The October 7, 2023 events exposed both Israelis, Palestinians, and the entire middle east to unprecedented complex trauma. Guided by theoretical considerations and expert panel discussions, we identified seven distinct exposure domains: missile attacks, physical violence, evacuation, combat participation, hostage involvement, media exposure, and group-based marginalization. We examined actual exposure, that of self and significant others, to these domains alongside subjective stress and major stressful life events. Outcomes included PTSD, depression, anxiety, and somatic symptoms. A representative sample of Israeli-Jewish adults (N=928) surveyed for political stress prior to the October 7th 23 events were assessed again in December 2023. They completed a newly developed measure capturing the above seven exposure domains, a measure of major stressful events, and measures of the above outcomes. Hierarchical Regression Analysis was employed to identify both linear and curvilinear effects of exposure, moderated by life stress. Self and significant others' exposure were unrelated to subjective stress (rs: 0.09 and 0.14, ns) but differentially predicted all symptom types. Subjective stress was the strongest predictor of outcomes overall (βs: 0.18-0.35). Curvilinear effects and interactions between trauma exposure and major life stress were documented, although the latter interactions were substantially trimmed by sensitivity analyses. A comprehensive conceptualization and assessment mass-casualty armed conflict is essential for identifying stress-distress profiles and guiding personalized care and preventive interventions worldwide.

This study examined factors associated with sexual and cervical cancer screening behaviors among Middle Eastern (ME) college women. This cross-sectional design included 406 college women of ME Arab background in the United States. Data were collected via an anonymous online survey. Analysis included regression models to identify predictors of sexual and screening behaviors. The rates were 61% ever having sexual intercourse, 24% sexual debut <18 years, 44% having >1 sexual partner in lifetime, 50% condom use in last sexual encounter, 78% other contraception methods, and 25% ever having a Pap test. The composite cervical cancer risk score, based on these behaviors, was significantly lower among single undergraduates belonging to student/religious organizations and having liberal attitudes toward women and traditional views towards sexuality. The study findings have implications for practice and research around sexual and screening behaviors related to cervical cancer among this population of young women on college campuses.

Antimicrobial resistance (AMR) in livestock is a growing global health concern with important implications for food security, human and animal health. However, the spatial distribution and determinants of AMR in livestock systems remain insufficiently characterised. This study examined spatial patterns and contributions of selected AMR drivers in livestock AMR, using data from the ResistanceBank database, which encompasses livestock species, bacterial pathogens, and antimicrobial categories. This study included all data compiled in the Resistancebank database, including prevalence studies published between 2000 and 2021 and 33,186 resistance data points compiled from 93 countries. Spatial dependence was evaluated using Global and Local Moran's I statistics, while the influence of livestock species, pathogens, and antimicrobial classes was analysed using beta regression and Extreme Gradient Boosting (XGBoost) machine learning models. The spatial analysis includes only countries listed in the Resistancebank database and displays them. Global Moran's I revealed significant positive spatial autocorrelation in AMR proportions (I = 0.1911, p = 0.0246; Z-score = 1.9676, expected I = - 0.0127), indicating geographic clustering of resistance. High-high clusters were identified across South and East Asia, the Middle East, parts of Sub-Saharan Africa, and South America, whereas low-low clusters occurred in Southern Africa, Southeast Asia, and several European regions. Beta regression showed that cattle (β = -0.5953, p = 0.0263) and sheep (β = -0.7873, p = 0.0034) contributed less to AMR variation than buffalo, whereas highly important antimicrobials were associated with increased proportions of resistance (β = 0.3365, p < 0.0001). The XGBoost model demonstrated slightly better predictive performance (Root Mean Squared Error (RMSE) = 0.3428) than beta regression (RMSE = 0.3471). These findings reveal pronounced spatial clustering of AMR in livestock and underscore the need for strengthened global surveillance, improved antimicrobial stewardship and integrated One Health strategies to mitigate the spread of AMR.

Worldwide hotspots and ecological drivers of canine Echinococcus granulosus sensu lato: Space-time scan statistics and Maxent modelling from a systematic evidence base.

Real-world efficacy and safety of omalizumab in chronic spontaneous urticaria: Insights from the Middle East.

Real-world outcomes of Axicabtagene Ciloleucel CAR-T therapy in large B-cell lymphoma: a single-center observational study.

Phylogenomics of the airbreathing catfishes (Siluriformes: Clariidae).

Middle East Respiratory Syndrome coronavirus (MERS-CoV) is a zoonotic virus first identified in 2012, responsible for severe respiratory illness and a high case fatality rate of approximately 35%. MERS-CoV is primarily transmitted from dromedary camels to humans, but human-to-human transmission, particularly in healthcare settings, has led to outbreaks beyond the Middle East, including a major epidemic in South Korea in 2015. Despite its significant public health threat and potential for future outbreaks, no approved vaccines or therapeutic agents are available for MERS-CoV. To address this urgent need, the Korea National Institute of Health (KNIH) developed therapeutic monoclonal antibodies derived from B cells of convalescent MERS patients. Among these, KNIH-88, a non-receptor-binding domain (non-RBD) S1-specific antibody, was selected for preclinical development. In this study, KNIH-88 was produced with high purity under controlled manufacturing conditions and extensively characterized for structural and physicochemical properties, including molecular weight, charge, hydrophobicity, and high molecular weight (HMW) profile. KNIH-88 demonstrated strong binding affinity to MERS-CoV Spike protein and potent neutralizing activity in vitro. To ensure stability and facilitate rapid deployment in outbreak scenarios, a lyophilized formulation of KNIH-88 was developed, maintaining structural integrity and biological activity under long-term storage. Collectively, these findings support KNIH-88 as a promising therapeutic antibody for MERS-CoV, combining potent antiviral efficacy, structural stability, and a formulation suitable for stockpiling and emergency use in endemic regions.

Regional and temporal trends in antimicrobial susceptibility among isolates from bacterial keratitis: a systematic review and meta-analysis.

Humanitarian aid workers face several ethical challenges. They work in resource-limited settings, navigate power imbalances and face obstacles responding to populations affected by crisis. The Covid-19 pandemic added additional layers of challenge in places such as camps for refugees and internally displaced persons. However, the impact of the pandemic in these settings was varied, and in many cases, less than anticipated, raising questions about calibration of Covid-19 prevention and response to local realities. We conducted an exploratory qualitative descriptive study to better understand humanitarian aid workers' experiences in temporary displacement camps in the context of the Covid-19 pandemic. We interviewed 10 humanitarian aid workers with pandemic experience working in the Middle East, Africa, Asia and Europe, among others. Participants described ethical challenges, including implementing proportionate Covid-19 prevention strategies while mitigating harms of this response; navigating an environment with misinformation; responding to expectations of external authorities; fulfilling aid worker obligations amidst a global pandemic; questioning power imbalances within the humanitarian aid organizational hierarchy. Further understanding these ethical challenges may help orient training and policy to support responses to the needs of displaced populations in future public health emergencies, as well as better support humanitarian aid workers in these situations.

Idiopathic granulomatous mastitis as an autoimmune disease: A review of immunopathogenesis and therapeutic response.

Implications of TLR4 Polymorphisms for Precision Therapeutics in Gram-negative Infections: An Ethnogeographic-Stratified Meta-Analysis.

Healthcare-associated infections (HAIs) are a major global patient safety concern, yet comprehensive national surveillance data remain limited in many regions, including the Middle East. In the United Arab Emirates (UAE), prior efforts were restricted to selected surgical site infections (SSIs), with no unified framework capturing the full spectrum of HAIs. We aimed to establish the first national benchmark for HAIs across multiple healthcare sectors and infection types. We conducted a cross-sectional analysis of national HAI surveillance data from 92 hospitals with ≥ 20 beds across the UAE in 2023. Data were reported through a standardized electronic reporting system using Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN) definitions. Outcomes included rates of central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated events (VAE), and SSIs, alongside causative organisms, multidrug-resistant organisms (MDROs), and hand hygiene compliance. Device-associated infection rates were expressed per 1,000 device-days and SSI rates per 100 procedures. Comparisons with NHSN pooled mean rates were descriptive. Across participating hospitals, 236 CLABSI, 225 CAUTI, 247 VAE, and 488 SSI events were identified. National rates were 0.95 per 1,000 central line-days for CLABSI and 0.84 per 1,000 catheter-days for CAUTI, both exceeding NHSN pooled mean rates (0.74 and 0.73, respectively). The VAE rate (2.85 per 1,000 ventilator-days) was lower than NHSN (8.04). SSI rates exceeded NHSN pooled mean rates for cesarean section (emergency 1.17%, elective 1.77%), appendectomy (0.37%), coronary artery bypass grafting (1.83%), laminectomy (2.02%), and craniotomy (2.11%), while rates were lower for knee (0.39%) and hip arthroplasty (0.20%). Among 464 causative isolates reported from Dubai and the Northern Emirates, 31.3% were multidrug-resistant, predominantly carbapenem-resistant Enterobacterales, methicillin-resistant Staphylococcus aureus, and Candida auris. Hand hygiene compliance was 91.3%. This first national HAI surveillance report in the UAE demonstrates the feasibility of multisector data integration and establishes a baseline for benchmarking. Elevated device-associated infection rates and substantial MDRO burden highlight priorities for prevention and antimicrobial stewardship. Comparisons with NHSN pooled mean rates should be interpreted cautiously due to differences in risk adjustment. Expansion of standardized surveillance and incorporation of patient-level data will be essential to refine benchmarking and guide targeted interventions.

Middle east respiratory syndrome coronavirus (MERS-CoV): An underestimated betacoronavirus with pandemic potential.

Genomic surveillance captures resistance evolution in Salmonella enterica ST376 during prolonged disseminated infection in an immunocompromised patient from the United Arab Emirates.

In recent decades, human-mediated gene flow has profoundly reshaped Apis mellifera diversity across much of its native range, a process well documented in Europe but still poorly understood elsewhere. Here, we analyse whole-genome data from 423 individuals sampled across six countries, spanning six subspecies native to the Middle East and Egypt, together with 59 reference individuals. Genome-wide analyses of nuclear and mitochondrial variation inferred pervasive admixture driven by the importation of commercial queens and large-scale migratory beekeeping. Introgression from commercial A. m. ligustica, and, particularly from A. m. carnica, is widespread, reaching its highest estimates in A. m. meda (Iran) and A. m. syriaca (Jordan). Notably, the Egyptian A. m. lamarckii, itself introgressed, emerges as a major regional donor, substantially contributing to populations in Lebanon and Jordan and largely replacing the native A. m. jemenitica in the UAE. In contrast, admixture in Türkiye is dominated by gene flow among native subspecies, with A. m. anatoliaca contributing substantially to the gene pools of A. m. caucasia and A. m. meda, while receiving smaller reciprocal contributions. Nucleotide diversity is highest in Levantine admixed populations and declines significantly when estimated from individuals with high genetic integrity. Mitogenomic data broadly corroborate the nuclear findings, except in Türkiye and Iran, where all individuals clustered within the same branch as the C-lineage, thereby precluding inference of maternal introgression. Together, these findings indicate that modern apiculture is rapidly reshaping honeybee gene pools and eroding subspecies integrity across the Middle East.

Enterobius vermicularis (pinworm) is a globally distributed intestinal nematode that primarily infects children. Despite its high prevalence, information on the molecular diversity of human-derived E. vermicularis populations remains limited, particularly in geographically diverse regions such as Türkiye. This study aimed to characterize genotype and haplotype diversity based on the mitochondrial cytochrome c oxidase subunit 1 (COI) gene in E. vermicularis egg isolates collected from humans in different regions of Türkiye. A total of 71 microscopy-positive samples were analyzed by nested PCR, and 40 COI amplicons (397 bp) yielded high-quality sequences for further evaluation. Sequence analysis revealed 16 distinct haplotypes defined by 20 polymorphic sites. Overall haplotype diversity was high (Hd = 0.871), whereas nucleotide diversity was low (π = 0.00714). Among the regional populations, the highest haplotype diversity was observed in Kars (Hd = 0.895), while the highest nucleotide diversity was detected in Balıkesir/Edremit (π = 0.00927). Maximum-likelihood phylogenetic analysis demonstrated that all Türkiye haplotypes belonged to Genotype B and formed three subclusters together with previously reported human-derived reference sequences from Europe and the Middle East. Seven haplotypes showed no 100% match in GenBank and were therefore considered novel, whereas the remaining haplotypes were identical to genotype B sequences previously reported from Greece, Bulgaria, Iran, Iraq, and Türkiye. To our knowledge, this study presents the first COI-based haplotype dataset of E. vermicularis egg isolates from multiple regions of Türkiye and demonstrates substantial intraspecific genetic diversity despite the predominance of a single mitochondrial genotype. These findings expand current knowledge of the genetic structure of human-derived E. vermicularis in Türkiye and provide a basis for future large-scale molecular epidemiological studies. Further studies including larger sample sizes and additional genetic markers are needed.

Climate change is reshaping plant species distributions, posing challenges for drought-adapted taxa with restricted native ranges. This study employed an optimized MaxEnt ecological niche model, using GBIF occurrence records and a suite of bioclimatic and UV-B radiation variables, to project the current and future potential distribution of Caryopteris Bunge under four climate scenarios (SSP126, SSP245, SSP370, and SSP585). The model exhibited relatively high predictive performance, forecasting a consistent expansion of highly suitable habitats across all future pathways, with the SSP585 scenario projecting a 24.41% increase by 2090. A northeastward shift of the habitat centroid suggests potential expansion into temperate and high-altitude ecosystems. UV-B radiation (28.4%), diurnal temperature range (23.0%), and precipitation seasonality (10.2%) were the most influential environmental predictors.However, increased fragmentation-especially in Central Asia and inland Australia-may reduce population viability.Conservation gap analysis revealed that, although the spatial extent of protected areas remains relatively stable under future climate scenarios, a large portion of highly suitable habitats, especially in East Asia and the Middle East, remains outside protected zones, indicating insufficient protection coverage in projected future hotspots. These findings provide critical insights for adaptive conservation planning and ecological restoration in arid and semi-arid regions.

There have been recent calls to increase the diagnosis rate of metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we quantified the prevalence of MASLD-associated risk factors and identified individuals at risk of advanced fibrosis in a large, real-world cohort. This was a large, multicenter study of adults attending Dubai Academic Health Corporation between January 2018 and August 2023. MASLD risk factors were defined as the presence of one or more of the following: type 2 diabetes; obesity with ≥1 cardiometabolic risk factor; and/or raised ALT. Fibrosis-4 (FIB-4), a non-invasive index based on age, transaminases, and platelet count, was calculated, with moderate-high risk defined using established cut-offs (≥1.3 for <65 years; ≥2.0 for ≥65 years). Half (n = 46,412, 49.0%) of the population screened at risk of MASLD and, of those, 21.7% were at moderate-high risk of advanced fibrosis. 15.0% of individuals without MASLD risk factors, including those without obesity, were at moderate-high risk of fibrosis. Reliance solely on metabolic risk-based case finding may miss individuals at risk of advanced fibrosis, highlighting the value of broader fibrosis risk assessment strategies.

Identifying health care provider, system, and resource-related factors associated with CLABSIs in ICUs of LMICs: A Scoping Review.