Vaccine practices, literacy, and hesitancy among parents in the United Arab Emirates.

BACKGROUND: Immunisation is one of public health's greatest success stories, yet, annually, 20 million children miss out entirely or partially on routine immunisation. National immunisation estimates have the United Arab Emirates (UAE) lagging behind with 4% of children under the age of 1 not having received any vaccines. Vaccine hesitancy is considered one of the biggest barriers to vaccination. This study aims to evaluate the UAE's parents' vaccination attitudes and practices as well as estimate vaccine hesitancy's prevalence and determinants. METHODOLOGY: This cross-sectional, descriptive study collected data from parents across the UAE during the months of March and April 2024. The 60-item questionnaire included the Parental Attitudes towards Childhood Vaccines scale (PACV), the Vaccine Hesitancy Scale, and the Digital Vaccine Literacy (DVL) scale. Univariate, bivariate (chi-squared test), and multivariate (logistic regression) analyses were conducted. RESULTS: A total of 550 responses were retained. 84.55% of participants were female (n = 465/550), half were middle-aged (31-45 years old), and 21.09% (n = 116/550) were healthcare workers. 94.36% (n = 519/550) had their child/children receive all mandated vaccines. Only 39.82% (n = 219/550) found their level of knowledge about childhood vaccinations to be good/excellent. 70.11% (n = 386/550) of participants had high digital vaccine literacy. More than 95% had positive attitudes towards measles, meningitis, and pertussis vaccines. 14.00% (n = 77/550) were identified as vaccine-hesitant according to the PACV. Overall, using general practitioner/ paediatrician as a knowledge source, digital vaccine literacy, perceived children's vaccine knowledge, and nationality were associated with lower vaccine hesitancy status. CONCLUSION: Vaccine hesitancy exists and is prevalent in the UAE; however, the majority of participants reported high trust in vaccines, the local healthcare systems and physicians. Vaccine hesitancy can be tackled but will require tailored solutions and proactive healthcare workers.

Perception, Usability, and Satisfaction with Telemedicine in the United Arab Emirates.

Background: Telemedicine has become a global tool for enhancing health care accessibility. However, its widespread adoption is still limited by technological illiteracy, lack of appropriate devices, slow internet services, and privacy concerns. In the Middle East and North Africa, including the United Arab Emirates (UAE), there is a dearth of telemedicine research. This study aimed to understand the perceptions and satisfaction levels of the UAE population regarding telemedicine. Methods: Between June and September 2023, a cross-sectional study was undertaken, using an online questionnaire distributed among UAE citizens and residents aged 18 years and above. The survey aimed to gauge the perceptions, usability, and satisfaction levels of telemedicine users, alongside identifying barriers hindering its acceptance. Data analysis was performed using Python 3, using Matplotlib v3.3.4 and Pandas v1.2. Results: The data analysis encompassed 1,013 participants, among whom 66.9% (678/1,013) were familiar with telemedicine. From this group, 29.8% (202/678) had previously utilized it. Of these users, 92.3% (186/202) found it to be useful or highly useful, whereas 83.1% (168/202) expressed overall satisfaction with their telemedicine experience. Among those who had not used telemedicine (47%, 476/1,013), the predominant concerns were a preference for in-person health care consultations for better care (77%, 367/476) and uncertainty about the quality of care offered through telemedicine (62%, 296/476). Conclusions: Despite high awareness of telemedicine in the UAE, its actual usage remains limited, highlighting the necessity for increased promotional efforts. Nevertheless, positive feedback suggests considerable potential for broad adoption. Future studies should address participants' concerns to enhance telemedicine utilization in the region.

Contemporary Trends of Holmium Laser Enucleation of the Prostate Utilization in the United States: A Comprehensive Analysis Using the National Surgical Quality Improvement Program Database (2011-2020).

Introduction: The most recent American Urological Association (AUA) Guidelines advocated laser enucleation of the prostate (LEP) as a size-independent surgical option for benign prostatic hyperplasia (BPH). Despite its endorsement by AUA and the growing body of evidence supporting its safety and efficacy, the utilization of LEP remains limited in the United States. This study aimed to evaluate the utilization trends and perioperative outcomes of LEP compared with other surgical procedures used for BPH management. Methods: A retrospective cohort analysis was performed using American College of Surgeons National Surgical Quality Improvement Program data from 2011 to 2020. Patients undergoing prostatectomy for BPH were identified using specific current procedural terminology (CPT) codes. Baseline demographic data, preoperative risk factors, and postoperative outcomes were collected. Multivariable logistic regression was employed to assess predictors of holmium laser enucleation of the prostate (HoLEP) utilization and postoperative complications. Results: Out of 8,415,549 patients, 95,144 underwent prostatectomy for BPH. Procedures included HoLEP 5305 cases, transurethral resection of the prostate (TURP) 57,803 cases, repeated TURP (re-TURP) 5549 cases, photoselective vaporization of the prostate (PVP) 23,739 cases, and simple prostatectomy 2748 cases. HoLEP utilization showed a gradual increase, from 4.8% in 2015 to 7.6% in 2020. Multivariable regression revealed that HoLEP selection significantly increased from 2016 to 2020 (odds ratio [OR]: 1.251, p < 0.001), and there was less likelihood of HoLEP selection for African American patients (OR: 0.752, p < 0.001). HoLEP had significantly lower complication rates, including urinary tract infections, blood transfusions, 30-day readmission, and reoperation. Conclusion: Despite underutilization, the adoption of HoLEP has slightly increased since 2015, rising from 4.8% in 2015 to 7.6% in 2020. The underutilization could be attributed to a lack of availability and the steep learning curve.

Attitudes and practices to adult vaccination among physicians before and after COVID-19 pandemic in the United Arab Emirates.

Introduction: Vaccination remains underutilised worldwide with low vaccine uptake rates across the board with many adults remaining unprotected. Across the Arab world, attitudes towards vaccines vary but high rates of vaccine hesitancy have been found. This study aims to explore the adult vaccination attitudes and practices by physicians in the UAE, both before and after the introduction of the COVID-19 vaccines. Methodology: This cross-sectional, descriptive study used convenience and snowball sampling to collect comprehensive data from UAE physicians. A self-administered questionnaire was distributed in two stages: the first (pre-COVID-19 vaccines) between the months of June and October 2020 and the second between the months of November 2022 and March 2023. Results: 1000 responses, 500 from each time period, were collected. Nearly a third were family physicians or internists with more than 70% of the physicians working in governmental hospitals. 95% agreed that vaccines are safe in both cohorts but 74.4% reported not having enough time to advise about vaccines. 80.8% of physicians in the 2022 cohort reported safety concerns as the most common reason for patients to refuse vaccines. The most recommended vaccines were influenza (68.6%), Hepatitis B (66.0%) and HPV (61.4%), with pneumococcal coming in close at 57.8%. Family medicine physicians showed the highest utilisation of preventive practices across both cohorts. Nearly half of all family medicine physicians did not regularly evaluate both the influenza and general immunisation status of their patients. 54.6% of physicians reported having patients with VPDs in the last five years (not including COVID-19) in 2022. Conclusion: Physicians have overly positive attitudes, but their practices reflect a more superficial appreciation of vaccines and lack of initiative. Physicians need to adopt a pro-vaccine stance, armed with the proper tools and the right mentality and beliefs.

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

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

Emirati Adolescents' and Young Adults' Usage of Social Media for Health Information.

During the COVID-19 pandemic and in the years after, adolescents' and young adults' (AYAs) usage of social media increased. Social media has been shown to influence both the physical and mental behaviour of AYAs. The Emirates' AYAs are among the world's heaviest consumers of social media. This study aims to explore the usage of social media networks by AYAs for sharing and looking up health information, as well as interacting with local health systems, with a special focus on doctors and social media. This cross-sectional, descriptive study was used to collect comprehensive data from Arabic- and English-speaking Emirati students in grades 7 through 12 and university students between the months of December 2022 and April 2023. A total of 876 out of 930 responses were included. Of the responses, 27.71% were university students, with another 46.46% in grades 11 and 12. Three-fourths had a hospital or clinic visit in the last 6 months and 79.11% had good health perception. Smartphones were the most commonly used devices, at 92.12%. A total of 74.7% reported being able to obtain useful health information, with 40% having had a health decision influenced by it. Posting information on social media was not common, with only 32% posting such content (most commonly mood-related). Health information on social media by health authorities was considered the most trustworthy, with celebrities being the least trustworthy. More than half of AYAs searched for a physician before a visit, and the majority would not mind having a rash picture being posted on a public website if consent (verbal or written) was taken. Social media can influence the various health decisions an AYA might take and which doctors they might choose to see. Physicians should consider their presence and the content they present on social media carefully.

Assessing the Link between Diabetic Metabolic Dysregulation and Breast Cancer Progression.

Diabetes mellitus is a burdensome disease that affects various cellular functions through altered glucose metabolism. Several reports have linked diabetes to cancer development; however, the exact molecular mechanism of how diabetes-related traits contribute to cancer progression is not fully understood. The current study aimed to explore the molecular mechanism underlying the potential effect of hyperglycemia combined with hyperinsulinemia on the progression of breast cancer cells. To this end, gene dysregulation induced by the exposure of MCF7 breast cancer cells to hyperglycemia (HG), or a combination of hyperglycemia and hyperinsulinemia (HGI), was analyzed using a microarray gene expression assay. Hyperglycemia combined with hyperinsulinemia induced differential expression of 45 genes (greater than or equal to two-fold), which were not shared by other treatments. On the other hand, in silico analysis performed using a publicly available dataset (GEO: GSE150586) revealed differential upregulation of 15 genes in the breast tumor tissues of diabetic patients with breast cancer when compared with breast cancer patients with no diabetes. SLC26A11, ALDH1A3, MED20, PABPC4 and SCP2 were among the top upregulated genes in both microarray data and the in silico analysis. In conclusion, hyperglycemia combined with hyperinsulinemia caused a likely unique signature that contributes to acquiring more carcinogenic traits. Indeed, these findings might potentially add emphasis on how monitoring diabetes-related metabolic alteration as an adjunct to diabetes therapy is important in improving breast cancer outcomes. However, further detailed studies are required to decipher the role of the highlighted genes, in this study, in the pathogenesis of breast cancer in patients with a different glycemic index.

Breast cancer knowledge and practices amongst women in Algeria.

PURPOSE: The present study aims at investigating how Algerian women feel about Breast Cancer (BC) and Breast Self-Examination (BSE) in terms of knowledge and attitude and to determine the factors associated with performing BSE and its reluctance. METHODS: We carried out a cross-sectional survey between October 14, 2021 and November 14, 2022, targeting Algerian females aged more than 18 years and living in the country using a self-administered questionnaire. RESULTS: A total of 436 participants were involved in this study among which 41.28% were aged between 21 and 30 years and 34.86% were aged between 31 and 40 years. The average level of correct responses with regard to knowledge about BC was estimated at 51.31%, whereas it was 32.93% concerning knowledge about BC risk factors. Family history was the less reported incriminating factor for developing BC among the asked women (7.34%). Concerning alarming signs of BC, the current study revealed that Algerian women were less knowledgeable about breast dimpling-puckering (44.27%), breast inward traction (50.23%), breast redness (54.13%), and nipple position change (54.13%). In terms of belief in the utility of BSE in the early detection of BC, almost all the participants (97.98%) were convinced of its utility, whereas 96.33% of them showed an interest in learning more about it. In what concerns the early screening tests, approximately, four-fifth of the participant (77.52%) heard about them, while 94.72% believed that its early detection could reduce the disease's severity and mortality. CONCLUSION: These findings revealed an insufficient level of knowledge concerning BC, especially in regard to its risk factors and some alarming signs as well as a lack of knowledge about BSE and other BC screening tests; hence the necessity of awareness campaigns about this disease that should target categories with the lowest level of knowledge.

The Usage and Trustworthiness of Various Health Information Sources in the United Arab Emirates: An Online National Cross-Sectional Survey.

Background: The increase in the quality and availability of health information as well as the accessibility of Internet-based sources, has driven growing demand for online health information. Information preferences are influenced by many factors, including information needs, intentions, trustworthiness, and socioeconomic variables. Hence, understanding the interplay of these factors helps stakeholders provide current and relevant health information sources to assist consumers in assessing their healthcare options and making informed medical decisions. Aims: To assess the different sources of health information sought by the UAE population and to investigate the level of trustworthiness of each source. Methods: The study adopted a descriptive online cross-sectional design. A self-administered questionnaire was used to collect data from UAE residents aged 18 years or above between July 2021 and September 2021. Health information sources, their trustworthiness, and health-oriented beliefs were explored through univariate, bivariate, and multivariate analysis in Python. Results: A total of 1083 responses were collected, out of which 683 (63%) were females. Doctors were the first source of health information (67.41%) before COVID-19, whereas websites were the first source (67.22%) during the pandemic. Other sources, such as pharmacists, social media, and friends and family, were not prioritized as primary sources. Overall, doctors had a high trustworthiness of 82.73%, followed by pharmacists with a high trustworthiness of 59.8%. The Internet had a partial trustworthiness of 58.4%. Social media and friends and family had a low trustworthiness of 32.78% and 23.73%, respectively. Age, marital status, occupation, and degree obtained were all significant predictors of Internet usage for health information. Conclusions: The population in the UAE commonly obtains health information from doctors who have been shown to have the highest trustworthiness; this is despite it not being the most common source used.

COVID-19 Breakthrough Infection Among Vaccinated Population in the United Arab Emirates.

BACKGROUND: Despite significant efforts to contain the Coronavirus Disease 2019 (COVID-19) pandemic through mass vaccination, numerous nations throughout the world have recorded breakout infections. The incidence and severity of COVID-19 breakthrough infections in the United Arab Emirates (UAE) remain unknown despite extensive COVID-19 vaccine coverage. The goal of this research is to establish the characteristics of COVID-19 breakthrough infections in the UAE's vaccinated population. METHODS: Between February and March 2022, we conducted a descriptive cross-sectional study in the UAE with 1533 participants to examine the characteristics of COVID-19 breakthrough infection among the vaccinated population. RESULTS: The vaccination coverage was 97.97%, and the COVID-19 breakthrough infection rate was 32.1%, requiring hospitalization in 7.7% of cases. The bulk of the 492 COVID-19 breakthrough infections reported was among young adults (67%), with the majority experiencing mild to moderate symptoms (70.7%) or remaining asymptomatic (21.5%). CONCLUSIONS: COVID-19 breakthrough infection were reported in younger age, male sex, non-healthcare professions, vaccination with inactivated whole virus vaccine (Sinopharm), and not receiving a booster dose. Information on breakthrough infection in the UAE might influence public health decisions and motivate measures such as providing additional booster doses of the vaccines to the people.

Knowledge and Awareness of Algerian Students about Cervical Cancer, HPV and HPV Vaccines: A Cross-Sectional Study.

Cervical cancer is one of the most recurrent and dangerous female cancers in Algeria and worldwide. It is mainly caused by human papillomaviruses (HPV), which can induce other cancers as well. Although it can be fatal, cervical cancer is one of the most preventable and manageable cancers. While HPV vaccination is the key weapon to win the battle against this pathology, it is still not approved in Algeria. Therefore, we set up a cross-sectional survey to assess the knowledge and awareness of students from Algerian universities concerning cervical cancer and HPV and to understand their attitudes towards HPV vaccination. The results reveal that, out of 715 students, the majority of students were aware of cervical cancer (84.6%). However, only 46.2% of students had heard about HPV. Furthermore, willingness to get the HPV vaccine was estimated at 26.7% among students with prior knowledge of HPV, and 21.5% of these students claimed to be willing to pay to get the HPV vaccine if available. Nevertheless, HPV vaccine hesitancy was estimated at 37.5% among the students aware of HPV. The main causes of HPV vaccine reluctance were: complacency (30.6%), refusal of vaccination in general (20.2%) and belief in the rarity of HPV-induced infections in Algeria (19.4%). Moreover, the embrace of vaccine conspiracy beliefs among students were significantly related with their HPV vaccine rejection. Overall, these findings encourage the establishment of a social education policy concerning the fight against HPV-induced cancers, particularly that of the cervix, and the implementation of a national HPV vaccination program targeting young people.

Adult Vaccination in the United Arab Emirates-A Physicians' Knowledge and Knowledge Sources Study.

Background: A lack of knowledge on adult vaccination has been documented among physicians. They play a critical role in promoting adult vaccines. This study aimed to review the status of adult vaccination in the United Arab Emirates (UAE) and evaluate physicians' knowledge and knowledge sources regarding adult vaccines. Methods: Local, regional, and global adult vaccination guidelines were reviewed. A 40-item questionnaire was used to collect data from physicians from June to October 2020, using convenience and snowball sampling. Knowledge score was calculated, and predictors identified using Mann-Whitney U and Kruskal-Wallis H-tests. Ordinary Least Squares regression was used for Multivariate Analysis. Results: A total of 500 responses were included. A quarter were internists, and another quarter were family physicians. Fifty-seven percent were medical interns and residents. Both perceived and actual knowledge of adult vaccination were low. Bivariate analysis showed knowledge depending on department, level of training, workplace, and perceived knowledge. All remained significant after multivariable regression except workplace. International and local guidelines were the most common knowledge sources. Forty-two percent were unable to access the local guidelines. Conclusions: Physicians' knowledge was poor and local guidelines were not clear or easily accessible. Participants were highly receptive to guidance and practice with adult vaccines.

XIST in Brain Cancer.

Long non-coding RNAs (lncRNAs) make up the majority of the human genome. They are a group of small RNA molecules that do not code for any proteins but play a primary role in regulating a variety of physiological and pathological processes. X-inactive specific transcript (XIST), one of the first lncRNAs to be discovered, is chiefly responsible for X chromosome inactivation: an evolutionary process of dosage compensation between the sex chromosomes of males and females. Recent studies show that XIST plays a pathophysiological role in the development and prognosis of brain tumors, a heterogeneous group of neoplasms that cause significant morbidity and mortality. In this review, we explore recent advancements in the role of XIST in migration, proliferation, angiogenesis, chemoresistance, and evasion of apoptosis in different types of brain tumors, with particular emphasis on gliomas.

Hepatitis A virus knowledge and immunization attitudes and practices in the United Arab Emirates community.

Annually, 1.5 million cases of hepatitis A infection occur worldwide. The United Arab Emirates (U.A.E.) has seen a decrease in infection rates and seroprevalence coupled with an increase in the average age of infection. This study aimed to assess the U.A.E. society's hepatitis A knowledge, and attitudes and vaccination practices, with the applicability of its introduction into the local immunization schedule. A self-administered, 50-item questionnaire was used to collect data from the four most populous cities in the U.A.E., between January and March 2020. A total of 458 responses were collected and analysed using IBM-SPSS-26, R-4.0.0 and Matplotlib-v3.2.1. Females had better attitudes (P = 0.036), practices (P < 0.0005), immunization schedule knowledge (AOR = 3.019; CI 1.482-6.678), and appreciation of the immunization schedule (AOR = 2.141; CI 1.310-3.499). A higher level of perceived knowledge was associated with an actual better knowledge (P < 0.0005), better practices (P = 0.011), and increased willingness to get vaccinated (AOR = 1.988; CI 1.032-3.828). Respondents were more likely to vaccinate their children against HAV if the vaccine were introduced into the National Immunization Program (P < 0.0005). Overall, disease knowledge was lacking but with positive attitudes and poor practices. There is high trust in the National Immunization Program and a potential for improving poor practices through local awareness campaigns.

GLIMPSE: a glioblastoma prognostication model using ensemble learning-a surveillance, epidemiology, and end results study.

PURPOSE: Glioblastoma is one of the most common and aggressive brain tumors in the world with a poor prognosis. A glioblastoma prognostication model has the potential to improve the cancer's standard of care. No other paper has looked at using ensemble learning with a population database to predict multiple binary glioblastoma survival outcomes. METHODS: We utilized ensemble learning to design, build, and test a prognostication system for glioblastoma for short-, intermediate- and long-term survival, based on various clinical features. We used the population database SEER which covers 17 different registries. The most important prognostic features were identified and used as a clinical feature set. The statistical feature set was determined using Random Forests. The accuracy, sensitivity, specificity, area under the receiver operating characteristic (AUROC), positive predictive value (PPV), and negative predictive value (NPV) were reported. RESULTS: Statistically-determined feature sets had the best performance. All the top models for short, intermediate, and long-term survival were random forests. With regards to short-term survival, top model had metrics AUROC = 0.937, accuracy = 86%, specificity = 88%, sensitivity = 85%, NPV = 85%, and PPV = 87%. For long-term survival, the top model had AUROC = 0.893, accuracy = 81%, specificity = 79%, sensitivity = 83%, NPV = 82%, and PPV = 79%. The top intermediate-term survival prediction had AUROC ≥ 0.780 and the other metrics were at least 70%. CONCLUSIONS: Our ensemble models were high-performing and achieved AUROCs as high as 0.94, highlighting the importance of balancing, using ensemble techniques and statistical feature selection. Our models can potentially be used by clinicians after external validation.