East Populations Research Articles

Genetic diversity and Wolbachia infection in the Japanese encephalitis virus vector Culex tritaeniorhynchus in the Republic of Korea

BackgroundCulex tritaeniorhynchus, a major vector of Japanese encephalitis virus (JEV), is found across a broad geographical range, including Africa, Asia, Australia and Europe. Understanding the population structure and genetic diversity of pathogen vectors is increasingly seen as important for effective disease control. In China and Japan, two countries in close proximity to the Republic of Korea (ROK), Cx. tritaeniorhynchus has been categorized into two clades based on the DNA barcoding region of mitochondrial cytochrome c oxidase subunit I (COI), suggesting the presence of cryptic species. No comprehensive analysis of the genetic diversity in Cx. tritaeniorhynchus has been conducted in the ROK. To address this gap, we investigated the population structure of Cx. tritaeniorhynchus in the ROK.MethodsIn Daegu, mosquito collections were conducted over a 2-year period from 2022 to 2023. For all other regions, Cx. tritaeniorhynchus specimens collected in 2023 were used. The COI barcoding region was analyzed to determine the genetic structure of the populations, supplemented with data from the 28S ribosomal DNA region. Each population was also examined for the eventual presence of Wolbachia infection. Finally, a back trajectory analysis was conducted to assess the possibility of international introduction of Cx. tritaeniorhynchus into the ROK.ResultsThe analysis of the COI region revealed the presence of two distinct clades within Cx. tritaeniorhynchus; these clades were the same as Cx. tritaeniorhynchus continental type (Ct-C) and C. tritaeniorhynchus Japanese type (Ct-J) previously reported. In contrast, the nuclear 28S region showed no significant genetic differentiation between these clades. Wolbachia infection was confirmed in some populations, but there was no evidence of an association with Wolbachia in Ct-C and Ct-J. It was also confirmed that the ROK is currently dominated by the Ct-J clade, with a possible introduction of Ct-C via air currents.ConclusionsDetermining the presence of cryptic species is important for preventing vector-borne diseases. The results of this study confirm the existence of two clades of Cx. tritaeniorhynchus in the ROK, with Ct-J being the dominant clade. Our findings enhance current understanding of the genetic diversity within Cx. tritaeniorhynchus and provide valuable insights for the prevention of JEV outbreaks and the effective management of Cx. tritaeniorhynchus populations in East Asia.Graphical

Understanding the Interaction Between Family Dynamics and Childhood Obesity in the Middle Eastern Population: A Qualitative Study.

We aim to understand the interaction between family dynamics and lifestyle behaviors of school-age children with overweight or obesity in Oman. The outcomes would clarify the mediating familial determinants that contribute to childhood obesity in the Middle East population. A qualitative phenomenological approach. Mothers of school-age children with overweight or obesity. Semi-structured interviews were conducted following an interview guide, and thematic analysis was used to identify key themes and subthemes. The study identified three main themes based on data collected from 12 participants. The first theme, "Children's Lifestyle Behaviors," highlighted the need to address unhealthy food consumption, low physical activity, and inconsistent sleeping habits. The second theme, "Parenting Lifestyle behaviors," underscored the importance of regaining control over children's eating behaviors, fostering shared interest in outdoor activities, and establishing a consistent sleep routine. Lastly, the third theme, "Determinants of Parenting Lifestyle Behaviors," identified factors such as parental stress, the high cost of healthy options, cultural influence on healthy eating, limited outdoor activity options, and the availability of unhealthy snacks in schools. Our study underscores the need for family-centered obesity programs that address several determinants of parenting lifestyle behaviors, including psychological, financial, social, and environmental challenges.

Prevalence of syphilis infection among migrant workers in Qatar: a nationwide cross-sectional survey

ObjectivesScant data are available on syphilis infection within migrant populations worldwide and in the population of the Middle East and North Africa region. This study investigated the prevalence of both...

Exploring determinants of vaccination status among pediatric populations in East Gojam, Amhara Region, Ethiopia

IntroductionVaccination is a critical public health intervention that significantly reduces morbidity and mortality among children. Despite its importance, vaccination coverage remains suboptimal in many regions, including East Gojam, Amhara Region, Ethiopia. This study investigated the sociodemographic, economic, and cultural determinants of vaccination status among pediatric populations in East Gojam.MethodsUsing a cross-sectional design, data were collected from 1,900 respondents, categorizing vaccination status as not vaccinated, partially vaccinated, or fully vaccinated. Multinomial logistic regression was used to analyze the impact of predictors such as child age, gender, parental education level, household income, geographic location, access to healthcare, trust in healthcare providers, sources of vaccination information, cultural beliefs, and perceived government support for vaccination.ResultsThe results revealed that higher parental education levels and urban residence positively influence vaccination status. Older children were less likely to be fully vaccinated, indicating a need for targeted outreach. Access to healthcare services and trust in healthcare providers significantly promoted vaccination, whereas negative cultural beliefs and misinformation adversely affected vaccination status. Perceived government support for vaccination was also a significant predictor.ConclusionThis study concludes that addressing these multifaceted determinants through educational programs, improved healthcare access, trust-building initiatives, accurate information dissemination, stronger governmental support, targeted outreach for older children, community engagement, and multisectoral collaboration can enhance vaccination coverage and improve public health outcomes in East Gojam and similar settings.

Revisiting the Normal Ranges of Aortic Valve Area in 2D Echocardiography and Its Association With Age, Sex, and Anthropometric Characteristics.

Defining normative aortic echocardiographic values in each geographical district is crucial as aortic valve area (AVA) may vary across races, genders, and ages. Notably, variations in normal values can have implications for clinical decision-making, and available data on the Middle East population is also scarce. We sought to establish normal ranges for aortic valve echocardiographic parameters in the Iranian population and assess the effect of age, gender, weight, height, BMI, BSA, and blood pressure on them. Our data were provided from the web-based echocardiographic data registry of Imam Khomeini Hospital Complex (IKHC). A total of 3251 healthy subjects older than 18 years old without any valvular stenosis were included in our study. AVA's normal range was estimated at 1.92-4.52 and 1.67-3.80 cm2 in men and women, respectively. The annulus, AVA, AV VTI, and LVOT VTI were significantly larger in males, and this association remained significant after indexing AVA for weight, height, BMI, and BSA. Also, smaller AVA was associated with lower height, weight, BMI, and BSA in both men and women. Obese and hypertensive subjects had significantly larger AVA and annulus diameters. Our study provided region-specific normal reference values for AV echocardiographic parameters and compared them across genders, ages, BMI, and blood pressure groups in the Iranian population.

Clinical and genetic spectrum of factor XII deficiency in the Han population of East China

BackgroundFactor XII (FXII or F12) deficiency is a rare inherited disorder, typically lacking haemorrhagic symptoms. There is limited literature exists on FXII deficiency and mutations within the Chinese population. This study aimed to characterize the spectrum of F12 gene mutations in a Chinese cohort and to investigate the relationship between FXII mutations and clinical phenotypes.MethodsGenetic and clinical data from 51 unrelated probands with FXII deficiency, along with their families, were meticulously collected and analysed.ResultsGenetic analysis revealed that 94.1% of probands carried genetic defects, with 29 mutations pinpointed in the F12 gene. Of these, 18 mutations were previously reported for the first time by our research group, including c.303_304delCA, c.1078G > A, c.1285 C > T, among others. Of the mutations, 17 are missense, constituting 58.6% of the total. Additionally, 11 are deletions or insertions, of which 8 result in frameshifts, while the remaining one is a nonsense mutation. These mutations were predominantly concentrated in two crucial regions: the catalytic domain and the kringle domain. The most frequently observed mutations were c.1681G > A, closely followed by c.1561G > A and c.1078G > A, indicating a dominance among these mutations. Additionally, a prevalent polymorphism at position 46 was observed in the majority of probands, with 47.1% having the 46T/T genotype and 13.7% having the 46 C/T genotype, which may potentially impact FXII activity. The broad spectrum of asymptomatic FXII deficiency observed within the Han population of East China.ConclusionsWe speculate on the potential impact of recurrent mutations on the efficacy of new drugs being developed to target FXII for thrombosis prevention and treatment. Furthermore, it is important to explore their influence on FXII-related pathways beyond the activation of the contact pathway in the coagulation cascade.

Dry Eye Disease Prevalence and Associated Risk Factors Among the Middle East Population: A Systematic Review and Meta-Analysis.

Dry eye disease (DED) is a common condition characterized by a loss of the tear film function, leading to symptoms of ocular discomfort and damage to the ocular surface. The prevalence and associated risk factors of DED may vary by region due to environmental, cultural, and genetic differences. The aim of the present study is to systematically review and analyze the prevalence and risk factors of DED in the Middle East (ME) region. This study adhered to the PRISMA 2020 guidelines. A comprehensive literature search was conducted using databases such as Web of Science, Scopus, Google Scholar, and PubMed to identify relevant studies published from January 2004 to July 2024. Studies included in the review were those that provided data on the prevalence and risk factors of DED in Middle Eastern populations. Data were extracted and analyzed to determine overall pooled prevalence and associated risk factors using a random-effects model. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42024583897. The meta-analysis included 17 studies from 10 countries with a total of 22,087 subjects. The estimated pooled prevalence of DED in the ME region was 28.33% (95% CI: 27.74-28.93). The primary risk factors include age, female gender, and smoking. Other risks are contact lens use, prolongedscreen time (over six hours daily), diabetes, glaucoma medications, allergies, autoimmune diseases, refractive surgery, arthritis, high cholesterol, acne treatments, antihistamines, antidepressants, thyroid disease, and a history of conjunctival infections or corneal abrasions. The prevalence of DED in Middle Eastern countries was higher than the global estimate, highlighting significant regional variation. Common risk factors for DED include older age, female gender, and smoking. These findings underscore the need for targeted prevention and management strategies that address the specific risk factors prevalent in the Middle Eastern population.

Prevalence of Trehalase Enzymopathy Genetic Determinants in Siberian and Russian Far East Populations.

. Using the Infinium iSelect HD Custom BeadChip biochip (Illumina, United States) on the iScan platform and real-time polymerase chain reaction on a Bio-Rad CFX96 Touch amplifier, genotyping of 1068 DNA samples was carried out, of which 667 represent 10 ethnic groups of the indigenous people of the North of Siberia and the Far East of the Russian Federation. Two reference groups (357 samples) of Russians (n=311) and Yakuts (n = 46) represent the "Caucasoid" and "Mongoloid" poles of the Russian population. : The reduced trehalase activity that the heterozygous GA*TREH genotype determines can manifest itself in 19.8-53.7% of indigenous northerners. An additional 1.0 to 19.7% of the population are carriers of the AA*TREH genotype, which is associated with apparent trehalose malabsorption. The carriers may experience nausea, abdominal pain, and other dyspeptic symptoms after eating trehalose containing foods. The total risk of trehalase enzymopathy among the indigenous northerners in the Asian part of the Russian Federation is very high and can reach 60-70%. There is a gradient in the A*TREH allele frequencies in the small-numbered indigenous northern groups of Russia from the west (Khanty, Mansi, Nenets) to the east (peoples of the Far East). : The results are consistent with previously reported data on the higher carriage of the A*TREH mutant allele in Mongoloid populations compared to Caucasoid groups. It was hypothesized that, while the initial A*TREH allele prevalence in Mongoloid groups was moderately high, an adaptation to a low-sugar protein-lipid "high-latitude" diet led to a weaker control over the maintenance of the carriage of the ancestral G* allele. Trehalose malabsorption requires special attention of specialists in the field of nutrition, gastroenterology, public health, and medical genetics working in high-latitude regions.

Fewer spine degenerations among Southeast Asians than among Southern Chinese suggests populations from a warmer climate have inherently better spine health.

Compared with older Caucasians, older Chinese have remarkably lower prevalence and lower severity of spine degenerative changes. There have been few studies on Southeast East populations. This study aims to compare radiographic spine degeneration features among older Hong Kong (HK) Chinese, older Thais, and older Indonesians. This study included 195 Thai women (mean: 73.6 years), 202 Thai men (mean: 73.7 years), 227 Indonesian women (mean: 70.5 years), and 174 Indonesian men (mean: 70.2 years), as well as same number of gender- and age-matched HK Chinese. The recruitment plan was that the participants would represent the general older population of their respective communities. With spine radiograph, spine hyper-kyphosis, osteoarthritic wedging (OAw), acquired short vertebrae (SVa), general osteophyte formation, lumbar disc space narrowing, and lumbar spondylolisthesis were assessed. Compared with Southeast Asians (Thais and Indonesian data together), Chinese women and men had a higher prevalence of hyper-kyphosis (24.9% vs. 16.4%), OAw (2.4% vs. 0.9%), general osteophyte formation (15.3% vs. 10.5%), lumber disc space narrowing (27.6% vs. 20.3%), and lumbar spondylolisthesis (20.7% vs. 15.3%). The trends were also consistent for sub-group data analyses. An even lower prevalence was noted among Indonesian women and men than among Thais in general osteophyte formation (5.9% vs. 14.1%), lumbar disc space narrowing (18.3% vs. 24.1%), and lumbar spondylolisthesis (11.4% vs. 19.3%). This study showed a lower prevalence of spine degeneration changes among older Thais and older Indonesians than among older Chinese. Indonesians, who inhabit an even warmer climate, show even fewer spine degeneration changes than Thais.

Incorporating New Datatypes to Enhance Species Delimitation: A Case Study in Rice Paddy Snakes (Homalopsidae: Hypsiscopus).

Homalopsids (Old World Mud Snakes) include 59 semiaquatic species in Asia and Australasia that display an array of morphological adaptations, behaviors, and microhabitat preferences. These attributes make homalopsids an ideal model system for broader questions in evolutionary biology, but the diversity of this understudied group of snakes is still being described. Recognized species diversity in rice paddy snakes (Hypsiscopus) has recently doubled after nearly 200 years of taxonomic stability. However, the evolutionary distinctiveness of some populations remains in question. In this study, we compare mainland Southeast Asian populations of Hypsiscopus east and west of the Red River Basin in Vietnam, a known biogeographic barrier in Asia, using an iterative approach with molecular phylogenetic reconstruction, machine-learning morphological quantitative statistics, and ecological niche modeling. Our analyses show that populations west of the Red River Basin represent an independent evolutionary lineage that is distinct in genetics, morphospace, and habitat suitability, and so warrants species recognition. The holotype of H. wettsteini, a species originally described in error from Costa Rica, grouped morphometrically with the population at the Red River Basin and eastward, and those west of the Red River Basin are referred to the recently described H. murphyi. The two species may have diversified due to a variety of geological and environmental factors, and their recognition exemplifies the importance of multifaceted approaches in taxonomy for downstream biogeographic studies on speciation scenarios.

Molecular Phylogenetics and Phylogeography of Malaysian Mousedeer (Tragulus kanchil) Based on Mitochondrial DNA Sequences of the D-Loop Region

Two sympatric mousedeer species, Tragulus kanchil and Tragulus napu, inhabit the Malaysian tropical rainforests. Previous studies have established their phylogenetic relationships based on morphological variations; however, comprehensive genetic data have yet to be extensively used to relate the relationships especially from different populations. The main objectives of this study were to determine the phylogenetic relationships, population genetics, and phylogeography of mousedeer species based on DNA sequences of the mitochondrial D-loop region. DNA from 32 mousedeer samples, representing various populations in Malaysia, was sequenced and analyzed using Neighbor-Joining, Maximum Parsimony, and Bayesian Inference approaches. The phylogenetic analyses showed two main clades representing the populations of T. kanchil and T. napu. The results also showed that the T. kanchil populations in Borneo was separated from Peninsular Malaysia taxa in MP and BI phylogenetic tree. However, Borneo population was nested in east population of Peninsular Malaysia in NJ tree. In addition, the T. kanchil population in Peninsular Malaysia further separated into east and west coast populations of Titiwangsa Range. It was supported with finding in population genetic relation that showed relatively low levels among population. This is expected because some of the populations are isolated geographically. The divergence of these populations is likely due to the Titiwangsa Range which acts as a barrier separating the east and west Peninsular Malaysia populations, and the South China Sea separates the populations of Peninsular Malaysia and Borneo. Molecular clock tree reconstruction showed that the separation of T. kanchil and T. napu occurred around 17.11 million years ago (MYAs). Furthermore, the T. kanchil populations from the east and west Peninsular Malaysia showed a branching pattern from those of Borneo of about 11.04 and 9.14 MYAs, respectively. The results of this study increase our understanding of Malaysian mousedeer phylogeny and phylogeography.

Determinants of youth financial inclusion in MENA countries: account holding versus the use of digital services

Purpose Youths aged 15–34 make half the population of Middle East and North Africa (MENA) and over one quarter of the labour force. The purpose of this paper is to address the two following questions. Why youths from Egypt, Jordan and Tunisia lack financial inclusion before (2014 and 2017) and during (2021) the COVID-19 pandemic? What are the determinants of their financial inclusion? Design/methodology/approach Financial inclusion encapsulates account holding at financial institutions and the use of digital services they provide. Two probit regressions address financial inclusion regarding these two dimensions, upon three pooled samples selected from the Global Findex Database, each sample gathering roughly 3,000 households including over two-fifths of youths. Findings Five results regarding financial inclusion highlight the role of job-status, income, education, gender and age. Prior the pandemic, financial inclusion of young entrepreneurs is affected by (female) gender, (middle) income, (low) education level and country policy. During the pandemic, y women became more financially included; there was no age gap regarding digital services; and despite improvement, digital services remain unsuitable for poorly educated youth. Gender has no effect on the financial inclusion of young employees before and during the pandemic. Research limitations/implications Government policy should target youth underserved population to foster financial inclusion, distinguishing voluntary from involuntary reasons of financial exclusion. Originality/value To the best of the authors’ knowledge, no paper has addressed yet the determinants of youth financial inclusion, especially the use of digital services, with a focus on job status (entrepreneurs vs employees) in MENA countries, prior and during the pandemic.

Defining indicators for disease burden, health outcomes, policies and barriers and facilitators to health services for migrant populations in the Middle East and North African region: a protocol for a suite of systematic reviews

IntroductionThe Middle East and North African (MENA) region is characterised by high and complex migration flows, yet little is known about the health of migrant populations, their levels of underimmunisation...

Seven-Year Experience of Intramural Surgery in the Middle East: A Safety and Feasibility Analysis.

Background: Intramural surgery techniques, particularly esophageal peroral endoscopic myotomy (E-POEM), gastric peroral endoscopic myotomy (G-POEM), and peroral endoscopic myotomy for Zenker's (Z-POEM), have emerged as forefront minimally invasive endoscopic procedures. While several studies have reported on the outcomes in North America and Asia, evidence in the Middle East and North Africa remains limited. This study aims to evaluate the feasibility and safety of intramural surgery techniques within this region. Methods: This retrospective cohort study was conducted with approval from the institutional review board. All patients who underwent esophageal peroral endoscopic myotomy, gastric peroral endoscopic myotomy, and peroral endoscopic myotomy for Zenker's from January 2016 to August 2023 were included. Results: In total, 119 patients underwent intramural surgery procedures during this period. The esophageal peroral endoscopic myotomy group had 81 (68%) patients, the gastric peroral endoscopic myotomy had 34 (28.6%) patients, and the peroral endoscopic myotomy for Zenker's had 4 (3.4%) patients. The full cohort was 48.7% female, with a mean overall age of 40.5 years. The mean overall body mass index was 27.5 kg/m2. The chief complaint was dysphagia (n = 80, 67.2%). All cases were successfully completed endoscopically. During the first 30 days, the most common complications were nausea/vomiting requiring admission (n = 4, 4.76%) and pneumomediastinum (n = 2, 2.38%). At a follow-up of 19 months, there were four mortalities; the causes of death were cardiac arrest (three cases) and end-stage prostate cancer (one case). Conclusions: Intramural surgery techniques are safe and technically feasible with low complication rates. Our study suggests that clinical success in the Middle East and Northern Africa population is comparable to larger international series.

Implementation of an atrial fibrillation better care (ABC) pathway management strategy: Findings from the Iranian registry of atrial fibrillation

IntroductionThe Atrial Fibrillation Better Care (ABC) pathway is such an integrated care approach, recommended in guidelines. The aim of this service evaluation study was to evaluate the impact of implementing the ABC pathway in Iranian population. MethodsIn this prospective longitudinal cohort study, consecutive patients with a diagnosis of AF were initially evaluated. Patients at baseline were evaluated in hence of adherence to ABC pathway strategy. After study enrolment, first and second follow-up service evaluations were conducted at 6 and 12 months, respectively. ResultsThe use of vitamin K antagonists (VKA) decreased from 25.1 % at enrolment to 13.8 % at follow-up; instead, non-VKA oral anticoagulants (NOAC) utilization increased from 40.0 % to 86.1 %, while antiplatelet treatment decreased from 34.9 % to 0 %. Use of antihypertensive drugs, ARBs, diuretics, and statins increased after implementation of the ABC pathway. Implementation of the ABC pathway approach led to a decrease in the occurrence of stroke/TIA (from 6.3 % to 2.2 %, p = 0.002), systemic thromboembolism (from 1.4 % to 0.0 %, p = 0.04), nose bleeds (from 0.8 % to 0.6 %, p = 0.04), skin bruising (from 1.2 % to 0.0 %, p = 0.002), and heart failure (from 7.7 % to 4.7 %, p = 0.04). The proportion of patients in EHRA Class I-II increased from 93.3 % at enrolment to 98.1 % at follow-up. ConclusionIn this first study from a Middle East population, compliance with ABC pathway strategy in the management of AF was associated with optimization of management and general improvements in patient outcomes during follow-up.

Epidemiology, biosafety, and biosecurity of Avian Influenza: Insights from the East Mediterranean region.

The World Organization for Animal Health defines Avian Influenza Virus as a highly infectious disease caused by diverse subtypes that continue to evolve rapidly, impacting poultry species, pet birds, wild birds, non-human mammals, and occasionally humans. The effects of Avian influenza viruses have been recognised as a precursor for serious health concerns among affected birds, poultry, and human populations in the Middle East. Furthermore, low and high pathogenic avian influenza viruses lead to respiratory illness with varying severity, depending on the virus subtype (e.g., H5, H7, H9, etc.). Possible future outbreaks and endemics of newly emerging subtypes are expected to occur, as many studies have reported the emergence of novel mutations and viral subtypes. However, proper surveillance programs and biosecurity applications should be developed, and countries with incapacitated defences against such outbreaks should be encouraged to undergo complete reinstation and reinforcement in their health and research sectors. Public education regarding biosafety and virus prevention is necessary to ensure minimal spread of avian influenza endemic.

Epidemiology of rare endocrine tumors in a developing Middle Eastern country over 18 years.

e23069 Background: Despite that thyroid and adrenal malignancies compose the vast majority of endocrine tumors, several other tumors could arise with significant resultant morbidity and mortality. Given the rarity of these tumors, thorough evaluation of the epidemiological features is of consequential significance in the diagnosis and management especially in the Middle East and Middle Eastern populations where adequate experience in such rare tumors is immensely limited. Methods: Extensive data on various endocrine tumors, other than thyroid and adrenal, diagnosed in patients from different nationalities residing in Jordan during the period of 2000-2018 were retrieved from the national institutionalized reporting body of cancer epidemiology in Jordan, the Jordan Cancer Registry. A total of 34 patients were included in the comprehensive epidemiological analysis performed to establish the epidemiological characteristics of these rare endocrine tumors. Results: A total of 34 patients with a mean age of 43.1 ± 18 years old with a female predominance of 64.7% have been enrolled. 11.8% of the patients were smokers at the time of diagnosis. Pituitary gland tumors were the most commonly encountered, 52.9%, followed by parathyroid gland malignancies reported in 32.4% of the patients, and craniopharyngioma in 14.7% of the patients. 29.4% of the patients had localized malignancy. There is a statistically nonsignificant increase in the crude incidence of these endocrine tumors with a crude incidence estimated effect of 0.001 (P-value = 0.21). Conclusions: Jordan has witnessed over the 18 years a range of rare endocrine tumors, mostly involving the pituitary gland. These rare endocrine tumors impose an unpredictable pattern in presentation and outcomes, and thus the determination of these epidemiological features will enable targeted diagnosis and management interventions.

#1386 Hypertension is associated with deterioration of kidney function among patients with systemic lupus erythematosus, with or without lupus nephritis

Abstract Background and Aims Systemic lupus erythematosus (SLE) frequently involves the kidneys, contributing to morbidity and mortality among this population. While hypertension often coexists with kidney involvement, it is not represented in the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index. Its effect on the morbidity and mortality of the SLE population in the Middle East should be evaluated. Our aims is to characterize the role of hypertension in Israeli SLE patients and identify variables associated with decreased eGFR over time. Method This retrospective study, conducted between 2014–2023 included adult patients with a diagnosis of SLE for at least 12 months. Kidney involvement was assessed based on a diagnosis of lupus nephritis (LN) on kidney biopsy. Hypertension was diagnosed based on documented diagnosis. Systolic and diastolic blood pressures were collected as continuous variables at multiple time-points. Associated variables, including socio-demographics, disease-related characteristics, kidney-related factors, comorbidities and all-cause mortality were assessed. Results A total of 182 patients were followed for a mean duration of 16.2 ± 13.8 years. Fifty-nine patients (32.4%) had chronic hypertension. Hypertension was more prevalent among SLE patients with LN [odds ratio (OR) 1.5, 95% CI 0.8-2.9, p = 0.23] as well as patients with chronic kidney disease (OR 7.2, 95% CI 1.9-27.7, p = 0.001). Patients with chronic hypertension had significantly relatively high rate of proteinuria at last follow-up (54.7%). On univariate analysis, patients with hypertension had higher rates of end-stage kidney disease (ESKD) (11.9% vs 1.6%, p = 0.003), heart failure (20.3% vs. 0.8%, p < 0.001), and all-cause mortality (16.9% vs. 0%, p < 0.001). All deaths (n = 10) occurred among hypertensive patients. LN and age were the most important predictors of hypertension on multivariate analysis (OR 6.2, 95% CI 2.4-16, p < 0.001; OR 1.1, 95% CI 1.1-1.2 p < 0.001, respectively). Repeated measures analysis showed that hypertension was significantly associated with decreased eGFR among SLE patients with or without LN (Fig. 1). Systolic and diastolic blood pressure were significantly correlated with age and inversely correlated with eGFR at last follow-up (Spearman's correlation coefficient 0.4, p < 0.01; 0.1, p = 0.07; −0.4, p < 0.01; −0.2, p = 0.04, respectively). Conclusion Hypertension is prevalent among Israeli patients with SLE, constituting a substantial comorbidity associated with ESKD, heart failure and mortality, irrespective of LN presence. Routine assessment and vigorous treatment of hypertension should be part of the management of patients with SLE.

A cross-sectional study on adult lifestyle habits during the COVID-19 pandemic.

COVID-19 has spread and developed into a pandemic disease, forcing countries to impose challenging protocols and lockdowns. This study assessed shopping, food consumption behavior, and feelings in Jordan and several Arab countries during the COVID-19 pandemic. A cross-sectional web-based survey among the Middle East population was conducted using an online questionnaire between July and September 2022. Participants were requested to answer a standardized and validated structured questionnaire. Demographic information, shopping behavior information, and mental health data were requested. A total of 542 respondents were included in the study. During COVID-19 quarantine, participants (68.6%) reported decreased shopping frequency and buying more food than usual (37.5%). Cereals and legumes were the primary food types stored by participants (76.9%). Multiple logistic regression revealed the age of the participant as a significant factor affecting storing of food (being ≤ 25 years old (OR = 0.456, p value = 0.038)). 75.7% of female participants eat less frequently in restaurants than usual. In contrast, among males, 48.5% reported that they eat at restaurants less frequently than usual. The country of residency and gender were the significant factors affecting negative feelings and emotions. Participants in countries other than Jordan had a higher negative feeling score (Beta = 0.086, p value = 0.042). Furthermore, females had a higher negative feeling score (Beta = -0.128, p value = 0.003) as the negative feelings score for females was 3.58 (SD = 5.443). On the other hand, it was 2.10 (SD = 5.091) for males. The COVID-19 pandemic has altered Jordanians' attitudes, shopping, and food consumption habits. Although positive behaviors have improved, such as shopping less frequently, eating home-cooked meals, and dining with family, frequent snacking and food storage have increased. Finally, public awareness of shopping and food consumption habits should be promoted.

First report of inclisiran utilization for hypercholesterolemia treatment in real-world clinical settings in a middle east population

First report of inclisiran utilization for hypercholesterolemia treatment in real-world clinical settings in a middle east population