The routine application of spirometric reference equations developed in Western populations may lead to inaccurate interpretation of lung function in Arab individuals. There is a clear need for developing standardized, population-specific reference equations that account for the ethnic and anthropometric characteristics of Arab populations to enhance diagnostic accuracy and clinical decision-making.

Molecular insight into heart development and congenital heart disease: An update review from the Arab countries

Cancer remains a major global health burden, with incidence rates rising globally. The Arab world, which is often regarded as an underrepresented population in literature, shows distinct patterns in cancer incidences, genetics, and outcomes in comparison with Western populations. This review aims to highlight key genomic studies conducted in the Arab world. We describe the epidemiological and genetic landscape of cancer in the Arab populations, focusing on lung, breast, and colorectal cancers, given their prominence and distinctive patterns in the region. We utilised data from GLOBOCAN 2022 and published genomic studies to assess subregional incidence trends, identify significant mutations, and explore hereditary and early-onset cancers profiles. Breast, lung, and colorectal cancers dominate the cancer profile in the region, with disparities in genetic alterations when compared to global trends. Variation in EGFR mutation frequencies in lung cancer across diverse ethnicities in the MENA region is representative of the extreme heterogeneity in the Arab region. Variations in BRCA1/2 mutation frequency, and unique founder mutations highlight breast cancer's particular regional genetic traits. Similarly, colorectal cancer studies show variations in mutational profiles, such as a low incidence of BRAF mutations and distinct epigenetic characteristics that represent region-specific disease pathways. Early-onset cancers, particularly breast and colorectal cancers, occur at higher rates than in Western populations and often diverge from the typical germline mutation patterns reported globally. The review emphasises the importance of conducting localised genetic studies in improving personalised medicine and public health strategies. Despite these efforts, significant gaps remain, particularly in understanding early-onset cancers and hereditary cancer genetic disorders, which are overrepresented in the region. Further research on the genetic basis of cancer in Arab populations is essential for advancing personalised treatment and improving cancer outcomes in these under-researched groups.

This research report describes individual Indian descendants in Ho Chi Minh city in the aim of raising research questions for the scholarship of Indian diaspora studies. I focus on the Indian diasporic members who are largely descendants of those who, in the second half of the nineteenth century and before, migrated from French–British India to Vietnam. They are economically and culturally different from the current Indian expats, the members of the capitalized 'Cộng Đồng Người Ấn Độ' (Indian Community) in Vietnam. The current Indian immigrants largely work in Indian companies and multinational groups. In other words, the Indians in Vietnam are not classified either as children of 'Kinh paternalism' or of Vietnamese 'state paternalism' (Salemink, The Ethnography of Vietnam’s Central Highlanders: A Historical Contextualization, 1850–1900. London: Routledge Curzon, 2003, 258, 287). Nor, are they perceptually overseas daughters and sons of 'Hindu paternalism' (Omvedt, Reinventing Revolution: New Social Movements and the Socialist Tradition in India. Armonk: M.E. Sharpe, 1993, 31). The Indian descendants in Vietnam belong nowhere politically. The ambiguity of the Indian descendants in Vietnamese history and society does not suggest that they would be a research subject of the Indian or South Asian diasporas in the field of diaspora studies. Indeed, exploring the Indian diaspora in the dynamic contexts of Vietnamese nationalism offers a new direction in the diaspora studies in general and South Asian diasporas in particular. The report is based on my ethnographic research in Ho Chi Minh City in 2012–2014 at Indian individuals’ houses and at cultural centres.

IDF21-0233 Health-related quality of life in patients with Diabetic Foot Ulcers in The Arab World: A systematic review

This chapter provides an overview of feminist inquiries into and deployments of the term diaspora as a conceptual framework for understanding the cultural dimensions of migration, migrant communities, long-distance nationalism, and the complex intersections of diaspora with race, gender, and sexuality. It situates the term diaspora as it has emerged historically, attending to contestations of the term and its relevance in negotiating the contours of various debates and concerns about migration and displacement. In reviewing some of the major developments in diaspora studies, the chapter provides close readings of several key texts that have emerged as canonical in the field of diaspora studies. Finally, the chapter examines connections between diaspora studies and feminist inquiry, surveying some of the major works that have emerged in the field, thus making it possible to see that diaspora functions multiply as an analytic as well as a descriptive category.

Background: Dry eye (DE) is a multifactorial disorder that can influence tear production, functional visual acuity and ultimately increase the osmolarity of the tear film. The prevalence of DE ranges from 7% to 33% across the world. However, to the best of our knowledge, the prevalence range of DE in Arab countries is not precisely documented in the literature. Aim: The aim of this article was to determine the prevalence range of DE, investigate the major risk factors of DE and identify the clinical diagnosis and medical management of DE. Method: In this study, only English language articles from 2017 to 2020 were selected. There were 52 articles on prevalence, risk factors, clinical diagnosis and medical management of DE in the Arab population. Results: The prevalence of DE in the Arab population varies in reports, from 10% in the United Arab Emirates (Dubai) to 69% in Palestine (West Bank). Gender difference (DE more in women), wearing of contact lenses, diabetes mellitus and glaucoma were all known to intensify the symptoms of DE. Lastly, there are two approaches to reduce DE in the Arab population, namely, pharmacologic and non-pharmacologic methods. Conclusion: The prevalence of DE in the Arab population was relatively high. In addition, the ocular surface disease index is one of the most common tools for the diagnosis of DE, whilst tear break-up time test is the common clinical test used in the Arab reports. Lastly, the most common treatment for DE is artificial tears.