Middle East Research Articles

Jordan’s Strategic Alliance With the West to Protect the Hashemite Regime

Jordan’s strategic alliance with the Western countries was established at the same time as the establishment of the state. It was a survival tool for the Hashemite regime which was perceived in the West and the Middle East in particular as a weak and vulnerable regime. The internal and external threats, as well as the coup attempts, were many and therefore the regime had to create a defense alliance with a Western power. Naturally, Britain was the first security support for the Hashemite regime and as its position in the Middle East declined at the end of the 1950s, the United States replaced Britain and became the Western power that protected the Hashemite regime. This was due to its pro-Western policy. Jordan receives the largest foreign aid from America (after Israel), is involved in security projects, participates in training with the American army and with Western countries, and is a partner with them in the fight against global terrorism. However, it should be mentioned that Israel also took a significant part in the defense of the Hashemite regime and was involved, officially and unofficially, in a number of operations starting in the 1950s. At that time, Israel’s perception of security took shape, which saw the existence of the Hashemite regime in Jordan as an Israeli interest, and therefore did everything possible to prevent its fall.

Cognitive performance, mental health, and quality of life in β-thalassemia individuals: a comprehensive analysis

IntroductionBeta-thalassemia is a prevalent autosomal recessive haemolytic disorder, particularly in the Middle East. Patients with beta-thalassemia major (βTM) require iron chelation therapy and regular blood transfusions, while those with beta-thalassemia intermedia (βTI) exhibit milder symptoms. This study aimed to evaluate cognitive function, behavioural problems, quality of life, and related aspects in individuals with βTM and βTI.MethodsThe cross-sectional study included 20 βTM participants, 20 βTI participants, and 19 healthy controls. Participants underwent psychiatric interviews, the Wechsler Adult Intelligence Scale (WAIS-III), Symptom Checklist-90 Revised (SCL-90R), and Short-Form Health Survey (SF-36). Clinical data and laboratory investigations were also collected.ResultsβTM participants exhibited lower vocabulary and picture completion scores on the WAIS-III compared to other groups. βTI participants had significantly higher scores on SCL-90R subscales for somatization, depression, anxiety, paranoid ideation, and psychoticism. Both patient groups reported poorer quality of life across all SF-36 domains compared with controls. Longer disease duration correlated with lower levels of somatization, interpersonal sensitivity, depression, anxiety, and paranoid ideation. Less frequent blood transfusions were associated with better physical and mental health summary scores but also higher somatization. Elevated serum iron levels corresponded with increased anxiety, hostility, and psychoticism symptoms, while higher serum ferritin related to more obsessive–compulsive behaviours but less somatization and psychoticism.ConclusionsIndividuals with thalassemia exhibit cognitive deficits, psychological disturbances, and diminished quality of life, with distinct patterns depending on disease severity. Regular monitoring and appropriate interventions are crucial for optimizing their overall well-being and functioning.

Geochronology and ice‐flow modelling of the Late Quaternary glaciers on Mt. Soğanlı, Türkiye

ABSTRACTUnderstanding Earth's climate history through the chronology and reconstruction of palaeoglaciers is a central topic of palaeoclimatology. Examining the remnants of past glaciations preserved in isolated alpine environments provides insight into critical palaeoclimatic conditions. Accurate dating techniques, such as terrestrial cosmogenic nuclides, are crucial for understanding the timing of these changes. The Anatolian Peninsula, characterized by diverse topographical and climatic factors, witnessed the presence of glaciers during the Late Pleistocene, shaping its alpine landscape significantly. While mountain ranges such as the Taurus and Pontic favoured glacier development due to their elevation and lower temperatures, isolated mountains such as Mount Soğanlı in the interior hinterland also supported significant palaeoglaciers. Despite previous studies on Anatolia's glaciers, numerical dating of glacial deposits on Mount Soğanlı has remained elusive until now, hindering precise palaeoclimatic interpretations. This study employs cosmogenic 36Cl surface exposure dating and physical‐based ice‐flow modelling using an open‐source framework, Parallel Ice Sheet Model (PISM), to determine the timing of glaciations and to reconstruct past glacier extents on Mount Soğanlı. The results reveal glacier retreat ages of 48.3 ± 13.4 and 18.3 ± 4.4 ka based on two well‐preserved moraines. Additionally, palaeoclimate simulations matched with the field observations indicate considerably colder conditions (6.65–8.15°C colder than today) necessary to sustain glaciers on Mount Soğanlı, when precipitation amounts were the same as today. These findings contribute to a better understanding of Anatolia's palaeoclimatic fluctuations and align with similar studies in neighbouring regions, enhancing our knowledge of past climate dynamics of the Eastern Mediterranean and the Middle East.

Application of PV on Commercial Building Facades: An Investigation into the Impact of Architectural and Structural Features

The rapid global transition toward renewable energy necessitates innovative solar PV deployment strategies beyond conventional roof installations. In this context, commercial building facades represent an expansive yet underutilized resource for solar energy harvesting in urban areas. However, existing studies on commercial rooftop solar PV predominantly focus on European contexts, neglecting the unique design constraints and performance trade-offs present in regions such as the Middle East. This study addresses this gap by specifically investigating the impact of architectural and structural features on the utilizable facade area for PV deployment in commercial buildings within the hot desert climate of Saudi Arabia. Detailed case studies of twelve representative buildings are conducted, combining architectural drawing analysis, on-site measurements, and stakeholder surveys. The methodology identified sixteen parameters across three categories—facade functionality, orientation suitability, and surrounding obstructions—that impose technical and non-technical restrictions on photovoltaic integration 3D modeling, and irradiance simulations revealed that, on average, just 31% of the total vertical facade area remained suitable for PV systems after accounting for the diverse architectural and contextual limitations. The study considered 698 kWh/m2 of solar irradiance as the minimum threshold for PV integration. Shopping malls displayed the lowest utilizability, with near-zero potential, as extensive opaque construction, brand signage, and shading diminish viability. Offices exhibited the highest utilizability of 36%, owing to glazed facades and unobstructed surroundings. Hotels and hospitals presented intermediate potential. Overall, the average facade utilizability factor across buildings was a mere 16%, highlighting the significant hurdles imposed by contemporary envelope configurations. Orientation unsuitability further eliminated 12% of the initially viable area. Surrounding shading contributed an additional 0.92% loss. The results quantify the sensitivity of facades to aspects such as material choices, geometric complexity, building form, and urban context. While posing challenges, the building facade resource holds immense untapped potential for solar-based urban renewal. The study highlights the need for early architectural integration, facade-specific PV product development, and urban planning interventions to maximize the renewable energy potential of commercial facades as our cities rapidly evolve into smart solar energy landscapes.

Decentering the Center: Dialogues with Zeynep Çelik

Review of Susan Slyomovics, ed., Ordering Imperial Worlds: From Late Medieval Spain to the Modern Middle East, Edinburgh: Edinburgh University Press, 2023, 328 pages, 14 b&w illustrations, 49 color illustrations. ISBN 9781399517867. In this volume of essays in honor of Zeynep Çelik, scholars engage with her rich corpus on built environments of the Mediterranean. Utilizing transdisciplinary and often innovative methods, they draw on diverse voices across space and time to interrogate the idea of empire.

Transit-Oriented Development in Middle Eastern Cities: The Urban Renewal Framework for the Souq Waqif in Doha, Qatar

Cities around the world are evolving dramatically due to urbanization. Over the last few decades, rapid urbanization coupled with rapid economic growth in Qatar has resulted in transport-related issues such as urban sprawl, traffic congestion, poor walkability, and an increasingly inefficient transit network lacking pedestrian accessibility and connectivity. The related sprawl (due to a lack of compactness), a lack of intricacy, and connectivity have challenged the built environment’s sustainability. The Souq Waqif neighborhood, renowned for its rich cultural heritage and historical significance, serves as the focal point of this study. Its central positioning and status as a prominent social nexus within Doha render it an ideal case study. Specifically, this research investigates the Souq Waqif metro station, evaluating it through the lens of five distinct design aspects: (1) walkability, (2) ground use balance, (3) mixed-use spaces and public spaces, (4) multi-modality and transportation hubs, and (5) public transportation network. To reach this aim, the study methodology uses a qualitative approach informed by the Integrated Modification Methodology (IMM). The IMM framework provides a means to transform underperforming neighborhoods like Souq Waqif, into more cohesive and sustainable communities by retrofitting, renovating, and reactivating the existing urban fabric. Site observations, interviews, and surveys were used to collect data to complement the analysis. Findings highlight the deficiencies in connectivity and multimodal transportation adjacent to the Souq Waqif metro station. In addition, the ability of metro stations to conserve crucial cultural legacy and social identity in rapidly urbanizing cities like Doha is explored. To this end, recommendations are given to increase the efficiency and sustainability of Souq Waqif and the like.

The Primacy of Commercial Gain over Ideology in Wars and Armed Conflicts

The paper provides a brief analysis of the causes and reasons for military conflicts and wars in the past and present and makes a forecast for the future. By comparing ideological differences and commercial goals, the author concludes that economic priorities are the primary causes of military conflicts and wars. Analyzing historical examples, the author shows that economic priorities have always been the main reasons for unleashing military actions. The main objectives that the aggressor solved by unleashing war were: expansion of the territory of its habitat; plundering of the defeated; transformation of the defeated population into slaves (cheap labor). These priorities, in the author’s opinion, are the main ones in all wars and armed conflicts in history. Similar tasks are currently being solved by the industrial and banking oligarchs of the United States and the United West in the Middle East, Africa, Latin America and Europe. Other goals and objectives of wars and armed conflicts are secondary and can be realized as additional ones. In this regard, the question of the primary and secondary objectives of commercial benefit and ideology is resolved in favor of commercial benefit. In the paper, on the basis of scientific and research works of the author, it is concluded that the current situation in the world is a well thought out and carefully calculated by the financial oligarchs of the United States and the united West, when a commercial project and its realization should bring them substantial profits, and the population of the planet Earth — destruction, grief and suffering.

Factors in the Decline of U.S. Agricultural Imports in the MENA Region

The Middle East and North Africa (MENA) region stands on a global pivot point, impacting the world through its diverse political and economic dynamics. While often recognized for its complex challenges, the region's food security remains surprisingly under-considered, even though it carries significant global repercussions. This research focuses on a concerning trend: the decline of U.S. agricultural exports to MENA, potentially jeopardizing regional stability and impacting global food systems. While EU competitiveness is acknowledged, this research delves deeper than mere identification of competitors such as the EU, dissecting the interplay of their advantages – superior pricing and yields – against the U.S. approach from a policy-perspective. The paper’s ultimate goal is to highlight how the US has suffered from out-competition from the EU, not simply MENA countries’ diversification, leading to the latter’s collapse as a source of staple crop importations, in order to prevent such drastic changes in the future as the same trend in other industries could provide much more devastating for the US. This analysis can impact US policy and inspire a shift towards more sensible and outcome-oriented spending policies.

“Neither of the East nor of the West”

What does it mean to do Islamic Studies within Religious Studies? Taking the cue from Thomas A. Tweed's intervention, this article discusses new theoretical and methodological approaches in Religious Studies and their relevance to researching Islam. Such approaches cross geographical, disciplinary, and intellectual boundaries while equally being emplaced in particular socio-cultural contexts that inform their perspectives. In order to overcome statist, normative, and essentialist understandings of Islam, the article explores three key themes: ambiguity, multi-locality, and aesthetics. When we approach the intellectual history of Islam, not only its diversity and plurality become obvious but also its culture of ambiguity, which is at ease with contradictions and inconsistencies. Recent reflections on diaspora religions decentre Islamic Studies from the Middle East and allow for exploring the multiple transnational connections between Muslim minority and majority contexts. Such approaches illustrate the multi-locality of Islam. Finally, the article explores what it means to approach Islam as an aesthetic formation in which rituals as embodied experiences and material sensory culture are central in forging and articulating Muslim individual and collective identities.

Shaking up the Neolithic - Tracing seismic impact at Neolithic Göbekli Tepe/Southeast-Türkiye

Neolithic societies were inherently vulnerable. In addition to the challenges of a changing climate and evolving subsistence strategies and social identities, Neolithic societies were also confronted with a range of natural hazards, including extreme weather events, unstable building grounds, and earthquakes. In particular, earthquakes appear to have had a significant impact on early Neolithic communities and their settlements across the Middle East. This contribution presents the findings of recent combined building archaeological and archaeoseismological research in relation to the various damage patterns observed in the built environment at Göbekli Tepe, Türkiye. Of particular interest here are the damages and anthropogenic reactions that can be linked to seismic activities during the Neolithic.

Molecular Identification of Genes Resistant to Antibiotics in Staphylococcus aureus Isolated from Sub-clinical Animals Affected by Mastitis

Background and Aim: Mastitis is a prevalent and costly disease that significantly impacts the dairy industry, affecting both sheep's health and milk quality. In order to determine the bacterial causes of subclinical mastitis in Iraq and its susceptibility to antibiotics, the study aims to molecularly detect resistant Staphylococcus aureus isolated from sheep infected with mastitis. Methods: Molecular assay and phylogenetic study to detect Staph aureus isolates by using 16 Sr RNA and resistance virulence genes (aac-aph, tetk) by the conventional method of PCR. Two hundred samples were collected from the subclinical mastitis of infected ewes, Samples were reserved on an icebox and transported to the laboratories. Milk samples were cultured on Blood Agar and Mannitol Salt Agar (7.5%) plates. The culture plates were then incubated at 37°C for 24 hours. Results: The PCR assay revealed amplification of the 16S rRNA gene in all 20 isolates, amplification of the aac-aph gene in 19 isolates, and the tetK gene in all 20 isolates. The PCR products of 20 positive samples for (16 Sr RNA) target genes were sequenced, evaluated, and dropped on the Genbank-NCBI under the accession number, which became a reference to Iraq and the world. According to the current study, Staphylococcus aureus is commonly found in milk. To combat drug resistance, antimicrobial drug use should be normalized, and antimicrobial resistance surveillance should be conducted regularly. Conclusion: PCR-product of 8 positive samples for 16sr RNA target gene were sequenced, analyzed, and deposited on the Genbank-NCBI under the accession number and became a reference to Iraq and the Middle East and the world.

Molecular Identification of Genes Resistant to Antibiotics in Staphylococcus aureus Isolated from Sub-clinical Animals Affected by Mastitis

Background and Aim: Mastitis is a prevalent and costly disease that significantly impacts the dairy industry, affecting both sheep's health and milk quality. In order to determine the bacterial causes of subclinical mastitis in Iraq and its susceptibility to antibiotics, the study aims to molecularly detect resistant Staphylococcus aureus isolated from sheep infected with mastitis. Methods: Molecular assay and phylogenetic study to detect Staph aureus isolates by using 16 Sr RNA and resistance virulence genes (aac-aph, tetk) by the conventional method of PCR. Two hundred samples were collected from the subclinical mastitis of infected ewes, Samples were reserved on an icebox and transported to the laboratories. Milk samples were cultured on Blood Agar and Mannitol Salt Agar (7.5%) plates. The culture plates were then incubated at 37°C for 24 hours. Results: The PCR assay revealed amplification of the 16S rRNA gene in all 20 isolates, amplification of the aac-aph gene in 19 isolates, and the tetK gene in all 20 isolates. The PCR products of 20 positive samples for (16 Sr RNA) target genes were sequenced, evaluated, and dropped on the Genbank-NCBI under the accession number, which became a reference to Iraq and the world. According to the current study, Staphylococcus aureus is commonly found in milk. To combat drug resistance, antimicrobial drug use should be normalized, and antimicrobial resistance surveillance should be conducted regularly. Conclusion: PCR-product of 8 positive samples for 16sr RNA target gene were sequenced, analyzed, and deposited on the Genbank-NCBI under the accession number and became a reference to Iraq and the Middle East and the world.

Psychometric characteristics of the decision‐making ability scale among high school students

AbstractThe process of decision‐making is a multifaceted cognitive endeavor encompassing various cognitive, emotional, psychological, and social processes. It empowers individuals to select from a range of alternatives. Its significance spans across age groups, impacting both adults and children, and the relevance of which goes beyond aiding learners in choosing their educational or professional paths; it also pertains to preparing them to navigate the diverse situations they will encounter throughout their lives. To approach this ability, we developed a scale comprising 20 items, assessing five distinct decision‐making factors. This scale was administered to a sample of 303 learners in the first and second years of the baccalaureate course (pre‐final and final years of secondary education), representing both genders, and studying in four high schools. The participants’ ages ranged between 16 and 20 years. The results of this study revealed positive psychometric properties of the scale after its apparent validity was verified. Additionally, principal component analysis, using a latent root criterion greater than one (Eigenvalue > 1), and performing Varimax rotation, resulted in five factors that represent decision‐making styles (dependent, avoidant, confident, rational, intuitive) that explain 53.67% of the total variance. Through the application of confirmatory factor analysis (CFA), the outcomes showcased favorable conformity indicators. The ratio of chi‐square value to degrees of freedom was recorded at less than 5 (x²/df = 1.531). The RMSEA index, at 0.041, remained below the accepted threshold of 0.08. The metrics (CFI, TLI, GFI, IFI) all surpassed 0.90, falling within acceptable ranges. Strong internal consistency between item scores and their respective factors was established by Pearson coefficients. The correlation coefficients between each factor's score and the total scale score were robust, ranging from 0.483 to 0.727. The Cronbach's alpha coefficient for the scale's factors ranged from 0.788 (highest) to 0.723 (lowest), with an overall scale stability coefficient of 0.748. These high coefficients collectively confirm the scale's validity, reliability, and appropriateness for implementation within the Middle East and North Africa (MENA) region.

Pore-scale modeling of wettability alteration coupled two-phase flow in carbonate porous media

The Middle East marine carbonate reservoirs are the primary targets for global crude oil exploration and production. In contrast to the clastic rock reservoirs, the marine carbonate reservoirs have undergone more complicated deposition, diagenesis and transformation, and the rock surface tends to be oil-wet or mixed-wet. One of the most effective methods for enhancing oil recovery in marine carbonate reservoirs is the use of an ion matched (IM)-surfactant (S) system to alter the wettability of rock surfaces. In this paper, we propose a microscale mathematical model of wettability alteration-coupled fluid flow by considering oil–water two-phase flow, wettability alteration, solute advection- diffusion and surfactant adsorption. The proposed microscale mathematical model is solved using the multi-component lattice Boltzmann model, and its accuracy is further verified. Finally, the effects of displacing fluid, ion-matched water concentration and surfactant concentration on oil mobilization at pore-scale are studied. Results show that, ion-matched water has a positive effect on wettability alteration, and typically shifts the cross-point of oil–water relative permeability curve to the right. The concentration of ion-matched water primarily affects fluid morphology of the wetting-phase and has little effect on phase permeability. After adding surfactant to the ion-matched water, the Euler coefficient of oil-phase gradually increases as the displacement continues, a large amount of remaining oil is gradually dispersed into scattered oil droplets and the oil-phase relative permeability is further improved.

British-Armenian Military Relations in Transcaucasia During the Early Stages of the Russian Civil War (1917–1918): A Critical Analysis

This article offers a critical examination of the British-Armenian military relations in Transcaucasia during the early stages of the Russian Civil War (1917-1918), highlighting the complex interplay between British foreign policy, imperial ambitions, and local nationalisms.The plight of the Armenians resonated deeply with the British public and politicians during the First World War. A crucial moment came when the Russian monarchy fell, triggering a complex scenario in Transcaucasia and necessitating a thorough reshuffle of Britain’s foreign and military strategies in the region. In this context, the present study analyses Britain’s political maneuvers and dealings with Armenians in response to the evolving situation in Transcaucasia after the February Revolution. This article shows that notwithstanding the humanitarian ethos that was prevalent in British political rhetoric after the February Revolution in Russia, the strategic undertakings of Britain on the Caucasus front were heavily influenced by its imperial politics and determination to maintain its role in shaping the future of the Middle East and larger Asia. Highlighting the contradictions in British policies toward the region, it argues that these policies were mainly characterized by a colonial mindset that regarded Armenians and other local forces merely as serviceable instruments for realizing a broader imperialist agenda.

Exploring essential features for developing a human resource management mobile application: Insights from the middle east

This study aims to investigate the key features necessary for the development of a mobile application for human resource management (HRM). It addresses the shortage of empirical studies on digital HRM in the Middle East and emphasizes the increasing importance of HRM mobile applications in the region. The research utilizes qualitative research methods, including the Delphi method, in-depth interviews, literature review, historical analysis, and critical discussion.A qualitative research strategy is employed, analyzing data from 43 HR experts and mobile app development team members from international and local businesses in the UAE and the Kingdom of Bahrain. NVivo software is used for data analysis, encompassing over 120 transcriptions, notes, and academic papers. The study identifies and explores the logical and practical features required for an HRM mobile app. It uncovers challenges related to the Delphi survey experiences, such as managing heterogeneous information and ensuring compatibility with iOS and Android platforms. This research fills a gap in the literature by investigating the digital HRM landscape and HRM mobile applications in the Middle East. It provides valuable insights from HR and technology experts, contributing to the advancement of digital HRM, mobile applications, and the application of the Delphi method methodology. The study highlights implications for industries to enhance HR operations and productivity through the adoption of mobile HR applications. Theoretical contributions include new insights into the digital HRM literature, specifically regarding the identification and discussion of essential features in HRM mobile applications. Practical implications involve the benefits of transitioning from traditional HRM to digitalized HRM in the professional era, as identified through the analyzed features of the HR app. The study offers practical insights for the development and implementation of mobile HR apps. Organizations can leverage these insights to create effective mobile HR apps that enhance HR operations and employee productivity.

The impact of religious diversity on the Kurdish identity within a geopolitical framework

Importance. The Kurds are currently dispersed across four countries (Turkey, Syria, Iran, and Iraq), which are quite negative towards them, trying to suppress expression of their identity. Historiographically, the Kurdish issue is usually perceived as another obstacle to regional stability in the Middle East, but the uniqueness of their position forces us to look at the situation from a different perspective. The aim of the study is to prove that the experience of asymmetric interaction of Kurds with various social actors can be extrapolated to address the problem of long-term stability in the Middle East and the resolution of other conflicts.Materials and Methods. The research is based on the principles of historicism and objectivity; chronological and structural methods and comparative analysis are used.Results and Discussion. The novelty of the study is that it allows us to consider the religious heterogeneity of the Kurds as a possible positive factor that can be used to build a new Kurdish identity. The peculiarities of the situation of the Kurds in different territories, including in a religious context, are also analyzed. The trends in ethnic relations in the territories of four nearby countries (Syria, Iraq, Iran, and Turkey) are determined.Conclusion. The eclectic nature of Kurdistan’s religious composition has greatly influenced Kurdish political identity, and despite external divisive factors, the diverse Kurdish population is united due to its culture of tolerance, which stems from its long history of diverse religious traditions. At the same time, it complicates their interactions with the neighbouring states that are intolerant of dissent and other faiths.

Racial referral bias in cardiac computed tomography: Differences, disparities or discrimination?

Disparities exist in medicine and can affect patient care. We sought to understand influences of racial biases in diagnostic testing within a Cardiac CT (CCT) population. Race of CCT patients, referring physicians and the population in the catchment area were captured between February 2006 and November 2021. The frequency of CCT referrals for each race was indexed to the catchment population. Of 21,241 CCT patients, 17,514 (82.5​%) patients were White. The Non-White population was comprised of 467(2.2​%) Indigenous, 656(3.1​%) Black, 932(4.4​%) Asian, 276(1.3​%) South Asian, 1100(5.2​%) Middle Eastern and 296(1.4​%) Latin American races. The catchment population was 907,675, with 619,514 individuals of whom 69.7​% identified as White. Compared to the catchment population, there was a disproportionately higher referral rate for Whites than Non-Whites. The referral index for Whites was higher than Non-Whites (1.2 versus 0.6, p​<​0.001)). This pattern was consistent across all racial minorities and age categories. A total of 356 physicians (236(66.3​%) White, 4(1.2​%) Black, 39(12.0​%) Asian, 30(9.2​%) South Asian, 43(13.2​%), Middle Eastern and 4 (1.2​%) Latin American) made referrals to CCT. The racial difference in referral patterns was independent of physician race and was independent of their years in practice. Racial differences exist in CCT referrals. These differences are independent of prevalence of disease, physician race or years in practice. This study supports the need to better understand reasons for disparity and strategies to mitigate potential bias.

China's Strategic Engagement in the Middle East: Navigating the Belt and Road Initiative and U.S. Leverage of the Abraham Accords

China's Strategic Engagement in the Middle East: Navigating the Belt and Road Initiative and U.S. Leverage of the Abraham Accords

The Prognostic Impact of Tumor Size and BRAF Mutational Status in Middle Eastern Differentiated Thyroid Cancer.

Tumor size at diagnosis has been widely used as a major mortality risk factor in risk stratification of DTC. The current study was designed to analyze whether tumor size at diagnosis is a major prognostic factor in Middle Eastern DTC. We conducted a comparative study of the relationship between tumor size at diagnosis and event free survival (EFS) with respect to BRAF status in 1709 consecutive patients treated surgically for DTC. Patients were divided into four groups according to the size of tumor and BRAF mutation status: Group 1 (≤4 cm without BRAF mutation), Group 2 (≤4 cm with BRAF mutation), Group 3 (>4 cm without BRAF mutation) and Group 4 (>4 cm with BRAF mutation). Predictors of EFS were compared using the Log-rank test and Cox proportional hazards models. Tumor size >4cm was associated with adverse clinico-pathologic characteristics, such as older age, male gender, bilateral tumors, extrathyroidal extension, lymphovascular invasion, advanced tumor stage and persistent/recurrent disease. Tumor size was also inversely associated with BRAF mutation. Both tumor size (> 4cm) and BRAF mutation were associated with EFS on univariate analysis. On subgroup analysis, larger tumor size was an independent predictor of EFS (Group 3 vs. Group 1), irrespective of BRAF mutation status. Also, within the BRAF mutant tumors, larger tumor size was still an independent predictor of EFS (Group 4 vs. Group 2). Tumor size is an independent predictor of EFS in Middle Eastern DTC patients, regardless of BRAF mutational status.