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Systematic Review of Real-time Remote Health Monitoring System in Triage and Priority-Based Sensor Technology: Taxonomy, Open Challenges, Motivation and Recommendations

Albahri OS, Albahri AS, Mohammed KI, Zaidan AA, Zaidan BB, Hashim M, et al.

J Med Syst, 2018 Mar 22;42(5):80.
PMID: 29564649 DOI: 10.1007/s10916-018-0943-4

The new and ground-breaking real-time remote monitoring in triage and priority-based sensor technology used in telemedicine have significantly bounded and dispersed communication components. To examine these technologies and provide researchers with a clear vision of this area, we must first be aware of the utilised approaches and existing limitations in this line of research. To this end, an extensive search was conducted to find articles dealing with (a) telemedicine, (b) triage, (c) priority and (d) sensor; (e) comprehensively review related applications and establish the coherent taxonomy of these articles. ScienceDirect, IEEE Xplore and Web of Science databases were checked for articles on triage and priority-based sensor technology in telemedicine. The retrieved articles were filtered according to the type of telemedicine technology explored. A total of 150 articles were selected and classified into two categories. The first category includes reviews and surveys of triage and priority-based sensor technology in telemedicine. The second category includes articles on the three-tiered architecture of telemedicine. Tier 1 represents the users. Sensors acquire the vital signs of the users and send them to Tier 2, which is the personal gateway that uses local area network protocols or wireless body area network. Medical data are sent from Tier 2 to Tier 3, which is the healthcare provider in medical institutes. Then, the motivation for using triage and priority-based sensor technology in telemedicine, the issues related to the obstruction of its application and the development and utilisation of telemedicine are examined on the basis of the findings presented in the literature.
Vulvar malignant melanoma: A case report and review of its management

Hashim M, Yayanto NH, Muda Abdullah BZ, Ramly F, Abd Rashid R, Duski DR

Dermatol Reports, 2022 Nov 21;14(4):9345.
PMID: 36483218 DOI: 10.4081/dr.2022.9345

Vulvar malignant melanoma (VMM) is uncommon and poses a significant management challenge. Here, we presented a case of VMM managed by surgery, chemoradiation, and planned for targeted therapy. A 70- year-old woman with underlying diabetes mellitus and hypertension presented with a black-colored exophytic growth around her left vulva for two months. Initial biopsy confirmed malignant melanoma with positive staining for S100, HMB 45, and Melan A. An imaging study showed that the disease was localized to the vulva. She underwent bilateral radical vulvectomy and bilateral inguinofemoral lymph node dissection followed by radiotherapy. She had a locoregional disease recurrence, which was subsequently managed by palliative perineal radiotherapy, chemotherapy, and planned for immunotherapy. Vulvar malignant melanoma is a rare and aggressive tumor, with a poor overall prognosis, and high recurrence rate. Adjuvant chemotherapy, radiotherapy, and immunotherapy may be beneficial for local recurrence and distant metastasis cases. Molecular Analysis has a potential role in targeted therapy to improve the survival and outcome of the patient.
Adherence to the Mediterranean diet during pregnancy is associated with lower odds of excessive gestational weight gain and postpartum weight retention: results of the Mother-Infant Study Cohort

Radwan H, Hashim M, Hasan H, Abbas N, Obaid RRS, Al Ghazal H, et al.

Br J Nutr, 2022 Oct 14;128(7):1401-1412.
PMID: 34294166 DOI: 10.1017/S0007114521002762

During the first 1000 d of life, gestational weight gain (GWG) and postpartum weight retention (PPWR) are considered critical determinants of nutritional status. This study examined the effect of adherence to the Mediterranean diet (MD) during pregnancy on GWG and PPWR at 2 and 6 months among women in the United Arab Emirates (UAE), using data from the Mother-Infant Study Cohort. The latter is a prospective study, for which pregnant women were recruited (n 243) during their third trimester and were followed up for 18 months. Data on socio-demographic characteristics and anthropometric measurements were obtained. An eighty-six-item FFQ was used to examine dietary intake during pregnancy. Adherence to the MD was assessed using the alternate MD (aMED) and the Lebanese MD (LMD). Adherence to the MD, PPWR2 (2 months) and PPWR6 (6 months) were considered high if participants belonged to the third tertile of the respective measures. Results indicated that 57·5 % of participants had excessive GWG while 50·7 % and 45 % retained ≥ 5 kg at 2 and 6 months postpartum, respectively. After adjustment, adherence to both MD scores was associated with lower odds of excessive GWG (aMED, OR:0·41, 95 % CI:0·18, 0·93; LMD, OR:0·40, 95 % CI: 0·16, 0·98). Adherence to MD was also associated with PPWR2 (aMED: OR: 0·23, 95 % CI: 0·06, 0·88) and PPWR6 (aMED OR:0·26; 95 % CI:0·08-0·86; LMD, OR:0·32; 95 % CI: 0·1, 0·98). The findings of this study showed that adherence to the MD may reduce GWG and PPWR and, hence, underscored the importance of promoting the MD for better health of the mother and infant.
Systematic Review of an Automated Multiclass Detection and Classification System for Acute Leukaemia in Terms of Evaluation and Benchmarking, Open Challenges, Issues and Methodological Aspects

Alsalem MA, Zaidan AA, Zaidan BB, Hashim M, Albahri OS, Albahri AS, et al.

J Med Syst, 2018 Sep 19;42(11):204.
PMID: 30232632 DOI: 10.1007/s10916-018-1064-9

This study aims to systematically review prior research on the evaluation and benchmarking of automated acute leukaemia classification tasks. The review depends on three reliable search engines: ScienceDirect, Web of Science and IEEE Xplore. A research taxonomy developed for the review considers a wide perspective for automated detection and classification of acute leukaemia research and reflects the usage trends in the evaluation criteria in this field. The developed taxonomy consists of three main research directions in this domain. The taxonomy involves two phases. The first phase includes all three research directions. The second one demonstrates all the criteria used for evaluating acute leukaemia classification. The final set of studies includes 83 investigations, most of which focused on enhancing the accuracy and performance of detection and classification through proposed methods or systems. Few efforts were made to undertake the evaluation issues. According to the final set of articles, three groups of articles represented the main research directions in this domain: 56 articles highlighted the proposed methods, 22 articles involved proposals for system development and 5 papers centred on evaluation and comparison. The other taxonomy side included 16 main and sub-evaluation and benchmarking criteria. This review highlights three serious issues in the evaluation and benchmarking of multiclass classification of acute leukaemia, namely, conflicting criteria, evaluation criteria and criteria importance. It also determines the weakness of benchmarking tools. To solve these issues, multicriteria decision-making (MCDM) analysis techniques were proposed as effective recommended solutions in the methodological aspect. This methodological aspect involves a proposed decision support system based on MCDM for evaluation and benchmarking to select suitable multiclass classification models for acute leukaemia. The said support system is examined and has three sequential phases. Phase One presents the identification procedure and process for establishing a decision matrix based on a crossover of evaluation criteria and acute leukaemia multiclass classification models. Phase Two describes the decision matrix development for the selection of acute leukaemia classification models based on the integrated Best and worst method (BWM) and VIKOR. Phase Three entails the validation of the proposed system.
Fulltext Characterisation of sol-gel method synthesised MgZnFe2O4 nanoparticles and its cytotoxic effects on breast cancer cell line, MDA MB-231 in vitro

Nordin N, Kanagesan S, Zamberi NR, Yeap SK, Abu N, Tamilselvan S, et al.

IET Nanobiotechnol, 2017 Apr;11(3):343-348.
PMID: 28476993 DOI: 10.1049/iet-nbt.2016.0007

In this study, nanocrystalline magnesium zinc ferrite nanoparticles were successfully prepared by a simple sol-gel method using copper nitrate and ferric nitrate as raw materials. The calcined samples were characterised by differential thermal analysis/thermogravimetric analysis, Fourier transform infrared spectroscopy and X-ray diffraction. Transmission electron microscopy revealed that the average particle size of the calcined sample was in a range of 17-41 nm with an average of 29 nm and has spherical size. A cytotoxicity test was performed on human breast cancer cells (MDA MB-231) and (MCF-7) at various concentrations starting from (0 µg/ml) to (800 µg/ml). The sample possessed a mild toxic effect toward MDA MB-231 and MCF-7 after being examined with MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyltetrazolium bromide) assay for up to 72 h of incubation. Higher reduction of cells viability was observed as the concentration of sample was increased in MDA MB-231 cell line than in MCF-7. Therefore, further cytotoxicity tests were performed on MDA MB-231 cell line.
Fulltext Synthesis, Characterization and in Vitro Evaluation of Manganese Ferrite (MnFe2O4) Nanoparticles for Their Biocompatibility with Murine Breast Cancer Cells (4T1)

Kanagesan S, Aziz SB, Hashim M, Ismail I, Tamilselvan S, Alitheen NB, et al.

Molecules, 2016 Mar 11;21(3):312.
PMID: 26978339 DOI: 10.3390/molecules21030312

Manganese ferrite (MnFe2O4) magnetic nanoparticles were successfully prepared by a sol-gel self-combustion technique using iron nitrate and manganese nitrate, followed by calcination at 150 °C for 24 h. Calcined sample was systematically characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), transmission electron microscopy (TEM), and vibrational sample magnetometry (VSM) in order to identify the crystalline phase, functional group, morphology, particle size, shape and magnetic behavior. It was observed that the resultant spinal ferrites obtained at low temperature exhibit single phase, nanoparticle size and good magnetic behavior. The study results have revealed the existence of a potent dose dependent cytotoxic effect of MnFe2O4 nanoparticles against 4T1 cell lines at varying concentrations with IC50 values of 210, 198 and 171 μg/mL after 24 h, 48 h and 72 h of incubation, respectively. Cells exposed to higher concentrations of nanoparticles showed a progressive increase of apoptotic and necrotic activity. Below 125 μg/mL concentration the nanoparticles were biocompatible with 4T1 cells.
Unravelling proximate cues of mass flowering in the tropical forests of South-East Asia from gene expression analyses

Yeoh SH, Satake A, Numata S, Ichie T, Lee SL, Basherudin N, et al.

Mol Ecol, 2017 Oct;26(19):5074-5085.
PMID: 28749031 DOI: 10.1111/mec.14257

Elucidating the physiological mechanisms of the irregular yet concerted flowering rhythm of mass flowering tree species in the tropics requires long-term monitoring of flowering phenology, exogenous and endogenous environmental factors, as well as identifying interactions and dependencies among these factors. To investigate the proximate factors for floral initiation of mast seeding trees in the tropics, we monitored the expression dynamics of two key flowering genes, meteorological conditions and endogenous resources over two flowering events of Shorea curtisii and Shorea leprosula in the Malay Peninsula. Comparisons of expression dynamics of genes studied indicated functional conservation of FLOWERING LOCUS T (FT) and LEAFY (LFY) in Shorea. The genes were highly expressed at least 1 month before anthesis for both species. A mathematical model considering the synergistic effect of cool temperature and drought on activation of the flowering gene was successful in predicting the observed gene expression patterns. Requirement of both cool temperature and drought for floral transition suggested by the model implies that flowering phenologies of these species are sensitive to climate change. Our molecular phenology approach in the tropics sheds light on the conserved role of flowering genes in plants inhabiting different climate zones and can be widely applied to dissect the flowering processes in other plant species.
Real-Time Medical Systems Based on Human Biometric Steganography: a Systematic Review

Mohsin AH, Zaidan AA, Zaidan BB, Ariffin SAB, Albahri OS, Albahri AS, et al.

J Med Syst, 2018 Oct 29;42(12):245.
PMID: 30374820 DOI: 10.1007/s10916-018-1103-6

In real-time medical systems, the role of biometric technology is significant in authentication systems because it is used in verifying the identity of people through their biometric features. The biometric technology provides crucial properties for biometric features that can support the process of personal identification. The storage of biometric template within a central database makes it vulnerable to attack which can also occur during data transmission. Therefore, an alternative mechanism of protection becomes important to develop. On this basis, this study focuses on providing a detailed analysis of the extant literature (2013-2018) to identify the taxonomy and research distribution. Furthermore, this study also seeks to ascertain the challenges and motivations associated with biometric steganography in real-time medical systems to provide recommendations that can enhance the efficient use of real-time medical systems in biometric steganography and its applications. A review of articles on human biometric steganography in real-time medical systems obtained from three main databases (IEEE Xplore, ScienceDirect and Web of Science) is conducted according to an appropriate review protocol. Then, 41 related articles are selected by using exclusion and inclusion criteria. Majority of the studies reviewed had been conducted in the field of data-hiding (particularly steganography) technologies. In this review, various steganographic methods that have been applied in different human biometrics are investigated. Thereafter, these methods are categorised according to taxonomy, and the results are presented on the basis of human steganography biometric real-time medical systems, testing and evaluation methods, significance of use and applications and techniques. Finally, recommendations on how the challenges associated with data hiding can be addressed are provided to enhance the efficiency of using biometric information processed in any authentication real-time medical system. These recommendations are expected to be immensely helpful to developers, company users and researchers.
Fulltext Gestational weight gain and gestational diabetes among Emirati and Arab women in the United Arab Emirates: results from the MISC cohort

Hashim M, Radwan H, Hasan H, Obaid RS, Al Ghazal H, Al Hilali M, et al.

BMC Pregnancy Childbirth, 2019 Dec 03;19(1):463.
PMID: 31795984 DOI: 10.1186/s12884-019-2621-z

BACKGROUND: Nutritional status of women during pregnancy has been considered an important prognostic indicator of pregnancy outcomes.
OBJECTIVES: To investigate the pattern of gestational weight gain (GWG) and gestational diabetes mellitus (GDM) and their risk factors among a cohort of Emirati and Arab women residing in the United Arab Emirates (UAE). A secondary objective was to investigate pre-pregnancy body mass index (BMI) and its socio-demographic correlates among study participants.
METHODS: Data of 256 pregnant women participating in the cohort study, the Mother-Infant Study Cohort (MISC) were used in this study. Healthy pregnant mothers with no history of chronic diseases were interviewed during their third trimester in different hospitals in UAE. Data were collected using interviewer-administered multi-component questionnaires addressing maternal sociodemographic and lifestyle characteristics. Maternal weight, weight gain, and GDM were recorded from the hospital medical records.
RESULTS: Among the study participants, 71.1% had inadequate GWG: 31.6% insufficient and 39.5% excessive GWG. 19.1% reported having GDM and more than half of the participants (59.4%) had a pre-pregnancy BMI ≥ 25 kg/m2. The findings of the multiple multinomial logistic regression showed that multiparous women had decreased odds of excessive gain as compared to primiparous [odds ratio (OR): 0.17; 95% CI: 0.05-0.54]. Furthermore, women with a pre-pregnancy BMI ≥ 25 kg/m2 had increased odds of excessive gain (OR: 2.23; 95%CI: 1.00-5.10) as compared to those with pre-pregnancy BMI
Influence of pathogenic bacterial activity on growth of Scenedesmus sp. and removal of nutrients from public market wastewater

Al-Gheethi AA, Mohamed RM, Jais NM, Efaq AN, Abd Halid A, Wurochekke AA, et al.

J Water Health, 2017 Oct;15(5):741-756.
PMID: 29040077 DOI: 10.2166/wh.2017.080

The present study aims to investigate the influence of Staphylococcus aureus, Escherichia coli and Enterococcus faecalis in public market wastewater on the removal of nutrients in terms of ammonium (NH4-) and orthophosphate (PO43) using Scenedesmus sp. The removal rates of NH4- and orthophosphate PO43- and batch kinetic coefficient of Scenedesmus sp. were investigated. The phycoremediation process was carried out at ambient temperature for 6 days. The results revealed that the pathogenic bacteria exhibited survival potential in the presence of microalgae but they were reduced by 3-4 log at the end of the treatment process. The specific removal rates of NH4- and PO43- have a strong relationship with initial concentration in the public market wastewater (R2 = 0.86 and 0.80, respectively). The kinetic coefficient of NH4- removal by Scenedesmus sp. was determined as k = 4.28 mg NH4- 1 log10 cell mL-1 d-1 and km = 52.01 mg L-1 (R2 = 0.94) while the coefficient of PO43- removal was noted as k = 1.09 mg NH4- 1 log10 cell mL-1 d-1 and km = 85.56 mg L-1 (R2 = 0.92). It can be concluded that Scenedesmus sp. has high competition from indigenous bacteria in the public market wastewater to remove nutrients, with a higher coefficient of removal of NH4- than PO43.
Fulltext Assessment of coastal sustainable development along the maritime silk road using an integrated natural-economic-social (NES) ecosystem

Zuo J, Zhang L, Chen B, Liao J, Hashim M, Sutrisno D, et al.

Heliyon, 2023 Jun;9(6):e17440.
PMID: 37426792 DOI: 10.1016/j.heliyon.2023.e17440

Understanding spatial change and its driving factors behind coastal development is essential for coastal management and restoration. There is an urgent need for quantitative assessments of sustainable development in the coastal ecosystems that are most affected by anthropogenic activities and climate change. This study built a theme-based evaluation methodology with the Natural-Economic-Social (NES) complex ecosystem and proposed an evaluation system of coastal sustainable development (CSD) to understand the complex interactions between coastal ecosystems and anthropogenic activities. The approach revealed the levels of coastal natural, economic, and social sustainable development in the countries along the Maritime Silk Road (MSR) from 2010 to 2020. The results showed (1) a decreasing trend for coastal sustainable development between 2010 and 2015 and a rapid increasing trend between 2015 and 2020; (2) spatially varied CSD, with higher levels in Europe and Southeast Asia and lower levels in South and West Asia and North Africa; and (3) a strong influence on CSD by a combination of economic and social factors and relatively little influence by natural factors. The study further assessed the natural, economic, and social development scores for 41 countries and compared them with the mean scores (MSR) to classify coastal development patterns into three stages (favorable, transitional, and unfavorable). Finally, in the context of the 2030 Agenda for Sustainable Development, the study highlighted the importance of more refined global indicators for CSD assessments.
Fulltext Dietary patterns and their associations with gestational weight gain in the United Arab Emirates: results from the MISC cohort

Itani L, Radwan H, Hashim M, Hasan H, Obaid RS, Ghazal HA, et al.

Nutr J, 2020 04 21;19(1):36.
PMID: 32316972 DOI: 10.1186/s12937-020-00553-9

BACKGROUND: Suboptimum weight gain during pregnancy may carry long term health consequences for the infant or mother. Nutritional imbalances are well recognized as a determinant of gestational weight gain. Few studies examined the effect of dietary patterns on gestational weight gain, especially in countries undergoing nutrition transition, such as the United Arab Emirates.
OBJECTIVES: To characterize dietary patterns among pregnant women living in the UAE and examine their associations with gestational weight gain and gestational weight rate.
METHODOLOGY: Data were drawn from the Mother-Infant Study Cohort, a two-year prospective cohort study of pregnant women living in the United Arab Emirates, recruited during their third trimester (n = 242). Weight gain during pregnancy was calculated using data from medical records. The Institute of Medicine's recommendations were used to categorize gestational weight gain and gestational weight gain rate into insufficient, adequate, and excessive. During face-to-face interviews, dietary intake was assessed using an 89-item culture-specific semi-quantitative food frequency questionnaire that referred to usual intake during pregnancy. Dietary patterns were derived by principal component analysis. Multiple logistic regression analyses were used to evaluate the associations of derived dietary patterns with gestational weight gain/gestational weight gain rate.
RESULTS: Two dietary patterns were derived, a "Diverse" and a "Western" pattern. The "Diverse" pattern was characterized by higher intake of fruits, vegetables, mixed dishes while the "Western" pattern consisted of sweets and fast food. The "Western" pattern was associated with excessive gestational weight gain (OR:4.04,95% CI:1.07-15.24) and gestational weight gain rate (OR: 4.38, 95% CI:1.28-15.03) while the "Diverse" pattern decreased the risk of inadequate gestational weight gain (OR:0.24, 95% CI:0.06-0.97) and gestational weight gain rate (OR:0.28, 95% CI:0.09-0.90).
CONCLUSION: The findings of this study showed that adherence to a "Diverse" pattern reduced the risk of insufficient gestational weight gain/gestational weight gain rate, while higher consumption of the "Western" pattern increased the risk of excessive gestational weight gain/gestational weight gain rate. In view of the established consequences of gestational weight gain on the health of the mother and child, there is a critical need for health policies and interventions to promote a healthy lifestyle eating through a life course approach.
Fulltext Biohydrogen Production by Antarctic Psychrotolerant Klebsiella sp. ABZ11

Mohammed A, Abdul-Wahab MF, Hashim M, Omar AH, Md Reba MN, Muhamad Said MF, et al.

Pol J Microbiol, 2018 11 20;67(3):283-290.
PMID: 30451444 DOI: 10.21307/pjm-2018-033

Lower temperature biohydrogen production has always been attractive, due to the lower energy requirements. However, the slow metabolic rate of psychrotolerant biohydrogen-producing bacteria is a common problem that affects their biohydrogen yield. This study reports on the improved substrate synthesis and biohydrogen productivity by the psychrotolerant Klebsiella sp. strain ABZ11, isolated from Antarctic seawater sample. The isolate was screened for biohydrogen production at 30°C, under facultative anaerobic condition. The isolate is able to ferment glucose, fructose and sucrose with biohydrogen production rate and yield of 0.8 mol/l/h and 3.8 mol/g, respectively at 10 g/l glucose concentration. It also showed 74% carbohydrate uptake and 95% oxygen uptake ability, and a wide growth temperature range with optimum at 37°C. Klebsiella sp. ABZ11 has a short biohydrogen production lag phase, fast substrate uptake and is able to tolerate the presence of oxygen in the culture medium. Thus, the isolate has a potential to be used for lower temperature biohydrogen production process.
Fulltext Antibiotic consumption at community pharmacies: A multicenter repeated prevalence surveillance using WHO methodology

Saleem Z, Faller EM, Godman B, Malik MSA, Iftikhar A, Iqbal S, et al.

Med Access Point Care, 2021 12 16;5:23992026211064714.
PMID: 36204499 DOI: 10.1177/23992026211064714

Background: Antibiotics are losing their effectiveness because of the rapid emergence of resistant bacteria. Unnecessary antimicrobial use increases antimicrobial resistance (AMR). There are currently no published data on antibiotic consumption in Pakistan at the community level. This is a concern given high levels of self-purchasing of antibiotics in Pakistan and variable knowledge regarding antibiotics and AMR among physicians and pharmacists.
Objective: The objective of this repeated prevalence survey was to assess the pattern of antibiotic consumption data among different community pharmacies to provide a baseline for developing future pertinent initiatives.
Methods: A multicenter repeated prevalence survey conducted among community pharmacies in Lahore, a metropolitan city with a population of approximately 10 million people, from October to December 2017 using the World Health Organization (WHO) methodology for a global program on surveillance of antimicrobial consumption.
Results: The total number of defined daily doses (DDDs) dispensed per patient ranged from 0.1 to 50.0. In most cases, two DDDs per patient were dispensed from pharmacies. Co-amoxiclav was the most commonly dispensed antibiotic with a total number of DDDs at 1018.15. Co-amoxiclav was followed by ciprofloxacin with a total number of 486.6 DDDs and azithromycin with a total number of 472.66 DDDs. The least consumed antibiotics were cefadroxil, cefotaxime, amikacin, and ofloxacin, with overall consumption highest in December.
Conclusion: The study indicated high antibiotic usage among community pharmacies in Lahore, Pakistan particularly broad-spectrum antibiotics, which were mostly dispensed inappropriately. The National action plan of Pakistan on AMR should be implemented by policymakers including restrictions on the dispensing of antimicrobials.
Fulltext Human Milk Oligosaccharide, Phospholipid, and Ganglioside Concentrations in Breast Milk from United Arab Emirates Mothers: Results from the MISC Cohort

McJarrow P, Radwan H, Ma L, MacGibbon AKH, Hashim M, Hasan H, et al.

Nutrients, 2019 Oct 08;11(10).
PMID: 31597293 DOI: 10.3390/nu11102400

Human milk oligosaccharides (HMOs), phospholipids (PLs), and gangliosides (GAs) are components of human breast milk that play important roles in the development of the rapidly growing infant. The differences in these components in human milk from the United Arab Emirates (UAE) were studied in a cross-sectional trial. High-performance liquid chromatography‒mass spectrometry was used to determine HMO, PL, and GA concentrations in transitional (5-15 days) and mature (at 6 months post-partum) breast milk of mothers of the United Arab Emirates (UAE). The results showed that the average HMO (12 species), PL (7 species), and GA (2 species) concentrations quantified in the UAE mothers' transitional milk samples were (in mg/L) 8204 ± 2389, 269 ± 89, and 21.18 ± 11.46, respectively, while in mature milk, the respective concentrations were (in mg/L) 3905 ± 1466, 220 ± 85, and 20.18 ± 9.75. The individual HMO concentrations measured in this study were all significantly higher in transitional milk than in mature milk, except for 3 fucosyllactose, which was higher in mature milk. In this study, secretor and non-secretor phenotype mothers showed no significant difference in the total HMO concentration. For the PL and GA components, changes in the individual PL and GA species distribution was observed between transitional milk and mature milk. However, the changes were within the ranges found in human milk from other regions.
Fulltext The Mother-Infant Study Cohort (MISC): Methodology, challenges, and baseline characteristics

Radwan H, Hashim M, Shaker Obaid R, Hasan H, Naja F, Al Ghazal H, et al.

PLoS One, 2018;13(5):e0198278.
PMID: 29851999 DOI: 10.1371/journal.pone.0198278

BACKGROUND: The United Arab Emirates (UAE) exhibits alarming high prevalence of Non-Communicable Diseases (NCDs) and their risk factors. Emerging evidence highlighted the role of maternal and early child nutrition in preventing later-onset NCDs. The objectives of this article are to describe the design and methodology of the first Mother and Infant Study Cohort (MISC) in UAE; present the baseline demographic characteristics of the study participants; and discuss the challenges of the cohort and their respective responding strategies.
METHODS: The MISC is an ongoing two-year prospective cohort study which recruited Arab pregnant women in their third trimester from prenatal clinics in Dubai, Sharjah and Ajman. Participants will be interviewed six times (once during pregnancy, at delivery, and at 2, 6, 12 and 24months postpartum). Perinatal information is obtained from hospital records. Collected data include socio-demographic characteristics, lifestyle, dietary intake and anthropometry; infant feeding practices, cognitive development; along with maternal and infant blood profile and breast milk profile.
RESULTS: The preliminary results reported that 256 completed baseline assessment (mean age: 30.5±6.0 years; 76.6% multiparous; about 60% were either overweight or obese before pregnancy). The prevalence of gestational diabetes was 19.2%. Upon delivery, 208 women-infant pairs were retained (mean gestational age: 38.5±1.5 weeks; 33.3% caesarean section delivery; 5.3% low birthweight; 5.7% macrosomic deliveries). Besides participant retention, the main encountered challenges pertained to cultural complexity, underestimation the necessary start-up time, staff, and costs, and biochemical data collection.
CONCLUSIONS: Despite numerous methodological, logistical and sociocultural challenges, satisfactory follow-up rates are recorded. Strategies addressing challenges are documented, providing information for planning and implementing future birth cohort studies locally and internationally.
Fulltext Impact of coronavirus 2019 on mental health and lifestyle adaptations of pregnant women in the United Arab Emirates: a cross-sectional study

Hashim M, Coussa A, Al Dhaheri AS, Al Marzouqi A, Cheaib S, Salame A, et al.

BMC Pregnancy Childbirth, 2021 Jul 19;21(1):515.
PMID: 34281501 DOI: 10.1186/s12884-021-03941-z

BACKGROUND: In light of the pandemic, pregnant women are particularly vulnerable to increased psychological distress and in need of imperative preventive measures. This study aimed to investigate the impact of the pandemic on mental health, lifestyle adaptations, and their determinants among pregnant women in the United Arab Emirates.
METHODS: A survey was conducted electronically between June and August 2020. Pregnant women were recruited from prenatal clinics in the UAE and invited to participate in an online survey developed on Google Forms. The questionnaire included socio-demographic characteristics, the Impact of Event Scale- Revised, the Perceived Support Scale and lifestyle-related factors.
RESULTS: A total of 384 pregnant women completed the questionnaire of whom 20.6% were in their 1st trimester, 46.1% in their 2nd and 33.3% in their 3rd trimester. The mean IES-R score for the respondents was 26.15 ± 13.55, corresponding to a mild stressful impact, which did not differ significantly among trimesters of pregnancy. Pregnant women expressed increased stress from staying home (64%), work (40%), feeling frightened (66%) and apprehensive (59%). Women reported increased support and sharing their feelings with family members (59%), mainly in the 1st and 3rd trimester of pregnancy (P
Fulltext Impact of COVID-19 on mental health and quality of life: Is there any effect? A cross-sectional study of the MENA region

Al Dhaheri AS, Bataineh MF, Mohamad MN, Ajab A, Al Marzouqi A, Jarrar AH, et al.

PLoS One, 2021;16(3):e0249107.
PMID: 33765015 DOI: 10.1371/journal.pone.0249107

The COVID-19 pandemic is a major health crisis that has changed the life of millions globally. The purpose of this study was to assess the effect of the pandemic on mental health and quality of life among the general population in the Middle East and North Africa (MENA) region. A total of 6142 adults from eighteen countries within the MENA region completed an online questionnaire between May and June 2020. Psychological impact was assessed using the Impact of Event Scale-Revised (IES-R) and the social and family support impact was assessed with questions from the Perceived Support Scale (PSS). The IES-R mean score was 29.3 (SD = 14.8), corresponding to mild stressful impact with 30.9% reporting severe psychological impact. Most participants (45%-62%) felt horrified, apprehensive, or helpless due to COVID-19. Furthermore, over 40% reported increased stress from work and financial matters. Higher IES-R scores were found among females, participants aged 26-35 years, those with lower educational level, and participants residing in the North Africa region (p<0.005). About 42% reported receiving increased support from family members, 40.5% were paying more attention to their mental health, and over 40% reported spending more time resting since the pandemic started. The COVID-19 pandemic was associated with mild psychological impact while it also encouraged some positive impact on family support and mental health awareness among adults in the MENA region. Clinical interventions targeted towards vulnerable groups such as females and younger adults are needed.
Fulltext Assessment of eating habits and lifestyle during the coronavirus 2019 pandemic in the Middle East and North Africa region: a cross-sectional study

Cheikh Ismail L, Osaili TM, Mohamad MN, Al Marzouqi A, Jarrar AH, Zampelas A, et al.

Br J Nutr, 2021 Sep 14;126(5):757-766.
PMID: 33198840 DOI: 10.1017/S0007114520004547

Coronavirus disease 2019 (COVID-19) has rapidly spread globally, forcing countries to apply lockdowns and strict social distancing measures. The aim of this study was to assess eating habits and lifestyle behaviours among residents of the Middle East and North Africa (MENA) region during the lockdown. A cross-sectional study among adult residents of the MENA region was conducted using an online questionnaire designed on Google Forms during April 2020. A total of 2970 participants from eighteen countries participated in the present study. During the pandemic, over 30 % reported weight gain, 6·2 % consumed five or more meals per d compared with 2·2 % before the pandemic (P < 0·001) and 48·8 % did not consume fruits on a daily basis. Moreover, 39·1 % did not engage in physical activity, and over 35 % spent more than 5 h/d on screens. A significant association between the frequency of training during the pandemic and the reported change in weight was found (P < 0·001). A significantly higher percentage of participants reported physical and emotional exhaustion, irritability and tension either all the time or a large part of the time during the pandemic (P < 0·001). Although a high percentage of participants reported sleeping more hours per night during the pandemic, 63 % had sleep disturbances. The study highlights that the lockdown due to the COVID-19 pandemic caused a variety of lifestyle changes, physical inactivity and psychological problems among adults in the MENA region.

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