Risk factors and early preventive measures for long COVID in non-hospitalized patients: analysis of a large cohort in the United Arab Emirates.

OBJECTIVES: Long COVID is characterized by persistent symptoms lasting for 4 weeks or more following the acute infection with SARS-CoV-2. Risk factors for long COVID and the impact of pre-COVID vaccination and treatment during acute COVID-19 remain uncertain. This study aimed to investigate patient-specific factors associated with long COVID in a large cohort of non-hospitalized adult patients with mild to moderate COVID-19 in Dubai. STUDY DESIGN: Cohort study. METHODS: The study included 28,375 non-hospitalized adult patients diagnosed with mild to moderate COVID-19 between January 1, 2021, and September 31, 2022, in Dubai, who were followed up for 90 days. The presence of long COVID symptoms was documented by physicians during patient visits to the family medicine department. Furthermore, long COVID-related risk factors were collected and analyzed, including patient demographics, comorbidities, pre-COVID vaccination status, and the COVID-related treatments received during the acute phase of the illness. Cox proportional hazard models were applied for the statistical analysis. RESULTS: Among the cohort, 2.8% of patients experienced long COVID symptoms during the 90-day follow-up. Patients with long COVID tended to be younger, female, and of Caucasian race. Common symptoms included fatigue, muscle pain, respiratory symptoms, abdominal and neurological symptoms, allergic reactions, skin rashes, and hair loss. Risk factors for long COVID were identified as diabetes mellitus, asthma, and Vitamin D deficiency. Females and Caucasians had a higher risk of long COVID during the pre-Omicron period compared to the Omicron period. Pre-COVID vaccination was associated with a reduced risk of long COVID in all patient subgroups. Treatment with favipiravir or sotrovimab during the acute phase of COVID-19 was linked to a decreased risk of long COVID, although favipiravir showed limited effectiveness in the high-risk group. CONCLUSION: This study contributes to the existing knowledge by identifying risk factors for long COVID among non-hospitalized patients and emphasizing the potential benefits of pre-COVID vaccination and timely treatment.

Circulating ceramide levels and ratios in Emirati youth under 18 years: associations with cardiometabolic risk factors.

BACKGROUND: Circulating ceramide (Cer) drives various pathological processes associated with cardiovascular diseases, liver illness, and diabetes mellitus. Although recognized as predictors of cardiometabolic diseases (CMD) in research and clinical settings, their potential for predicting CMD risk in individuals under 18 remains unexplored. OBJECTIVES: This study was designed to utilize Liquid Chromatography-Mass Spectrometry (LC-MS/MS) methodology to determine the biological reference ranges for Cer in plasma samples of Emirati children and develop a risk assessment score (CERT-1) based on Cer concentrations. METHODS: Using LC-MS/MS, we developed a method to measure five Cer species in plasma samples of 582 Emirati participants aged 5-17. We used the circulating concentrations of these Cer to determine their reference intervals in this population. We employed traditional statistical analyses to develop a risk score (CERT-1) and assess the association between Cer levels and conventional biomarkers of CMD. RESULTS: We validated a high-throughput methodology using LC-MS/MS to quantify five Cer species in human plasma. Reference values for this population (n = 582) were quantified: CerC16:0 (0.12-0.29 µmol/L), CerC18:0 (0.019-0.067 µmol/L), CerC22:0 (0.102-0.525 µmol/L), CerC24:0 (0.65-1.54 µmol/L) and CerC24:1 (0.212-0.945 µmol/L). We devised a risk assessment score (CERT-1) based on plasma Cer content in the study participants, showing that 72.5% have low to moderate risk and 9.3% are at a higher risk of developing CMD. Our analyses also revealed a significant correlation (P < 0.05) between this score and the conventional risk factors linked to CMD, indicating its potential clinical implication. CONCLUSION: This study presents a clinical-scaled LC-MS/MS methodology for assessing clinically relevant Cer, setting reference ranges, and developing a risk score (CERT-1) for young Emirati individuals. Our findings can enhance primary risk prediction and inform the management and follow-up of CMD from an early age.

Validity of self-reported weight and height among female young adults in the United Arab Emirates.

Self-reported weight and height serve as important metrics in estimating overweight and obesity prevalence within epidemiological studies, primarily due to their cost and time efficiency. However, the accuracy and reliability of these self-reported measures remain controversial, with conflicting reports emerging from different regions. This study aims to compare self-reported weight and height with measured values among young female adults in the United Arab Emirates. A cross-sectional study of 131 female university students aged 17-27 reported their weight and height on a self-administered questionnaire and on the same day had their height and weight measured. Body Mass Index (BMI) values of both self-reported and measured weight and height were calculated and categorized according to the World Health Organization's cut-off points. Overall, 87% of students had a resultant self-reported BMI value within their actual BMI category. The mean differences between self-reported and measured weight and height in the present study were -0.92 kg and 0.38 cm, respectively. Results indicated strong agreement between self-reported and direct measurements, as demonstrated by weighted Kappa statistics (kappa = 0.87). Bland & Altman plots illustrated that the majority of values fell within the limits of agreement (2 SD), with no systemic bias detected. BMI calculated from self-reported data demonstrates high sensitivity and specificity. Linear regression analyses revealed that self-reported weight (r2 = 0.973; p<0.001), height (r2 = 0.902; p<0.001), and BMI (r2 = 0.964; p<0.001) accurately predicted measured weight, height, and BMI. The study's results highlight the ability of female university students in the UAE to accurately provide self-reports of their weight and height. This finding provides further support for the utilization of self-reported data on height and weight as a valid method for collecting anthropometric information.

Real-World Registry on the Pharmacotherapy of Multiple Myeloma and Associated Renal and Pulmonary Impairments in the Greater Gulf Region: Protocol for a Retrospective Real-World Data Study.

BACKGROUND: Multiple myeloma (MM) is the second-most common cancer among hematological malignancies. Patients with active disease may experience several comorbidities, including renal insufficiency and asthma, which may lead to treatment failure. The treatment of relapsed or refractory MM (RRMM) has been associated with multiple factors, causing a decline in progression-free survival as well as overall survival with subsequent lines of therapy. Data about the characteristics of this group of patients in the Greater Gulf region are lacking. OBJECTIVE: The primary objective of this study is to describe the disease characteristics and various treatment approaches or regimens used in the management of patients with RRMM in the Greater Gulf region. METHODS: We will conduct a regional, retrospective study collecting real-world and epidemiological data on patients with MM in countries of the Greater Gulf region. Medical records will be used to obtain the required data. Around 150 to 170 patients' records are planned to be retrospectively reviewed over 6 months without any cross-sectional or prospective intervention. Cases will be collected from Saudi Arabia, the United Arab Emirates, Kuwait, Oman, and Qatar. Descriptive as well as analytical statistics will be performed on the extracted data. The calculated sample size will allow us to estimate the percentages of RRMM cases with acceptable precision while complying with the challenges in light of data scarcity. We will obtain a comprehensive description of the demographic profile of patients with MM; treatment outcomes; the proportion of patients with MM with renal impairment and asthma, chronic obstructive pulmonary disease, or both at the time of diagnosis and any subsequent point; and data related to treatment lines, regimens, and MM-associated morbidities. RESULTS: Patient medical records were reviewed between June 2022 and January 2023 for eligibility and data extraction. A total of 148 patients were eligible for study inclusion, of whom 64.2% (n=95) were male and 35.8% (n=53) were female. The study is currently in its final stages of data analysis. The final manuscript is expected to be published in 2024. CONCLUSIONS: Although MM is a predominant hematological disease, data on its prevalence and patients' characteristics in the Greater Gulf region are scarce. Therefore, this study will give us real-world insights into disease characteristics and various management approaches of patients with MM in the Greater Gulf region. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/49861.

Correlation between maternal and umbilical cord 25-hydroxy-vitamin D levels over a range of values. A prospective observational study from the United Arab Emirates.

Worldwide vitamin D insufficiency is remarkably prevalent in both children and adults, including pregnant women. The total amount of the vitamin is best measured by 25-hydroxy-vitamin D (25(OH)D), which is a measurement of total serum cholecalciferol 25(OH)D3 and ergocalciferol 25(OH)D2. There is a known correlation between maternal and umbilical cord blood (UCB) 25(OH)D; however, whether specific maternal demographics or comorbidities influence the correlation remains uncertain. This prospective observational study was designed to study if maternal 25(OH)D levels, maternal age and BMI, amount of supplementation, mode of delivery, diabetes, hypertension/preeclampsia, or sunlight exposure had an impact on the correlation. Women were enrolled in the study at admission to the labor ward. If they agreed to participate, venous blood was directly collected and analyzed for 25(OH)D. The UCB was sampled after delivery from the unclamped cord and immediately analyzed for 25(OH)D. ANOVA, Fisher's exact test, Pearson's correlation, and test of the differences between correlations using Fisher's z-transformation with Bonferroni correction were used accordingly. Of the 298 women enrolled, blood from both the mother and umbilical cord was analyzed successfully for 25(OH)D in 235 cases. The crude correlation between maternal and UCB 25(OH)D was very strong over all values of 25(OH)D (r = 0.905, R2 = 0.821, p <0,001) and remained strong independently of maternal demographics or co-morbidities (r ≥ 0.803, R2 ≥ 0.644, p <0.001). For women who delivered by caesarean section in second stage the correlation was strong (r ≥ 0.633, R2 ≥ 0.4, p <0.037). Test of differences between correlations showed significant stronger correlation in women with unknown 25(OH)D3 supplementation compared to women receiving 10.000 IU/week (p = 0.02) and 20.000IU/week (p = 0.01) and that the correlation was significantly stronger for women with a BMI of 25-29.9 compared to women with a BMI of <24.9 (p = 0.004) and 30-34.9 (p = 0.002). 213 (91%) women had lower 25(OH)D compared to the neonate, with a mean difference of -13.7nmol/L (SD = 15.6). In summary, the correlation between maternal and UCB 25(OH)D is very strong throughout low to high maternal levels of 25(OH)D with lower levels in maternal blood. Typical maternal demographics and comorbidities did not affect the transition.

The prevalence of selected vector-borne diseases in dromedary camels (Camelus dromedarius) in the United Arab Emirates.

Vector-borne diseases (VBDs) affecting dromedary camels (Camelus dromedarius) have considerable importance in the United Arab Emirates (UAE) because of the consequences associated with production decline and economic losses. Our study aimed to determine the prevalence of selected VBDs in camels in the UAE and identify risk factors. This research is currently affected by the low number of epidemiological molecular surveys addressing this issue. Blood samples were obtained from 425 dromedary camels from different locations across the UAE. Whole genomic DNA was isolated, and PCR screening was done to detect piroplasmids (Babesia/Theileria spp.), Trypanosoma spp., and Anaplasmataceae spp. (Anaplasma, Ehrlichia, Neorickettsia and Wolbachia spp.). Amplicons were sequenced, and phylogenetic trees were constructed. Trypanosoma sequences were identified as T. brucei evansi, whereas Anaplasmataceae sequences were identified as A. platys-like. All camels were negative for Babesia/Theileria spp. (0%); however, 18 camels were positive for T. b. evansi (4%) and 52 were positive for A. platys-like (12%). Mixed infection with T. b. evansi and A. platys-like was found in one camel. Statistical analyses revealed that camels with a brown coat colour were significantly more prone to acquire the A. platys-like strain compared with those having a clearer coat. A similar finding was observed when comparing urban moving camels with desert indoor and urban indoor camels. Continuous disease surveillance is required to ensure and maintain the good health status of the camels in the UAE. Nonetheless, the risk of disease outbreak remains if the misuse of drugs continues.

Gender, age and nationality differences in chronic kidney disease prevalence in the emirate of Abu Dhabi, UAE.

AIM: We aimed to better understand the prevalence of chronic kidney disease in Abu Dhabi, UAE, where a very diverse ethnic population lives, each with their own risk profile. METHODS: Data were analysed on all patients who were tested for serum creatinine in December 2019 for 4 years within our healthcare network. We analysed data for kidney disease by age, gender and nationality to study differences in prevalence and risk. RESULTS: The entire cohort (EC) consisted 1 925 672 samples from 703 122 patients. 24% of patients had GFR < 90 mL/min/1.73 m2 (CKD2-5), 4% had more severe kidney dysfunction (CKD3-5) and 2% had UACR >3 mg/mmol and with GFR > 90 (CKD1). The long follow-up (LFU) group comprised 45.6% of patients who had eGFR on at least two occasions more than 90 days apart, and of these 19.5% had sustained eGFR <90, and 5.2% had CKD3-5. Males had lower eGFR than females in the EC (RR 1.68) and the LFU group (RR 1.76). Emirati Females had the lowest prevalence in the EC (2.9%) and expatriate females in the LFU (3.5%) groups. The relative risks of CKD in expatriate males were highest in the EC (2.14) and the LFU (2.39) groups. When we looked at the age distribution by nationality there were highly significant differences in some populations being highly represented at younger ages. CONCLUSION: The prevalence of kidney disease in Abu Dhabi has a male predominance, with younger expatriates highly represented. A targeted strategy to identify those at high risk may identify early CKD to prevent progression to end-stage kidney disease.

Prevalence of adverse childhood experiences and their cumulative impact associated lifetime health outcomes in the Emirate of Abu-Dhabi, United Arab Emirates.

BACKGROUND: Adverse Childhood Experiences have been associated with poor health outcomes later in life. OBJECTIVE: The objective of the study was to determine the relationship between cumulative ACEs, risky health behaviors, chronic diseases, and mental health among a large-scale sample from the Emirate of Abu Dhabi. PARTICIPANTS AND SETTING: A retrospective cross-sectional study was performed with 922 participants over the age of 18, living in Abu Dhabi. METHODS: The Adverse Childhood Experiences International Questionnaire (ACE-IQ) was used to assess ACEs, alongside a survey of adult health outcomes, mental health outcomes, and risk-taking behaviors. RESULTS: Logistic regression models examined the association between retrospective ACEs and these outcomes. The respondents reported an average of 1.74 ACEs. The most prevalent ACEs were household violence, parental death or divorce, and community violence. The accumulation of ACEs significantly predicts increases in the risk of a variety of adult-onset health morbidities, all measured mental health morbidities, and all measured risk-taking behaviors, with evidence of thresholds of ACE accumulation dictating risk. CONCLUSIONS: The baseline presence of ACEs among this Abu Dhabi sample, along with the associated risks of physical and mental health morbidities, and risk-taking behaviors play a significant role in understanding the extent, nature, and associated sequalae of ACEs in this population; providing nuanced context for early intervention. Our findings will inform the planning and implementation of specific prevention and awareness raising programs while promoting safe environments where children are healthy and can thrive.

Work-related musculoskeletal disorders among United Arab Emirates schoolteachers: an examination of physical activity.

OBJECTIVE: To estimate the prevalence of work-related musculoskeletal disorders and their association with physical activity among schoolteachers in the United Arab Emirates. METHODS: This observational cross-sectional study involved 209 schoolteachers (aged 20-60) with a minimum of two years of experience. Data, including demographics (gender, age), Nordic Musculoskeletal Questionnaire (NMQ) for WMSD prevalence and pain sites, and Global Physical Activity Questionnaire (GPAQ) for physical activity levels, were collected. Six schools were visited for data collection, with consent from school heads and participants. Schedules were tailored to participant availability, allowing up to three attempts for participation. Non-respondents were identified after three unsuccessful attempts. RESULTS: Of the total 206 participants, 149 were female, while the remaining 57 were male. Age distribution analysis revealed that 18% of individuals were within the 20 to 30 years range, 26.2% fell within the 30 to 40 years, and 36.9% had 40 to 50 years age brackets. The responses were obtained in Arabic (90%) and English (10%). The study identified a high prevalence (71.4%) of work-related musculoskeletal disorders (WMSD) in UAE schoolteachers, with neck pain being the most common (74.3%). Major risk factors included age, workload, and low physical activity. The data was normally distributed, and Pearson's Correlation test revealed weak positive correlation (r: 0.14), but statistically significant (p value = 0.04) between WMSD and PA, indicating that it was a contributing factor but other factors beyond PA influenced WMSD prevalence in this cohort. The findings of the study are based on certain limitations such as cross-sectional design and convenient sampling which could have potential selection bias and affect generalizability of the results. CONCLUSION: Findings suggest the need to promote physical activity and reduce workload for teachers, considering their age and gender. Additionally, there is a need to raise awareness regarding ergonomics and the importance of taking short breaks for stretching or physical movement to enhance the overall well-being of schoolteachers in the UAE and similar contexts. Diverse prevalence rates across different body areas underscore the necessity for individualized treatments.

Influence of COVID-19 pandemic on pregnancy and fertility preferences among the residents of the United Arab Emirates (UAE).

Background: The coronavirus disease 2019 (COVID-19) significantly impacted the lifestyles of millions of people, with new challenges arising as the pandemic progresses. However, little attention has been given to issues like fertility intentions and pregnancy planning during COVID-19. Consequently, we aimed to investigate the influence of the pandemic on pregnancy and fertility decisions among the residents of the United Arab Emirates (UAE). Methods: We surveyed UAE residents of reproductive age between November 2021 to June 2022 via the Google Forms platform and collected data on demographics, associated health conditions, COVID-19 infections, as well as plans for pregnancy and fertility intentions. We presented data through descriptive statistics (frequencies and percentages) and used Pearson's χ2 test to compare the characteristics of participants who reported that the COVID-19 pandemic has influenced their fertility preferences with those who reported that it had not. Results: Overall, 564 participants completed the survey, of whom 115 (20.4%) stated that the COVID-19 pandemic had influenced their fertility preferences. Meanwhile, 234 (41.5%) reported previous history of COVID-19 infection; regarding post-COVID-19 infection symptoms, 53 (22.6%) reported decreased libido and 40 (17%) reported trouble in conceiving a baby. Participants who were ≤30 years of age were less likely to be influenced by the COVID-19 pandemic on their decision on fertility compared to those >30 years of age. Factors like education, income, chronic health conditions, and previous history of COVID-19 infection or vaccination did not have any significant effect on the COVID-19 pandemic influence on fertility preferences. Conclusions: The COVID-19 pandemic has brought in new challenges which could affect fertility and this needs to be studied further for planning effective measures.

Knowledge and barriers to hepatitis C screening among social media users in United Arab Emirates.

Background: Hepatitis C affects nearly 58 million people worldwide, the majority of whom live in the Eastern Mediterranean Region. There is limited data about hepatitis C disease or its knowledge in the United Arab Emirates (UAE). Aim: This study assessed knowledge about hepatitis C and barriers to screening for it in the UAE. Methods: This exploratory, descriptive, cross-sectional study evaluated 1083 participants using a convenience sampling method. Participants aged 18 and above, literate in English or Arabic, were included in the study. The validated questionnaire was administered online and distributed across social media platforms from November 2020 to February 2021 and responses were analysed using Python. Results: Mean knowledge score was 11.83 (SD = 7.28). Knowledge was average with 57.52% (n = 489 of 850) of respondents achieving a moderate knowledge score, but poor awareness about treatment options were noted. Only 54.12% (n = 460 of 850) were aware that treatment was possible and 24.10% (n = 205 of 850) knew that there was no vaccine for hepatitis C. Field of work (P < 0.001), marital status (P < 0.001) and perceived knowledge (P < 0.001) were statistically significant predictors of knowledge score. Lack of insurance coverage for testing and limited knowledge about hepatitis C were identified as the most common barriers to getting tested. Conclusion: The UAE community has moderate knowledge about hepatitis C but a poor understanding of available preventive and treatment options. Targeted outreach programmes, particularly for high-risk groups, are needed to improve community awareness of hepatitis C.

Predictive factors of perinatal depression among women with gestational diabetes mellitus in the UAE: a cross-sectional clinical study.

BACKGROUND: Gestational Diabetes Mellitus (GDM) is responsible for the development of 30-50% of type 2 diabetes mellitus that predisposes later to adverse consequences among affected mothers and their offspring. Several studies have suggested that GDM increases the risk of developing perinatal depression (PND); however, factors that are involved in this association are yet to be determined. This study aims to identify factors that interrelate GDM and PND among pregnant and postnatal women in the United Arab Emirates (UAE). METHODS: A total of 186 women between 18 and 45 years old attending the obstetrics clinic during their 3rd trimester or up to 6 months postnatal were recruited between October 2021 and April 2022. Women who were known to have pre-existing diabetes mellitus (type 1 or type 2), kidney disease, liver disease, and those receiving hormonal therapy were excluded. Participants completed a structured questionnaire including sociodemographic data and the Edinburgh Postnatal Depression Scale (EPDS). Based on their EPDS scores, study participants were categorized into three groups: no depression (> 9), possible depression (9-11), and high possibility/strong positive depression (≥ 12). SPSS 26 was used for data analysis. RESULTS: Among the 186 participants, 81% (n = 151) were Emirati, 41% (n = 76) had no GDM, and 58% (n = 110) had GDM. Of the study participants, 34.4% had a high possibility of strong positive depression, 40.9% had possible depression, and only 6.5% had no depression. The association between GDM and PND was clinically and statistically insignificant, with a calculated odds ratio (OR) of 1.574 (p value = 0.204) and a 95% confidence interval (0.781-3.172). However, age, personal history of depression, and BMI were found to be strong predictors of depression among pregnant/postpartum women in the UAE. CONCLUSIONS: The study findings propose that age, personal history of depression, and obesity are strong predictors of depression during pregnancy. The strong correlation between obesity (which is a known strong predictor of GDM) and PND suggests that further studies with longitudinal designs and longer observational periods might better reveal the relationship between GDM and PND. TRIAL REGISTRATION: Retrospectively registered study by Research Ethics Committees of the University Hospital Sharjah and the University of Sharjah (Ref. No.: UHS-HERC- 025-17122019) December 17, 2019.

Pathological investigation of high pathogenicity avian influenza H5N8 in captive houbara bustards (Chlamydotis undulata), the United Arab Emirates 2020.

At the end of 2020, an outbreak of HPAI H5N8 was registered in captive African houbara bustards (Chlamydotis undulata) in the United Arab Emirates. In order to better understand the pathobiology of this viral infection in bustards, a comprehensive pathological characterization was performed. A total of six birds were selected for necropsy, histopathology, immunohistochemistry, RNAscope in situ hybridization and RT-qPCR and nanopore sequencing on formalin-fixed and paraffin-embedded (FFPE) tissue blocks. Gross lesions included mottled and/or hemorrhagic pancreas, spleen and liver and fibrinous deposits on air sacs and intestine. Necrotizing pancreatitis, splenitis and concurrent vasculitis, hepatitis and fibrino-heterophilic peritonitis were identified, microscopically. Viral antigens (nucleoprotein) and RNAs (matrix gene) were both detected within necro-inflammatory foci, parenchymal cells, stromal cells and endothelial cells of affected organs, including the myenteric plexus. Molecular analysis of FFPE blocks successfully detected HPAI H5N8, further confirming its involvement in the lesions observed. In conclusion, HPAI H5N8 in African houbara bustards results in hyperacute/acute forms exhibiting marked pantropism, endotheliotropism and neurotropism. In addition, our findings support the use of FFPE tissues for molecular studies of poorly characterized pathogens in exotic and endangered species, when availability of samples is limited.

Prevalence and factors associated with mental illness symptoms among school students post lockdown of the COVID-19 pandemic in the United Arab Emirates: A cross-sectional national study.

Limited data exists on the mental health of children in the United Arab Emirates (UAE). This study aimed to fill this gap by examining the prevalence of anxiety, depression, and risk for Post-Traumatic Stress Disorder (PTSD) among school students in post-lockdown of the COVID-19 pandemic. A sample of 3,745 school students participated, responding to standardized tests (Mood and Feeling Questionnaire-Child Self-Report, Screen for Child Anxiety Related Disorders-Child Version, and Children's Revised Impact of Event Scale-8). Findings showed that the risk for PTSD was the most prevalent (40.6%), followed by symptoms of anxiety (23.3%), and depression (17.1%). For gender differences, symptoms of the three conditions (depression, anxiety, and PTSD) were higher in female students (9.2%) compared to male peers (7.7%) (p = 0.09). Moreover, symptoms of depression and anxiety were found to be higher among late adolescents (p<0.05). Further analysis revealed that having medical problems was a positive predictor for anxiety (OR = 2.0, p<0.01) and risk for PTSD (OR = 1.3, p = 0.002); similarly, witnessing the death of a close family member due to COVID-19 (OR for depression, anxiety, and PTSD = 1.7, p<0.01) were positive predictors associated with PTDS, depression, and anxiety. The study concluded that post COVID-19 lockdown, symptoms of anxiety, depression, and risk for PTSD were found to be prevalent among school students in the UAE. Researchers put forward recommendations on the initiation of a national school mental health screening program, the provision of follow-up services for vulnerable students, and the integration of a mental health support system in the disaster preparedness plans.

Clinical and Pathological Characteristics of Breast Cancer Among Emirati National Patients.

INTRODUCTION: Breast cancer is the most frequent cancer among Emirati women and is the second leading cause of death among women in the UAE. To date, published studies regarding breast cancer in the UAE have investigated a mixed population of different ethnicities with a low percentage of UAE nationals. This is the first study to highlight the clinical and pathological data of a large cohort of exclusively Emirati national breast cancer patients diagnosed at a tertiary care medical facility. MATERIALS AND METHODS: This is a retrospective study involving breast cancer patients in UAE women who were evaluated and/or treated at the Cleveland Clinic Abu Dhabi during the period from May 2015 until June 2021. RESULTS: This study initially included 372 participants. The median age at diagnosis was 48 years (24-86 years) and 12.3% of patients had screening detected tumors. 30% of patients presented with locally advanced disease and 20% had stage IV disease at presentation. 24% were 40 years or younger at the time of diagnosis. DISCUSSION: To our knowledge, this is the largest study to date focusing exclusively on the presentation and characteristics of Emirati women with breast cancer. The median age of incidence was 48 years and the percentage of patients diagnosed with breast cancer at age 40 or younger years was 24%. This is an agreement with data published in the Middle East, but is significantly below what is reported in Caucasian women in the Western world. In this study, Emirati patients presented with advanced stages of disease. More advanced disease, and higher stage 4 at presentation is another reflection of the low screening rates, but also an indication of a higher patient thresholds for reporting breast health concerns to medical professionals for evaluation. CONCLUSION: Findings of our study do suggest the need to focus efforts on continuing to understand the exact presentation of breast cancer among Emirati women and underscore the need to pursue efforts to improve public education, increase screening utilization and early detection to reduce the burden of disease and address an essential health care need for this unique population.

Utilizing machine learning for survival analysis to identify risk factors for COVID-19 intensive care unit admission: A retrospective cohort study from the United Arab Emirates.

BACKGROUND: The current situation of the unprecedented COVID-19 pandemic leverages Artificial Intelligence (AI) as an innovative tool for addressing the evolving clinical challenges. An example is utilizing Machine Learning (ML) models-a subfield of AI that take advantage of observational data/Electronic Health Records (EHRs) to support clinical decision-making for COVID-19 cases. This study aimed to evaluate the clinical characteristics and risk factors for COVID-19 patients in the United Arab Emirates utilizing EHRs and ML for survival analysis models. METHODS: We tested various ML models for survival analysis in this work we trained those models using a different subset of features extracted by several feature selection methods. Finally, the best model was evaluated and interpreted using goodness-of-fit based on calibration curves,Partial Dependence Plots and concordance index. RESULTS: The risk of severe disease increases with elevated levels of C-reactive protein, ferritin, lactate dehydrogenase, Modified Early Warning Score, respiratory rate and troponin. The risk also increases with hypokalemia, oxygen desaturation and lower estimated glomerular filtration rate and hypocalcemia and lymphopenia. CONCLUSION: Analyzing clinical data using AI models can provide vital information for clinician to measure the risk of morbidity and mortality of COVID-19 patients. Further validation is crucial to implement the model in real clinical settings.

Intention to quit and its correlates among dieticians residing in the United Arab Emirates during the COVID-19 pandemic: A cross-sectional survey.

BACKGROUND: The COVID-19 pandemic precipitated increased workload, stress, and burnout on healthcare providers on the frontlines of the pandemic, dieticians were no exception. Such unprecedented occupational risks and stressors contributed to a higher intention to quit, potentially leading to workforce shortages, and hindering the delivery of quality care, especially for patients with chronic conditions. The aim of this study was to examine the prevalence factors associated with the intention to quit among dieticians in the United Arab Emirates during a public health emergency. METHODS: The study utilized a cross-sectional design with an online survey sent to dieticians between January and May 2021. The final version of the questionnaire included four sections: A sociodemographic section, intention to quit, work-related practices and challenges, as well as the resilience scale using the 25 items- Connor-Davidson Resilience Scale© (CD-RISC). Descriptive statistics as well as simple and multiple logistic regression analyses were carried out to explore factors associated with the intention to quit among dieticians. RESULTS: Study results revealed that a quarter of dieticians intend to quit their jobs. Higher odds of intention to quit among dieticians were significantly associated with male gender, younger age, having a chronic condition, being non-resilient, feeling unappreciated, using online platforms for dietary counseling, reporting increased workload, and working from home or in a blended format during the pandemic. CONCLUSION: This study revealed a high intention to quit among dieticians during the COVID-19 pandemic and identified a few correlates for the intention to quit that could support the development of evidence-based interventions. Such interventions should address through targeted programs the challenges faced by male dieticians, younger dieticians, as well as dieticians with Chronic health conditions. Furthermore, the findings of this study showed that promoting resilience among dieticians is crucial in reducing their intention to quit.

Association of sociodemographic, anthropometric, and sleep quality factors with accelerometer-measured sitting and physical activity times among Emirati working women during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Although a significant lack of physical activity has been linked to an increase in obesity among Emirati women, the factors associated with accelerometer-measured sitting and physical activity times in Emirati women remain unclear. OBJECTIVES: To explore the association of accelerometer-measured sitting and physical activity times with sociodemographic, anthropometric, and sleep quality factors among Emirati working women. DESIGN: A cross-sectional study. METHODS: A convenience sample of 163 healthy working Emirati women aged 18-45 years was used. Sedentary and physical activity times were measured using the Fibion accelerometers worn on the thighs for 4-7 days. General demographic information, anthropometric measurements, and self-reported sleep quality (Pittsburgh sleep quality index score) were collected. Only participants who had valid data (i.e. wear time of ⩾600 min (10 h) per day for a minimum of 4-7 days) were evaluated. All values were normalized to a 16-h day to mitigate differences in wear time among the participants. RESULTS: Overall, 110 Emirati women were included. The mean sitting time per 16-h day was 11.6 ± 1.1 h; mean moderate activity time per day, 40.88 ± 17.99 min; and mean vigorous activity time per day, 2.41 ± 1.21 min. Longer sitting time was associated with high body fat, secondary education, and divorce. Sitting time was reduced in those with good sleep quality. Moderate-to-vigorous physical activity time was increased in women with postgraduate education and was decreased in women with a longer work experience and with comorbidities. The total activity time increased with increasing age and good sleep quality, whereas it decreased with increasing body fat, presence of at least one comorbidity, secondary education, and divorce. CONCLUSION: Certain demographic, anthropometric, and sleep quality factors were associated with accelerometer-measured sitting and physical activity times among Emirati working women. Future longitudinal studies should consider these factors when investigating predictors of physical activity levels in this population.

The role of human rhinovirus in COPD exacerbations in Abu Dhabi: molecular epidemiology and clinical significance.

This study aimed to describe the molecular epidemiology and seasonality of human rhinovirus (HRV) in chronic obstructive pulmonary disease (COPD) and its association with COPD exacerbations in Abu Dhabi, the United Arab Emirates (UAE). Sputum specimens were collected for analysis from all COPD patients who visited a medical center from November 2021 to October 2022. The real-time quantitative polymerase chain reaction (qPCR) test was used to detect HRV. Of the 78 COPD patients included in the study, 58 (74%) patients presented with one or more exacerbation episodes. The incidence of COPD exacerbation peaked over the winter and substantially decreased during the summer. HRV positivity in patients during exacerbation (E1) was 11/58 (19%) and 15/58 (26%) two weeks after the exacerbation episode (E2). There was no significant difference in the HRV load in these patients. No statistically significant difference was observed in the detection of HRV during exacerbation compared to patients with stable COPD. This is the first study to assess the association between HRV detection by qPCR and COPD exacerbations in the UAE. The high sensitivity of the detection technology helped collect reliable epidemiologic data. Few studies have provided similar Middle East data. This study's pattern of COPD exacerbations and HRV detection parallels that of temperate countries. This information can help with future, more extensive surveillance of respiratory viruses in the UAE and the Middle East and their association with COPD exacerbations.

A survey on awareness of the disease and pulmonary rehabilitation in bronchial asthma patients in the United Arab Emirates.

BACKGROUND: Asthma, a prevalent and severe chronic respiratory condition, can be significantly managed and controlled through informed awareness about the disease and pulmonary rehabilitation strategies, thereby enhancing patients' health-related quality of life. OBJECTIVE: To determine the knowledge and awareness of Bronchial asthma and pulmonary rehabilitation among asthma-diagnosed patients in the United Arab Emirates. METHODS: Utilizing a cross-sectional study design, 237 asthma patients, aged 18 and above, were recruited from the Royal NMC Hospital, Sharjah. A comprehensive questionnaire was administered, focusing on two critical domains: understanding of the disease and knowledge about pulmonary rehabilitation. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) software, version 26. RESULTS: The majority of participants (31.6%) reported the onset of asthma before reaching two years of age. Bronchodilators emerged as the most used medication, utilized by 31.6% of the respondents. Weather conditions (34.6%) were identified as the most prevalent risk factor. Chi-square tests revealed no significant correlations between gender and knowledge about asthma (p = 0.278) or pulmonary rehabilitation awareness (p = 0.929). A negative correlation was found between age and knowledge about asthma (p<0.001), but not with pulmonary rehabilitation awareness (p = 0.731). Education demonstrated no significant association with either knowledge about asthma (p = 0.974) or awareness of pulmonary rehabilitation (p = 0.676). CONCLUSION: The study implies that most people have a basic understanding of asthma. However, there are still significant gaps in their knowledge. For instance, many aren't sure how asthma is influenced by exercise or which parts of the body are affected. Also, understanding about therapies such as lung rehabilitation, and the contributions physical therapists can make in addressing lung problems, is only average. Interestingly, these knowledge gaps are not related to a person's age or their educational background.