Journal articles on the topic 'Tribes – Kuwait'

This study examines the socio-cultural spaces of the two major groups in Kuwait: the Hadhar and Badu. These groups are not an ethnic classification but are rooted in their historic settlements. The Hadhar refer to people who lived in old Kuwait town and were mostly merchants and artisans who made their living from the sea. The Badu on the other hand, most commonly referred to as Bedouins, are nomadic tribes who lived on the outskirts of old Kuwait town or in the Arabian Desert. This study employs cognitive maps to reveal fascinating insights into the lifestyles and cultural differences of these two groups as it relates to their domestic built environment. This study argues that house spatial organization is tightly coupled with a family’s socio-cultural traditions and values; hence, there are major spatial distinctions between the houses of the Hadhar and Badu. These differences are apparent in the houses’ main spaces such as the living hall, male guest reception space or diwaniya, and main entrance. This paper also contends that these differences are rooted historically in the traditional Hadhar mud brick courtyard houses and the traditional Badu Arabian tents. Although the oil boom and consequent impact of globalization transformed Kuwait’s houses into modern villas, on the inside they are still linked to each group’s traditional use of space.

Information and technological skills instruction has been a lingering challenge for librarians and information professionals. Even though undergraduate incoming students to colleges and universities are a technology-savvy generation, evaluation of their Information Literacy (IL) and Technology Literacy (TL) skills might reveal a different situation. This research evaluates the familiarity and skills of the incoming class of undergraduate students of the College of Social Sciences at Kuwait University with Internet and other Social Media Networks (SMN). It seeks to investigate the relation to the educational background of the family and tries to ascertain the uses and means of accessing Internet and its various tools and practical implications on librarianship and the undergraduate curriculum.

Purpose The purpose of this paper is to understand the pervasiveness of mobile devices in ubiquitous access of information. Moreover, the study tries to ascertain the growing demands of mobile devices in library settings. Design/methodology/approach A survey was administered to gain in-depth information regarding the use of mobile devices and their use in information access. Further, it investigated the general uses of mobile devices in day to day life. The survey also contained some questions aimed at obtaining more comprehensive information about the impediments faced by the students in library settings and the way out. Findings The study highlights the rapid growth of mobile device usage among students at the College of Basic Education, Public authority for Applied Education and Training, Kuwait, and indicates the urgent need of libraries to the embrace mobile web. Originality/value The use of mobile devices in comfort zones demands libraries to disseminate information anytime, anywhere. This study examines the academic library users’ insistence for such services and the competence of libraries to provide services “on the go”.

This study aims to investigate the sort of cultural content that is being taught in CBE, Kuwaiti EFL teachers’ views and opinions towards teaching a foreign culture in their classrooms at the College of Basic Education, and their strategies when they encounter socially inappropriate subjects or practices in their textbook, Empower B1+. Particularly, it tries to explore three research questions: (a) what sort of cultural content is being taught in EFL classrooms in the College of Basic Education? (b) What are the views and opinions of Kuwaiti EFL teachers at the College of Basic Education towards teaching a foreign culture (native or international) in their EFL textbooks with special reference to the cultural content of the textbook Empower B1+? (c) What are the strategies used by Kuwaiti EFL teachers when they encounter teaching inappropriate subjects or items? The data was collected by means of a questionnaire of 7 questions distributed to 25 randomly selected Kuwaiti EFL teachers working in CBE. The questionnaire had a rating scale of three (agree, not sure, and disagree) for all questions except for questions 1 and 4, where participants had to choose the appropriate answer of 3 sentences. The questionnaire was followed by a semi-structured interview for 10 Kuwaiti EFL teachers to get detailed and in-depth answers for question 3 of the research questions and to further discuss the other two questions. After the data analyses were carried out, the results revealed that the cultural content being taught in CBE is a mixed culture (native speaker and international cultures). The findings also showed that the vast majority of EFL teachers had positive views and opinions towards the teaching of a foreign culture in their classrooms with the condition of careful selection. In terms of encountering the socially inappropriate texts or items in the textbook Empower B1+, the results of the interviews showed that most of the EFL teachers preferred to skip such articles; a few were ready to discuss them, but only in boys’ classes.

Environmental damages caused by Iraqi occupation of Kuwait and its aftermath are to be assessed through the compensation system created by the UN Security Council. The UN Compensation Commission (‘UNCC’) has scheduled its first decision on environmental claims for the summer of 2001. These claims, however, deserve a particular treatment by the UNCC: problems related to the law applicable, the principle of due process, the principle of causal link, the assessment of damage, the identification of injured subjects, and the type of compensation are particularly addressed in the following pages. Keeping in mind the ‘precedent-setting procedure’ used by the UNCC, this article tries to explore previous applicable precedents, ordering them into a structured ‘legal’ framework and exposing existing gaps, if any.

Purpose The purpose of this paper is to examine the extent to which perceived servant leadership of the supervisors impacts the intrinsic and extrinsic job satisfaction of the followers. Design/methodology/approach Servant leadership factor structure was evaluated by applying Liden et al.’s (2008) measure, and used the second-order model to test its relationship with the intrinsic and extrinsic job satisfaction. Confirmatory factor analysis and structural equation modeling were used to test data from 205 individuals working in service-sector organizations in Kuwait. Findings The seven-factor structure proposed by Liden et al. (2008) holds valid in this sample, thus providing greater validity for this measure to be used in similar contexts. The results also indicate that second-order factor of servant leadership positively affects both intrinsic and extrinsic job satisfaction. Research limitations/implications Servant leadership was measured using follower perception of their leader attributes. Next, the cross-sectional data limit the ability to demonstrate causality between servant leadership and employee satisfaction. Further, data were collected only from service-sector organizations in Kuwait, which limits the generalizability of results. Practical implications This research helps in highlighting the significance of embracing more altruistic leadership approach in enhancing job satisfaction. Leaders in the analyzed region must be aware of the positive outcomes of this approach on job satisfaction, which can eventually contribute to engaged employees and their performance. Originality/value This research tries to add to the growing body of knowledge in terms of assessing relationship between servant leadership and job satisfaction in the service sector in the Middle East.

The eight species in five genera belonging to the tribe Serrolecaniini recorded from China are discussed, including a newspecies Serrolecanium ferrisi Wu & Lu (previously misidentified as S. tobai (Kuwana) or S. indocalamus Wu) and a newcountry record for Serrolecanium kawaii Hendricks & Kosztarab. A key to species belonging to the tribe Serrolecaniini now known from China is included and illustrations are provided to the adult female of all species found in China.

The purpose of this study is to discuss the vagueness in multiple wh_questions in the spoken Kuwaiti Arabic (KA) in order to sharpen it up in some way. This study tries to provide a basic analysis for the construction of this process in KA. Some differences in the syntax and structure of other languages are mentioned to highlight the differences between them. Furthermore, this study provides some piece of evidence to support the claim of how the multiple wh_ questions are structured in KA and what constrains govern them. The study concluded with some recommendations including more researches in the different aspects of the KA syntax.

Although the countries in the present world are staying away from formal wars like that of the First and the Second World Wars, still there has been persistence of informal wars among countries. The countries are now observed to be investing upon defence items in a larger way. The so-called backward countries are coming in a strong way in terms of increasing defence outlays and trying to catch up with the advanced countries in possessing military items. The present article, thus, tries to study whether the countries are converging in terms of per capita military expenses across a selection of 45 countries for the period 1988–2013. It reveals that there are absolute β and σ convergence among the countries with Kuwait and South Africa as outlier countries. It also observes conditional β convergence among the countries with various resources, particularly, crude oil production, regional dummies and time trend as significant conditional variables. JEL: H56, O47, C13, O50

Purpose – The purpose of this paper is to reveal the cover of research regarding Mosque Speechmakers (MSs) in the Arabic environment. The researcher tries to investigate the information-seeking behaviour of MSs in the State of Kuwait in terms of their thoughts, approaches, habits, preferences, tools and problems met when using of and accessing information. Design/methodology/approach – The author employed a questionnaire, with a response rate 70.6 per cent (561/795). Findings – The findings of the study revealed that most of MSs in Kuwait tend to be older (aged over 35 years), educated (mostly with BA degrees) and with an average monthly income over 300 KD ($1000 = 282 KD). The study showed that MSs were significantly seeking information to make a specific/general research, to collect necessary statistics, to make a speech/sermon and to present religious sermons/lectures. They preferred to use the home/personal library as well as the special library, specifically the Mosque library. The information-seeking behaviour of a large number of them indicated a preference for printed sources over electronic sources, and a good number preferred to access information through the audio-visual materials as well as the web. A very small number of them were looking for information for the purpose of making a speech (Friday speech/sermon). The study also showed that the most important sources of information MSs were seeking for were biographies, specialised books, particularly Islamic books, mass media (press, TV, videos, etc.). The study also showed that a large number of MSs were poor in the usage of foreign languages, and this in turn has negatively affected to take advantage of the vast information available in these languages. The unpretentious role of the library to deliver requested information, the use of foreign languages as well as the high cost of information were the most significant problems met by MSs when using of and accessing information. Research limitations/implications – This paper investigates the topic of MSs’ use of and access to information. This topic, unfortunately, has limited previous research, especially in the Arabic and Islamic environment. Practical implications – The paper provides valuable insight into the information behaviour of a very important client group, namely, MSs. Originality/value – Being the second one of its type throughout the Arab world, this study is characterised to be a distinguishing one among several studies conducted in the area of the information-seeking behaviour, especially with such a significant group of information users/seekers. Any findings resulted from this study may help in a better understanding of the MSs’ information-seeking behaviour, and may also help policy and decision-makers (Mosques and Islamic institutions) as well as religious information service providers to understand well the nature of these beneficiaries of information sources and to enrich the awareness of researchers and professionals on the topic of information-seeking behaviour of Mosque speechmakers.

e16511 Background: Gastric adenocarcinoma still have dismal outcome in spite of the progress made in systemic treatment in last 2 decades. In localized disease, treatment outcome still suboptimal, with up to 88% suffer from recurrence/metastasis. Hence, improvement in radical initial treatment is mandatory. Recent trials showed survival benefit of adding radiotherapy (preoperative or adjuvant) with favorable toxicity profile when using current advances radiation techniques. Methods: We retrospectively analyzed impact of radiotherapy in management of localized gastric cancer in Kuwait. 87 adult patients with newly diagnosed gastric cancers were treated and followed up at Kuwait Cancer Control Center (KCCC) between 2009-2015, 12 were excluded due to inoperability. 13 patients were excluded as they had early disease and underwent only surgery. Finally, 62 patients were submitted in study 48 patient received radiotherapy (RT group) as part of treatment (44 postoperative, 3 postoperative after induction Chemotherapy, 1 preoperative). 14 patients did not receive radiotherapy (NRT group); five received perioperative chemotherapy, nine received postoperative chemotherapy). Survival analysis was done using Kaplan-Meier, and comparison was done according to clinicopathological features. Results: The median age at diagnosis was 55 (range 25-70). Men represented 65.5%. Asian were 17 patients and Caucasian were 70 patients. 68.9% were nonsmoker while 31% were smoker. Median follow up was 45 months (1-89). 2 year Overall survival in the NRT group was 50% while in RT group was 79.1%. 3 year OAS was 42.8% and 64.5% in NRT group and RT group respectively. Median overall survival for NRT group was 82 months. While for the RT group median survival was not reached at time of analysis with p value (0.025). 2 year DFS in NRT group was 50% while in RT group was 66.6%. 3 year DFS was 42.8% and 54.1% in NRT group and RT group respectively. Median DFS not reached in both groups p value (0.04). On correlation of prognostic clinicopathological features with benefits of adding radiotherapy it was noticed that high grade, positive margins statistically benefit more from local radiotherapy and had better local control. Distal tumours behave badly whether received radiotherapy or not. Interestingly benefit of adding radiotherapy was not significantly affected by nodal status. Conclusions: Radiotherapy should be part of management in postoperative locally advanced gastric cancer especially with high grade tumours and positive margins. However still ongoing trials to clear the role of radiotherapy in preoperative setting.

This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper IPTC 21441, “First-Time Worldwide Application of Glass-Reinforced Epoxy-Lined Tubing for Prevention of Asphaltene Deposition in Tubing in Oil Wells: A Case Study From Kuwait,” by Reji E. Chinnappan, SPE, Milan Telang, SPE, and Riyad Quttainah, SPE, Kuwait Oil Company, et al., prepared for presentation at the virtual 2021 International Petroleum Technology Conference, 23 March–1 April. The paper has not been peer reviewed. Copyright 2021 International Petroleum Technology Conference. Reproduced by permission. Asphaltene deposition in production tubing represents a major flow-assurance challenge. Common strategies to mitigate asphaltene deposition downhole include mechanical or solvent cleanouts and chemical inhibition. These are associated with production deferment, high job costs, safety and environmental risks, and operational issues. An operator has addressed this challenge using production tubing lined with glass-fiber-reinforced epoxy (GRE). This technology was implemented in two trial wells. The paper describes the different mitigation strategies employed by the operator and presents the findings of successful trials. Background Jurassic wells of a Kuwait Oil Company asset are producing light crude from a tight matrix-type reservoir located at a depth of 13,000–15,000 ft. Reservoir pressure has depleted from approximately 9,500–10,000 psi to approximately 6,000 psi because of sustained production in the absence of any significant pressure support. Oil production rates per well have diminished to the 500- to 1,000-BOPD range. The oil features high asphaltene onset pressures (4,000–5,000 psi). When considering time-lapse plots of caliper logs from a well where asphaltene deposition used to occur, the plot indicates that significant asphaltene deposition in the well took place below 4,500 ft and progressively increased over time. In approximately 5 months, the average internal diameter of the tubing reduced from 2.75 in. to less than 2 in., thereby constricting the flow significantly and requiring cleaning of the tubing. In extreme cases, the tubing string could be fully plugged. Many field trials with different tools and chemicals using batch and continuous treatment have been conducted in past years to solve this problem but without satisfactory results. Application of GRE-Lined Tubing for Asphaltene Control The operator decided to apply a novel strategy of using tubing internally lined with GRE based on its established ability to retard, and even eliminate, scale nucleation and deposition. The technology uses a thin-walled, solid-filament-wound GRE/fiberglass tube run inside carbon steel production tubing. Cement is pumped into the annulus between the steel tubing and the GRE liner. The ability to prevent asphaltene from sticking to the inner wall of the tubing is attributed to the smoother internal surface. It is also corroborated by a higher Hazen Williams coefficient value of 150 for GRE as compared with 110 for carbon steel pipe, which provides for lesser frictional pressure loss during flow. The GRE liners used by the operator have a surface roughness of 0.00011 in., which, unlike bare steel, is retained over the life of the GRE. The GRE-lined tubing proved to withstand temperatures of up to 280°F and hydrogen sulfide concentrations of up to 50%. This is comfortably more than the process conditions for the trial wells in consideration.

Introduction: AML is a malignant clonal disease that affects mainly the elderly [1]. Data on younger populations, particularly from the Middle East is scarce. The aim of this retrospective study is to investigate the risk factors that are associated with lower survival, particularly when applying the European Leukemia Network (ELN) prognostic scheme [2].Methods: Overall survival (OS) was calculated from the date of diagnosis until the date of death from any cause. Kaplan-Meier curves were plotted to evaluate OS [3]. Log Rank test was used to assess the statistical significance of our findings. Results: This study included 231 AML cases, with a median age of 47 years, ranging from 16 to 96 years of age. The majority of the cases are young (20-39: 35.1%; 40-59: 37.7%). Females accounted for 48.5% of all cases (table 1). Cases were assigned to a risk group based on the ELN risk stratification scheme (table 1). Accordingly, 86 (37.2%) cases were assigned to the favorable group, 104 (45.0%) patients were in the intermediate group, and 41 (17.8%) enrollees were in the adverse group. Among the 154 cases with a normal cytogenetic profile, 32 cases were FLT3 positive/dominant, 19 patients tested positive for NPM1 only, and 103 enrollees were negative for both mutations. Figure 1 shows the negative impact of a positive/dominant FLT3 mutational status on OS, with a median survival time of 10 months (95% CI: 1.44 - 18.56). The other groups have not reached their median survival. Figure 2 illustrates that those who are among the ELN adverse group fared the worst in terms of OS, with a median survival of 11 months (95% CI: 0.00-22.31). Additionally, the median survival of the intermediate risk groups is 30 months (95% CI: 14.61 - 45.39). The favorable risk group has not reached its median survival. Conclusion: This retrospective study confirms the impact of the ELN risk categories, and the detrimental effects of FLT3 mutation on OS among AML cases. Currently, FLT3 inhibitors have been shown to improve leukemia free survival in those who are mutated at presentation, as well as at the time of relapse [4, 5]. Alternative strategies that are less toxic but more effective are needed to improve the survival of older patients. ELN risk-grouping is robust in our cohort of younger cases , and can be used to guide the choice of intensive treatment, particularly for bone marrow transplantation or enrollment into clinical trials. References 1. Arber, D.A., et al.,The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia.Blood, 2016.127(20): p. 2391-405. 2. Döhner, H., et al.,Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel.Blood, 2017.129(4): p. 424-447. 3. Altman, D.G. and J.M. Bland,Time to event (survival) data.Bmj, 1998.317(7156): p. 468-469. 4. Perl, A.E., et al.,Gilteritinib or chemotherapy for relapsed or refractory FLT3-mutated AML.New England Journal of Medicine, 2019.381(18): p. 1728-1740. 5. Levis, M.,Midostaurin approved for FLT3-mutated AML.Blood, The Journal of the American Society of Hematology, 2017.129(26): p. 3403-3406. Disclosures Pandita: Novartis:Honoraria;Pfizer:Honoraria;Amgen:Honoraria;AstraZeneca:Honoraria;Takeda:Honoraria;Jansen:Honoraria;Cilag:Honoraria.

Background: Fragility fractures are common due to osteoporosis and there is very limited data on hip fractures from the Middle East in general and Kingdom of Bahrain in particular. The aim of this paper is to review the published data of femoral fractures in the Middle East and extrapolate the financial burden of osteoporosis related hip fractures in Bahrain and suggest some course of action for the region in controlling the fragility fractures. Methods: An extensive search was performed on published studies on hip fracture from 1990 to 2020 by a Medline, EMBASE the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews and the Science Citation Index, Bahrain Medical Bulletin, Qatar Medical J, Oman with the key words: Osteoporosis, osteopenia, fragility hip fractures. The inclusion criterion was studies published during 1990-2020 describing the prevalence of osteoporosis and proximal hip fractures in patients with ≥50 years, from the Kingdom of Bahrain, Saudi Arabia, State of Kuwait, Sultanate of Oman, United Arab Emirates, State of Kuwait, Iraq, Iran, Turkey and the State Hashemite Kingdom of Jordan. Based on the fractures per 1000, an average was taken and extrapolated for the Kingdom of Bahrain and direct and indirect costs were assessed. Results: A total of 19 studies were selected for analysis from 10 countries. The average prevalence of postmenopausal osteoporosis was 29.37±6.97% (Range 20.2 to 38.5). In these 10 countries, 252.411 million people live, with an average of 28.56% suffering from osteoporosis. A total of 72.088 million are at risk of having a fragility fracture. The prevalence of fragility fractures of the proximal femur in six countries means prevalence is 4.41/1000. With this average, it is extrapolated that femoral fractures due to osteoporosis costs Bahrain yearly a total of BD 5.31 million. Conclusion: The prevalence of Osteoporosis is going to increase in Bahrain as the population is aging. This will further increase the economic impact of taking care of elderly patients with osteoporosis and related fractures. Early intervention to diagnose and treat this aging population will reduce the cost and save lives.

We provide species lists and geographical occurrence records of the beetle family Passalidae for three subregions of the department of Sucre, northern Colombia. The sampling localities are lowland environments with typical tropical dry forest vegetation. We selected 15 sampling sites and examined decomposing trunks. We record seven species, four genera, and two tribes of Passalidae. The most abundant species were Passalus punctiger Lepeletier & Serville, 1825, P. interstitialis Eschscholtz, 1829, and P. interruptus (Linnaeus, 1758). We also provide new records for Passalus punctatostriatus Percheron, 1835, Paxillus leachi MacLeay, 1819, and Popilius marginatus (Percheron, 1835) in the department of Sucre. Veturius aspina Kuwert, 1898 was present only in the localities with well-preserved forests. Finally, the species number recorded in this study is low compared to other inventories in Neotropical regions.

AbstractObjectiveThe present study aimed to model obesity trends and future obesity-related disease for nine countries in the Middle East; in addition, to explore how hypothetical reductions in population obesity levels could ameliorate anticipated disease burdens.DesignA regression analysis of cross-sectional data v. BMI showed age- and sex-specific BMI trends, which fed into a micro simulation with a million Monte Carlo trials for each country. We also examined two alternative scenarios where population BMI was reduced by 1 % and 5 %.SettingStatistical modelling of obesity trends was carried out in nine Middle East countries (Bahrain, Egypt, Iran, Jordan, Kuwait, Lebanon, Oman, Saudi Arabia and Turkey).SubjectsBMI data along with disease incidence, mortality and survival data from national and sub-national data sets were used for the modelling process.ResultsHigh rates of overweight and obesity increased in both men and women in most countries. The burden of incident type 2 diabetes, CHD and stroke would be moderated with even small reductions in obesity levels.ConclusionsObesity is a growing problem in the Middle East which requires government action on the primary prevention of obesity. The present results are important for policy makers to know the effectiveness of obesity interventions on future disease burden.

This paper attempts to examine in a descriptive way the pioneering model of “World Englishes” proposed by Kachru in the mid-1980s that allocates the presence of English into three concentric circles: The Inner Circle, the Outer Circle, and the Expanding Circle. The Inner Circle presents the countries where English is used as a native language and as a first language among people. These countries include the USA, the UK, Canada, Australia, and New Zealand. The Outer Circle includes countries that have old historical British colonial relations and where English is commonly used in social life or the government sectors. Most of the countries that belong to this circle are former colonies of the British Empire, such as India, Malaysia, Singapore, Ghana, Kenya, and others. The usage of English in these countries is similar to what is known as English as a second language. The third circle, The Expanding Circle, includes countries that introduce English as a foreign language in schools and universities, mostly for communicating in English with the Inner and Outer Circles. Such countries include Turkey, Saudi Arabia, The Emirates, Japan, China, Korea, and others. Since its first introduction in 1985, Kachru's Three Concentric Circles Model of English Language has occasioned a great debate. Many linguists considered it one of the most influential models for understanding the use of English in different countries. Some, on the other hand, including Kachru himself, criticized the model for its oversimplification and the unclear membership to the circles. In addition to an overview of criticism on Kachru's model based on different studies, this paper tries to locate the place of ELT in Kuwait among the three circles.

The novel of MEN IN THE SUN by Ghassan Kanafani reflects the Palestinian cause, the 1948 catastrophe and its impact on the Palestinian people through Palestinian men of different generations who tell their story in a wonderful symbolic way. The novelist reflected the issue through the characters, as each character in the novel symbolizes a certain personality of his people. The story is the story of three men who decide to emigrate from Palestine to Kuwait illegally for their desire to improve their living conditions. The novel ends with the death of the three men suffocating for fear of beating the walls of the tank. This study is an attempt to examine the symbolism in Men in the Sun and its significance and the deep meaning behind the literal meaning of these symbols. The study tries to examine the basic symbol of the story "the walls of the tank are not pounded", as these three men die suffocating in the tank, without any of them daring to knock the walls of the tank for help. The symbolism of the non-knocking of the walls indicates the legitimate cry of the Palestinian people conflict, who have suffered from displacement. Other symbols in the novel are also analyzed to show how the writer used them for artistic and political purposes.

In this paper, test results are presented from laboratory trials of blending discarded tire derived crumb rubber with 60/70pen grade Kuwaiti bitumen. The virgin bitumen, in addition to 15% and 18% crumb rubber blends were tested for PG grading and multiple stress creep recovery at temperatures in the range from 40°C to 70°C. Elastic recovery and nonrecoverable creep compliance showed optimum performance at 18% rubber content. The optimized rubberized-bitumen blend was next converted into a pelletized form which was then used as a partial substitute to the conventional bitumen in the manufacture of continuously graded hot mix asphalts at various binder contents. The rubberized-bitumen pellet contents trialed were 2.5%, 3.0% and 3.5% by mass of mix. The Marshall method of mix design was used to assess the various mixes and the overall volumetric, stability and flow results, though satisfactory, was not entirely sufficient to aid in the selection of the best performing formulation.

AbstractObjective:Assess the effectiveness of iron-fortified flour on iron status.Design:Systematic review and meta-analysis.Setting:Argentina, Australia, Azerbaijan, Bangladesh, Brazil, Cameroon, Chile, China, Costa Rica, Côte d’Ivoire, Denmark, India, Iran, Jordan, Kazakhstan, Kenya, Kuwait, Mongolia, Morocco, Norway, South Africa, Sri Lanka, Tajikistan, Thailand, UK, USA, Uzbekistan, Venezuela, Vietnam, and Zambia.Participants:Fifty-two articles (ninety-four trials) were examined. The main target groups were women, children, and infants/toddlers. The effects of different types of iron-fortified flour (wheat, maize, rice, soy, and beans) on iron status were examined.Results:A random effects analysis of before–after studies showed that iron-fortified flour led to significant increases of mean haemoglobin level (3·360 g/l; 95 % CI: 0·980, 5·730) and mean serum ferritin level (4·518 µg/l; 95 % CI: 2·367, 6·669); significant decreases of anaemia (−6·7 %; 95 % CI: −9·8 %, −3·6 %) and iron deficiency (ID) (−10·4 %; 95 % CI: −14·3 %, −6·5 %); but had no significant effect on iron deficiency anaemia (IDA). A random effects analysis of controlled trials indicated that iron-fortified flour led to significant increases of mean haemoglobin level (2·630 g/l; 95 % CI: 1·310, 3·950) and mean ferritin level (8·544 µg/l; 95 % CI: 6·767, 10·320); and significant decreases of anaemia (−8·1 %; 95 % CI: −11·7 %, −4·4 %), ID (−12·0 %; 95 % CI: −18·9 %, −5·1 %), and IDA (−20·9 %; 95 % CI: −38·4 %, −3·4 %).Conclusions:Flour fortification with iron is an effective public health strategy that improves iron status of populations worldwide.

Objectives: Countries in the Gulf Cooperation Council (GCC) have some of the highest prevalence rates of diabetes mellitus (DM) in the world; however, DM-related research activity in this region is limited. This study aimed to examine trends in published diabetic foot disease (DFD) research undertaken in GCC countries. Methods: This bibliometric study was conducted in December 2016. Standardised criteria were used to search the MEDLINE® database (National Library of Medicine, Bethesda, Maryland, USA) for DFD-related publications authored by GCC researchers between January 1990 and December 2015. Various details such as the type of publication, journal impact factor and number of article citations were analysed. Results: A total of 96 research articles were identified. The number of publications per year significantly increased from nil prior to 1991 to 15 in 2015 (P <0.01). Basic/clinical research articles accounted for 96.9% of publications, with three randomised controlled trials and no systematic reviews/meta-analyses. When adjusted for population size, Kuwait had the highest number of published papers per year, followed by Bahrain and Qatar. The number of authors per publication significantly increased during the study period (P = 0.02). However, 16 articles (16.7%) had no citations. The median journal impact factor was 0.15 ± 1.19 (range: 0–6.04). Conclusion: The number of publications authored by GCC researchers has risen in recent years. Increasing research funding and promoting collaboration between local and international researchers and institutes are recommended to bolster research regarding DFD prevention and management in GCC countries.Keywords: Bibliometric Analysis; Diabetes Mellitus; Diabetic Foot; Research; Publications; Arab Countries; Gulf Cooperation Council.

The fourteen case studies that compose this volume address the variousinstitutional, economic, social, cultural, and political dimensions of thedebate on gender and citizenship in the Middle East. Using a crossculturalcomparative approach, the theoretical introduction as well as theindividual case studies seek to challenge dominant (especially western)feminist models of analysis of the question of gender and citizenship in theMiddle East. The validity of dominant feminist paradigms is questioned byintroducing new social and cultural variables, and putting at stake anumber of traditionally unquestioned or unrecognized modes of identityformation, such as kinship, family, tribe, and sects, which critically affect awoman's citizenship status. The volume purports to contest essentializingmyths about the Middle East that artificially give it a character of regionalcoherence, and homogenize the image of Middle Eastern women as acategory. The volume thus theorizes the gendering of citizenship from thelargely unexplored perspectives that open up from introducing the abovevariables, toward a better understanding of the complex nature of the laws(religious, political, patriarchal and patrilineal) governing the constructionof a gendered citizenship in the Middle East.The theoretical introduction to the volume outlines the dynamics of anumber of points of departure that presumably underlie the writing of the"legal subject in the Middle East," namely nations, states, religion, family.The contributors seem to all concede that "most Middle Eastern states havecemented the linkage between religious identity, political identity,patrilineality, and patriarchy-that is, between religion, nation, state, andkinship." The Middle Eastern countries studied in the volume are dividedregionally into four areas: North Africa (including Egypt, Algeria, Tunisiaand Morocco); Eastern Arab States (including Lebanon, Palestine, Jordanand Iraq); the Arab Gulf (including Saudi Arabia, Kuwait and Yemen); theNon-Arab Middle East (including Turkey, Iran, and Jewish and PalestinianArab women in Israel). The authors of the various case studies conductedan exhaustive investigation of the related topics, albeit with a notabledifference of outlook varying between liberal individualistic and communitarianconservative positions.The methodological approach adopted by various contributors draws ...

IntroductionPrevalence of overweight, obesity and diabetes are high and rising across the Gulf Cooperation Council (GCC) countries (Oman, Bahrain, Kuwait, Qatar, Saudi Arabia and the United Arab Emirates). In parallel, physical activity (PA) levels are low relative to international standards. PA aids weight control and reduces risk of non-communicable diseases including diabetes and cardiovascular disease. It is likely interventions developed elsewhere will not translate to GCC countries due to unique environmental, social and cultural factors. This protocol is for a systematic review assessing the efficacy of interventions promoting PA within GCC countries among generally healthy adults and children. The primary outcome of interest is change in objectively measured or self-reported PA levels, the secondary outcomes of interest are changes in anthropometry or chronic disease risk factors (eg, blood pressure). Interventions will be compared with no intervention or those of differing PA intensity or duration. The relationships between PA change and the following will be assessed: intervention intensity or duration, season in which intervention occurs, sex, age, nationality and sustainability over time.Methods and analysisA systematic search strategy will identify indexed publications on the efficacy of interventions promoting PA. Randomised controlled trials and quasi-experimental studies recruiting predominantly healthy children and adults will be included. Studies of exercise rehabilitation will be excluded. Medline, Embase, Cinahl, Cochrane Library, SportDiscus, Web of Science, Index Medicus for the Eastern Mediterranean Region and Qscience will be searched. Clinical trial registries including the International Clinical Trials Registry Platform, the Iranian Registry of Clinical Trials and ClinicalTrials.gov will be searched for ongoing and unpublished studies. Searches will be ran from database inception until 1 May 2020 and be supplemented by checking references of key articles. Two reviewers will independently screen identified citations then full texts using prespecified inclusion and exclusion criteria. Piloted data extraction forms will be used in duplicate. Inconsistencies in screening or data extraction will be resolved by a third investigator or study author contact. Risk of bias will be independently assessed by two reviewers using validated tools. A narrative summary of findings will be produced supplemented with meta-analyses and exploration of heterogeneity as appropriate.Ethics and DisseminationThe review aims to strengthen the findings of the primary studies it incorporates and explore the impact of setting. It will synthesise existing published aggregate patient data. If publications or data with ethical concerns are identified, they will be excluded from the review. Results of the systematic review will be published in full and authors will engage directly with research audiences and key stakeholders to share findings.PROSPERO registration number131817.

e17008 Background: The optimal treatment of pediatrics and young adolescents with nasopharyngeal carcinoma (NPC) is not clearly addressed in large clinical trials. Systemic failure remains the problem. Our aim is to analyze the profile and treatment outcome of NPC in this age group in Kuwait, and whether the change of practice from neoadjuvant to concomitant chemoradiotherapy (CRT) has an impact on outcome, particularly distant metastasis. Methods: Between 2002-2010, 7 NPC patients aged </=20 years (mean age 16.7 years, SD 3.5) were treated in our institution with concomitant CRT. They represented 4.5% of all NPC cases seen during that time. We analyzed the profile and treatment outcome of that patient cohort, and compared it to our previous results published in 2002, who were treated with neoadjuvant chemotherapy (CTH) followed by radiotherapy (RT). Results: 6 patients were females, and 1 male. All patients had locoregional advanced disease. The median follow-up was 81 ms (r = 25-125 ms). 6 patients (86%) were treated with upfront CRT. Only 1 patient had neoadjuvant CTH followed by CRT. 4 patients had hyperfractionated radiotherapy (RT). The median dose of RT was 70 Gy (r = 66-75.6 Gy). G 3 acute toxicity were as follows. Hematological and skin 29%, mucositis 71%. 57% of patients >10% weight loss. No G 4 acute toxicity was recorded. All patient developed delayed G 2 hypothyroidism, and most developed significant subcutaneous fibrosis. All patient achieved locoregional CR. The only patient that developed distant metastasis was the one who could not tolerate CTH even as adjuvant due to prolonged neutropenia. All patients were alive at time of analysis. Comparing these results to our previous report which included patients between 1991-2001, the general profile of the patients seems to be the same. However, in the former patient cohort, 50% died within the same follow-up period due to distant metastasis. Conclusions: It seems that adoption of concomitant rather than neoadjuvant CTH, and modern RT techniques rather than conventional methods may have an impact on reducing distant metastasis. However, large patient cohort is needed to validate such finding.

AbstractThe attraction of several adult predators, genera Elatophilus, Hemerobius and Sympherobius, to the sex pheromones of pine bast scales, Matsucoccus Cockerell, has already been demonstrated. Here, the hypothesis that the larvae of these predators are similarly attracted to the host prey sex pheromone is tested. The response of predators was tested in field trials using pine tree arenas baited with the sex pheromones of M. josephi Bodenheimer & Harpaz, M. feytaudi Ducasse and M. matsumurae Kuwana. Experiments were conducted in Israel in stands of Pinus halepensis infested by M. josephi and in Portugal in stands of P. pinaster infested by M. feytaudi, respectively. The selectivity of larvae for the three sex pheromones was tested in Petri dish arenas in the laboratory. In the field, the larval stages exhibited similar modes of attraction to those of the conspecific adults: Elatophilus hebraicus Pericart in Aleppo pine forest, E. crassicornis Reuter and Hemerobius stigma Stephens in the maritime pine forests. Laboratory choice tests confirmed the kairomonal selectivity of larvae. Both forest and laboratory tests demonstrated the response of a coccinellid of the genus Rhyzobius to the sex pheromones of M. feytaudi and M. matsumurae. A unique chemical communication system among several taxa of predators of Matsucoccus spp. was highlighted that may be attributed to their coevolution on a geological time scale.

Planococcus ficus (Signoret) and Pseudococcus comstocki (Kuwana) (Hemiptera: Pseudococcidae) are economically important pests occurring in vineyards, causing severe economic losses for growers and compromising bunch production. The partial effectiveness of insecticides used in controlling mealybug infestations as well as their high impact on the environment and on human health have led to the research of alternative and sustainable control methods, including biological control. Several natural enemies are reported to be effective against mealybugs, but their activity may be hindered by tending ants. These social insects are known to exhibit a mutualistic relationship with mealybugs, resulting in extremely aggressive behavior against beneficial insects. Consequently, this study explored a method to mitigate ant attendance by means of sugar dispensers in order to improve ecosystem services, as well as decrease mealybug infestation in vineyards. Field trials were carried out in four commercial vineyards of Northern Italy infested by mealybugs, in which Anagyrus vladimiri Triapitsyn (Hymenoptera: Encyrtidae) and Cryptolaemus montrouzieri Mulsant (Coleoptera: Coccinellidae) were released as biological control agents. Our results showed that sugar dispensers reduced ant activity and mealybug infestation, leading to a significant enhancement of ecosystem services. The technique showed a great potential in boosting biological control against mealybugs in field conditions, though the field application seemed to be labour intensive and needs to be replicated for a multi-year evaluation.

e12555 Background: Oncotype DX Breast Recurrence Score (RS) is the currently used risk-assessment tool for early-stage, hormone receptor-positive, HER-2 negative, node-negative breast cancer in the US. Studies showed inconsistency in RS distribution and treatment among races. Causes may include variations in somatic mutations like Ki-67, which have been reported to express higher in African American (AA) and Asian populations than in Non-Hispanic White (NHW) population, germline mutations in BRCA and TP53, that are not in the RS algorithm, and financial burden of the testing. We analyzed data from different countries to investigate racial disparity in RS. Methods: We searched Medline, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, indexed from January 2010 to January 2021. More than 85% of studies were conducted in the pre-TAILORx study phase. To include data that are available and better represent different races, we included studies that used the previous cutoff value, low-risk ( < 18), intermediate-risk (18-30), high-risk ( > 30). Retrospective studies using Surveillance, Epidemiology, and End Results or National Cancer Database were excluded to avoid overlap data. A total of 17 studies, 9789 patients from seven countries (US, Japan, China, Taiwan, Kuwait, UAE, Israel) were pooled. The Odds Ratio (OR) was extracted with a 95% confidence interval (CI) for RS distribution and post-RS treatment. Both fixed-effect and random-effect meta-analysis were performed. Results: Among AA and NHW, AA were 1.7 times more likely to have high recurrence score (OR = 1.75; 95% CI = 1.46 - 2.10; P < 0.0001), with no heterogeneity among studies (I2 = 0%, heterogeneity P = 0.59). Asian were 1.59 more likely than NHW to be high-risk using a random effects model (OR = 1.59; 95% CI = 1.06 - 2.40; P = 0.0259). High-risk Asian were two times more likely to receive adjuvant chemotherapy post-RS comparing to NHW (OR: 2.31, CI: 1.07 - 4.98, fixed effect model; OR: 2.85, CI: 0.48, 17.05, random effects model), while high-risk AA were less likely to receive chemotherapy comparing to NHW (OR: 0.74, CI: 0.54-1.01, fixed effect model; OR: 0.73, CI: 0.54-0.99, random effects model). Intermediate-risk Asian and AA were more likely to receive chemotherapy compared to NHW (Asian to NHW; OR: 1.68, CI: 1.16-2.43, with fixed effect model, OR: 1.68, CI: 0.94-3.02, with random effects model; AA to NHW; OR: 1.16, CI: 0.93-1.46 with fixed effect model; OR: 1.06, CI: 0.62-1.79 with random effect model). Conclusions: We identified racial disparity in RS and post-RS treatment. Future research is required to elucidate the causes for AA and Asian receiving higher recurrence scores, a need for tailoring RS cutoffs for different races, and the utilization in adequate post-RS treatment.

In the past, the morphology of adult males of Coccoidea has provided strong support for diagnosing the higher taxonstatus of scale insects (Coccoidea). In particular, studies on adult male morphology have produced some of the stron-gest evidence for considering the Putoidae and Eriococcidae (as then defined) as separate families from the Pseudo-coccidae. This paper uses adult male morphology to assess the relationships of the Pseudococcidae and the hypogaeicand myrmecophilous mealybugs. The latter most often are classified as a subfamily (Rhizoecinae) of the Pseudococ-cidae. In order to diagnose the latter taxa, the adult males of fifteen named species of hypogaeic rhizoecine mealybugs(Kissrhizoecus hungaricus Kozár & Konczné Benedicty, Rhizoecus cacticans (Hambleton), Rh. coffeae Laing, Rh.dianthi Green, Rh. falcifer Künckel d’Herculais, Rh. kazachstanus Matesova, Ripersiella cryphia (Williams), Ri.hibisci (Kawai & Takagi), Ri. kondonis (Kuwana), Ri. malschae (Williams), Ri. puhiensis (Hambleton), Capitisetellamigrans (Green) and Pseudorhizoecus proximus Green) plus two unidentified Ripersiella species are described. Inaddition, the adult males of a Xenococcus sp., three Eumyrmococcus spp. and two Neochavesia spp. are illustratedfrom previously published papers and the adult male of another Neochavesia sp. is described and illustrated. In orderto compare the diagnoses of the above taxa with that of adult males of Pseudococcidae (minus the Rhizoecinae), theadult males of two apterous pseudococcid mealybugs are described or redescribed: Asaphococcus agninus Cox andthe myrmecophilous Promyrmococcus dilli Williams, both belonging to the Pseudococcinae. In addition, threemacropterous Pseudococcidae, namely Phenacoccus solenopsis Tinsley (Phenacoccinae), Planococcus glaucus(Maskell) and Maconellicoccus hirsutus (Green) (Pseudococcinae) are also described and/or illustrated. Prior to thisstudy, the hypogaeic and myrmecophilous mealybugs generally were included in the subfamily Rhizoecinae of thePseudococcidae, with the hypogaeic mealybugs in tribe Rhizoecini and the myrmecophilous mealybugs in Xenococ-cini. Based on the present study and on phylogenetic data, it is concluded that the rhizoecine mealybugs form a sepa-rate family from the Pseudococcidae — Rhizoecidae Williams. This family is considered here to include twosubfamilies, Rhizoecinae Williams and Xenococcinae Tang. Based on adult male characters, there is little support forthe present generic divisions of the Rhizoecinae. Keys are given for separating the adult males of Rhizoecidae from those of Pseudococcidae, and for separating the known adult males within each subfamily.

Background:pSScHI may cause tissue, functional and conduction abnormalities with varied clinical manifestations. The absence of a clear definition of pSScHI impairs the significance and ability of focussed research, frequently not allowing the distinction between primary and secondary involvement.Objectives:We aimed to establish an expert consensus definition for pSScHI, to be used in clinical trials and everyday clinical practice, and to start its validation process.Methods:A SLR for cardiac manifestations and alterations in SSc was conducted using PubMed, Web of Science and Embase. Articles published from inception to December 31st, 2018 were identified. Inclusion criteria included papers in English on adult SSc patients, with heart involvement as outcome. We excluded non-human studies, secondary heart involvement (eg PAH, drugs, infections), reviews and case reports. PRISMA recommendations were followed where applicable. Extracted data were categorized into relevant domains (signs, symptoms, anatomical site involved, physiological abnormalities, pathological changes, prognostic outcomes), which informed the consensus definition. Sixteen senior experts (7 rheumatologists, 8 cardiologists, 1 pathologist) discussed the data and, using a nominal group technique, added expert opinion, provided statements to consider and ranked them. Consensus was attained for agreement >70%. Sixteen clinical cases were evaluated in two rounds to test for face validity, feasibility, inter- and intra-rater reliability and criterion validity (gold standard set by agreed evaluation between expert rheumatologist, cardiologist and methodologist).Results:2593 publications were identified and screened, 251 full texts were evaluated,172 met eligibility criteria. Data from the 7 domains were extracted and used to develop the World Scleroderma Foundation – Heart Failure Association (WSF-HFA) consensus-derived definition of pSSc-HI, as follows:“pSScHI comprises cardiac abnormalities that are predominantly attributable to SSc rather than other causes and/or complications*. pSScHI may be sub-clinical and must be confirmed through diagnostic investigation. The pathogenesis of pSScHI comprises one or more of inflammation, fibrosis and vasculopathy. *Non SSc-specific cardiac conditions (e.g. Ischaemic heart disease, arterial hypertension, drug toxicity, other cardiomyopathy, primary valvular disease) and/or SSc non cardiac conditions (e.g. PAH, Renal involvement, ILD).”Face validity was determined by a 100% agreement on credibility; application was feasible, with a median 60 (5-600) seconds taken per case; inter rater agreement was moderate [mKappa (95%CI) 0.56 (0.46-1.00) and 0.55 (0.44-1.00) for the two rounds] and intra rater agreement was good [mKappa (95%CI) 0.77 (0.47-1,00)]. Content validity was reached based on the wide variety of patients in the SLR, criterion validity was reached with 78 (73-84) % correctness.Conclusion:Using a SLR and modified nominal technique, we have developed a preliminary pSScHI consensus-based definition and started a validation process for it to be used in clinical research and clinical practice.Acknowledgments:Aleksandra Djokovic, Giacomo De Luca, Raluca B. Dumitru,Alessandro Giollo, Marija Polovina, Yossra Atef Suliman, Kostantinos Bratis, Alexia Steelandt, Ivan Milinkovic, Anna Baritussio, Ghadeer Hasan, Anastasia Xintarakou, Yohei Isomura, George Markousis-Mavrogenis, Silvia Bellando-Randone, Lorenzo Tofani, Sophie Mavrogeni, Luna Gargani, Alida L.P. Caforio, Carsten Tschoepe, Arsen Ristic, Karin Klingel, Sven Plein, Elijah Behr, Yannick Allanore, Masataka Kuwana, Christopher Denton, Daniel E. Furst, Dinesh Khanna, Thomas Krieg, Renzo Marcolongo.Disclosure of Interests:Cosimo Bruni Speakers bureau: Actelion, Eli Lilly, Maya H Buch Grant/research support from: Pfizer, Roche, and UCB, Consultant of: Pfizer; AbbVie; Eli Lilly; Gilead Sciences, Inc.; Merck-Serono; Sandoz; and Sanofi, Petar Seferovic: None declared, Marco Matucci-Cerinic Grant/research support from: Actelion, MSD, Bristol-Myers Squibb, Speakers bureau: Acetelion, Lilly, Boehringer Ingelheim

Venetoclax (Ven) is an effective element of treatments for chronic lymphocytic leukemia (CLL) with high response rates observed in the upfront and relapsed/refractory (R/R) settings. In addition to inducing apoptosis in CLL cells, Ven also induces apoptosis within normal and malignant myeloid lineage populations (accounting for its efficacy in the treatment of acute myeloid leukemia). We investigated the effects of Ven outside the target tumor compartment in patients (pts) with CLL receiving long-term continuous Ven and make the novel observation of the development of BAX-mutated clonal hematopoiesis in this heavily pre-treated patient group. 92 pts with CLL receiving continuous non time-limited Ven have been treated at our institutions on clinical trials. Of these, 41 had sufficient (&gt;6 mo) follow up (median 70; range 14-95 mo) and suitable samples available for further analysis. 38/41 (93%) pts had received previous treatment with alkylators and/or fludarabine. In order to assess the non-CLL compartment in these 41 pts we identified those with peripheral blood or bone marrow aspirate samples taken during deep response to Ven demonstrating either minimal (&lt;5%) or no CLL involvement by flow cytometry (sensitivity 10-4). We initially performed unique molecular index (UMI)-based targeted next generation sequencing of apoptosis pathway genes as well a panel of 60 genes recurrently mutated in lymphoid and myeloid malignancy. From these 41 pts we identified mutations in the apoptosis effector BAX in samples from 12 (29%). 20 different BAX mutations were observed across these 12 pts at variant allele frequencies (VAF) consistent with their occurrence in the non-CLL compartment. Mutations included frameshift, nonsense, canonical splice site and missense mutations occurring in key structural elements of BAX consistent with a loss-of-function mechanism (Fig 1A). Interestingly, an enrichment of missense and truncating mutations predicted to escape nonsense mediated decay were observed at the C-terminus of the BAX protein affecting the critical α9 helix. Mutations in this region have previously been shown in cell lines to cause aberrant intracellular BAX localization and abrogation of normal BAX function in apoptosis (Fresquet Blood 2014; Kuwana J Biol Chem 2020). For comparison, NGS targeted sequencing for BAX mutations was performed on samples from cohorts of pts with (i) myeloid or lymphoid malignancy (n=80) or (ii) R/R CLL treated with BTK inhibitors (n=15) after a similar extent of preceding chemotherapy. Neither of these cohorts had previous exposure to Ven. BAX mutations were not detected in any samples from these pts. Longitudinal sampling from pts on Ven harboring BAX mutations in the non-CLL compartment was performed to further understand compartment dynamics over time (in 9 pts over 21-93 months of follow up). Multiple pts demonstrated a progressive increase in VAF of single BAX mutations over time to become clonally dominant within the non-CLL compartment and with observed VAFs consistent with their presence in the myeloid compartment. Mutations in other genes implicated in clonal hematopoiesis and myeloid malignancy including ASXL1, DNMT3A, TET2, U2AF1 and ZRSR2 were also detected in these pts samples. Targeted amplicon single cell sequencing (Mission Bio) demonstrated the co-occurrence of clonally progressive BAX mutations within the same clones as mutations in DNMT3A and ASXL1 as well as the existence of further BAX mutations at low VAF outside these dominant clones which remained non-progressive over time (Fig 1B). In addition, fluctuations in the presence and VAF of myeloid-disease associated mutations was noted with Ven exposure. In aggregate these data are consistent with the existence of a selective pressure within the myeloid compartment of these pts and an interplay of BAX with other mutations in determining survival and enrichment of these clones over time with ongoing Ven therapy. In summary, we have observed the development of BAX-mutated clonal hematopoiesis specifically in pts with CLL treated with long-term Ven. These data are consistent with a multi-lineage pharmacological effect of Ven leading to a survival advantage for clones harboring BAX mutations within the myeloid compartment during chronic Ven exposure. Finally, our data support the further investigation of BAX mutations as a potential resistance mechanism in myeloid malignancies treated with Ven. Disclosures Blombery: Invivoscribe: Honoraria; Amgen: Consultancy; Janssen: Honoraria; Novartis: Consultancy. Anderson:Walter and Eliza Hall Institute: Patents & Royalties: milestone and royalty payments related to venetoclax.. Seymour:Celgene: Consultancy, Honoraria, Research Funding; F. Hoffmann-La Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Janssen: Consultancy, Honoraria, Research Funding; AstraZeneca: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Gilead: Consultancy; Mei Pharma: Consultancy, Honoraria; Morphosys: Consultancy, Honoraria; Nurix: Honoraria; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Tam:Janssen: Honoraria, Research Funding; AbbVie: Honoraria, Research Funding; BeiGene: Honoraria. Huang:Servier: Research Funding; Walter and Eliza Hall Institute: Patents & Royalties: milestone and royalty payments related to venetoclax.; Genentech: Research Funding. Wei:Janssen: Honoraria, Other; Walter and Eliza Hall Institute: Patents & Royalties; AMGEN: Honoraria, Other: Advisory committee, Research Funding; Novartis: Honoraria, Research Funding, Speakers Bureau; Astellas: Honoraria, Other: Advisory committee; Pfizer: Honoraria, Other: Advisory committee; Macrogenics: Honoraria, Other: Advisory committee; Abbvie: Honoraria, Other: Advisory committee, Research Funding, Speakers Bureau; Genentech: Honoraria, Other: Advisory committee; Servier: Consultancy, Honoraria, Other: Advisory committee; Celgene: Honoraria, Other: Advisory committee, Speakers Bureau; Astra-Zeneca: Honoraria, Other: Advisory committee, Research Funding. Roberts:Janssen: Research Funding; Servier: Research Funding; AbbVie: Research Funding; Genentech: Patents & Royalties: for venetoclax to one of my employers (Walter & Eliza Hall Institute); I receive a share of these royalties.

Background:Tocilizumab (TCZ) showed trends for improving skin fibrosis and prevented progression of lung fibrosis in patients with systemic sclerosis (SSc) in placebo-controlled randomised clinical trials (RCTs). However, safety and effectiveness of TCZ beyond these selected and enriched clinical trial populations in SSc is still unknown.Objectives:To assess safety and effectiveness of TCZ treatment compared to standard of care in SSc patients from the large, multicentre, observational, real-life EUSTAR network/database using propensity score matching.Methods:SSc patients from the EUSTAR network/database, who fulfilled the ACR/EULAR 2013 classification criteria, with a baseline and a follow-up visit at 12±3 months, receiving TCZ or standard of care (controls), were selected. The following variables were used for the propensity score matching (1:1): age at diagnosis, gender, disease subtype, baseline modified Rodnan skin score (mRSS), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO), co-therapy with immunosuppressives, disease duration, and year of treatment. Primary endpoints were mRSS and FVC at 12±3 months follow-up compared between the groups, using paired t-tests. Secondary endpoints were the percentage of progressive/regressive patients for skin and lung at 12±3 months follow-up according to standard definitions (1,2). Sensitivity analyses assessed pre-processing decisions (selection of most recent vs. random observation for control patients with multiple suitable time intervals), as well as the matching method (optimal vs. exact matching). Missing values were addressed with 100-fold multiple imputation using chained equations. Safety data were analysed in all patients. The study including the statistical analysis plan was pre-registered at www.drks.de (DRKS-ID: DRKS00015537).Results:We identified 93 SSc patients treated with TCZ and 2370 SSc patients with standard of care who fulfilled the inclusion criteria. Forty nine (57.7%) of the TCZ treated patients were diffuse, eight patients were not classified, disease duration was (mean±SD) 6.35±5.40 years, their baseline mRSS was 15.05±10.85, and 76 (81.7%) received immunosuppressive therapy in addition to TCZ.Through multiple imputation and propensity score matching, 100 imputed sets of 93 pairs of TCZ/controls were generated. Comparison between groups showed consistent effects of TCZ across all pre-defined primary and secondary endpoints: mRSS was lower in the TCZ group (mean difference (95% confidence interval (CI)) -1.8 (-4.79 to 1.19), p=0.24, Figure 1A). Similarly, FVC % predicted was higher in the TCZ group mean difference (2.25, 95% CI -4.57 to 9.06), p=0.51, Figure 1B). Considering secondary endpoints, the percentage of skin progressors as well as lung progressors at follow up was lower in the TCZ group (odds ratio OR 0.67 (95% CI 0.07 to 6.41), p=0.74 and OR 0.53 (95% CI 0.16 to 1.7); p=0.2, respectively. Consistently, the percentage of regressors for skin (OR 1.6 (95% CI 0.56 to 4.54), p=0.38) and for lung (OR 1.74 (95% CI 0.66 to 4.58), p=0.26) was higher in TCZ. These results were robust regarding the sensitivity analyses. Safety analysis confirmed previously reported adverse event profiles.Conclusion:In this large, observational, controlled, real-life EUSTAR study, effectiveness of TCZ did not reach statistical significance compared to standard of care treatment but showed consistent positive effects of TCZ on skin and lung fibrosis across all pre-defined primary and secondary endpoints confirming data from recent RCTs.References:[1]Prediction of improvement in skin fibrosis in diffuse cutaneous systemic sclerosis: a EUSTAR analysis. Ann Rheum Dis 2016:1743-8.[2]Progressive interstitial lung disease in patients with systemic sclerosis-associated interstitial lung disease in the EUSTAR database. Ann Rheum Dis 2021:219-227.Disclosure of Interests:Simon Kuster: None declared, Suzana Jordan: None declared, Muriel Daniele Elhai: None declared, Ulrike Held: None declared, Klaus Steigmiller: None declared, Cosimo Bruni: None declared, Florenzo Iannone: None declared, Serena Vettori: None declared, Elise Siegert: None declared, Simona Rednic: None declared, Veronica Codullo: None declared, Paolo Airò Consultant of: Dr. Airo’ reports personal fees (consultancies) from Bristol Myers Squibb, Bohringer Ingelheim, non-financial support from CSL Behring, SOBI, Janssen, Roche, Sanofi, Pfizer, Yolanda Braun-Moscovici: None declared, Nicolas Hunzelmann: None declared, Maria Joao Salvador: None declared, Valeria Riccieri: None declared, Ana Maria Gheorghiu: None declared, Juan Jose Alegre Sancho: None declared, Katarzyna Romanowska-Prochnicka: None declared, Ivan Castellví: None declared, Ina Koetter: None declared, Marie-Elise Truchetet Consultant of: Marie-Elise Truchetet has had consultancy relationships and/or has received research funding from Boehringer Ingelheim, Genentech/Roche, and Sanofi in the area of potential treatments of scleroderma and its complications., Grant/research support from: Marie-Elise Truchetet has had consultancy relationships and/or has received research funding from Boehringer Ingelheim, Genentech/Roche, and Sanofi in the area of potential treatments of scleroderma and its complications., Francisco J López-Longo: None declared, Pavel Novikov: None declared, Alessandro Giollo: None declared, Yuichiro Shirai: None declared, Laura Belloli: None declared, Elisabetta Zanatta: None declared, Eric Hachulla: None declared, Vanessa Smith: None declared, Christopher Denton: None declared, Ruxandra Ionescu: None declared, Tim Schmeiser: None declared, Jörg H.W. Distler: None declared, Armando Gabrielli: None declared, Anna-Maria Hoffmann-Vold Consultant of: AMHV has received research funding and/or consulting fees and/or other remuneration from Actelion, Boehringer Ingelheim, Roche, Bayer, Merck Sharp & Dohme, ARXX, Lilly and Medscape, Grant/research support from: AMHV has received research funding and/or consulting fees and/or other remuneration from Actelion, Boehringer Ingelheim, Roche, Bayer, Merck Sharp & Dohme, ARXX, Lilly and Medscape. Masataka Kuwana: None declared, Yannick Allanore: None declared, Oliver Distler Speakers bureau: Oliver Distler has/had consultancy relationship and/or has received research funding in the area of potential treatments for systemic sclerosis and its complications from (last three years): Abbvie, Acceleron Pharma, Amgen, AnaMar, Arxx Therapeutics, Baecon Discovery, Blade Therapeutics, Bayer, Boehringer Ingelheim, ChemomAb, Corbus Pharmaceuticals, CSL Behring, Galapagos NV, Glenmark Pharmaceuticals, GSK, Horizon (Curzion) Pharmaceuticals, Inventiva, iQvia, Italfarmaco, iQone, Kymera Therapeutics, Lilly, Medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Roche, Sanofi, Serodapharm, Topadur, Target Bioscience and UCB. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Consultant of: Oliver Distler has/had consultancy relationship and/or has received research funding in the area of potential treatments for systemic sclerosis and its complications from (last three years): Abbvie, Acceleron Pharma, Amgen, AnaMar, Arxx Therapeutics, Baecon Discovery, Blade Therapeutics, Bayer, Boehringer Ingelheim, ChemomAb, Corbus Pharmaceuticals, CSL Behring, Galapagos NV, Glenmark Pharmaceuticals, GSK, Horizon (Curzion) Pharmaceuticals, Inventiva, iQvia, Italfarmaco, iQone, Kymera Therapeutics, Lilly, Medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Roche, Sanofi, Serodapharm, Topadur, Target Bioscience and UCB. Patent issued “mir-29 for the treatment of systemic sclerosis” (US8247389, EP2331143)., Grant/research support from: The study was partially supported by a grant from Roche. Roche was not involved in analysis or interpretation of the results.

Background:Lenabasum is an oral CB2 agonist that attenuates inflammation and fibrosis in SSc animal models and showed clinical benefit with acceptable safety in a Phase 2 trial in dcSSc.Objectives:Test efficacy and safety of lenabasum in a Phase 3 trial in dcSSc.Methods:Subjects ≥18 years old with disease duration ≤ 6 years were randomized 1:1:1 to lenabasum 5 mg, 20 mg, or placebo (PBO), all BID, with stable background immunosuppressant therapy (IST) allowed. The primary efficacy endpoint was ACR CRISS score, and secondary endpoints were ΔmRSS, ΔHAQ-DI, and ΔFVC, all at Week 52 for lenabasum 20 mg vs PBO.Results:363 adults were dosed; 37 (10%) stopped study drug early, with only 1 subject (PBO cohort) stopping due to adverse event (AE). Baseline demographics were similar among groups. Disease duration was ≤ 3 years in 60% and 66%, mean mRSS score was 22.0 and 23.3, and background IST was used by 89% and 84% of lenabasum 20 mg and PBO groups, respectively.Safety results showed serious AEs and severe AEs occurred in 9.2% and 5.8% vs 14.6% and 13.0%, respectively, of lenabasum 20 mg and PBO groups.Efficacy results (Table) demonstrated:Table 1.Primary and secondary efficacy endpoints and post-hoc analyses, Week 52Group, by IST treatmentCohortNΔmRSS, mean (SD)ΔFVC% mean (SD)ΔFVC, mL mean (SD)ΔHAQ-DI mean (SD)ACR CRISS medianmITT population, MMRM primary analysis methodAllPlacebo123-8.1 (7.72)-1.0 (8.68)-51 (317)-0.13 (0.468)0.887Lenabasum 20 mg120-6.7 (6.59)-1.6 (6.91)-78 (265)-0.13 (0.436)0.888Placebo subjects, per protocol completers, LOCFNo ISTPlacebo16-2.3 (9.4)-2.8 (7.4)-97 (244)0.12 (0.34)0.417All ISTPlacebo97-8.9 (7.07)-1.0 (9.2)-43 (330)-0.17 (0.474)0.936MMF, no other ISTPlacebo29-10.7 (8.1)-0.58 (7.1)-37 (235)-0.12 (0.456)0.935MMF ≤ 2 years, no other ISTPlacebo23-11.7 (8.1)-0.3 (6.0)-41 (197)-0.13 (0.495)0.935Non-MMF ≤ 2 yearsPlacebo24-6.7 (6.2)-1.4 (7.87)-52 (281)-0.15 (0.357)0.931Post-hoc comparisons, per protocol completers, LOCFNo ISTPlacebo16-2.3 (9.4)-2.8 (7.4)-97 (244)0.12 (0.34)0.417Lenabasum 20 mg10-6.3 (6.02)-2.3 (5.58)-99 (209)-0.06 (0.498)0.811Established IST1Placebo26-6.1 (5.35)-4.6 (10.11)-170 (350)-0.17 (0.445)0.619Lenabasum 20 mg38-7.4 (5.08)-0.4 (5.70)2-21 (233)3-0.07 (0.357)0.941Established IST, subjects with ILDPlacebo22-5.9 (5.28)-3.7 (5.43)-133 (206)-0.10 (0.372)0.553Lenabasum 20 mg33-7.2 (5.70)-1.0 (10.5)-47 (365)-0.06 (0.391)0.8192 P = 0.0386 two-sample t-test; 3 P = 0.0481 two-sample t-test; other comparisons were not significant• No significant differences were seen in primary and secondary efficacy endpoints. Primary MMRM analyses with treatment-by-time-by-subgroup interactions showed that background mycophenolate (MMF) significantly influenced the outcome•oSubjects on no IST with disease duration ≤3 years were only 7% of PBO subjects and showed little improvement on PBO, in line with other dcSSc trials in which IST was restricted. Post-hoc subgroup analyses of these subjects on no IST suggested improvement in ΔmRSS and ΔHAQ-DI, for lenabasum 20 mg vs PBO•uUnexpectedly high improvement occurred in PBO subjects receiving IST, notably those on MMF started within 2 years of baseline•nPost-hoc analyses of subjects on established IST (MMF or, if no MMF, ≥ 1 non-MMF IST started > 2 years before baseline) suggested improvement in ΔFVC% (nominal P = 0.0386) and ΔFVC mL (nominal P = 0.0481) for lenabasum 20 mg vs PBO. Improvement in FVC was also seen in subjects on established IST who had ILD at baseline, lenabasum 20 mg vs PBO•mACR CRISS score demonstrated a ceiling effect and correlated most highly with ΔmRSS (r = -0.739) and moderately with MDGA (-0.432), HAQ-DI (-0.362), FVC% (0.366), and PtGA (-0.288)Conclusion:Lenabasum was safely used in this study. Unexpectedly high improvement on background IST, especially MMF, has not been previously reported at this level. The primary endpoint was not met. Post-hoc analyses showed greater improvement in lenabasum- vs PBO-treated subjects who were not on background IST and those on established IST, including subjects with ILD.Disclosure of Interests:Robert Spiera Consultant of: Abbvie, Roche-Genetech, GSK, CSL Behring, Sanofi, Janssen, Chemocentryx, Formation Biologics, Mitsubishi Tanabe, Grant/research support from: Roche-Genetech, GSK, Boehringer Ingelheim, Chemocentryx, Corbus, Formation Biologics, Sanofi, Inflarx, Astra Zeneca, Kadmon, Masataka Kuwana Speakers bureau: Boehringer-Ingelheim, Chugai, Janssen, Consultant of: Boehringer-Ingelheim, Chugai, Corbus, Grant/research support from: Boehringer-Ingelheim, Chugai, MBL, Ono Pharmaceuticals, Tanabe-Mitsubishi, Dinesh Khanna Shareholder of: Eicos Sciences, Inc (less than 5%). Leadership/Equity position – Chief Medical Officer, CiviBioPharma/Eicos Sciences, Inc, Consultant of: Acceleron, Actelion, Abbvie, Amgen, Bayer, Boehringer Ingelheim, CSL Behring, Corbus, Gilead, Galapagos, Genentech/Roche, GSK, Horizon, Merck, Mitsubishi Tanabe Pharma, Sanofi-Aventis, and United Therapeutics, Grant/research support from: NIH, Immune Tolerance Network, Bayer, BMS, Horizon, Pfizer, Laura Hummers Consultant of: CSL Behring, Boehringer Ingelheim, Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals. Corbus, Boehringer Ingelheim, Medpace, Kadmon, Cumberland, CSL Behring, Tracy Frech Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Wendy Stevens Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Jessica Gordon Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals. Research funding for EICOS Pharmaceuticals and Cumberland Pharmaceuticals., Suzanne Kafaja Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Marco Matucci-Cerinic Consultant of: Actelion, Janssen, Inventiva, Bayer, Biogen, Boehringer, CSL Behring, Corbus, Galapagos, Mitsubishi, Samsung, Regeneron, Acceleron, MSD, Chemomab, Lilly, Pfizer, Roche, Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Oliver Distler Consultant of: Consultancy relationship and/or has received research funding in the area of potential treatments for systemic sclerosis and its complications from (last three years): Abbvie, Acceleron Pharma, Amgen, AnaMar, Arxx Therapeutics, Baecon Discovery, Blade Therapeutics, Bayer, Boehringer Ingelheim, ChemomAb, Corbus Pharmaceuticals, CSL Behring, Galapagos NV, Glenmark Pharmaceuticals, GSK, Horizon (Curzion) Pharmaceuticals, Inventiva, iQvia, Italfarmaco, iQone, Kymera Therapeutics, Lilly, Medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Roche, Sanofi, Serodapharm, Topadur, Target Bioscience and UCB., Eun Bong Lee Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Yair Levy Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Jae-Bum Jun Consultant of: Consultant to Boehringer Ingelheim Korea, Jeil Pharma, Dae Woong Pharma, Kwangdong Pharma, and Sama Pharma., Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Scott Constantine Employee of: Employee of Corbus Pharmaceuticals, Nancy Dgetluck Employee of: Employee of Corbus Pharmaceuticals, Barbara White Employee of: Employee and stockholder of Corbus Pharmaceuticals, Daniel Furst Consultant of: Corbus, Galapagos, Pfizer, CSL Behring, Mitsubishi Tanabi, Actelion, Amgen, Novartis, Roche/Genentech, Gilead, Talaris, and Boehringer Ingelheim., Grant/research support from: grants from Corbus, Galapagos, GSK, Pfizer, Talaris, CSL Behring, Mitsubishi Tanabi, Christopher Denton Consultant of: Consultancy fees and/or honoraria from Corbus, Actelion, GlaxoSmithKline, Bayer, Sanofi, Galapagos, Inventiva, Boehringer Ingelheim, Roche, CSL Behring, Acceleron, Horizon, Arxx Therapeutics

This article describes the creation of the Bedoun Archive at the Australian Data Archive, managed by the Australian National University. The Bedoun are a Bedouin minority comprising stateless members of the main tribes of Kuwait. They have been subjected to “Othering” in scholarly literature, indicative of both Orientalism and neo-Orientalism, approaches that have contributed to their oppression by the state and omission from the official histories of Kuwait and the academic literature. The theory and methodology behind the creation of the Bedoun Archive, based on the principles of humanistic sociology and collaborative research with Indigenous Peoples, are discussed. The archive provides safe storage for data analysed in the project, which can be used by others in future. This article contributes to improving understanding of the impact of Orientalism and neo-Orientalism on perceptions of the people and history of the Middle East in general, and the Arabian Gulf and Kuwait in particular. It also contributes new knowledge regarding the complex situation currently faced by the Bedoun, the role of intellectuals in the Arab Spring social movement and subsequently, their contribution to developing formal systems of knowledge about their own culture.

This article describes the preliminary investigation of the initial feasibility of the ‘ Fostering Youth Resilience Project’, a universal school-based program delivered by school social workers to 54 high school students in Kuwait. Results reported significant positive change and high satisfaction with the program. The study provided initial evidence support to the applicability of the program for youth in a non-Western culture. Future research needs to evaluate the effect of the program in larger groups, using controlled trials and longer term follow ups. Discussion of limitations and practical implications for the social work profession are presented.

Despite different views among scholars about the position of Ijma’ as a source of Shari’ah and about the possibility of Ijma’ to take place in its classical form in the contemporary times, the authenticity of it is proved by the Qur’an and Sunnah and the authority of Ijma’ is unanimously agreed. Hence the aim of the paper is to find out whether Ijma’ takes place in the contemporary Islamic Finance Fiqhi rulings or not. Based on document analysis that is the resolutions of different Shari’ah bodies like OIC Fiqh Academy, AAOIFI, SC of Malaysia, Kuwait Finance House, Dhallah of Baraka, Dubai Islamic Bank, Al-Rajhi Bank as well as different books and articles on Ijma’, this paper tries to get clear ideas about the classical and contemporary view of Ijma’ and also tries to find out unanimous agreement of Mujtahids on Islamic Finance rulings. Findings reveal that as per its classical definition Ijma’ does not take place in the contemporary Islamic finance, as no claim is found in favor of it. However, few rulings related to Islamic Finance are agreed by all Mujtahids of different Fiqh academy/ organizations and Shari’ah scholars which are the results of collective Ijtihad of Mujtahids of the current world and are binding in nature, so can be said are the results of Ijma’ of contemporary scholars.

Abstract Background and aims The prevalence of internet addiction (IA) varies widely in the Gulf Cooperation Council (GCC) countries (4%–82.6%). We aimed to assess the quality of IA studies from the GCC and pool their data to get an accurate estimate of the problem of IA in the region. Methods A systematic review of available studies was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PubMed, Embase, and Cochrane Controlled Register of Trials were systematically searched; studies conducted in GCC countries (i.e., Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) with a validated instrument for internet addiction assessment were eligible. Ten studies were eligible for the systematic review, all of which were included in the meta-analysis. The Newcastle Ottawa Scale was used for quality assessment. Results Nine out of ten of the included studies had either adolescent and/or young adult participants (age < 25). Two studies were of ‘good’ quality, six were of ‘satisfactory’ quality, and two were of ‘unsatisfactory’ quality. The pooled internet addiction prevalence was 33%; it was significantly higher among females than males (male = 24%, female = 48%, P = 0.05) and has significantly increased over time (P < 0.05). Discussion and conclusions One in every three individuals in GCC countries was deemed to be addicted to the internet, according to Young's Internet Addiction Test. A root cause analysis focusing on family structure, environment, and religious practices is needed to identify modifiable risk factors.

AbstractIntroductionThe adoption of poor dietary and lifestyle habits have been associated with the development of non-communicable disease. The majority of strategies implemented to enhance dietary quality of individuals follow a “one size fits all” standardised approach. Results of recent trials have suggested that Personalised Nutrition (PN), tailored to individual requirements, is able to improve dietary intakes, yet limited focus has been given to the effectiveness of face-to-face compared with online methods. The aim of the EatWellQ8 randomised control trial (RCT) was to assess the impact of web-based PN advice, face-to-face PN advice and standardised advice, on adherence to healthy eating in Kuwait.Materials and MethodsFree living adults aged 21–65 years, were recruited for the 12-week study and randomised to; face-to-face PN, web-based PN or generalised (control) advise groups. Dietary intake and self-reported anthropometric measurements were assessed at baseline, 6 and 12 weeks. A validated food frequency questionnaire (FFQ) modified from the EPIC FFQ was used to assess food and nutrient intake. Diet quality was assessed by a 10-component modified Alternative Healthy Eating Index (m-AHEI) which was used to generate the PN advice. At 0 and 12-weeks post FFQ completion, participants randomised to the PN intervention groups were presented with 3 tailored dietary messages based on the m-AHEI components that received the lowest scores.Results320 participants completed the trial. Due to over/underreporting, 100 were included in the analysis (71% female, 29% male) with a mean age of 38.6 years (SD 14.3), and body mass index (BMI) of 25.1 kg/m2 (SD 4.2). After 12-weeks intervention, m-AHEI scores increased significantly in both PN intervention groups (face-to-face PN 19%, web-based 12%) compared to controls (4%) (P < 0.01) and significantly higher intakes of vegetables and fruits, and lower intakes of sugars compared with controls (P < 0.05). The PN intervention groups also significantly increased their intakes of omega 3 fatty acids and total folate compared with the control group (P < 0.05). The Face-to-face PN group significantly reduced weight (-1.9 kg) and BMI (-0.5 kg/m2) compared to web-based PN and control groups(P < 0.01).DiscussionIn adults living in Kuwait, PN advice, delivered face-to-face or online, was more effective at improving dietary quality than population-based advice. Face-to-face PN was found to be more effective at inducing weight-loss in adults compared to web-based PN and population-based advice.

Background and aims: Hepatitis B virus infection is a significant public health crisis global. Hepatitis B virus genotyping is an important tool in epidemiological studies to determine the category and extent of treatment and to predict the outcome of chronic infections, for instance hepatocellular carcinoma and cirrhosis. The study designed to determine the prevalence of hepatitis B virus genotypes among Yemeni patients with chronic hepatitis B (CHB) and to evaluate some of the associated risk factors. Methods: Fifty patients (38 males, 12 females) with chronic hepatitis B from Al-Thawra Modern General Hospital, Al-Kuwait University Hospital, and AL-Gomhoria Hospital were included. HBV DNA was first detected by conventional PCR then HBV genotypes were determined using nested and multiplex PCR. Results: Mixed HBV genotypes (A+B+C+D+E), (A+B+C+D+E+F), and (A+B+C+D) were found to be the most prevalent (60 %), it is followed by genotype D (16 %), genotype B (16%) and genotype A (8%), whereas C, E, and F genotype were not found individually among the study population. Blood transfusion was associated with mixed infection (χ2=13.06; p= 0.005). Conclusions: In assumption, this study demonstrates the general prevalence of hepatitis B virus genotypes among HBV-infected Yemeni hepatitis B patients who request medical consideration in a hospital. In mono-genotype HBV infection, genotype B and D were the most prevalent genotypes. In HBV mixed genotype infection, the A/B/C/D/E genotype was the most prevalent in the study area. In the future, based on genotype, clinical trials and treatment regimens must be individually assumed to efficiently manage chronic HBV infection. To this end, a prospective nationwide population study of HBV genotype spreading and clinical outcomes is suggested. Peer Review History: Received: 15 May 2021; Revised: 11 June; Accepted: 27 June, Available online: 15 July 2021 Academic Editor: Ahmad Najib, Universitas Muslim Indonesia, Makassar, Indonesia, ahmad.najib@umi.ac.id UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Dr. Salfarina Ramli, Department of Pharmacology and Pharmaceutical Chemistry, Faculty of Pharmacy, Universiti Teknologi MARA, 42300 Puncak Alam, Selangor, Malaysia. salfarina2892@uitm.edu.my Dr. Asia Selman Abdullah, University of Basrah, Iraq, asia_abdullah65@yahoo.com Similar Articles: EXPLOSION OF HEPATITIS B AND C VIRUSES AMONG HEMODIALYSIS PATIENTS AS A RESULT OF HEMODIALYSIS CRISIS IN YEMEN PREVALENCE AND GENOTYPING OF HEPATITIS C VIRUS IN HEMODIALYSIS PATIENTS AND EVALUATION OF HCV-CORE ANTIGEN TEST IN SCREENING PATIENTS FOR DIALYSIS IN SANA'A CITY, YEMEN PREVALENCE OF HBV AND HCV; AND THEIR ASSOCIATED RISK FACTORS AMONG PUBLIC HEALTH CENTER CLEANERS AT SELECTED PUBLIC HEALTH CENTERS IN SANA'A CITY-YEMEN

Malignant hyperthermia (MH) is a clinical response happened to patient who is sensitive with inhaled anesthesia drug that could cause suddently death. Many previous studies showed that malignant hyperthermia strongly related to genetic background of patients including RYR1, CACNA1S or STAC3 gene polymorphisms. With the development of high technology such as next generation sequencing, scientists found that 37 to 86 percents of MH cases had RYR1 mutations and approximately 1 percent of those had CACNA1S mutations. Gene analysis testing was recommended to apply for patient with MH medical history or MH patient’s family relations. Keywords Malignant hyperthermia, inhaled anesthesia, RYR1, CACNA1S, STAC3. References [1] G. Torri, Inhalation anesthetics: a review, Minerva Anestesiologica 76 (2010) 215–228. [2] N. Kassiri, S. Ardehali, F. Rashidi, S. Hashemian, Inhalational anesthetics agents: The pharmacokinetic, pharmacodynamics, and their effects on human body, Biomed. Biotechnol. Res. 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Photograph by Gonzalo Echeverria (2010)Declaring War Soon after Al Qaeda’s terrorist attacks on 11 September 2001, the Bush Administration described its new grand strategy: the “Global War on Terror”. This underpinned the subsequent counter-insurgency in Afghanistan and the United States invasion of Iraq in March 2003. Media pundits quickly applied the Global War on Terror label to the Madrid, Bali and London bombings, to convey how Al Qaeda’s terrorism had gone transnational. Meanwhile, international relations scholars debated the extent to which September 11 had changed the international system (Brenner; Mann 303). American intellectuals adopted several variations of the Global War on Terror in what initially felt like a transitional period of US foreign policy (Burns). Walter Laqueur suggested Al Qaeda was engaged in a “cosmological” and perpetual war. Paul Berman likened Al Qaeda and militant Islam to the past ideological battles against communism and fascism (Heilbrunn 248). In a widely cited article, neoconservative thinker Norman Podhoretz suggested the United States faced “World War IV”, which had three interlocking drivers: Al Qaeda and trans-national terrorism; political Islam as the West’s existential enemy; and nuclear proliferation to ‘rogue’ countries and non-state actors (Friedman 3). Podhoretz’s tone reflected a revival of his earlier Cold War politics and critique of the New Left (Friedman 148-149; Halper and Clarke 56; Heilbrunn 210). These stances attracted widespread support. For instance, the United States Marine Corp recalibrated its mission to fight a long war against “World War IV-like” enemies. Yet these stances left the United States unprepared as the combat situations in Afghanistan and Iraq worsened (Ricks; Ferguson; Filkins). Neoconservative ideals for Iraq “regime change” to transform the Middle East failed to deal with other security problems such as Pakistan’s Musharraf regime (Dorrien 110; Halper and Clarke 210-211; Friedman 121, 223; Heilbrunn 252). The Manichean and open-ended framing became a self-fulfilling prophecy for insurgents, jihadists, and militias. The Bush Administration quietly abandoned the Global War on Terror in July 2005. Widespread support had given way to policymaker doubt. Why did so many intellectuals and strategists embrace the Global War on Terror as the best possible “grand strategy” perspective of a post-September 11 world? Why was there so little doubt of this worldview? This is a debate with roots as old as the Sceptics versus the Sophists. Explanations usually focus on the Bush Administration’s “Vulcans” war cabinet: Vice President Dick Cheney, Secretary of Defense Donald Rumsfield, and National Security Advisor Condoleezza Rice, who later became Secretary of State (Mann xv-xvi). The “Vulcans” were named after the Roman god Vulcan because Rice’s hometown Birmingham, Alabama, had “a mammoth fifty-six foot statue . . . [in] homage to the city’s steel industry” (Mann x) and the name stuck. Alternatively, explanations focus on how neoconservative thinkers shaped the intellectual climate after September 11, in a receptive media climate. Biographers suggest that “neoconservatism had become an echo chamber” (Heilbrunn 242) with its own media outlets, pundits, and think-tanks such as the American Enterprise Institute and Project for a New America. Neoconservatism briefly flourished in Washington DC until Iraq’s sectarian violence discredited the “Vulcans” and neoconservative strategists like Paul Wolfowitz (Friedman; Ferguson). The neoconservatives' combination of September 11’s aftermath with strongly argued historical analogies was initially convincing. They conferred with scholars such as Bernard Lewis, Samuel P. Huntington and Victor Davis Hanson to construct classicist historical narratives and to explain cultural differences. However, the history of the decade after September 11 also contains mis-steps and mistakes which make it a series of contingent decisions (Ferguson; Bergen). One way to analyse these contingent decisions is to pose “what if?” counterfactuals, or feasible alternatives to historical events (Lebow). For instance, what if September 11 had been a chemical and biological weapons attack? (Mann 317). Appendix 1 includes a range of alternative possibilities and “minimal rewrites” or slight variations on the historical events which occurred. Collectively, these counterfactuals suggest the role of agency, chance, luck, and the juxtaposition of better and worse outcomes. They pose challenges to the classicist interpretation adopted soon after September 11 to justify “World War IV” (Podhoretz). A ‘Two-Track’ Process for ‘World War IV’ After the September 11 attacks, I think an overlapping two-track process occurred with the “Vulcans” cabinet, neoconservative advisers, and two “echo chambers”: neoconservative think-tanks and the post-September 11 media. Crucially, Bush’s “Vulcans” war cabinet succeeded in gaining civilian control of the United States war decision process. Although successful in initiating the 2003 Iraq War this civilian control created a deeper crisis in US civil-military relations (Stevenson; Morgan). The “Vulcans” relied on “politicised” intelligence such as a United Kingdom intelligence report on Iraq’s weapons development program. The report enabled “a climate of undifferentiated fear to arise” because its public version did not distinguish between chemical, biological, radiological or nuclear weapons (Halper and Clarke, 210). The cautious 2003 National Intelligence Estimates (NIE) report on Iraq was only released in a strongly edited form. For instance, the US Department of Energy had expressed doubts about claims that Iraq had approached Niger for uranium, and was using aluminium tubes for biological and chemical weapons development. Meanwhile, the post-September 11 media had become a second “echo chamber” (Halper and Clarke 194-196) which amplified neoconservative arguments. Berman, Laqueur, Podhoretz and others who framed the intellectual climate were “risk entrepreneurs” (Mueller 41-43) that supported the “World War IV” vision. The media also engaged in aggressive “flak” campaigns (Herman and Chomsky 26-28; Mueller 39-42) designed to limit debate and to stress foreign policy stances and themes which supported the Bush Administration. When former Central Intelligence Agency director James Woolsey’s claimed that Al Qaeda had close connections to Iraqi intelligence, this was promoted in several books, including Michael Ledeen’s War Against The Terror Masters, Stephen Hayes’ The Connection, and Laurie Mylroie’s Bush v. The Beltway; and in partisan media such as Fox News, NewsMax, and The Weekly Standard who each attacked the US State Department and the CIA (Dorrien 183; Hayes; Ledeen; Mylroie; Heilbrunn 237, 243-244; Mann 310). This was the media “echo chamber” at work. The group Accuracy in Media also campaigned successfully to ensure that US cable providers did not give Al Jazeera English access to US audiences (Barker). Cosmopolitan ideals seemed incompatible with what the “flak” groups desired. The two-track process converged on two now infamous speeches. US President Bush’s State of the Union Address on 29 January 2002, and US Secretary of State Colin Powell’s presentation to the United Nations on 5 February 2003. Bush’s speech included a line from neoconservative David Frumm about North Korea, Iraq and Iran as an “Axis of Evil” (Dorrien 158; Halper and Clarke 139-140; Mann 242, 317-321). Powell’s presentation to the United Nations included now-debunked threat assessments. In fact, Powell had altered the speech’s original draft by I. Lewis “Scooter” Libby, who was Cheney’s chief of staff (Dorrien 183-184). Powell claimed that Iraq had mobile biological weapons facilities, linked to Abu Musab al-Zarqawi. However, the International Atomic Energy Agency’s (IAEA) Mohamed El-Baradei, the Defense Intelligence Agency, the State Department, and the Institute for Science and International Security all strongly doubted this claim, as did international observers (Dorrien 184; Halper and Clarke 212-213; Mann 353-354). Yet this information was suppressed: attacked by “flak” or given little visible media coverage. Powell’s agenda included trying to rebuild an international coalition and to head off weather changes that would affect military operations in the Middle East (Mann 351). Both speeches used politicised variants of “weapons of mass destruction”, taken from the counterterrorism literature (Stern; Laqueur). Bush’s speech created an inflated geopolitical threat whilst Powell relied on flawed intelligence and scientific visuals to communicate a non-existent threat (Vogel). However, they had the intended effect on decision makers. US Under-Secretary of Defense, the neoconservative Paul Wolfowitz, later revealed to Vanity Fair that “weapons of mass destruction” was selected as an issue that all potential stakeholders could agree on (Wilkie 69). Perhaps the only remaining outlet was satire: Armando Iannucci’s 2009 film In The Loop parodied the diplomatic politics surrounding Powell’s speech and the civil-military tensions on the Iraq War’s eve. In the short term the two track process worked in heading off doubt. The “Vulcans” blocked important information on pre-war Iraq intelligence from reaching the media and the general public (Prados). Alternatively, they ignored area specialists and other experts, such as when Coalition Provisional Authority’s L. Paul Bremer ignored the US State Department’s fifteen volume ‘Future of Iraq’ project (Ferguson). Public “flak” and “risk entrepreneurs” mobilised a range of motivations from grief and revenge to historical memory and identity politics. This combination of private and public processes meant that although doubts were expressed, they could be contained through the dual echo chambers of neoconservative policymaking and the post-September 11 media. These factors enabled the “Vulcans” to proceed with their “regime change” plans despite strong public opposition from anti-war protestors. Expressing DoubtsMany experts and institutions expressed doubt about specific claims the Bush Administration made to support the 2003 Iraq War. This doubt came from three different and sometimes overlapping groups. Subject matter experts such as the IAEA’s Mohamed El-Baradei and weapons development scientists countered the UK intelligence report and Powell’s UN speech. However, they did not get the media coverage warranted due to “flak” and “echo chamber” dynamics. Others could challenge misleading historical analogies between insurgent Iraq and Nazi Germany, and yet not change the broader outcomes (Benjamin). Independent journalists one group who gained new information during the 1990-91 Gulf War: some entered Iraq from Kuwait and documented a more humanitarian side of the war to journalists embedded with US military units (Uyarra). Finally, there were dissenters from bureaucratic and institutional processes. In some cases, all three overlapped. In their separate analyses of the post-September 11 debate on intelligence “failure”, Zegart and Jervis point to a range of analytic misperceptions and institutional problems. However, the intelligence community is separated from policymakers such as the “Vulcans”. Compartmentalisation due to the “need to know” principle also means that doubting analysts can be blocked from releasing information. Andrew Wilkie discovered this when he resigned from Australia’s Office for National Assessments (ONA) as a transnational issues analyst. Wilkie questioned the pre-war assessments in Powell’s United Nations speech that were used to justify the 2003 Iraq War. Wilkie was then attacked publicly by Australian Prime Minister John Howard. This overshadowed a more important fact: both Howard and Wilkie knew that due to Australian legislation, Wilkie could not publicly comment on ONA intelligence, despite the invitation to do so. This barrier also prevented other intelligence analysts from responding to the “Vulcans”, and to “flak” and “echo chamber” dynamics in the media and neoconservative think-tanks. Many analysts knew that the excerpts released from the 2003 NIE on Iraq was highly edited (Prados). For example, Australian agencies such as the ONA, the Department of Foreign Affairs and Trade, and the Department of Defence knew this (Wilkie 98). However, analysts are trained not to interfere with policymakers, even when there are significant civil-military irregularities. Military officials who spoke out about pre-war planning against the “Vulcans” and their neoconservative supporters were silenced (Ricks; Ferguson). Greenlight Capital’s hedge fund manager David Einhorn illustrates in a different context what might happen if analysts did comment. Einhorn gave a speech to the Ira Sohn Conference on 15 May 2002 debunking the management of Allied Capital. Einhorn’s “short-selling” led to retaliation from Allied Capital, a Securities and Exchange Commission investigation, and growing evidence of potential fraud. If analysts adopted Einhorn’s tactics—combining rigorous analysis with targeted, public denunciation that is widely reported—then this may have short-circuited the “flak” and “echo chamber” effects prior to the 2003 Iraq War. The intelligence community usually tries to pre-empt such outcomes via contestation exercises and similar processes. This was the goal of the 2003 NIE on Iraq, despite the fact that the US Department of Energy which had the expertise was overruled by other agencies who expressed opinions not necessarily based on rigorous scientific and technical analysis (Prados; Vogel). In counterterrorism circles, similar disinformation arose about Aum Shinrikyo’s biological weapons research after its sarin gas attack on Tokyo’s subway system on 20 March 1995 (Leitenberg). Disinformation also arose regarding nuclear weapons proliferation to non-state actors in the 1990s (Stern). Interestingly, several of the “Vulcans” and neoconservatives had been involved in an earlier controversial contestation exercise: Team B in 1976. The Central Intelligence Agency (CIA) assembled three Team B groups in order to evaluate and forecast Soviet military capabilities. One group headed by historian Richard Pipes gave highly “alarmist” forecasts and then attacked a CIA NIE about the Soviets (Dorrien 50-56; Mueller 81). The neoconservatives adopted these same tactics to reframe the 2003 NIE from its position of caution, expressed by several intelligence agencies and experts, to belief that Iraq possessed a current, covert program to develop weapons of mass destruction (Prados). Alternatively, information may be leaked to the media to express doubt. “Non-attributable” background interviews to establishment journalists like Seymour Hersh and Bob Woodward achieved this. Wikileaks publisher Julian Assange has recently achieved notoriety due to US diplomatic cables from the SIPRNet network released from 28 November 2010 onwards. Supporters have favourably compared Assange to Daniel Ellsberg, the RAND researcher who leaked the Pentagon Papers (Ellsberg; Ehrlich and Goldsmith). Whilst Elsberg succeeded because a network of US national papers continued to print excerpts from the Pentagon Papers despite lawsuit threats, Assange relied in part on favourable coverage from the UK’s Guardian newspaper. However, suspected sources such as US Army soldier Bradley Manning are not protected whilst media outlets are relatively free to publish their scoops (Walt, ‘Woodward’). Assange’s publication of SIPRNet’s diplomatic cables will also likely mean greater restrictions on diplomatic and military intelligence (Walt, ‘Don’t Write’). Beyond ‘Doubt’ Iraq’s worsening security discredited many of the factors that had given the neoconservatives credibility. The post-September 11 media became increasingly more critical of the US military in Iraq (Ferguson) and cautious about the “echo chamber” of think-tanks and media outlets. Internet sites for Al Jazeera English, Al-Arabiya and other networks have enabled people to bypass “flak” and directly access these different viewpoints. Most damagingly, the non-discovery of Iraq’s weapons of mass destruction discredited both the 2003 NIE on Iraq and Colin Powell’s United Nations presentation (Wilkie 104). Likewise, “risk entrepreneurs” who foresaw “World War IV” in 2002 and 2003 have now distanced themselves from these apocalyptic forecasts due to a series of mis-steps and mistakes by the Bush Administration and Al Qaeda’s over-calculation (Bergen). The emergence of sites such as Wikileaks, and networks like Al Jazeera English and Al-Arabiya, are a response to the politics of the past decade. They attempt to short-circuit past “echo chambers” through providing access to different sources and leaked data. The Global War on Terror framed the Bush Administration’s response to September 11 as a war (Kirk; Mueller 59). Whilst this prematurely closed off other possibilities, it has also unleashed a series of dynamics which have undermined the neoconservative agenda. The “classicist” history and historical analogies constructed to justify the “World War IV” scenario are just one of several potential frameworks. “Flak” organisations and media “echo chambers” are now challenged by well-financed and strategic alternatives such as Al Jazeera English and Al-Arabiya. Doubt is one defence against “risk entrepreneurs” who seek to promote a particular idea: doubt guards against uncritical adoption. Perhaps the enduring lesson of the post-September 11 debates, though, is that doubt alone is not enough. What is needed are individuals and institutions that understand the strategies which the neoconservatives and others have used, and who also have the soft power skills during crises to influence critical decision-makers to choose alternatives. Appendix 1: Counterfactuals Richard Ned Lebow uses “what if?” counterfactuals to examine alternative possibilities and “minimal rewrites” or slight variations on the historical events that occurred. The following counterfactuals suggest that the Bush Administration’s Global War on Terror could have evolved very differently . . . or not occurred at all. Fact: The 2003 Iraq War and 2001 Afghanistan counterinsurgency shaped the Bush Administration’s post-September 11 grand strategy. Counterfactual #1: Al Gore decisively wins the 2000 U.S. election. Bush v. Gore never occurs. After the September 11 attacks, Gore focuses on international alliance-building and gains widespread diplomatic support rather than a neoconservative agenda. He authorises Special Operations Forces in Afghanistan and works closely with the Musharraf regime in Pakistan to target Al Qaeda’s muhajideen. He ‘contains’ Saddam Hussein’s Iraq through measurement and signature, technical intelligence, and more stringent monitoring by the International Atomic Energy Agency. Minimal Rewrite: United 93 crashes in Washington DC, killing senior members of the Gore Administration. Fact: U.S. Special Operations Forces failed to kill Osama bin Laden in late November and early December 2001 at Tora Bora. Counterfactual #2: U.S. Special Operations Forces kill Osama bin Laden in early December 2001 during skirmishes at Tora Bora. Ayman al-Zawahiri is critically wounded, captured, and imprisoned. The rest of Al Qaeda is scattered. Minimal Rewrite: Osama bin Laden’s death turns him into a self-mythologised hero for decades. Fact: The UK Blair Government supplied a 50-page intelligence dossier on Iraq’s weapons development program which the Bush Administration used to support its pre-war planning. Counterfactual #3: Rogue intelligence analysts debunk the UK Blair Government’s claims through a series of ‘targeted’ leaks to establishment news sources. Minimal Rewrite: The 50-page intelligence dossier is later discovered to be correct about Iraq’s weapons development program. Fact: The Bush Administration used the 2003 National Intelligence Estimate to “build its case” for “regime change” in Saddam Hussein’s Iraq. Counterfactual #4: A joint investigation by The New York Times and The Washington Post rebuts U.S. Secretary of State Colin Powell’s speech to the United National Security Council, delivered on 5 February 2003. Minimal Rewrite: The Central Intelligence Agency’s whitepaper “Iraq’s Weapons of Mass Destruction Programs” (October 2002) more accurately reflects the 2003 NIE’s cautious assessments. Fact: The Bush Administration relied on Ahmed Chalabi for its postwar estimates about Iraq’s reconstruction. Counterfactual #5: The Bush Administration ignores Chalabi’s advice and relies instead on the U.S. State Department’s 15 volume report “The Future of Iraq”. Minimal Rewrite: The Coalition Provisional Authority appoints Ahmed Chalabi to head an interim Iraqi government. Fact: L. 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