Predicting Long-term Renal Impairment in Post-COVID-19 Patients with Machine Learning Algorithms (preprint)

The COVID-19 pandemic has had far-reaching implications for global public health. As we continue to grapple with its consequences, it becomes increasingly clear that post-COVID-19 complications are a significant concern. Among these complications, renal impairment has garnered particular attention due to its potential long-term health impacts. This study, conducted with a cohort of 821 post-COVID-19 patients from diverse regions of Iraq across the years 2021, 2022, and 2023, endeavors to predict the risk of long-term renal impairment using advanced machine learning algorithms. Our findings have the potential to revolutionize post-COVID-19 patient care by enabling early identification and intervention for those at risk of renal impairment, ultimately improving clinical outcomes. This research encompasses comprehensive data collection and preprocessing, feature selection, and the development of predictive models using various machine learning algorithms. The study's objectives are to assess the incidence of long-term renal impairment in post-COVID-19 patients, identify associated risk factors, create predictive models, and evaluate their accuracy. We anticipate that our machine learning models, drawing from a rich dataset, will provide valuable insights into the risk of renal impairment, ultimately enhancing patient care and quality of life. In conclusion, the research presented herein offers a critical contribution to the field of post-COVID-19 care. By harnessing the power of machine learning, we aim to predict long-term renal impairment risk accurately. These predictions have the potential to inform healthcare professionals, enabling them to take proactive measures and provide targeted interventions for post-COVID-19 patients at risk of renal complications, thus minimizing the impact of this serious health concern.

Machine Learning-driven Analysis of Gastrointestinal Symptoms in Post-COVID-19 Patients (preprint)

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has posed significant health challenges worldwide. While respiratory symptoms have been the primary focus, emerging evidence has highlighted the impact of COVID-19 on various organ systems, including the gastrointestinal (GI) tract. This study, based on data from 913 post-COVID-19 patients in Iraq collected during 2022 and 2023, investigates the prevalence and patterns of GI symptoms in individuals recovering from COVID-19 and leverages machine learning algorithms to identify predictive factors for these symptoms. The research findings reveal that a notable percentage of post-COVID-19 patients experience GI symptoms during their recovery phase. Diarrhea emerged as the most frequently reported symptom, followed by abdominal pain and nausea. Machine learning analysis uncovered significant predictive factors for GI symptoms, including age, gender, disease severity, comorbidities, and the duration of COVID-19 illness. These findings underscore the importance of monitoring and addressing GI symptoms in post-COVID-19 care, with machine learning offering valuable tools for early identification and personalized intervention. This study contributes to the understanding of the long-term consequences of COVID-19 on GI health and emphasizes the potential benefits of utilizing machine learning-driven analysis in predicting and managing these symptoms. Further research is warranted to delve into the mechanisms underlying GI symptoms in COVID-19 survivors and to develop targeted interventions for symptom management. Keywords: COVID-19, gastrointestinal symptoms, machine learning, predictive factors, post-COVID-19 care, long COVID.

Early Detection of Post-COVID-19 Fatigue Syndrome Using Deep Learning Models (preprint)

The research titled "Early Detection of Post-COVID-19 Fatigue Syndrome using Deep Learning Models" addresses a pressing concern arising from the COVID-19 pandemic. Post-COVID-19 Fatigue Syndrome (PCFS) has become a significant health issue affecting individuals who have recovered from COVID-19 infection. This study harnesses a robust dataset comprising 940 patients from diverse age groups, whose medical records were collected from various hospitals in Iraq over the years 2022, 2022, and 2023. The primary objective of this research is to develop and evaluate deep learning models for the early detection of PCFS. Leveraging the power of deep learning, these models are trained on a comprehensive set of clinical and demographic features extracted from the dataset. The goal is to enable timely identification of PCFS symptoms in post-COVID-19 patients, which can lead to more effective interventions and improved patient outcomes. The study's findings underscore the potential of deep learning in healthcare, particularly in the context of COVID-19 recovery. Early detection of PCFS can aid healthcare professionals in providing timely care and support to affected individuals, potentially reducing the long-term impact of this syndrome on their quality of life. This research contributes to the growing body of knowledge surrounding COVID-19-related health complications and highlights the importance of leveraging advanced machine learning techniques for early diagnosis and intervention. Keywords: Early Detection, Post-COVID-19 Fatigue Syndrome, Deep Learning Models, Healthcare, COVID-19 Recovery, Medical Data Analysis, Machine Learning, Health Interventions.

Automated Detection of Persistent Inflammatory Biomarkers in Post-COVID-19 Patients Using Machine Learning Techniques (preprint)

The COVID-19 pandemic has left a lasting impact on individuals, with many experiencing persistent symptoms, including inflammation, in the post-acute phase of the disease. Detecting and monitoring these inflammatory biomarkers is critical for timely intervention and improved patient outcomes. This study employs machine learning techniques to automate the identification of persistent inflammatory biomarkers in 290 post-COVID-19 patients, based on medical data collected from hospitals in Iraq. The data encompassed a wide array of clinical parameters, such as C-reactive protein and interleukin-6 levels, patient demographics, comorbidities, and treatment histories. Rigorous data preprocessing and feature selection processes were implemented to optimize the dataset for machine learning analysis. Various machine learning algorithms, including logistic regression, random forests, support vector machines, and gradient boosting, were deployed to construct predictive models. These models exhibited promising results, showcasing high accuracy and precision in the identification of patients with persistent inflammation. The findings of this study underscore the potential of machine learning in automating the detection of persistent inflammatory biomarkers in post-COVID-19 patients. These models can serve as valuable tools for healthcare providers, facilitating early diagnosis and personalized treatment strategies for individuals at risk of persistent inflammation, ultimately contributing to improved post-acute COVID-19 care and patient well-being. Keywords: COVID-19, post-COVID-19, inflammation, biomarkers, machine learning, early detection.

Outbreaks of different viral etiologies amidst COVID-19 pandemic

The COVID-19 pandemic has severely affected public health system and surveillance of other communicable diseases across the globe. The lockdown, travel constraints and COVID phobia turned down the number of people with illness visiting to the clinics or hospitals. Besides this, the heavy workload of SARS-CoV-2 diagnosis has led to the reduction in differential diagnosis of other diseases. Consequently, it added to the underlying burden of many diseases which remained under-diagnosed. Amidst the pandemic, the rise of emerging and re-emerging infectious diseases was observed worldwide and reported to the World Health Organization i.e., Crimean Congo Hemorrhagic Fever (2022, Iraq;2021 India), Nipah virus (2021, India), Zika virus (2021, India), and H5N1 influenza (2021, India), Monkeypox (2022, multicountry outbreak), Ebola virus disease (2022, DRC, Uganda;2021, DRC, Guinea;2020, DRC), Marburg (2022, Ghana;2021, Guinea), Yellow fever (2022, Uganda, Kenya, West and Central Africa;2021, Ghana, Venezuela, Nigeria;2020, Senegal, Guinea, Nigeria, Gabon;2020, Ethiopia, Sudan, Uganda), Dengue (2022, Nepal, Pakistan, Sao Tome, Temor-Leste;2021, Pakistan), Middle east respiratory syndrome coronavirus (2022, Oman, Qatar;2021, Saudi Arabia, UAE;2020, Saudi Arabia, UAE), Rift valley fever (2021, Kenya;2020, Mauritania), wild poliovirus type 1 (2022, Mozambique), Lassa fever (2022, Guinea, Togo, Nigeria;2020, Nigeria), Avian Influenza (H3N8) (2022, China), Avian Influenza (H5N1) (2022, USA), H10N3 influenza (2021, China), Hepatitis E virus (2022, Sudan), Measles (2022, Malawi, Afghanistan;2020, Burundi, Mexico), Mayaro virus disease (2020, French Guiana), Oropouche virus disease (2020, French Guiana). All these diseases were associated with high morbidity and burdened the public health system during the COVID-19 pandemic. During this critical public health menace, majority of the laboratory workforce was mobilized to the SARS-CoV-2 diagnosis. This has limited the surveillance efforts that likely led to under diagnosis and under-detection of many infectious pathogens. Lockdowns and travel limitations also put a hold on human and animal surveillance studies to assess the prevalence of these zoonotic viruses. In addition, lack of supplies and laboratory personnel and an overburdened workforce negatively impacted differential diagnosis of the diseases. This is especially critical given the common symptoms between COVID-19 and other pathogens causing respiratory illnesses. Additionally, the vaccination programs against various vaccine preventable diseases were also hampered which might have added to the disease burden. Despite these challenges, the world is better prepared to detect and respond to emerging/re-emerging pathogens. India now has more than 3000 COVID-19 diagnostic laboratories and an enhanced hospital infrastructure. In addition, mobile BSL-3 facilities are being validated for onsite sampling and testing in remote areas during outbreak situations and surveillance activities. This will undoubtedly be valuable as the COVID-19 pandemic evolves as well as during future outbreaks and epidemics. In conclusion, an increase in the emergence and re-emergence of viruses demonstrates that other infectious diseases have been neglected during the COVID-19 pandemic. Lessons learned from the infrastructure strengthening, collaborations with multiple stakeholders, increased laboratory and manufacturing capacity, large-scale COVID-19 surveillance, extensive network for laboratory diagnosis, and intervention strategies can be implemented to provide quick, concerted responses against the future threats associated with other zoonotic pathogens.

Telemedicine interventions in six conflict-affected countries in the WHO Eastern Mediterranean region: a systematic review.

BACKGROUND: The COVID-19 pandemic has escalated the use of telemedicine in both high and low resource settings however its use has preceded this, particularly in conflict-affected settings. Several countries in the WHO Eastern Mediterranean (EMR) region are affected by complex, protracted crises. Though telemedicine has been used in such settings, there has been no comprehensive assessment of what interventions are used, their efficacy, barriers, or current research gaps. MAIN BODY: A systematic search of ten academic databases and 3 grey literature sources from January 1st 2000 to December 31st 2020 was completed, identifying telemedicine interventions in select EMR conflict-affected settings and relevant enablers and barriers to their implementation. Included articles reported on telemedicine use in six conflict-affected EMR countries (or territories) graded as WHO Health Emergencies: Afghanistan, Gaza, Iraq, Libya, Syria and Yemen. Data were extracted and narratively synthesised due to heterogeneity in study design and outcomes. Of 3419 articles identified, twenty-one peer-reviewed and three grey literature sources met the inclusion criteria. We analysed these by context, intervention, and evaluation. CONTEXT: eight related to Afghanistan, eight to Syria and seven to Iraq with one each in Yemen and Gaza. Most were implemented by humanitarian or academic organisations with projects mostly initiated in the United States or Europe and mostly by physicians. The in-country links were mostly health professionals rather than patients seeking specialist inputs for specialities not locally available. INTERVENTIONS: these included both SAF (store and forward) and RT (real-time) with a range of specialities represented including radiology, histopathology, dermatology, mental health, and intensive care. EVALUATION: most papers were observational or descriptive with few describing quality measures of interventions. CONCLUSIONS: Telemedicine interventions are feasible in conflict-affected settings in EMR using low-cost, accessible technologies. However, few implemented interventions reported on evaluation strategies or had these built in. The ad hoc nature of some of the interventions, which relied on volunteers without sustained financial or academic investment, could pose challenges to quality and sustainability. There was little exploration of confidentiality, ethical standards, data storage or local healthcare worker and patient acceptability.

Highlighting Complementary Benefits of Problem Management Plus (PM+) and Doing What Matters in Times of Stress (DWM) Interventions Delivered Alongside Broader Community MHPSS Programming in Zummar, Ninewa Governorate of Iraq

Internally displaced persons (IDPs), refugees, returnees and host communities in conflict settings experience high rates of mental health problems associated with prolonged and repeated exposure to multiple exposure to distress, as is the case in Iraq. We sought to highlight the outcomes and complementarity of Problem Management Plus (PM+) and Doing What Matters in Times of Stress (DWM) in addressing the mental health and psychosocial support needs of IDPs, returnees and host community teens and adults in Zummar, Iraq. A total of 290 adults were included in the PM+ intervention, while DWM included 648 adults and 282 teens. DWM was delivered to adults with accessibility barriers to receiving PM+ and to all teens in the study due to security reasons and COVID-19 restrictions. The Patient Health Questionnaire (PHQ-9) and World Health Organization Disability Assessment Schedule (WHODAS 2.0) were used to measure psychological distress and functioning in adults, respectively. The Revised Children Anxiety and Depression Scale (RCADS) was also used to measure symptoms of depression and anxiety in teens pre and postintervention. Personally identified problems were measured using the Psychological Outcome Profiles (PSYCHLOPS) for adults and teens. Psychological and emotional challenges were the main problem faced by both teens and adults at baseline. For PM+ and DWM interventions in adults, the mean difference in PSYCHLOPS, WHODAS and PHQ-9 scores between preintervention and postintervention assessment were significant (P < 0.001). For DWM teens, the paired mean difference for pre and postintervention RCADS and PSYCHLOPS teens was 55.9 (SD = 8.0) and 4.8 (SD = 2.40), respectively (P < 0.001, Cohen’s d > 2). There was a significant reduction in the number of days off work and increased ability to carry out usual activities after both interventions. The study findings highlight the applicability of PM+ and DWM in conflict settings of Iraq when there are barriers to applying one.

Interest Rate Based on The Lie Group SO(3) in the Evidence of Chaos

This paper aims to test the structure of interest rates during the period from 1 September 1981 to 28 December 2020 by using Lie algebras and groups. The selected period experienced substantial events impacting interest rates, such as the economic crisis, the military intervention of the USA in Iraq, and the COVID-19 pandemic, in which economies were in lockdown. These conditions caused the interest rate to have a nonlinear structure, chaotic behavior, and outliers. Under these conditions, an alternative method is proposed to test the random and nonlinear structure of interest rates to be evolved by a stochastic differential equation captured on a curved state space based on Lie algebras and group. Then, parameter estimates of this equation were obtained by OLS, NLS, and GMM estimators (hereafter, LieNLS, LieOLS, and LieGMM, respectively). Therefore, the interest rates that possess nonlinear structures and/or chaotic behaviors or outliers were tested with LieNLS, LieOLS, and LieGMM. We compared our LieNLS, LieOLS, and LieGMM results with the traditional OLS, NLS, and GMM methods, and the results favor the improvement achieved by the proposed LieNLS, LieOLS, and LieGMM in terms of the RMSE and MAE in the out-of-sample forecasts. Lastly, the Lie algebras with NLS estimators exhibited the lowest RMSE and MAE followed by the Lie algebras with GMM, and the Lie algebras with OLS, respectively.

Decision-making in immature projects organisational environment: A mental model approach that influences conscientious critical thinking

Hepworth Construction, a consultancy organisation for Oil and Gas project management offices, identified a decision-making problem in the project office environments and the field because of continued erroneous decisions and the processes used. Erroneous decisions led to poor project performances that impacted projects cost, time, and resource allocation. The research intervention aimed to develop a shared mental decision model to improve project performances and decision-making processes in both the project office and the field and influence critical and conscientious thinking. Moreover, a successful decision model could lead to speeding up project maturity processes and reducing project risk.The research methodology used was a qualitative, thematic analysis approach that used an action research focus using colleague participants from two action learning sets. One learning set was based in Azerbaijan the other learning set was established in Iraq. The individual sets attended cycle events using an online platform to participate and interact. Each set attended three separate action cycle events. Before the action cycle events, seven initial interviews were conducted online to develop concepts that focused on decision models. Further interview cycles were performed to authenticate action cycle data and identify new theories relating to the discussed concepts. Data was analysed between action cycles that informed the next cycle event. The data was processed using NVivo for open and thematic coding, identifying the main categories, and capturing memos and annotations. Thematic diagrams were also used to determine the linkages and relationships between critical concepts and add meaning to the theories (see Appendix K) (Corbin & Strauss, 2015). Axial coding was the output from the thematic diagrams that presented the six selected themes and interpreted them into actionable knowledge.The findings were espoused through the learning sets participant's reflections crossing three action cycles. Each learning cycle progressed with new insights and evolved the main categories. The transcribed and analysed data led to discovering the selected themes and interpretation of actionable knowledge. The selected theme findings: situation, conscience, experience, listening, confidence, and sensemaking were interpreted into actionable knowledge and the shared mental model framework and the critical components: situation, experience, priorities, prompts, proposed action, and sensemaking. The mental model framework influences practical approaches to decision-making, which logically justifies decisions. The organisation accepted the research in January 2021, and the framework was implemented in the project office and field. The research implications were the successful methodology used and drawing on participants responses and the interview data that enriched the action cycles and influenced the success and co-development of the mental model framework. Furthermore, the practical consequences of the research were the outbreak of COVID-19 forcing an online study. However, the online study approach evolved to a diverse opportunity using two learning set locations and selected interviewees worldwide. Future practice organisational change should consider a similar approach using insider empowered participants. And future research might focus on a mental model implementation's complexity, a shift of mind towards system thinking, or how organisational learning bridges both vision and system acceptance. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Role of IFN-?, TNF-a, IL-6 and C-reactive protein in newly diagnosed Iraqi corona patients

The exceptional conditions sweeping the world due to the Corona virus epidemic have prompted researchers to race to study each of the symptoms, phenomena and relevant clinical biochemical parameters to provide science and scientists with valuable information to achieve victory over the virus. The aim of this investigation is to study the early inflammatory features caused by the immune system before a cell storm occurs in Iraqi Corona patients. The investigation was conducted at Yarmouk Teaching Hospital, Baghdad, Iraq, during the period from January 2021 until the end of March 2021. Our team obtained five milliliters of venous blood from 50 participants newly diagnosed with the Coronavirus (24 males and 26 females). Their ages ranged between (25-55) years compared to 38 individuals (18 males and 20 females). Corona virus patients had statistically significant higher (P<0.01) with Low density lipoproteins-cholesterol (LDL-C), urea, C-Reactive Protein (CRP), and (P<0.001) with D-dimer when they were compared with control group. There was a significant increase in the value of Interleukin-6(IL-6) in people infected with the virus compared to the reviewers whose swab results showed that they were not infected with the virus. For both interferon-? (IFN) and Tumor necrosis factor -a (TNF- a), the data showed a significant decrease in morale of reviewers diagnosed with acute respiratory syndrome (COVID-19) against their non-infected peers. These data indicate that early intervention for IFN antiviral infection could be fundamental in inhibiting fibrosis to improve functional recovery. Any source of cytokine control, such as interferon-? and Tumor necrosis factor -a combined with combination therapies for clinical treatment, will be important in the future for COVID-19 infection.

The Medical and Health Humanities in the Middle East: Report on the Meeting of the 2nd International Conference on the Medical Humanities in the Middle East (online) in Doha, Qatar

On April 9 and 10, 2022, over 79 scholars and 230 attendees met online to share their research on the health and medical humanities in the Middle East and North Africa (MENA) region at the 2nd International Conference on the Medical Humanities in the Middle East (online). This meeting was the second convening of experts since the successful 2018 in-person conference in Doha, Qatar at the Sheraton Hotel. The 2022 conference was jointly sponsored by VCUArts Qatar and Weill Cornell Medicine – Qatar, and was convened by Drs. Alan Weber, Byrad Yyelland, and Mohamud Verjee. The diversity and increase in submissions from 2018 to 2022 testify to the growing importance of humanism in medicine in the region. The published s in this special issue of QScience Connect provide a comprehensive overview of the medical and health humanities as they are currently practiced and researched in the Middle East region. For example, the first keynote speech, "Is the Beauty Industry a Virus Invading the Medical Profession?" by Iraqi surgeon and visual artist Dr. Ala Bashir, addressed a critical issue in the region, the growing popularity of cosmetic surgery and the unlicensed and unregulated nature of the industry. The second keynote speech by health humanities professor Paul Crawford (University of Nottingham) entitled "Towards Creative Public Health: The Contribution of the Medical and Health Humanities," provided an overview of recent international initiatives to harness the arts for health education, healing, and wellness. The other presentations from researchers in Kuwait, UK, Jordan, US, Turkey, Israel, Iran, Qatar, Iraq, UAE, India, and Egypt represented the full range of the medical and health humanities that are developing internationally, including the history of medicine, medical sociology and anthropology, narrative medicine, literature and medicine, graphic medicine, healthcare communications, art therapy, the visual arts, film and medicine, and medical ethics. In addition, a panel of premedical and medical students led by Maryam Arabi and Abdallah Tom provided their perspectives on the topic with respect to the educational needs of students. A group of gerontology experts composed of Mark Clarfield, Regina Roller-Wirnsberger, and Desmond O'Neill directed a workshop on publishing research on the health and medical humanities in scientific scholarly journals. Authors Shahd Alshammari and Robin Fetherston gave dramatic readings from their fiction and non-fiction works. Three posters published on the website added to the oral presentations (https://qatar-weill.cornell.edu/event/medical-humanities-in-the-middle-east/posters). Three of the oral presentations spoke to ethics in medical humanities within the Middle East. Banu Buruk and Berna Arda shared the Turkish National Artificial Intelligence Strategy (TNAIS) report which describes methods for determining and initiating national priorities related to AI. This report identifies four ethical values and eight ethical principles worthy of examination since almost one in five AI strategies are applied in the health sciences. The authors discussed TNAIS and concomitant ethical issues, concluding with recommendations for dealing with conflicts as they arise. Alya Al Shakaki then presented on ethical questions related to use of the gene-editing tool, CRISPR-Cas9, which enables "designer babies". CRISPR has been used in China to create babies that are immune to HIV and thereby able to create offspring with similar immunities;however, what happens to individual autonomy in such cases? Scholars of Islamic bioethics ask two questions: which cells will be edited and what is the aim of the editing? Editing confined to one individual without affecting the offspring is considered acceptable but human dignity must be protected. Fahad Ahmed, Yazgı Beriy Altun Güzelderen and Sefik Yurdakul shared their research on publications written by Turkish authors that have been retracted from scientific journals. In a study of PubMEd, Scopus and Web of Science databases, they identified 147 pub ications that had been removed due to duplication and irrelevant studies. Six presentations were related to the history of medicine in the Middle East. Dmitry Balalykin tied the apodictic method (the method of rational and rigorous proof), typically accepted as the method of knowledge in the natural sciences, to the development of medicine as seen in anatomical dissections, clinical systematization and general pathology in Greek and medieval Islamic medicine. Balalykin cited Galen and Muhammad ibn Zakariya as pivotal influences. Katarzyna Gromek then discussed the history of perfumes as medical agents in early Islamic states;for example, scenting clothes, mostly undergarments, shirts, dresses, and bed linens, was also thought to increase therapeutic health effects, both in the sick and healthy. Fatima Saadatmand continued the historical discussion with a look at mystical applications of arithmetic, Ariṯmāṭῑqῑ in Arabic, in treating disease throughout the 9th to 13th centuries through an examination of ancient texts and modern writings. Abdulnaser Kaadan's historical research moves us into the writings of Avicenna (Ibn Sina) related to the diagnosis and treatment of breast lesions and the relevance of this historical work to current medicine. Amanda Caterina Leong then shared her work on the writings of Qajar Iranian Princess Taj al-Saltana in 19th century Iran, who discussed systemic challenges in reactions to Iran's cholera epidemic and subsequent health care perils related to a corrupt patriarchy. Leong connected this work to current governmental handlings of COVID-19 issues. Finally, Forozan Falahatpishe examined the invisibility of autopsy within Islamic medicine. Of interest to mystics, theologians and philosophers as well as physicians, the autopsy has been historically avoided within the Avestan (ancient Iranian) approach to Islamic medicine because it has been perceived as a violation against the sanctity of the human body. Nevertheless, surgery has thrived within the Islamic world. Art therapy in the Gulf was well represented by two full panels, one of which presented by Trish Bedford, Mowafa Househ, and Dr. Jens Schneider surveyed current art therapy practices including development of an art therapy app for making initial assessments powered by AI. In addition, Michelle Dixon, Natalia Gómez Carlier, Sara Powell, Mariam El-Halawani, and Alan Weber detailed in the paper, "Art Therapy Service Provision during the COVID-19 Pandemic in the Gulf Cooperation Council (GCC)" how services provision shifted abruptly to online telehealth. Natalia Gómez Carlier and Sara Powell additionally reported on their art therapy pilot dyadic (parent/caregiver and child) telemedicine program for children living with Autism Spectrum Disorder. In a panel dedicated to healthcare communications, one paper described the best practices in communication skills with visually impaired patients (Dr. Nahla Khalaf Ali, Dr. Abdulsalam S. Sultan, Muna Hameed Faris, Muna Muneer Ahmed, Mohammed Modar Hameed, and Dr. Marab younis Abdullah Al-Fathy). A paper by Raji Anand and Dr. Sohaila Cheema included usage data that demonstrated that digital tools such as Mailchimp direct-mail campaigns can effectively promote positive public health behaviors. Another successful intervention for public health awareness was described in the panel "On Film and Medicine: Reflections on 'Medfest Egypt', an international 'film for health' forum," chaired by Khalid Ali, Mina El Naggar, and Robert Abrams. Gatherings such as the 2nd International Conference on the Medical Humanities in the Middle East are designed to share the latest research findings among area experts, to help form new research collaborations, and to encourage translational medicine projects in which insights and pilot and full-scale studies of the medical and health humanities can be harnessed to revise medical education curricula, improve training for health sciences students, enhance clinical practice and ultimately improve patient outcomes to create more equitable, satisfying, and effectiv healthcare systems. Additionally, medical and health experiences can form the basis of artistic expression since health, disease, and illness represent key milestones in the universal life course. [ FROM AUTHOR] Copyright of QScience Connect is the property of Hamad bin Khalifa University Press (HBKU Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Effect of coronavirus disease 2019 (COVID-19) pandemic on catheterization laboratory activity in Azadi Heart Center, Duhok, Iraq

Background: Coronavirus disease 2019 (COVID-19) has a remarkable impact on healthcare systems globally, and it has challenged patients, healthcare personnel, healthcare systems, and the general population under serious threats. Aim: The aim was to determine the effect of the COVID-19 pandemic on catheterization laboratory activity in Azadi Heart Center, Duhok, Iraq. Materials and Methods: All data of consecutive patients visiting Azadi Heart Center for Cardiac Intervention (coronary angiography, congenital intervention, and cardiac device implantation) in two calendar years period (2019 and 2020) were collected, compared, and studied to explore the effect of the pandemic on catheterization laboratories activity during the peak of the pandemic in our region. Results: A significant decrease in all cardiac procedures and interventions was detected except for emergency percutaneous coronary intervention, and the total number of procedures performed between January 1 and December 31, 2020 reduced by one-third as compared with the same period in 2019. Conclusion: During the peak of disease, the COVID-19 pandemic had reduced all catheterization laboratories activity by one-third except for emergency percutaneous coronary intervention. © 2022 Medical Journal of Babylon ;Published by Wolters Kluwer - Medknow

Investigation of Risk Factors for Hospitalization of COVID-19 Patients with Diabetes in Najaf, Iraq.

Preliminary findings indicate that patients with diabetes mellitus (DM) are at additional risk of infecting with COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is associated with increased mortality in these patients. Hyperglycemia can affect inflammatory and immune responses, which leads patients to severe COVID-19 consequences. The present study investigated risk factors for hospitalized COVID-19 patients with DM in Najaf, Iraq. 127 patients with positive PCR tests were selected from Al-Hakeem Hospital and Al-Sadr Teaching Hospital. Demographic characteristics and laboratory data were collected to compare patients with and without DM. Chi-squared test followed by odds ratio calculations were used to investigate the risk factors associated with hospitalization of COVID-19 patients with or without DM in the ICU and RCU. Analysis of the relationship between risk factors indicated that age above 65 years, high BMI, hypertension, respiratory rate> 24 BPM, CVD, blood sugar> 180 mg/dl, D-dimer> 1000, ALT> 50 and AST> 40 U/L were independent risk factors for hospitalized COVID-19 patients with DM (P≤0.05). Therefore, investigating these factors may detect the risk of infection with COVID-19 in patients with DM in advance. Physicians should further consider risk factors to discover a targeted intervention to improve clinical efficacy.

Attitudes toward Receiving COVID-19 Booster Dose in the Middle East and North Africa (MENA) Region: A Cross-Sectional Study of 3041 Fully Vaccinated Participants.

COVID-19 vaccines are crucial to control the pandemic and avoid COVID-19 severe infections. The rapid evolution of COVID-19 variants such as B.1.1.529 is alarming, especially with the gradual decrease in serum antibody levels in vaccinated individuals. Middle Eastern countries were less likely to accept the initial doses of vaccines. This study was directed to determine COVID-19 vaccine booster acceptance and its associated factors in the general population in the MENA region to attain public herd immunity. We conducted an online survey in five countries (Egypt, Iraq, Palestine, Saudi Arabia, and Sudan) in November and December 2021. The questionnaire included self-reported information about the vaccine type, side effects, fear level, and several demographic factors. Kruskal-Wallis ANOVA was used to associate the fear level with the type of COVID-19 vaccine. Logistic regression was performed to confirm the results and reported as odds ratios (ORs) and 95% confidence intervals. The final analysis included 3041 fully vaccinated participants. Overall, 60.2% of the respondents reported willingness to receive the COVID-19 booster dose, while 20.4% were hesitant. Safety uncertainties and opinions that the booster dose is not necessary were the primary reasons for refusing the booster dose. The willingness to receive the booster dose was in a triangular relationship with the side effects of first and second doses and the fear (p < 0.0001). Females, individuals with normal body mass index, history of COVID-19 infection, and influenza-unvaccinated individuals were significantly associated with declining the booster dose. Higher fear levels were observed in females, rural citizens, and chronic and immunosuppressed patients. Our results suggest that vaccine hesitancy and fear in several highlighted groups continue to be challenges for healthcare providers, necessitating public health intervention, prioritizing the need for targeted awareness campaigns, and facilitating the spread of evidence-based scientific communication.

The Effect of Melatonin on C-reactive Protein, Serum Ferritin and D-Dimer in COVID-19 Patients

Aim: To evaluate the effect of melatonin on C-reactive protein, serum ferritin and D–dimer level in adult patients with severe coronavirus disease 2019 (COVID-19). Method: This single center, prospective, randomized clinical trial conducted in Al-Shifaa hospital at Mosul, Iraq from 1st December 2020 to 1st June 2021 on 158 patients divided into two groups 82 patients in melatonin group (given 10 mg melatonin) and 76 patients in control group. Then C-reactive protein (CRP), serum ferritin and D-dimer level were evaluated and recorded at day 5, 11, 17 of symptoms. Results: Totally, 82 patients in the intervention group and 76 patients in the control group have completed the treatment. In comparison with the control group, the level of CRP, serum ferritin and D-dimer have significantly improved (P < 0.05) in melatonin group in the second week of infection. Conclusions: The adjuvant use of melatonin in COVID-19 patients has a potential to improve CRP, ferritin, and D-dimer. © 2022, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved.

The Evaluation of a Social Media Campaign to Increase COVID-19 Testing in Migrant Groups: Cluster Randomized Trial.

BACKGROUND: A low test positivity rate is key to keeping the COVID-19 pandemic under control. Throughout the pandemic, several migrant groups in Norway have seen higher rates of confirmed COVID-19 and related hospitalizations, while test positivity has remained high in the same groups. The Norwegian government has used several platforms for communication, and targeted social media advertisements have in particular been an important part of the communication strategy to reach these groups. OBJECTIVE: In this study, we aimed to investigate whether such a targeted Facebook campaign increased the rate of COVID-19 tests performed in certain migrant groups. METHODS: We randomly assigned 386 Norwegian municipalities and city districts to intervention or control groups. Individuals born in Eritrea, Iraq, Pakistan, Poland, Russia, Somalia, Syria, and Turkey residing in intervention areas were targeted with a social media campaign aiming at increasing the COVID-19 test rate. The campaign message was in a simple language and conveyed in the users' main language or in English. RESULTS: During the 2-week follow-up period, the predicted probability of having a COVID-19 test taken was 4.82% (95% CI 4.47%-5.18%) in the control group, and 5.58% (95% CI 5.20%-5.99%) in the intervention group (P=.004). CONCLUSIONS: Our targeted social media intervention led to a modest increase in test rates among certain migrant groups in Norway. TRIAL REGISTRATION: ClinicalTrials.gov NCT04866589; https://clinicaltrials.gov/ct2/show/NCT04866589.

Evaluating Public Health Interventions to Improve COVID-19 Testing Among Underserved Populations

Childhood Injury Pattern During Covid 19 Pandemic: A Population - based Study in Rural Area in Basrah City (Iraq)

Background: Children injuries are a major public health problem globally and considered as an important social health issue that needs an urgent care and action, regards as a health consideration in the whole world, influencing both developed and developing countries. The increased exposure to potentially hazardous home environments and activities caused by stay-at-home orders and closures of schools due to COVID-19 pandemic may be responsible for a new spate of injuries among children in 2020. method: population based cross sectional study done in rural area (Al-Jazeera/Shatt Al-Arab). This cross sectional study involved households with at least one child in age group of less than 18 years, in rural area in Basra city (2020). Objectives: To determine the magnitude of childhood injuries during COVID-19 pandemic in terms of incidence, to determine nature and causes of injuries and factors that may affect the incidence of childhood injuries that is associated with quarantine and homestay for long periods during pandemic. A total of 652 children under 18 years of age (according to the definition of WHO) were included in the study, 109 children had injuries during the pandemic year (2020). Result: The incidence rate of injury in the area was 167.1/1000 children, males show higher incidence rate of injury rather than females. the effect of child sex, mother education and age on the incidence of injury were highly significant, while age of child and birth order were not significant. Soft tissue injuries and burns were the leading causes of injuries in our household study. General improvement and modification of sociocultural environment are recommended, children and adolescent education about safety and necessary precaution. establishing of injury surveillance system is important for preventing and control of injuries Governments and healthcare authorities should proactively implement appropriate intervention programs and better resources to prevent these home injuries during lockdown.

Acceptance and Commitment Training for Veterans with Polytrauma: A randomized controlled trial protocol.

BACKGROUND: Mild traumatic brain injury (mTBI) is a signature wound of Veterans of operations in Iraq and Afghanistan (i.e., OIF/OEF/OND). Most Veterans with mTBI also experience stress-based psychopathology (e.g., depression, posttraumatic stress disorder) and chronic pain. This combination - referred to as polytrauma - results in detrimental long-term effects on social, occupational, and community reintegration. This study will compare the efficacy of a one-day Acceptance and Commitment Training plus Education, Resources, and Support (ACT+ERS) workshop to a one-day active control group (ERS) on symptoms of distress and social, occupational, and community reintegration. We will also examine mediators and moderators of treatment response. METHODS: This is an ongoing randomized clinical trial. 212 OIF/OEF/OND Veterans with polytrauma are being recruited. Veterans are randomly assigned to a one-day ACT+ERS or a one-day ERS workshop with two individualized booster sessions approximately two- and four-weeks post-workshop. Veterans complete assessments prior to the workshop and again at six weeks, three months, and six months post-workshop. Of note, workshops were converted to a virtual format due to the COVID-19 pandemic. RESULTS: The primary outcomes are symptoms of distress and reintegration; secondary outcomes are post-traumatic stress disorder symptoms and pain interference. Secondary analyses will assess whether changes in avoidance at three months mediate changes in distress and reintegration at six months. CONCLUSION: Facilitating the psychological adjustment and reintegration of Veterans with polytrauma is critical. The results of this study will provide important information about the impact of a brief intervention for Veterans with these concerns.

The Effect of Melatonin on Thrombosis, Sepsis and Mortality Rate in COVID-19 Patients.

OBJECTIVES: This study aimed to determine the effect of melatonin on thrombosis, sepsis, and mortality rate in adult patients with severe coronavirus infection (COVID-19). METHODS: This single-center, prospective, randomized clinical trial was conducted from 1 December 2020 to 1 June 2021 at Al-Shifaa hospital in Mosul, Iraq. There were 158 patients with severe COVID-19 included in the study: 82 in the melatonin group (who received 10 mg melatonin in addition to standard therapeutic care) and 76 in the control group (given standard therapeutic care only). Patients were chosen by a blocked randomization design. The physician then evaluated and recorded the incidence of thrombosis, sepsis, and mortality rate on days 5, 11, and 17 of symptoms. RESULTS: The intervention group consisted of 82 patients, while the control group consisted of 76 patients. In comparison to the control group, thrombosis and sepsis developed significantly less frequently (P < 0.05) in the melatonin group during the second week of infection, while mortality was significantly higher in the control group (P < 0.05). CONCLUSIONS: Adjuvant use of melatonin may help to reduce thrombosis, sepsis, and mortality in COVID-19 patients.

Fallout of covid-19 pandemic on the iraqi economy and the means of addressing

The aim of the research is to identify the effects of the covid-19 pandemic on the Iraqi economy by analyzing the data of some of the indicators of different economic sectors. With regard to the fallout of the global pandemic on the Iraqi economy, Iraq's crude oil exports fell by 38.81%) than before the COVID-19 pandemic, and this reduction in oil exports led to a drop in oil revenues by 51.94%. The pandemic has also contributed to raising the proportion of total public debt in Iraq by 12.67% than before. In the light of these results, the Iraqi economy has been hit by a real structural shock, including through the intervention of the Central Bank of Iraq through a number of actions, most notably reducing its reserves from 15% to 13%, as well as reducing interest on expired loans at 20 million Iraqi dinars from 4.8% to 3.5%, between 21 million. One billion dinars to 1 billion dinars for 4% after it was 6.3%, and other actions will be covered in this research.

Data-Driven and Machine-Learning Methods to Project Coronavirus Disease 2019 Pandemic Trend in Eastern Mediterranean.

Background: The coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis worldwide, and the Eastern Mediterranean is one of the most affected areas. Materials and Methods: We use a data-driven approach to assess the characteristics, situation, prevalence, and current intervention actions of the COVID-19 pandemic. We establish a spatial model of the spread of the COVID-19 pandemic to project the trend and time distribution of the total confirmed cases and growth rate of daily confirmed cases based on the current intervention actions. Results: The results show that the number of daily confirmed cases, number of active cases, or growth rate of daily confirmed cases of COVID-19 are exhibiting a significant downward trend in Qatar, Egypt, Pakistan, and Saudi Arabia under the current interventions, although the total number of confirmed cases and deaths is still increasing. However, it is predicted that the number of total confirmed cases and active cases in Iran and Iraq may continue to increase. Conclusion: The COVID-19 pandemic in Qatar, Egypt, Pakistan, and Saudi Arabia will be largely contained if interventions are maintained or tightened. The future is not optimistic, and the intervention response must be further strengthened in Iran and Iraq. The aim of this study is to contribute to the prevention and control of the COVID-19 pandemic.

Exploring the acceptance of COVID-19 vaccine among healthcare workers and general population using health belief model.

RATIONALE, AIMS AND OBJECTIVES: Little is known about hesitancy to receive the COVID-19 vaccines. The objectives of this study were (1) to assess the perceptions of healthcare workers (HCWs) and the general population regarding the COVID-19 vaccines, (2) to evaluate factors influencing the acceptance of vaccination using the health belief model (HBM), and (3) to qualitatively explore the suggested intervention strategies to promote the vaccination. METHODS: This was a cross-sectional study based on electronic survey data that was collected in Iraq during December first-19th, 2020. The electronic survey was designed using Qualtrics. HBM was followed to develop the survey items. A regression analysis was used to identify factors influencing people accepting vaccination. Thematic analysis for participant comments to an open-ended question. RESULTS: A total of 1680 completed surveys were received. The mean age of 31.2 ± 9.9 years, 53.0% were female and 47.0% were male. The largest group was HCWs (45.7%), followed by general population (37.5%) and health college students (16.8%). Our findings expressed some hesitancy to receive the COVID-19 vaccine with the acceptance rate of 61.7%. The HCWs perceived significantly higher susceptibility and severity of the COVID-19 infection compared to the general population. The HCWs were significantly more likely than the general population to receive COVID-19 vaccine. Concerns with proper storage was the biggest barrier to vaccine receipt. The regression analysis indicated eight factors that were significantly associated with the willingness to receive COVID-19 vaccine: Preventive measures, perceived benefit, perceived barriers, cue to action, subjective norm, supportive of vaccination in general and having received a flu vaccine before. CONCLUSIONS: Awareness campaign can focus on enhancing the vaccine perceived benefit, debunking misconceptions, and increasing the disease perceived severity. Additionally, the public health leaders need to minimize the perceived barriers by providing the vaccines and appeasing people concerns about their storage, effectiveness, and adverse events.

Assessment of COVID-19 Treatment containing both Hydroxychloroquine and Azithromycin: A natural clinical trial.

The goal of this study was to assess the clinical effectiveness and safety profile of the COVID-19 treatment protocol (containing both hydroxychloroquine (HCQ) and azithromycin) in an Iraqi specialised hospital. METHODS: This prospective study used a pre- and post-intervention design without a comparison group. The intervention was routine Ministry of Health (MOH) approved the management of COVID-19 for all patients. The study was conducted in a public healthcare setting in Baghdad, Iraq from March 1st to May 25, 2020. The study outcome measures included the changes in clinical and biochemical parameters during the hospitalisation period. Paired t-test and Chi-square test were used to compare the measures of vital signs, lab tests and symptoms before and after treatment. RESULTS: The study included 161 patients who were admitted with positive RT-PCR and clinical symptoms of COVID-19. In terms of severity, 53 (32.9%) patients had amild condition, 47 (29.2%) had moderate condition, 35 (21.7%) had severe condition and 26 (16.1%) had critical condition. Most patients (84.5%) recovered and were discharged without symptoms after testing negative with RT-PCR, while 11 (6.8%) patients died during the study period. The signs and symptoms of COVID-19 were reduced significantly in response to a therapy regimen containing HCQ and azithromycin. The most common reported side effects were stomach pain, hypoglycemia, dizziness, itching, skin rash, QT prolongation, arrhythmia, and conjunctivitis. CONCLUSIONS: This natural trial showed that the COVID-19 regimen containing both HCQ and azithromycin can be helpful to promote the recovery of most patients and reduced their signs and symptoms significantly. It also shows some manageable side effects mostly those related to heart rhythm. In the absence of FDA-approved medications to treat COVID-19, the repurposing of HCQ and azithromycin to control the disease signs and symptoms can be useful.

Analysis coronavirus disease (COVID-19) model using numerical approaches and logistic model

The coronavirus disease (COVID-19) is a global health care problem that international efforts have been suggested and discussed to control this disease. Although, there are many researches have been conducted on the basis of the clinical data and recorded infected cases, there is still scope for further research due to the fact that a number of complicated parameters are involved for future prediction. Thus, mathematical modeling with computational simulations is an important tool that estimates key transmission parameters and predicts model dynamics of the disease. In this paper, we review and introduce some models for the COVID-19 that can address important questions about the global health care and suggest important notes. We suggest three well known numerical techniques for solving such equations, they are Euler's method, Runge-Kutta method of order two (RK2) and of order four (RK4). Results based on the suggested numerical techniques and providing approximate solutions give important key answers to this global issue. Numerical results may use to estimate the number susceptible, infected, recovered and quarantined individuals in the future. The results here may also help international efforts for more preventions and improvement their intervention programs. More interestedly, for both countries, Turkey and Iraq, the basic reproduction numbers R-0 have been reported recently by several groups, a research estimation by 9 April 2020 revealed that R-0 for Turkey is 7.4 and for Iraq is 3.4, which are noticeably increased from the beginning of the pandemic. In addition, on the basis of WHO situation reports, the new confirmed cases in Turkey on 11 April are 5138, and in Iraq on 29 May are 416, which can be counted as the peak value from the beginning of the disease. Thus, we investigate the forecasting epidemic size for Turkey and Iraq using the logistic model. It can be concluded that the suggested model is a reasonable description of this epidemic disease.

Characteristics and Outcomes in Patients Presenting With COVID-19 and ST-Segment Elevation Myocardial Infarction.

There is limited information regarding clinical characteristics and outcomes of patients with SARS-CoV-2 (COVID-19) disease presenting with ST-segment elevation myocardial infarction (STEMI). In this multicenter retrospective study, we reviewed charts of patients admitted with symptomatic COVID-19 infection and STEMI to a total of 4 hospitals spanning Italy, Lithuania, Spain and Iraq from February 1, 2020 to April 15, 2020. A total of 78 patients were included in this study, 49 (63%) of whom were men, with a median age of 65 [58, 71] years, and high comorbidity burden. During hospitalization, 8 (10%) developed acute respiratory distress syndrome, and 14 (18%) required mechanical ventilation. 19 (24%) patients were treated with primary Percutaneous Coronary Intervention (PCI) and 59 (76%) were treated with fibrinolytic therapy. 13 (17%) patients required cardiac resuscitation, and 9 (11%) died. For the 19 patients treated with primary PCI, 8 (42%) required intubation and 8 (42%) required cardiac resuscitation; stent thrombosis occurred in 4 patients (21%). A total of 5 patients (26%) died during hospitalization. 50 (85%) of the 59 patients initially treated with fibrinolytic therapy had successful fibrinolysis. The median time to reperfusion was 27 minutes [20, 34]. Hemorrhagic stroke occurred in 5 patients (9%). Six patients (10%) required invasive mechanical ventilation; 5 (9%) required cardiac resuscitation, and 4 (7%) died. In conclusion, this is the largest case series to-date of COVID-19 positive patients presenting with STEMI and spans 4 countries. We found a high rate of stent thrombosis, indicating a possible need to adapt STEMI management for COVID-19 patients.