Primary sex determination in birds depends on DMRT1 dosage, but gonadal sex does not determine adult secondary sex characteristics.

In birds, males are the homogametic sex (ZZ) and females the heterogametic sex (ZW). Primary sex determination is thought to depend on a sex chromosome gene dosage mechanism, and the most likely sex determinant is the Z chromosome gene Doublesex and Mab-3-Related Transcription factor 1 (DMRT1). To clarify this issue, we used a CRISPR-Cas9-based monoallelic targeting approach and sterile surrogate hosts to generate birds with targeted mutations in the DMRT1 gene. The resulting chromosomally male (ZZ) chicken with a single functional copy of DMRT1 developed ovaries in place of testes, demonstrating the avian sex-determining mechanism is based on DMRT1 dosage. These ZZ ovaries expressed typical female markers and showed clear evidence of follicular development. However, these ZZ adult birds with an ovary in place of testes were indistinguishable in appearance to wild-type adult males, supporting the concept of cell-autonomous sex identity (CASI) in birds. In experiments where estrogen synthesis was blocked in control ZW embryos, the resulting gonads developed as testes. In contrast, if estrogen synthesis was blocked in ZW embryos that lacked DMRT1, the gonads invariably adopted an ovarian fate. Our analysis shows that DMRT1 is the key sex determination switch in birds and that it is essential for testis development, but that production of estrogen is also a key factor in primary sex determination in chickens, and that this production is linked to DMRT1 expression.

Oestrogen in the chick embryo can induce chromosomally male ZZ left gonad epithelial cells to form an ovarian cortex that can support oogenesis.

In chickens, the embryonic ovary differentiates into two distinct domains before meiosis: a steroidogenic core (the female medulla), overlain by the germ cell niche (the cortex). The differentiation of the medulla is a cell-autonomous process based on chromosomal sex identity (CASI). In order to address the extent to which cortex differentiation depends on intrinsic or extrinsic factors, we generated models of gonadal intersex by mixing ZW (female) and ZZ (male) cells in gonadal chimeras, or by altering oestrogen levels of ZW and ZZ embryos. We found that CASI does not apply to the embryonic cortex. Both ZW and ZZ cells can form the cortex and this can happen independently of the phenotypic sex of the medulla as long as oestrogen is provided. We also show that the cortex-promoting activity of oestrogen signalling is mediated via estrogen receptor alpha within the left gonad epithelium. However, the presence of a medulla with an 'intersex' or male phenotype may compromise germ cell progression into meiosis, causing cortical germ cells to remain in an immature state in the embryo.

Transformational leadership and predictors of resilience among registered nurses: a cross-sectional survey in an underserved area.

BACKGROUND: High resilience increases nurses' ability to cope with job-related stressors and enhances job satisfaction and, consequently, their retention. The study aims to identify resilience predictors and perceptions of transformational leadership in a convenience sample of registered nurses in Lebanon. METHODS: An anonymous cross-sectional survey of a convenience sample of 240 registered nurses working for more than a year at three private hospitals in an underserved area in South Lebanon was used. The survey instrument included demographic questions, the True Resilience Scale ©, and the Global Transformational Leadership Scale. Multiple linear regression was used to assess the predictors of resilience after a descriptive analysis of the study variables. RESULTS: The survey response rate was 85%. The nurses' mean resilience score was 119.4 (SD 15.3), and their perception of transformational leadership score was M = 25.0, SD = 6.8. Compared to bedside nurses, nurse managers, nurses with more than five years of experience, and nurses in critical nursing units had statistically significant higher resilience scores (p < 0.05). Resilience scores and perception of global transformational leadership were moderately correlated (r = 0.53, p < 0.05). In the final multiple linear regression model, 30% of the variation in resilience scores was explained by designation (p < 0.05) and perception of Global Transformational Leadership (p < 0.01). Perception of global transformational leadership scores explained 29% of the variance in resilience scores. Designation and perception of global transformational leadership predicted resilience in this sample. CONCLUSIONS: A national survey of the Lebanese nursing workforce is needed to achieve an improved predictive model and support policy developments to increase resilience among bedside nurses and retain them in the nursing workforce. Nurse administrators can help by strengthening their transformational leadership behaviors. Consistent use of transformational leadership styles will strengthen bedside nurses' resilience, increase nurse retention, and help sustain the Lebanese nursing workforce.

On Bender's orientation to models: Towards a philosophical debate on covering laws, theory, emergence and mechanisms in nursing science.

Nursing scholars continuously refine nursing knowledge and the philosophical foundations of nursing practice. They advance nursing knowledge by creating new knowledge and weighing the relevance of developments in cognate sciences. Nurse philosophers go further by providing epistemological and ontological arguments for explanations of nursing phenomena. In this article, I engage with Bender's arguments about why mechanisms should have more primacy as carriers of nursing knowledge. Despite the careful scholarship involved, Bender's arguments need to be more convincing. Accordingly, this article encourages debate about Bender's arguments for reorientating nursing science to mechanisms. I begin by suggesting that the claim that the theory-practice divide can be overcome by reorientating to mechanisms is acceptable only if we accept Bender's depiction of the challenge. Then I question the ontology Bender relies on to justify reorientating nursing science. After that, I argue that mechanisms in models that parallel analytical sociology undermine the kind of nursing science Bender advocates. I illustrate my arguments with a social mechanism thought experiment. Then I explain why Bender's arguments cannot escape the received view of science or inform emancipatory nursing action without theory. Finally, I mention some caveats and implications for nursing science.

Feather arrays are patterned by interacting signalling and cell density waves.

Feathers are arranged in a precise pattern in avian skin. They first arise during development in a row along the dorsal midline, with rows of new feather buds added sequentially in a spreading wave. We show that the patterning of feathers relies on coupled fibroblast growth factor (FGF) and bone morphogenetic protein (BMP) signalling together with mesenchymal cell movement, acting in a coordinated reaction-diffusion-taxis system. This periodic patterning system is partly mechanochemical, with mechanical-chemical integration occurring through a positive feedback loop centred on FGF20, which induces cell aggregation, mechanically compressing the epidermis to rapidly intensify FGF20 expression. The travelling wave of feather formation is imposed by expanding expression of Ectodysplasin A (EDA), which initiates the expression of FGF20. The EDA wave spreads across a mesenchymal cell density gradient, triggering pattern formation by lowering the threshold of mesenchymal cells required to begin to form a feather bud. These waves, and the precise arrangement of feather primordia, are lost in the flightless emu and ostrich, though via different developmental routes. The ostrich retains the tract arrangement characteristic of birds in general but lays down feather primordia without a wave, akin to the process of hair follicle formation in mammalian embryos. The embryonic emu skin lacks sufficient cells to enact feather formation, causing failure of tract formation, and instead the entire skin gains feather primordia through a later process. This work shows that a reaction-diffusion-taxis system, integrated with mechanical processes, generates the feather array. In flighted birds, the key role of the EDA/Ectodysplasin A receptor (EDAR) pathway in vertebrate skin patterning has been recast to activate this process in a quasi-1-dimensional manner, imposing highly ordered pattern formation.

Investigation of MicroRNA Biomarkers in Equine Distal Interphalangeal Joint Osteoarthritis.

Osteoarthritis of the equine distal interphalangeal joint is a common cause of lameness. MicroRNAs from biofluids are promising biomarkers and therapeutic candidates. Synovial fluid samples from horses with mild and severe equine distal interphalangeal joint osteoarthritis were submitted for small RNA sequencing. The results demonstrated that miR-92a was downregulated in equine synovial fluid from horses with severe osteoarthritis and there was a significant increase in COMP, COL1A2, RUNX2 and SOX9 following miR-92a mimic treatment of equine chondrocytes in monolayer culture. This is the first equine study to evaluate the role of miR-92a in osteoarthritic chondrocytes in vitro.

Lignocellulosic Biomass Waste-Derived Cellulose Nanocrystals and Carbon Nanomaterials: A Review.

Rapid population and economic growth, excessive use of fossil fuels, and climate change have contributed to a serious turn towards environmental management and sustainability. The agricultural sector is a big contributor to (lignocellulosic) waste, which accumulates in landfills and ultimately gets burned, polluting the environment. In response to the current climate-change crisis, policymakers and researchers are, respectively, encouraging and seeking ways of creating value-added products from generated waste. Recently, agricultural waste has been regularly appearing in articles communicating the production of a range of carbon and polymeric materials worldwide. The extraction of cellulose nanocrystals (CNCs) and carbon quantum dots (CQDs) from biomass waste partially occupies some of the waste-recycling and management space. Further, the new materials generated from this waste promise to be effective and competitive in emerging markets. This short review summarizes recent work in the area of CNCs and CQDs synthesised from biomass waste. Synthesis methods, properties, and prospective application of these materials are summarized. Current challenges and the benefits of using biomass waste are also discussed.

Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon's political and financial collapse.

BACKGROUND: The COVID-19 pandemic compounded political and financial pressures on the nursing workforce in Lebanon. The government resigned in October 2019 in response to the popular uprising that called for an end to corruption and economic mismanagement 5 months before the first COVID-19 case appeared in the country. The continuing crises and the added stress of COVID-19 has increased the risk of occupational burnout and turnover in the nursing workforce. Therefore, valid and reliable measurement is imperative to determine burnout levels, prioritize intervention, and inform evidence-based workforce policy and practice. The primary aim of the study was to delineate burnout levels and cut-points in a national sample of nurses to inform workforce policies and prioritize interventions. METHODS: Multidimensional and unidimensional Rasch analyses of burnout data collected from a national convenience sample of 457 hospital nurses 9-12 months after Lebanon's political and economic collapse began. The data were collected in July-October 2020. RESULTS: Multidimensional Rasch analysis confirmed that the Copenhagen Burnout Inventory has three highly correlated unidimensional scales that measure personal burnout, work-related burnout, and client-related burnout. Except for a ceiling effect of ~ 2%, the three scales have excellent measurement properties. For each scale, Rasch rating scale analysis confirmed five statistically different nurse burnout levels. The mean personal burnout scores and work-related burnout scores (50.24, 51.11 respectively) were not higher than those reported in the international literature. However, the mean client-related burnout score of 50.3 was higher than reported for other countries. Compared with a baseline study conducted at the beginning of Lebanon's political and economic crises, only client-related burnout scores were higher p. <.01. CONCLUSIONS: The CBI scales are reliable and valid measures for monitoring nurse burnout in crises torn countries. Stakeholders can use the CBI scales to monitor nurse burnout and prioritize burnout interventions. Urgent action is needed to reduce levels of client-related burnout in Lebanon's nursing workforce.

Sexually dimorphic expression of a chicken sex chromosome gene (VCP) reflects differences in gonadal development between males and females.

The chicken has a Z-W sex chromosome system, in which the males are the homogametic sex (ZZ) and the females the heterogametic sex (ZW). The smaller W chromosome is generally considered to be a highly degraded copy of the Z chromosome that retains around 28-30 homologous protein-coding genes' These Z-W homologues are thought to have important, but undefined, roles in development, and here we explore the role of one of these genes, VCP (Valosin Containing Protein) in gonadogenesis. We established RNA expression levels of both Z and W VCP homologues, the levels of VCP protein, and the cellular localization of VCP protein in male and female embryonic gonads during development. We also assessed the effects of female-to-male sex-reversal on VCP expression in developing gonads. The results showed that both VCP RNA and protein are expressed at higher levels in female than male gonads, and the expression levels of VCP protein and VCP-Z transcript, but not VCP-W transcript, are decreased in female-to-male sex reversed gonads. In addition, the spatial expression of VCP protein differs between male and female embryonic gonads: in testes, VCP protein is mainly confined to the medullary sex cords, while in ovaries, VCP protein is expressed throughout the medulla and at higher levels in the cortex. The results suggest that sexually dimorphic expression of chicken VCP reflects differences in gonadal morphology between sexes.

Factors Associated With the Resilience of Nurses During the COVID-19 Pandemic.

BACKGROUND: The delivery of health care during the COVID-19 outbreak imposed significant challenges on the global nursing workforce and placed them at a higher risk of occupational burnout and turnover. In Lebanon, the pandemic hit when nurses were already struggling with an economic collapse caused by government failures. Resilience may play a protective factor against adversity and enable effective adaption to the burden of the pandemic. AIMS: To determine the level of resilience in the nursing workforce and its relationship to burnout, intention to quit, and perceived COVID-19 risk. METHODS: A cross-sectional study was employed among all registered nurses affiliated with the Order of Nurses in Lebanon and working in patient care positions in hospitals. The online survey questionnaire incorporated the Connor-Davidson Resilience Scale and the Copenhagen Burnout Inventory. Quartile scores were used to differentiate levels of resilience and burnout. Multiple logistic regression identified variables significantly associated with resilience. RESULTS: Five-hundred and eleven nurses responded to the questionnaire. Nurses had a moderate level of resilience (M  = 72 ± 13.5). In multivariate analyses, being male (OR = 3.67; 95% CI [1.46, 9.22]; p = .006) and having a master's degree (OR = 4.082; 95% CI [1.49, 11.20]; p = .006) were independently associated with higher resilience. Resilience levels decreased with higher personal burnout (OR = 0.12; 95% CI [0.03, 0.435]; p = .001), work-related burnout (OR = 0.14; 95% CI [0.04, 0.46]; p = .001), and client-related burnout rates (OR = 0.09; 95% CI [0.03, 0.34]; p < .001). Nurses reporting the intention to quit their job had lower resilience scores (OR = 0.20; 95% CI [0.04, 0.88]; p = .033). LINKING EVIDENCE TO ACTION: Nursing stakeholders must introduce programs to regularly assess and enhance the resilience of nurses especially at time of crisis. Such programs would protect nurses from the perils of burnout and enhance their retention during times when they are most needed. Protecting nurses from burnout is an ethical imperative as well as an operational requirement.

LIF-dependent survival of embryonic stem cells is regulated by a novel palmitoylated Gab1 signalling protein.

The cytokine leukaemia inhibitory factor (LIF) promotes self-renewal of mouse embryonic stem cells (ESCs) through activation of the transcription factor Stat3. However, the contribution of other ancillary pathways stimulated by LIF in ESCs, such as the MAPK and PI3K pathways, is less well understood. We show here that naive-type mouse ESCs express high levels of a novel effector of the MAPK and PI3K pathways. This effector is an isoform of the Gab1 (Grb2-associated binder protein 1) adaptor protein that lacks the N-terminal pleckstrin homology (PH) membrane-binding domain. Although not essential for rapid unrestricted growth of ESCs under optimal conditions, the novel Gab1 variant (Gab1ß) is required for LIF-mediated cell survival under conditions of limited nutrient availability. This enhanced survival is absolutely dependent upon a latent palmitoylation site that targets Gab1ß directly to ESC membranes. These results show that constitutive association of Gab1 with membranes through a novel mechanism promotes LIF-dependent survival of murine ESCs in nutrient-poor conditions.

Reprogramming and remodeling: transcriptional and epigenetic regulation of salicylic acid-mediated plant defense.

As a plant hormone, salicylic acid (SA) plays essential roles in plant defense against biotrophic and hemibiotrophic pathogens. Significant progress has been made in understanding the SA biosynthesis pathways and SA-mediated defense signaling networks in the past two decades. Plant defense responses involve rapid and massive transcriptional reprogramming upon the recognition of pathogens. Plant transcription factors and their co-regulators are critical players in establishing a transcription regulatory network and boosting plant immunity. A multitude of transcription factors and epigenetic regulators have been discovered, and their roles in SA-mediated defense responses have been reported. However, our understanding of plant transcriptional networks is still limited. As such, novel genomic tools and bioinformatic techniques will be necessary if we are to fully understand the mechanisms behind plant immunity. Here, we discuss current knowledge, provide an update on the SA biosynthesis pathway, and describe the transcriptional and epigenetic regulation of SA-mediated plant immune responses.

Hypoxanthine phosphoribosyltransferase (HPRT)-deficiency is associated with impaired fertility in the female rat.

The purine hypoxanthine plays important role in regulating oocyte maturation and early embryonic development. The enzyme hypoxanthine phosphoribosyltransferase (HPRT) recycles hypoxanthine to generate substrates for nucleotide synthesis and key metabolites, and here we show that HPRT deficiency in the rat disrupts early embryonic development and causes infertility in females.

Using frame analysis to re-analyse the results of inductive thematic analysis: A methodological discussion of investigating meanings and learning contexts in baccalaureate nurse education.

AIMS: Recovery of the antecedents and assumptions of Goffman's frame analysis to illustrate learning contexts in baccalaureate nursing programs. DESIGN: A discussion paper on the secondary analysis of focus group data. DATA SOURCES: Focus group data collected in a multi-site study conducted in 2017 to understand the challenges of transitioning to practice in Lebanon. The discussion is illustrated with empirical data, but the article is a conceptual paper not a research report. IMPLICATIONS FOR NURSING: Transition to practice research requires studies of interaction in university schools of nursing to examine the meanings embedded in classroom instruction. METHODS: Clarification and use of Goffman's concepts of primary frame, mainframe (storyline), keying, and re-keying to describe how differences in learning contexts make the transition to practice difficult. CONCLUSION: Baccalaureate nursing education consists in re-keying the knowledge students bring with them to university into an idealized conception of nursing practice. This storyline dominates classroom learning and is re-keyed into the pragmatic approach to nursing practice that dominates learning contexts in clinical units. Students respond to discrepancies between the meanings embedded in classroom and clinical unit learning contexts by striving to apply the classroom storyline or delaying their commitment to a nursing career. IMPACT: The discussion explains how secondary analysis can overcome some of the limitations of inducive thematic analysis. It promotes frame analysis as an intuitive, conceptually sound method for identifying dominant meanings in baccalaureate nursing education. Qualitative researchers who have used inductive thematic analysis can use frame analysis to complement their previous analyses with a structural sociological perspective. We suggest dimensions to help investigators interpret learning contexts. Frame analysis of classroom interaction will bring new insights to transition to practice research.

The relationship between work-related musculoskeletal disorders, chronic occupational fatigue, and work organization: A multi-hospital cross-sectional study.

AIMS: To identify the prevalence of work-related musculoskeletal disorders, levels of chronic occupational fatigue, and how they vary with individual and work organization factors. DESIGN: A multi-hospital cross-sectional survey. METHODS: Nurses from 39 hospitals completed self-reported questionnaires from June to September 2015. Descriptive statistics were used to summarize hospitals and nurses' characteristics, fatigue levels and prevalence, and type of musculoskeletal disorders. Linear and logistic regression analyses were used to identify correlational factors. RESULTS: The results revealed that 71.3% of participants reported a work-related musculoskeletal disorder in the previous 12 months, mainly back pain. The reported musculoskeletal disorders were significantly correlated with years of experience, nurse to patient ratios, and chronic occupational fatigue. Higher chronic occupational fatigue levels were associated with education, age, years of experience, nurse to patient ratio, and model of care. CONCLUSION: Preventive work organization strategies are needed to ensure healthier occupational environment for nurses.

Pain and its Impact on the Functional Ability in Children Treated at the Children's Cancer Center of Lebanon.

PURPOSE: The purpose of this study was to describe the characteristics of pain in children under treatment at the Children Cancer Centre of Lebanon at the American University of Beirut Medical Centre. Design and Methods A cross-sectional correlational survey was used. The Adolescent Pediatric Pain Tool and the Functional Disability Inventory were used to examine the characteristics of pain experienced in a consecutive sample of children treated at the CCCL and its impact on their functional abilities. RESULTS: The mean age of the 62 participants was 12.3 (SD 2.9). The overall mean pain intensity rating for the sample was 5.06 (SD 1.87) on a 10 cm Word Graphic Rating Scale. More than one-half of the children in the sample (57.4%) reported having pain "sometimes" with a median duration of two hours per pain episode. The most frequently reported locations of pain were the forehead, the abdomen, and the lower back. For the most part, the children used sensory words to describe their pain experience. The children reported moderate levels of functional disability (mean FDI score 25.04, SD 13.81). Multivariable linear regression analysis identified frequency, duration, location, use of affective descriptors, and treatments as statistically significant predictors of pain intensity. CONCLUSION: Regrettably, the findings reported attest once again to unrelieved pain in a pediatric oncology population. PRACTICE IMPLICATIONS: Policy makers can contribute to pain control by introducing legislation and national policies to ensure adequate pain management for children with cancer in Lebanon.

The first Arabic version of the Actual Scope of Nursing Practice Scale: Psychometric evaluation.

AIM: We examined the validity and reliability of nursing activity levels of complexity in the first Arabic version of the Actual Scope of Nursing Practice Questionnaire. BACKGROUND: Nurse executives need valid and reliable data on the scope and complexity of nursing practice to make decisions about cost-effective and safe deployment of the nursing workforce. We translated the English version of the Actual Scope of Nursing Practice Questionnaire into Arabic for use in Lebanon and the eastern Mediterranean region. METHODS: Data were collected from a national sample of bedside nurses in Lebanon in which 3,157 questionnaires were returned for analysis. We used multidimensional scaling, hierarchical cluster analysis, and confirmatory factor analysis to examine the Arabic Actual Scope of Nursing Practice Questionnaire levels of nursing complexity. RESULTS: Multidimensional scaling analysis and hierarchical cluster analysis confirmed the unidimensionality of the Arabic Actual Scope of Nursing Practice Questionnaire. Confirmatory factor analysis produced essentially the same fit statistics for the unidimensional model and three-dimensional models of item complexity. CONCLUSION: The Arabic Actual Scope of Nursing Practice Questionnaire is a valid and reliable unidimensional measure of nursing complexity. IMPLICATION FOR NURSING MANAGEMENT: Nurse executives and hospital managers in Lebanon and the eastern Mediterranean region can use total and mean Arabic Actual Scope of Nursing Practice Questionnaire scores as aids when making decisions about nursing workforce deployment.

'Philosophy Lost': Inquiring into the effects of the corporatized university and its implications for graduate nursing education.

Drawing on a comprehensive, pan-national analysis of the corporatization of Canadian universities, as well as the notions of 'parrhesiastic' mentorship and practice, the authors examine the effects of the corporatized university, its implications for graduate nursing education and nursing's relative silence on the subject. With the preponderance of business interests, the increasing dependence of universities on industry funding, cults of efficiency, research intensivity, and the pursuit of profit so prevalent in today's corporatized university, we argue that philosophical presuppositions so crucial to critical teaching, research, and reflection on nursing as a discipline are troublingly losing ground. We lament the erosion and fragmentation of philosophy, politics, and ethics as foundations for graduate education, which are increasingly perceived as less valuable, problematic, and in some cases, even burdensome. The effect of corporatization is the suppression of the critical engagement required of faculty in the everyday workings of institutions. We argue that, when the ideals of intellectual freedom, academic responsibility, duty, and obligation, as supported by philosophical thought, are smothered by the normalizing power of corporatized research agendas, philosophical approaches to inquiry and knowledge development become marginalized as scholars find themselves floundering in the face of a seeming 'philosophy lost'.

Representation, archaeology and genealogy: Three "spatial metaphors" for inquiring into nursing phenomena with Foucauldian discourse analysis.

Foucault used the "Quadrilateral of Language" metaphor to describe how language functioned in what the French called the Classic Age, roughly 1650 to 1800, the period from Descartes to Kant. His purpose was to show how the functions of language changed radically with the arrival of the Modern Age (~1800). Foucault developed his archaeological methods to investigate the impact of this change, but later revised his methods to introduce genealogical strategies to conduct "histories of the present". Our purpose in this paper is to clarify Foucault's thinking about ruptures in the functions of language and to show their implications for analyzing nursing discourse. Our account provides an overview of radical changes in both the functions of language and in Foucault's analytical methods. Drawing on Foucault's "Quadrilateral of Language", his anthropological quadrilateral, and our spatialized conception of his genealogical methods, we critique advanced nursing practice (APN) discourse and invite others to inquire into nursing phenomena with spatialized thinking.

Study protocol: Mother and Infant Nutritional Assessment (MINA) cohort study in Qatar and Lebanon.

BACKGROUND: The Middle East and North Africa region harbors significant proportions of stunting and wasting coupled with surging rates of non-communicable diseases (NCDs). Recent evidence identified nutrition during the first 1000 days of life as a common denominator not only for optimal growth but also for curbing the risk of NCDs later in life. The main objective of this manuscript is to describe the protocol of the first cohort in the region to investigate the association of nutrition imbalances early in life with birth outcomes, growth patterns, as well as early determinants of non-communicable diseases. More specifically the cohort aims to 1) examine the effects of maternal and early child nutrition and lifestyle characteristics on birth outcomes and growth patterns and 2) develop evidence-based nutrition and lifestyle guidelines for pregnant women and young children. METHODS/DESIGN: A multidisciplinary team of researchers was established from governmental and private academic and health sectors in Lebanon and Qatar to launch the Mother and Infant Nutritional Assessment 3-year cohort study. Pregnant women (n = 250 from Beirut, n = 250 from Doha) in their first trimester are recruited from healthcare centers in Beirut, Lebanon and Doha, Qatar. Participants are interviewed three times during pregnancy (once every trimester) and seven times at and after delivery (when the child is 4, 6, 9, 12, 18, and 24 months old). Delivery and birth data is obtained from hospital records. Data collection includes maternal socio-demographic and lifestyle characteristics, dietary intake, anthropometric measurements, and household food security data. For biochemical assessment of various indicators of nutritional status, a blood sample is obtained from women during their first trimester. Breastfeeding and complementary feeding practices, dietary intake, as well as anthropometric measurements of children are also examined. The Delphi technique will be used for the development of the nutrition and lifestyle guidelines. DISCUSSION: The Mother and Infant Nutritional Assessment study protocol provides a model for collaborations between countries of different socio-economic levels within the same region to improve research efficiency in the field of early nutrition thus potentially leading to healthier pregnancies, mothers, infants, and children.