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This research aimed to qualitatively explore whether the determinants of handwashing behaviour change according to the duration of displacement or the type of setting that people are displaced to. We conducted an exploratory qualitative study in three different post-conflict settings in Northern Iraq–a long-term displacement camp, a short-term displacement camp, and villages where people were returning to post the conflict. We identified 33 determinants of handwashing in these settings and, of these, 21 appeared to be altered by the conflict and displacement. Determinants of handwashing behaviour in the post-conflict period were predominantly explained by disruptions to the physical, psychological, social and economic circumstances of displaced populations. Future hygiene programmes in post-conflict displacement settings should adopt a holistic way of assessing determinants and design programmes which promote agency, build on adaptive norms, create an enabling environment and which are integrated with other aspects of humanitarian response.

BACKGROUND:Children in humanitarian situations are particularly vulnerable to diseases such as diarrhoea. Handwashing with soap can greatly reduce transmission but handwashing rates are often low and traditional interventions ineffective. To aid future intervention design, this study aims to understand the determinants of child handwashing and the key motivational drivers of children's behaviour within a specific humanitarian setting. METHODS:In an internally displaced persons camp in Northern Iraq we conducted a series of 36 friendship-paired interviews with children aged 7-12 years, six semi-structured caregiver interviews, and three semi-structured hygiene promoter interviews. Perceived determinants of child handwashing were explored qualitatively, and motivational drivers were explored quantitatively with children in a rating exercise. Qualitative data were analysed thematically, using an inductive approach, and logistic regression analyses of motive rating data were performed to determine the predicted probabilities of motives being rated as important. RESULTS:Access to soap and water was perceived to be high across all participant groups. Children, caregivers and hygiene promoters all perceive the determinants of child handwashing to be associated with familial role, environmental factors pertaining to location and quality of handwashing materials and facilities, and level of exposure to hygiene promotion, and children also attribute their handwashing to social norms. We find that children in this context are motived most by play and nurture. CONCLUSIONS:Provision of soap and water alone is not sufficient to encourage children to practice handwashing with soap in a humanitarian context. Our findings suggest that equal consideration should be given to the quality and location of handwashing materials and facilities and social norms could be leveraged to promote and enhance child handwashing. Motive-based interventions targeting play or nurture may be a promising approach and are likely most effective when used in conjunction, along with other motivational drivers such as affiliation and love.

This research aimed to qualitatively explore whether the determinants of handwashing behaviour change according to the duration of displacement or the type of setting that people are displaced to. We conducted an exploratory qualitative study in three different post-conflict settings in Northern Iraq-a long-term displacement camp, a short-term displacement camp, and villages where people were returning to post the conflict. We identified 33 determinants of handwashing in these settings and, of these, 21 appeared to be altered by the conflict and displacement. Determinants of handwashing behaviour in the post-conflict period were predominantly explained by disruptions to the physical, psychological, social and economic circumstances of displaced populations. Future hygiene programmes in post-conflict displacement settings should adopt a holistic way of assessing determinants and design programmes which promote agency, build on adaptive norms, create an enabling environment and which are integrated with other aspects of humanitarian response., Competing Interests: The authors have declared that no competing interests exist.

Background: Children in humanitarian situations are particularly vulnerable to diseases such as diarrhoea. Handwashing with soap can greatly reduce transmission but handwashing rates are often low and traditional interventions ineffective. To aid future intervention design, this study aims to understand the determinants of child handwashing and the key motivational drivers of children's behaviour within a specific humanitarian setting., Methods: In an internally displaced persons camp in Northern Iraq we conducted a series of 36 friendship-paired interviews with children aged 7-12 years, six semi-structured caregiver interviews, and three semi-structured hygiene promoter interviews. Perceived determinants of child handwashing were explored qualitatively, and motivational drivers were explored quantitatively with children in a rating exercise. Qualitative data were analysed thematically, using an inductive approach, and logistic regression analyses of motive rating data were performed to determine the predicted probabilities of motives being rated as important., Results: Access to soap and water was perceived to be high across all participant groups. Children, caregivers and hygiene promoters all perceive the determinants of child handwashing to be associated with familial role, environmental factors pertaining to location and quality of handwashing materials and facilities, and level of exposure to hygiene promotion, and children also attribute their handwashing to social norms. We find that children in this context are motived most by play and nurture., Conclusions: Provision of soap and water alone is not sufficient to encourage children to practice handwashing with soap in a humanitarian context. Our findings suggest that equal consideration should be given to the quality and location of handwashing materials and facilities and social norms could be leveraged to promote and enhance child handwashing. Motive-based interventions targeting play or nurture may be a promising approach and are likely most effective when used in conjunction, along with other motivational drivers such as affiliation and love., Competing Interests: The authors have declared that no competing interests exist.

Widely considered as one of the cradles of human civilization, Mesopotamia is largely situated in the Republic of Iraq, which is also the birthplace of the Sumerian, Akkadian, Assyrian and Babylonian civilizations. These lands were subsequently ruled by the Persians, Greeks, Romans, Arabs, Mongolians, Ottomans and finally British prior to the independence. As a direct consequence of this rich history, the contemporary Iraqi population comprises a true mosaic of different ethnicities, which includes Arabs, Kurds, Turkmens, Assyrians, and Yazidis among others. As such, the genetics of the contemporary Iraqi populations are of anthropological and forensic interest. In an effort to contribute to a better understanding of the genetic basis of this ethnic diversity, a total of 500 samples were collected from Northern Iraqi volunteers belonging to five major ethnic groups, namely: Arabs (n = 102), Kurds (n = 104), Turkmens (n = 102), Yazidis (n = 106) and Syriacs (n = 86). 17-loci Y-STR analyses were carried out using the AmpFlSTR Yfiler system, and subsequently in silico haplogroup assignments were made to gain insights from a molecular anthropology perspective. Systematic comparisons of the paternal lineages of these five Northern Iraqi ethnic groups, not only among themselves but also in the context of the larger genetic landscape of the Near East and beyond, were then made through the use of two different genetic distance metric measures and the associated data visualization methods. Taken together, results from the current study suggested the presence of intricate Y-chromosomal lineage patterns among the five ethic groups analyzed, wherein both interconnectivity and independent microvariation were observed in parallel, albeit in a differential manner. Notably, the novel Y-STR data on Turkmens, Syriacs and Yazidis from Northern Iraq constitute the first of its kind in the literature. Data presented herein is expected to contribute to further population and forensic investigations in Northern Iraq in particular and the Near East in general. [ABSTRACT FROM AUTHOR]

Cardiopulmonary complications are among the most important complications of thalassemia major. Pulmonary hypertension is among these complications and studies addressing its frequency and associations in the latter disorder are sparse from Iraq. For this purpose a total 100 thalassemia major patients (≥ 8 years old) were enrolled from a main thalassemia center in Kurdistan, Northern Iraq. All patients had a full history and clinical examination. Full blood count, biochemical tests and viral screen including hepatitis B surface antigen and hepatitis C virus antibody, in addition to transthoracic Doppler echocardiography for tricuspid regurgitation jet velocity (TRV). The enrolled patients had a mean (SD) age of 17.6 (5.5) years, and included 52 males and 48 females. Pulmonary hypertension as defined by TRV> 2.8 m/s coupled with both exertional dyspnea and an absence of left sided heart failure, was identified in nine patients (9%). The latter subgroup of patients had significantly higher reticulocyte counts, S. LDH, S. ferritin, and hepatitis C sero-positivity compared to those without this complication by univariate analysis. While by multivariate logistic regression only reticulocytes and hepatitis C sero-positivity remained significant. Furthermore, TRV as a continuous variable was positively correlated with reticulocytes, S. bilirubin and LDH (p<0.001, p = 0.002 and p<0.001 respectively), but not with age or S. ferritin (p = 0.77, and p = 0.93 respectively). In conclusion, pulmonary hypertension is not uncommon in Iraqi patients with thalassemia major, and it appears to be linked to chronic hemolysis rather than iron overload. [ABSTRACT FROM AUTHOR]

Background: Traumatized refugees often suffer from diverse psychosomatic symptoms. Female Yazidi refugees from Northern Iraq who survived attacks of the so-called "Islamic State" were brought to Germany to receive special medical and psychotherapeutic treatment in a unique worldwide humanitarian admission program (HAP). Here, we report on their psychosomatic symptoms and helpful strategies from the perspective of care providers. Methods: Care providers (N = 84) in this HAP were interviewed in an individual setting as well as in focus groups to gather information about the HAP beneficiaries' psychosomatic symptoms. Data analysis followed Qualitative Content Analysis by Mayring. Results: The care providers reported five main psychological burdens of the Yazidis: 1) insecurity regarding loss, 2) worries about family members, 3) ambivalence about staying in Germany or returning to Iraq, 4) life between two worlds and 5) re-actualization of the traumatic experiences. The predominant psychological symptoms the care providers noticed were fear, depressive symptoms, feelings of guilt, and sleep and eating disorders. Regarding somatic symptoms, the care providers mainly received complaints about pain in the head, back, chest and stomach. Helpful strategies for providing adequate health care were care providers' cooperating with physicians, precise documentation of beneficiaries' symptoms, and additional support in directing the beneficiaries through the health care system. Regarding psychotherapy, interpreters help to overcome language barriers, onsite psychotherapy, flexible therapy appointments, psychoeducational methods, time for stabilization, and support in coping with daily life aspects. In the care providers' experience, psychotherapists have to build a relationship of trust. After grief therapy, a trauma-specific therapy in a culturally adapted way is possible. Conclusion: The HAP is a unique model health care program to offer highly traumatized refugees medical and psychological help. Care providers reported on several (psycho-)somatic symptoms of the traumatized women. The strategies the HAP care providers perceived as helpful can be recommended for similar projects in the future. [ABSTRACT FROM AUTHOR]

This article [[1]] includes a reference error: the wrong article was listed for reference 16. These samples were described in [[1]] as Syrian, Syria [Syrians] or Syria [Syriacs], whereas, article [[2]] indicates that these were Syriac samples "mostly collected at various refugee camps in Erbil". Where samples from the Erbil camps are described in [[1]], "Syrian", "Syria [Syrians]" or "Syria [Syriacs]" should be replaced by "Northern Iraq [Syriacs]". [Extracted from the article]

Hodgkin’s Lymphoma (HL) reveals variable epidemiological and clinico-pathological features in different geographical locations. In this retrospective study, we aimed to assess the epidemiological and clinic-pathological features, and outcome of HL patients treated at one hemato-oncology centre in Erbil, northern Iraq. Medical records of 103 HL patients treated over more than six years were reviewed. Treatment outcome was evaluated by measuring the 5-year overall and progression-free survival rates. The median age of patients was 23 years, children up to 17 years constituted 31.1%, and male to female ratio was 1:1.05. The majority (96.1%) of patients presented with lymphadenopathy. Nodular sclerosis subtype was the mostly encountered histologic type (48.5%); about half of the patients (49.5%) had stage II disease. Relapse occurred in 20 patients; the 5-year overall survival for children was better (89%) compared to adult patients (79%). The associated risk features found to have adverse effects on the survival, however, only high LDH level and presence of B-symptoms at presentation showed significant correlation. The epidemiological and clinical characteristics of HL in our locality followed the pattern in the western world. The 5-year overall and progression-free survivals were far below the international rates, a matter which may necessitate a revision to HL treatment strategy at our centre. [ABSTRACT FROM AUTHOR]

In order to predict the global potential distribution range of Ixodes pacificus (I. pacificus) under different climate scenario models in the future, analyze the major climate factors affecting its distribution, and provide references for the transformation of passive vector surveillance into active vector surveillance, the maximum entropy model (MaxEnt) was used in this study to estimate the global potential distribution range of I. pacificus under historical climate scenarios and different future climate scenarios. The global distribution data of I. pacificus were screened by ENMtools and ArcGIS 10.8 software, and a total of 563 distribution data of I. pacificus were obtained. Maxent 3.4.1 and R 4.0.3 were used to screen climate variables according to the contribution rate of environmental variables, knife cutting method and correlation analysis of variables. R 4.0.3 was used to calculate model regulation frequency doubling and feature combination to adjust MaxEnt parameters. The model results showed that the training omission rate was in good agreement with the theoretical omission rate, and the area under ROC curve (AUC) value of the model was 0.978. Among the included environmental variables, the Tmin2 (minimum temperature in February) and Prec1 (precipitation in January) contributed the most to the model, providing more effective information for the distribution of I. pacificus. MaxEnt model revealed that the distribution range of I. pacificus was dynamically changing. The main potential suitable areas are distributed in North America, South America, Europe, Oceania and Asia. Under the future climate scenario model, the potential suitable areas show a downward trend, but the countries and regions ieeeeeeenvolved in the suitable areas do not change much. Therefore, the invasion risk of the potential suitable area of I. pacificus should be paid attention to. [ABSTRACT FROM AUTHOR]

Evaluating archaeobotanical data from over 3.9 million seeds and 124,300 charcoal fragments across 330 archaeological site phases in Southwest Asia, we reconstruct the history of olive and grape cultivation spanning a period of 6,000 years. Combining charcoal and seed data enables investigation into both the production and consumption of olive and grape. The earliest indication for olive and grape cultivation appears in the southern Levant around ca. 5000 BC and 4th millennium BC respectively, although cultivation may have been practiced prior to these dates. Olive and grape cultivation in Southwest Asia was regionally concentrated within the Levant until 600 BC, although there were periodic pushes to the East. Several indications for climate influencing the history of olive and grape cultivation were found, as well as a correlation between periods of high population density and high proportions of olive and grape remains in archaeological sites. While temporal uncertainty prevents a detailed understanding of the causal mechanisms behind these correlations, we suggest that long distance trade in olives, grapes and their associated products was integral to the economic, social, and demographic trajectories of the region. [ABSTRACT FROM AUTHOR]

Background: During the summer of 2014, ISIS overran Nineveh governorate in Northern Iraq. Yazidis and other religious minorities were subjected to brutal attacks and forced to seek refuge into the neighbouring Kurdistan Region, where they remain living in local communities or in camps. This survey provides a population-based assessment of the health needs and care seeking behaviours of Yazidis and other groups currently residing in camps. Methods: The survey covered 13 camps managed by the Kurdish Board of Relief and Humanitarian Affairs. A systematic random sample of 1,300 households with a total of 8,360 members were interviewed between November and December 2015. Participants were asked if any household members had needed care for a health condition in the two weeks preceding the survey, and whether care was obtained from the camp primary health care centre, an outside public hospital or a private clinic. If care was received, the out-of-pocket payment was recorded; otherwise, the reason for not seeking care was queried. Results: In 33.9% (CI: 31.0–37.0) of households one or more members had needed care for a health condition in the two weeks preceding the survey. The most likely to have needed care were older persons (18.5%; CI: 13.6–24.6) and infants (18.0%; CI: 11.6–26.8). The reported health conditions revealed a complex picture of communicable and non-communicable diseases as well as mental health problems and physical injuries. Care was primarily sought from private clinics (41.8%; CI: 36.4–47.4) or public hospitals (27.3%; CI: 22.6–32.7) rather than from the camp primary health care clinics (23.6%; CI: 19.5–28.2). The mean out-of-pocket payment for care received was nearly 3 times higher in public hospitals than in the camp primary health care clinics and nearly 11 times higher in private clinics. Cost was the main perceived barrier to obtaining health services. Conclusion: Demand for health services was high among Yazidis and other minorities living in camps. Private services were preferred in spite of the tenuous economic circumstances of displaced households. Declines in public sector funding may further restrict access from camp clinics stressing the need for alternative access strategies. [ABSTRACT FROM AUTHOR]

With the rapid advancement of technology, Artificial Intelligence (AI) painting has emerged as a leading intelligence service. This study aims to empirically investigate users' continuance intention toward AI painting applications by utilizing and expanding the Expectation Confirmation Model (ECM), Technology Acceptance Model (TAM), Unified Theory of Acceptance and Use of Technology (UTAUT), and the Flow Theory. A comprehensive research model is proposed. A total of 443 questionnaires were distributed to users with AI painting experiences for data collection. The hypotheses were tested through structural equation modeling. The primary conclusions drawn from this research include: 1) Confirmation plays a crucial role, significantly and positively predicting satisfaction and social impact. 2) Personal innovativeness has a significant effect on confirmation. 3) Satisfaction, flow experience, and social influence directly and positively predict intention, with social influence showing the most significant impact, while perceived usefulness, perceived enjoyment, and performance expectancy show no significant impact on intention. 4) Habit plays a negative moderating role in the association between social influence and continued intention to use. These findings offer valuable insights and inspiration for users seeking to understand the appropriate utilization of AI painting and provide actionable directions for the development of AI painting. [ABSTRACT FROM AUTHOR]

Humanitarian crises such as disease outbreaks, conflict and displacement and natural disasters affect millions of people primarily in low- and middle-income countries. Here, they often reside in areas with poor environmental health conditions leading to an increased burden of infectious diseases such as gastrointestinal and respiratory infections. Water, sanitation, and hygiene behaviours are critical to prevent such infections and deaths. A scoping review was conducted to map out what is known about the association between three mental health disorders and people's perceived and actual ability to practice hygiene-related behaviours, particularly handwashing, in humanitarian and pandemic crises. Published and grey literature was identified through database searches, humanitarian-relevant portals, and consultations with key stakeholders in the humanitarian sector. 25 publications were included, 21 were peer-reviewed published articles and four were grey literature publications. Most of the studies were conducted in mainland China (n = 12) and most were conducted in an outbreak setting (n = 20). Six studies found a positive correlation between handwashing and anxiety where participants with higher rates of anxiety were more likely to practice handwashing with soap. Four studies found an inverse relationship where those with higher rates of anxiety were less likely to wash their hands with soap. The review found mixed results for the association between handwashing and depression, with four of the seven studies reporting those with higher rates of depression were less likely to wash their hands, while the remaining studies found that higher depression scores resulted in more handwashing. Mixed results were also found between post-traumatic stress disorder (PTSD) and handwashing. Two studies found that lower scores of PTSD were associated with better hygiene practices, including handwashing with soap. The contradictory patterns suggest that researchers and practitioners need to explore this association further, in a wider range of crises, and need to standardize tools to do so. [ABSTRACT FROM AUTHOR]

A database for the Iraqi Sorani Kurds, specifically focused on the 12 X-short tandem repeat (STR) loci, has been developed to fascilitate forensic and population genetics investigations. The present study involved genotyping 117 unrelated individuals from the Sorani Kurds ethnic group using the Investigator Argus X-12 QS kit. The analysis revealed that the DXS10135 locus exhibited the highest degree of polymorphism, as indicated by a polymorphism information content (PIC) value of 0.94565 and a gene diversity (GD) value of 0.95623. Conversely, the DXS8378 locus displayed the lowest level of polymorphism, with a PIC value of 0.61026 and a GD value of 0.68170. Notably, two individuals were found to possess a rare allele (allele = 6) at the DXS8378 locus, which was not included in the allelic ladder of the kit. Furthermore, a significant linkage disequilibrium (LD) (p < 0.05/117) was observed between the DXS10103 and DXS10101 loci on linkage group 3 (LG3). The ancestral composition of the five primary geographic regions, namely Africa, Middle East, East Asia, Europe, and South America, was determined through the utilization of the FST/FSTmax ratio. The findings of this analysis revealed that the Middle Eastern populations exhibited the lowest FST/FSTmax ratio, measuring at 0.23243, indicating a relatively lower ancestral diversity. Conversely, the European populations showcased the highest FST/FSTmax ratio, measuring at 0.27122, indicative of a greater ancestral diversity within this region. Additionally, the allelic richness indicators, namely distinctive and private alleles, indicated that Africa and the Middle East displayed the highest levels, while Far East Asia exhibited the lowest. This analysis supports the hypothesis of repeated founder effects during outward migrations, as evidenced by both the ancestry variability and the allelic richness. Consequently, the findings of this study have important implications for forensic genetics and population genetics research, particularly in relation to the consideration of genetic predispositions within specific ethnic groups. [ABSTRACT FROM AUTHOR]

Background: Face to face mode of delivery has been a standard method of teaching courses in the majority of African Universities Tanzania included. The COVID-19 pandemic has caused the closure of all schools and universities worldwide; therefore, face-to-face teaching is no longer the only appropriate and feasible teaching method. This requires changes in the teaching method with the remarkable rise of e-learning, whereby teaching must be undertaken remotely and on digital platforms. Objective: The main objective of this study is to determine the perceived factors that hinder the adoption of online teaching in Tanzanian universities. Method: A mixed method dominated by a quantitative approach was used to answer the research questions. A total of 173 academic and ICT staff from nineteen universities in Tanzania participated in this study. Descriptive statistics (univariate analysis) and binary logistic regression were applied to analyse the frequency and compare the mean to describe the characteristics of respondents and determine the factors influencing the academic staff to have an online course. This was followed by content analysis to analyse the academic staff's proposed adaptation to online classes. Results: The findings indicated that the main hindrances to online teaching are lack of capacity; knowledge on how to conduct online courses; knowledge and technological factors; environmental factors; staff attitudes towards delivering online courses, and years spent using eLearning. The academic staff proposed improving ICT infrastructure and strengthening the capacity of academic staff to provide online courses. Conclusion: The study concludes that most academic staff are willing to adopt online teaching while suggesting improving the organisational and individual factors to enhance online education. The paper recommends that the university use freely available online teaching tools and platforms while simultaneously focusing on addressing the corporate and individual factors identified in this paper to enhance online teaching, which is mandatory in response to lockdown measures. [ABSTRACT FROM AUTHOR]

Since the start of the Syrian civil war in 2011, the rich archaeological heritage of Syria and northern Iraq has faced severe threats, including looting, combat-related damage, and intentional demolition of monuments. However, the inaccessibility of the conflict zone to archaeologists or cultural heritage specialists has made it difficult to produce accurate damage assessments, impeding efforts to develop mitigation strategies and policies. This paper presents results of a project, undertaken in collaboration with the American Schools of Oriental Research (ASOR) and the US Department of State, to monitor damage to archaeological sites in Syria, northern Iraq, and southern Turkey using recent, high-resolution satellite imagery. Leveraging a large database of archaeological and heritage sites throughout the region, as well as access to continually updated satellite imagery from DigitalGlobe, this project has developed a flexible and efficient methodology to log observations of damage in a manner that facilitates spatial and temporal queries. With nearly 5000 sites carefully evaluated, analysis reveals unexpected patterns in the timing, severity, and location of damage, helping us to better understand the evolving cultural heritage crisis in Syria and Iraq. Results also offer a model for future remote sensing-based archaeological and heritage monitoring efforts in the Middle East and beyond.

Widely considered as one of the cradles of human civilization, Mesopotamia is largely situated in the Republic of Iraq, which is also the birthplace of the Sumerian, Akkadian, Assyrian and Babylonian civilizations. These lands were subsequently ruled by the Persians, Greeks, Romans, Arabs, Mongolians, Ottomans and finally British prior to the independence. As a direct consequence of this rich history, the contemporary Iraqi population comprises a true mosaic of different ethnicities, which includes Arabs, Kurds, Turkmens, Assyrians, and Yazidis among others. As such, the genetics of the contemporary Iraqi populations are of anthropological and forensic interest. In an effort to contribute to a better understanding of the genetic basis of this ethnic diversity, a total of 500 samples were collected from Northern Iraqi volunteers belonging to five major ethnic groups, namely: Arabs (n = 102), Kurds (n = 104), Turkmens (n = 102), Yazidis (n = 106) and Syriacs (n = 86). 17-loci Y-STR analyses were carried out using the AmpFlSTR Yfiler system, and subsequently in silico haplogroup assignments were made to gain insights from a molecular anthropology perspective. Systematic comparisons of the paternal lineages of these five Northern Iraqi ethnic groups, not only among themselves but also in the context of the larger genetic landscape of the Near East and beyond, were then made through the use of two different genetic distance metric measures and the associated data visualization methods. Taken together, results from the current study suggested the presence of intricate Y-chromosomal lineage patterns among the five ethic groups analyzed, wherein both interconnectivity and independent microvariation were observed in parallel, albeit in a differential manner. Notably, the novel Y-STR data on Turkmens, Syriacs and Yazidis from Northern Iraq constitute the first of its kind in the literature. Data presented herein is expected to contribute to further population and forensic investigations in Northern Iraq in particular and the Near East in general.

Introduction: Conflict, fragility and political violence, that are taking place in many countries in the Middle East and North Africa (MENA) region have devastating effects on health. Digital health technologies can contribute to enhancing the quality, accessibility and availability of health care services in fragile and conflict-affected states of the MENA region. To inform future research, investments and policy processes, this scoping review aims to map out the evidence on digital health in fragile states in the MENA region. Method: We conducted a scoping review following the Joanna Briggs Institute (JBI) guidelines. We conducted descriptive analysis of the general characteristics of the included papers and thematic analysis of the key findings of included studies categorized by targeted primary users of different digital health intervention. Results: Out of the 10,724 articles identified, we included 93 studies. The included studies mainly focused on digital health interventions targeting healthcare providers, clients and data services, while few studies focused on health systems or organizations managers. Most of the included studies were observational studies (49%). We identified no systematic reviews. Most of the studies were conducted in Lebanon (32%) followed by Afghanistan (13%) and Palestine (12%). The first authors were mainly affiliated with institutions from countries outside the MENA region (57%), mainly United Kingdom and United States. Digital health interventions provided a platform for training, supervision, and consultation for health care providers, continuing education for medical students, and disease self-management. The review also highlighted some implementation considerations for the adoption of digital health such as computer literacy, weak technological infrastructure, and privacy concerns. Conclusion: This review showed that digital health technologies can provide promising solutions in addressing health needs in fragile and conflict-affected states. However, rigorous evaluation of digital technologies in fragile settings and humanitarian crises are needed to inform their design and deployment. [ABSTRACT FROM AUTHOR]

Allopolyploid speciation is a major evolutionary process in wheat (Triticum spp.) and the related Aegilops species. The generation of synthetic polyploids by interspecific crosses artificially reproduces the allopolyploidization of wheat and its relatives. These synthetic polyploids allow breeders to introduce agriculturally important traits into durum and common wheat cultivars. This study aimed to evaluate the genetic and phenotypic diversity in wild einkorn Triticum monococcum ssp. aegilopoides (Link) Thell., to generate a set of synthetic hexaploid lines containing the various Am genomes from wild einkorn, and to reveal their trait characteristics. We examined the genetic diversity of 43 wild einkorn accessions using simple sequence repeat markers covering all the chromosomes and revealed two genetically divergent lineages, L1 and L2. The genetic divergence between these lineages was linked to their phenotypic divergence and their habitats. L1 accessions were characterized by early flowering, fewer spikelets, and large spikelets compared to L2 accessions. These trait differences could have resulted from adaptation to their different habitats. We then developed 42 synthetic hexaploids containing the AABBAmAm genome through interspecific crosses between T. turgidum cv. Langdon (AABB genome) as the female parent and the wild einkorn accessions (AmAm genome) as the male parents. Two of the 42 AABBAmAm synthetic hexaploids exhibited hybrid dwarfness. The phenotypic divergence between L1 and L2 accessions of wild einkorn, especially for days to flowering and spikelet-related traits, significantly reflected phenotypic differences in the synthetic hexaploids. The differences in plant height and internodes between the lineages were more distinct in the hexaploid backgrounds. Furthermore, the AABBAmAm synthetic hexaploids had longer spikelets and grains, long awns, high plant heights, soft grains, and late flowering, which are distinct from other synthetic hexaploid wheat lines such as AABBDD. Utilization of various Am genomes of wild einkorn resulted in wide phenotypic diversity in the AABBAmAm synthetic hexaploids and provides promising new breeding materials for wheat. [ABSTRACT FROM AUTHOR]

Fossil and archaeological evidence indicates that hominin dispersals into Southwest Asia occurred throughout the Pleistocene, including the expansion of Homo sapiens populations out of Africa. While there is evidence for hominin occupations in the Pleistocene in Iran, as evidenced by the presence of Lower to Upper Paleolithic archaeological sites, the extent to which humid periods facilitated population expansions into western Asia has remained unclear. To test the role of humid periods on hominin dispersals here we assess Paleolithic site distributions and paleoenvironmental records across Iran. We developed the first spatially comprehensive, high-resolution paleohydrological model for Iran in order to assess water availability and its influence on hominin dispersals. We highlight environmentally mediated routes which likely played a key role in Late Pleistocene hominin dispersals, including the expansion of H. sapiens and Neanderthals eastwards into Asia. Our combined analyses indicate that, during MIS 5, there were opportunities for hominins to traverse a northern route through the Alborz and Kopet Dagh Mountains and the Dasht-I Kavir desert owing to the presence of activated fresh water sources. We recognize a new southern route along the Zagros Mountains and extending eastwards towards Pakistan and Afghanistan. We find evidence for a potential northern route during MIS 3, which would have permitted hominin movements and species interactions in Southwest Asia. Between humid periods, these interconnections would have waned, isolating populations in the Zagros and Alborz Mountains, where hominins may have continued to have had access to water. [ABSTRACT FROM AUTHOR]

The present study involved an extra-cultural adaptation and validation of questionnaire regarding online teaching (QOT) to know faculty perception, attitude and experiences of online teaching. Cronbach's alpha was determined for assessing internal reliability of QOT and found to be 0.886, confirmed that the scale have good reliability. Factor Analysis of the scale (Principal Component Analysis) was used to examine factor structure and then trailed by varimax rotation. The items were allocated four sub scales. A survey technique was used for the validation of QOT and the survey was conducted during September-December' 2020 in private and public universities of Karachi to determine the pharmacy faculty's perception and experience regarding online teaching. Approximately 35% responded that "It is very easy to prepare and deliver an online course" and 45% opined that "The universities offering Pharm.D should adopt the use of e-learning for teaching in future to complement traditional teaching". Majority of the faculty were in favor of starting online teaching during pandemic to complete semester on time (72%). However, in-campus courses contribute more to students' learning than online courses in pharmaceutical sciences (65.5%). The present study summarizes that academic staff did opt online teaching over one-to-one teaching in the lock down situation during Covid-19 pandemic however, they agreed not to replace traditional teaching to online teaching. Teachers recognized some difficulties and challenges during online teaching including difficulty in preparing lecture for online teaching than traditional classroom teaching, shortage of long time training sessions. Female teachers were inclined to online teaching than male and lecturers tend to prefer online teaching compared to senior teachers. Universities and administration should take imperative acts for improving online teaching for better learning during lock down or any other situation where social distancing is required. [ABSTRACT FROM AUTHOR]

Entamoeba are amoeboid extracellular parasites that represent an important group of organisms for which the regulatory networks must be examined to better understand how genes and functional processes are interrelated. In this work, we inferred the gene regulatory networks (GRNs) in four Entamoeba species, E. histolytica, E. dispar, E. nuttalli, and E. invadens, and the GRN topological properties and the corresponding biological functions were evaluated. From these analyses, we determined that transcription factors (TFs) of E. histolytica, E. dispar, and E. nuttalli are associated mainly with the LIM family, while the TFs in E. invadens are associated with the RRM_1 family. In addition, we identified that EHI_044890 regulates 121 genes in E. histolytica, EDI_297980 regulates 284 genes in E. dispar, ENU1_120230 regulates 195 genes in E. nuttalli, and EIN_249270 regulates 257 genes in E. invadens. Finally, we identified that three types of processes, Macromolecule metabolic process, Cellular macromolecule metabolic process, and Cellular nitrogen compound metabolic process, are the main biological processes for each network. The results described in this work can be used as a basis for the study of gene regulation in these organisms. [ABSTRACT FROM AUTHOR]

The emergence of Neolithic economies and their spread through Eurasia was one of the most crucial transitions of the Holocene, with different mechanisms of diffusion—demic, cultural—being proposed. While this phenomenon has been exhaustively studied in Europe, with repeated attempts to model the speed of Neolithic diffusion based on radiocarbon dates, much less attention has been devoted to the dispersal towards the East, and in particular to South Asia. The Neolithic in the latter region at least partly derived from southwest Asia, given the presence of "founder crops" such as wheat and barley. The process of their eastward diffusion, however, may have been significantly different to the westward dispersal, which was mainly due to demic diffusion, as local domesticates were already available and farming was already practiced in parts of South Asia. Here, we use radiocarbon dates specifically related to the spread of the southwest Asian Neolithic crops to model the speed of dispersal of this agricultural package towards South Asia. To assess potential geographical and environmental effects on the dispersal, we simulate different speeds depending on the biomes being crossed, employing a genetic algorithm to search for the values that most closely approach the radiocarbon dates. We find that the most important barrier to be crossed were the Zagros mountains, where the speed was lowest, possibly due to topography and climate. A large portion of the study area is dominated by deserts and shrublands, where the speed of advance, albeit closer to the range expected for demic diffusion, was lower than observed in Europe, which can also potentially be attributed to environmental constraints in the adaptation of the crops. Finally, a notable acceleration begins in the Indus valley, exceeding the range of demic diffusion in the tropical and subtropical environments east of the Indus. We propose that the latter is due to the rapid diffusion among populations already familiar with plant cultivation. [ABSTRACT FROM AUTHOR]

Today, the satellite-based monitoring of archaeological sites and site damage is a widespread practice, especially in conflict-affected regions. However, the vast majority of these remote sensing cultural heritage monitoring efforts have been led and conducted by remote researchers, and there remains an urgent need to embed this work within existing, in-country institutions at local and regional levels. Here, we present the archaeological site monitoring approach and results from the project Archaeological Practice and Heritage Protection in the Kurdistan Region of Iraq, a collaborative project between the Sirwan Regional Project and Kurdish Iraqi archaeologists aimed at generating a fully functional and sustainable programme of archaeological site management co-created with, and managed by, Kurdish Iraqi archaeologists and antiquities officials. Between August 2018 and February 2020, 376 archaeological sites in the Sirwan/Upper Diyala River Valley region, located in the Kurdistan Region of Iraq, were assessed for damage by Kurdish Iraqi archaeologists in collaboration with the Sirwan Regional Project. This work represents the first large-scale, systematic dataset of archaeological site conditions and longer-term damage in the Kurdistan Region of Iraq (KRI). Our results show that 86.7% of the assessed archaeological sites and 38.6% of the site surface area in this region were affected by damage between 1951–2018, and demonstrate the great urgency with which action must be taken to develop appropriate safeguarding measures for the KRI's archaeological heritage. On the basis of these results, we outline relevant recommendations for the immediate protection of archaeological sites in Garmian and the greater Kurdistan Region. [ABSTRACT FROM AUTHOR]

From 2014 to 2017, the Islamic State in Irak and Syria (ISIS), a terrorist political organization of Salafist jihadist ideology, had put in place an operational and relatively stable educational system. Among its Complementary Programs, ISIS included a curriculum for programming using the Scratch software. In this article, we discuss this curriculum by analyzing the content of the official ISIS programming textbook, with the objectives of characterizing: 1) the curriculum's pedagogical intentions and definition of programming; 2) the programming curriculum; and 3) the religious and military indoctrination value. We found that, first, ISIS's programming curriculum intentions are more about religious and military injunctions to build the caliphate than they are about developing 21st-century skills such as computational thinking. Second, although the progression of learning in the sequence of activities designed by ISIS seems logical and, overall, well-ordered, the ISIS programming curriculum does not encourage the development of 21st-century skills such as problem solving, discovery learning, or creativity—nor for that matter, the transfer of programming knowledge to different contexts. Finally, the textbook is particularly rich in elements of military and religious indoctrination and effectively participates in the indoctrination of students by helping to inculcate values consistent with ISIS's jihadist ideology. This contribution seeks to better understand ISIS's approach to education, which could provide support for initiatives aimed at rebuilding impacted education systems and groups. [ABSTRACT FROM AUTHOR]

Giardiasis is a protozoan disease caused by the parasite Giardia lamblia. Around 200 million people are infected worldwide annually while, 500,000 deaths were reported each year. The infection rates were between 2–5% in the developed nations and 20–30% in the developing countries. The parasite is associated with poverty, poor sanitation, lack of clean and safe drinking water supply, and poor personal hygiene. The aim of our study was to assess the prevalence rate and associated risk factors of G. lamblia infection among the elementary school children at Loka Abaya town, Ethiopia. A cross-sectional study was conducted from December 2018 to July 2019. A total number of 422 students were selected by using simple random sampling. Structured and semi-structured questionnaire was used to identify known risk factors such as environmental, socio-demographic, and behavioural. Stool specimens were collected from the study subjects and examined using direct smear method, microscopically. A bivariate and multivariate logistic regression analysis was done. P value less than 0.05 at 95% of the confidence interval was considered statistically significant. The overall prevalence rates of G. lamblia infection were 27.1%. Rural school from Aregeda [AOR: 9.997, P = 0.005], age group of 6–9 years [AOR: 2.305, P = 0.019], consuming tap water [AOR: 0.011, P = 0.006], hand washing habit after defecation with water only [AOR = 0.313, P = 0.040], use of soap and water [AOR: 0.046, P = 0.000] were the factors which are found to be associated with the parasite infection when compared to urban school. As such, the prevalence of G. lamblia infection was found to be high in the studied area among school children. Thus, scaling-up of access to safe water, toilets, education, and health facilities are required to possibly eradicate this predicament. [ABSTRACT FROM AUTHOR]

Drawing on Social Exchange Theory and Self-Determination Theory, this study examines the impact of three leadership styles (ethical, transformational, and passive avoidant) on employee knowledge sharing. Further, this study explores the mediating effect of introjected motivation in the relationship between three leadership styles and employee knowledge sharing. Using time lag data this study employed a sample of 254 faculty members of public sector universities in Pakistan. Results supported the positive relationship between three styles of leadership and employee knowledge sharing. Moreover, our findings confirmed the mediating role of introjected motivation in the relationship between three leadership styles and employee knowledge sharing. Our study is unique, as it simultaneously examines how various styles of leadership predict introjected motivation and employee knowledge sharing. Implications along with limitations and future research directions are discussed. [ABSTRACT FROM AUTHOR]

Neanderthal extinction has been a matter of debate for many years. New discoveries, better chronologies and genomic evidence have done much to clarify some of the issues. This evidence suggests that Neanderthals became extinct around 40,000–37,000 years before present (BP), after a period of coexistence with Homo sapiens of several millennia, involving biological and cultural interactions between the two groups. However, the bulk of this evidence relates to Western Eurasia, and recent work in Central Asia and Siberia has shown that there is considerable local variation. Southwestern Asia, despite having a number of significant Neanderthal remains, has not played a major part in the debate over extinction. Here we report a Neanderthal deciduous canine from the site of Bawa Yawan in the West-Central Zagros Mountains of Iran. The tooth is associated with Zagros Mousterian lithics, and its context is preliminary dated to between ~43,600 and ~41,500 years ago. [ABSTRACT FROM AUTHOR]

Y-chromosome analysis provides valuable information regarding the migration patterns of male ancestors, ranging from the Paleolithic age to the modern humans. STR and SNP genotyping analysis provides data regarding the genetic and geographical ancestry of the populations studied. This study focused on the analysis of the Y-chromosome in Maronite Cypriots and Armenian Cypriots, who came to the island as a result of different historical events. The aim was to provide information on the paternal genetic ancestry of Maronites and Armenians of Cyprus and investigate any affinity with the Greek Cypriots and Turkish Cypriots of the island. Since there is limited information in the current literature, we proceeded and used 23 Y-chromosome STRs and 28 Y-chromosome SNPs to genotype 57 Maronite Cypriots and 56 Armenian Cypriots, which were then compared to data from 344 Greek Cypriots and 380 Turkish Cypriots. All samples were assigned to eight major Y-haplogroups but the most frequent haplogroup among all Cypriots is haplogroup J in the major subclade J2a-L559. The calculated pairwise genetic distances between the populations show that Armenian Cypriots are genetically closer to Greek and Turkish Cypriots compared to Maronite Cypriots. Median Joining Network analysis in 17 Y-STR haplotypes of all Cypriots assigned to J2a-L559, revealed that Cypriots share a common paternal ancestor, prior to the migration of the Armenians and Maronites to Cyprus, estimated in the Late Bronze Age and Early Iron Age. [ABSTRACT FROM AUTHOR]

The Aceramic Neolithic site of Ganj Dareh (Kermanshah, Iran) is arguably one of the most significant sites for enhancing our understanding of goat domestication and the onset of sedentism. Despite its central importance, it has proven difficult to obtain contextually reliable data from it and integrate the site in regional syntheses because it was never published in full after excavations ceased in 1974. This paper presents the Ganj Dareh archive at Université de Montréal and shows how the documentation and artifacts it comprises still offer a great deal of useful information about the site. In particular, we 1) present the first stratigraphic profile for the site, which reveals a more complex depositional history than Smith's five-level sequence; 2) reveal the presence of two possible pre-agricultural levels (H-01 and P-01); 3) explore the spatial organization of different levels; 4) explain possible discrepancies in the radiocarbon dates from the site; 5) show some differences in lithic technological organization in levels H-01 and P-01 suggestive of higher degrees of residential mobility than subsequent phases of occupation at the site; and 6) reanalyze the burial data to broaden our understanding of Aceramic Neolithic mortuary practices in the Zagros. These data help refine our understanding of Ganj Dareh's depositional and occupational history and recenter it as a key site to improve our understanding the Neolithization process in the Middle East. [ABSTRACT FROM AUTHOR]

The Middle and Late Bronze Age, a period roughly spanning the 2nd millennium BC (ca. 2000–1200 BC) in the Near East, is frequently referred to as the first 'international age', characterized by intense and far-reaching contacts between different entities from the eastern Mediterranean to the Near East and beyond. In a large-scale tandem study of stable isotopes and ancient DNA of individuals excavated at Tell Atchana (Alalakh, located in Hatay, Turkey), we explored the role of mobility at the capital of a regional kingdom, named Mukish during the Late Bronze Age, which spanned the Amuq Valley and some areas beyond. We generated strontium and oxygen isotope data from dental enamel for 53 individuals and 77 individuals, respectively, and added ancient DNA data of 10 newly sequenced individuals to a dataset of 27 individuals published in 2020. Additionally, we improved the DNA coverage of one individual from this 2020 dataset. The DNA data revealed a very homogeneous gene pool. This picture of an overwhelmingly local ancestry was consistent with the evidence of local upbringing in most of the individuals indicated by the isotopic data, where only five were found to be non-local. High levels of contact, trade, and exchange of ideas and goods in the Middle and Late Bronze Ages, therefore, seem not to have translated into high levels of individual mobility detectable at Tell Atchana. [ABSTRACT FROM AUTHOR]

In the 12,000 years preceding the Industrial Revolution, human activities led to significant changes in land cover, plant and animal distributions, surface hydrology, and biochemical cycles. Earth system models suggest that this anthropogenic land cover change influenced regional and global climate. However, the representation of past land use in earth system models is currently oversimplified. As a result, there are large uncertainties in the current understanding of the past and current state of the earth system. In order to improve representation of the variety and scale of impacts that past land use had on the earth system, a global effort is underway to aggregate and synthesize archaeological and historical evidence of land use systems. Here we present a simple, hierarchical classification of land use systems designed to be used with archaeological and historical data at a global scale and a schema of codes that identify land use practices common to a range of systems, both implemented in a geospatial database. The classification scheme and database resulted from an extensive process of consultation with researchers worldwide. Our scheme is designed to deliver consistent, empirically robust data for the improvement of land use models, while simultaneously allowing for a comparative, detailed mapping of land use relevant to the needs of historical scholars. To illustrate the benefits of the classification scheme and methods for mapping historical land use, we apply it to Mesopotamia and Arabia at 6 kya (c. 4000 BCE). The scheme will be used to describe land use by the Past Global Changes (PAGES) LandCover6k working group, an international project comprised of archaeologists, historians, geographers, paleoecologists, and modelers. Beyond this, the scheme has a wide utility for creating a common language between research and policy communities, linking archaeologists with climate modelers, biodiversity conservation workers and initiatives. [ABSTRACT FROM AUTHOR]

Since the World Health Organization (WHO) announced that the coronavirus disease (COVID-19) is a worldwide pandemic, many countries' authorities, including the Iraqi authorities, started responding and taking action to control the spread of the pandemic. The public's knowledge and practices play an important role in curbing the spreading of the virus by following the health guidelines. This study aimed to assess the socio-demographic correlate of knowledge and practices of Iraqi living in Mosul-Iraq towards COVID-19 during its rapid rise. A cross-sectional online survey of 909 participants was conducted among a sample of the Mosul-Iraq population between 20th June to 1st July 2020. The survey included three parts: 1) socio-demographic characteristics, 2) participants' knowledge, 3) participants' practices. T-test, ANOVA, chi-square, and binary logistic regression were used. A p-value less than 0.05 (p < 0.05) was considered statistically significant. The results showed a knowledge and practice mean score of (12.91±1.67) and (21.56± 2.92) with cumulative knowledge and practice of 86% and 76% respectively towards COVID-19. Socio-demographic characteristics such as age, marital status, gender, level of education and employment were statistically related with a higher mean score of knowledge and practice towards the virus as P<0.05. We concluded that the majority of the respondents demonstrate a high level of knowledge and practices towards COVID-19 except for respondents with socio-demographic characteristics such as those who were younger, male respondents, those with lower education and those unemployed as such campaigns that will increase the knowledge and encourage adequate preventive practice towards COVID-19 should be targeted towards this group. [ABSTRACT FROM AUTHOR]

To achieve the strategic goals of the Belt and Road Initiative (BRI), it is necessary to deepen our understanding of terrorist attacks in BRI countries. First, we selected data for terrorist attacks in BRI regions from 1998 to 2017 from the Global Terrorism Database and analyzed their time distribution using trend analysis and wavelet analysis. Then, we used honeycomb hexagons to present the spatial distribution characteristics. Finally, based on the Fragile States Index, we used GeoDetector to analyze the driving forces of the terrorist attacks. The following conclusions were obtained: (1) During 1998–2017, the number of events was the highest on Mondays and the lowest on Fridays. In addition, the incidence of events was high between Monday and Thursday but was the lowest on Fridays and Saturdays. The number of events was the largest in January, May, July, and November and was the lowest in June and September; the incidence of terrorist attacks from April to May and July to August was high. (2) Terrorist attacks showed a 10-year cycle during the study period. Terrorist attacks in the last 10 years of the study period were broader in scope and higher in number compared with the previous 10 years. In addition, China, Russia, Saudi Arabia, and northeastern Europe saw many new terrorist attacks during the latter 10 years. (3) The number of terrorist attacks by bombing/explosion was the largest, followed by armed attack; assassination, kidnapping, and infrastructure attacks were the least frequent. The core areas of the terrorist attacks were Iraq, Israel, Afghanistan, Pakistan, and India. (4) The driving force analysis revealed that the indicators "security apparatus," "human flight and brain drain," and "external intervention" contributed the most to BRI terrorist attacks. [ABSTRACT FROM AUTHOR]

The rise and fall of ancient societies have been attributed to rapid climate change events. One of the most discussed of these is the 4.2kya event, a period of increased aridity and cooling posited as the cause of societal changes across the globe, including the collapse of the Akkadian Empire in Mesopotamia. Studies seeking to correlate social and climatic changes around the 4.2kya event have tended to focus either on highly localized analyses of specific sites or surveys or more synthetic overviews at pan-continental scales, and temporally on the event and its aftermath. Here we take an empirical approach at a large spatial scale to investigate trends in population and settlement organization across the entirety of Northern Fertile Crescent (Northern Mesopotamia and the Northern Levant) from 6,000 to 3,000 cal BP. We use Summed Probability Distributions of radiocarbon dates and data from eighteen archaeological surveys as proxies for population, and a dataset of all settlements over ten hectares in size as a proxy for the degree of urbanization. The goal is to examine the spatial and temporal impact of the 4.2kya event and to contextualize it within longer term patterns of settlement. We find that negative trends are visible during the event horizon in all three proxies. However, these occur against a long-term trend of increased population and urbanization supported through unsustainable overshoot and the exploitation of a drier zone with increased risk of crop failure. We argue that the 4.2kya event occurred during a period of unprecedented urban and rural growth which may have been unsustainable even without an exogenous climate forcing. [ABSTRACT FROM AUTHOR]

BackgroundTraumatized refugees often suffer from diverse psychosomatic symptoms. Female Yazidi refugees from Northern Iraq who survived attacks of the so-called "Islamic State" were brought to Germany to receive special medical and psychotherapeutic treatment in a unique worldwide humanitarian admission program (HAP). Here, we report on their psychosomatic symptoms and helpful strategies from the perspective of care providers.MethodsCare providers (N = 84) in this HAP were interviewed in an individual setting as well as in focus groups to gather information about the HAP beneficiaries' psychosomatic symptoms. Data analysis followed Qualitative Content Analysis by Mayring.ResultsThe care providers reported five main psychological burdens of the Yazidis: 1) insecurity regarding loss, 2) worries about family members, 3) ambivalence about staying in Germany or returning to Iraq, 4) life between two worlds and 5) re-actualization of the traumatic experiences. The predominant psychological symptoms the care providers noticed were fear, depressive symptoms, feelings of guilt, and sleep and eating disorders. Regarding somatic symptoms, the care providers mainly received complaints about pain in the head, back, chest and stomach. Helpful strategies for providing adequate health care were care providers' cooperating with physicians, precise documentation of beneficiaries' symptoms, and additional support in directing the beneficiaries through the health care system. Regarding psychotherapy, interpreters help to overcome language barriers, onsite psychotherapy, flexible therapy appointments, psychoeducational methods, time for stabilization, and support in coping with daily life aspects. In the care providers' experience, psychotherapists have to build a relationship of trust. After grief therapy, a trauma-specific therapy in a culturally adapted way is possible.ConclusionThe HAP is a unique model health care program to offer highly traumatized refugees medical and psychological help. Care providers reported on several (psycho-)somatic symptoms of the traumatized women. The strategies the HAP care providers perceived as helpful can be recommended for similar projects in the future.

Cardiopulmonary complications are among the most important complications of thalassemia major. Pulmonary hypertension is among these complications and studies addressing its frequency and associations in the latter disorder are sparse from Iraq. For this purpose a total 100 thalassemia major patients (≥ 8 years old) were enrolled from a main thalassemia center in Kurdistan, Northern Iraq. All patients had a full history and clinical examination. Full blood count, biochemical tests and viral screen including hepatitis B surface antigen and hepatitis C virus antibody, in addition to transthoracic Doppler echocardiography for tricuspid regurgitation jet velocity (TRV). The enrolled patients had a mean (SD) age of 17.6 (5.5) years, and included 52 males and 48 females. Pulmonary hypertension as defined by TRV> 2.8 m/s coupled with both exertional dyspnea and an absence of left sided heart failure, was identified in nine patients (9%). The latter subgroup of patients had significantly higher reticulocyte counts, S. LDH, S. ferritin, and hepatitis C sero-positivity compared to those without this complication by univariate analysis. While by multivariate logistic regression only reticulocytes and hepatitis C sero-positivity remained significant. Furthermore, TRV as a continuous variable was positively correlated with reticulocytes, S. bilirubin and LDH (p

Introduction: Intimate partner violence against women is one of the most common forms of violence. Different research fields are trying to understand the cycle of violence, such as the psychological field, to understand how these women's relational patterns and intrapsychic conflict function in the cycle of violence. Objective: To investigate the operationalized psychodynamic diagnosis of women victims of domestic violence, exploring the severity and experience of violence, structural functions, dysfunctional interpersonal patterns, and intrapsychic conflicts. Method: We conducted a cross-sectional quantitative study using the OPD-2 Clinical Interviews, which were recorded and transcribed. The sample was composed by 56 women victims of domestic violence, mean age 30.07 (SD = ±9.65). Reliability was satisfactory for judges interviews(k>0,6). Results: According to the OPD-2 evaluation, we found that the severity of the violence was associated with the intensity of women's subjective suffering. In the relational pattern, they stay in the relationship, leaving themselves vulnerable; perceive the partner as controlling, aggressive, offensive, and fear abandonment. As a defensive mechanism to relational discomfort and suffering victims anticipate the aggressor's desire, resulting in submissive behavior. The main psychic conflict was the "need for care versus self-sufficiency" (78.6%). And medium was the predominant structure level, in which they presented insecure internal objects, presenting difficulties in emotional regulation and perceiving reality in a distorted way. Hence, they do not recognize their limitations and needs. We found that 78.6% of the cases had some psychiatric disorder: MDD, PTSD. Conclusion: This study provides empirical evidence on clinical observations on the psychological functioning of this population and the issues that make up the maintenance of domestic violence against women. The understanding of internalized patterns, structural functions, and motivational tensions are fundamental for the prevention of re-victimization and improving coping mechanisms, as well as promoting greater adherence to treatment. [ABSTRACT FROM AUTHOR]

The objectives are exploring the impacts of geologic hazards on the construction of homestays, improving the safety of homestay buildings, guaranteeing the safety of tourists, and enhancing the disaster-resistance of homestays in scenery spots. The computer simulation system and Building Information Modeling (BIM) technology are employed to construct a geologic hazard prediction model for homestays. The model utilizes a time history method to establish a complete early-warning and monitoring system by learning the geologic disaster data. The detection of various geologic hazards has verified the effectiveness of the proposed model. The results show that the model can reduce the losses in the case of water accumulation and landslides during storms, and the BIM technology-based homestay buildings will suffer fewer losses. In the case of earthquakes, BIM technology-based homestay buildings have no noticeable shaking and displacement. Compared to traditional construction methods, the displacement is reduced by 49.15%. In the case of a spontaneous fire, the burning area of the BIM technology-based homestay building is only 270m2. The most severe factors affecting the construction of homestay buildings are earthquakes and landslide risks. The BIM technology generates 3D building planning; therefore, planners can fully understand the problems in the building. In the meantime, the multi-source monitoring data of multiple geologic hazards can be monitored and fed back, thereby improving the timeliness of early-warning of geologic hazards. The results are of considerable significance to the prevention of losses caused by geologic hazards, which can significantly improve the understanding of geologic hazards. [ABSTRACT FROM AUTHOR]

Palegawra cave, alongside its neighbouring Zarzi, has been an emblematic site of the Epipalaeolithic (Zarzian) cultural horizon in the NW Zagros of Southwest Asia ever since its first exploration in 1951 by Bruce Howe and Robert Braidwood in the context of the Iraq-Jarmo project. At the time scientific excavation, sampling and analysis methods were either under-developed or did not exist. In this paper we present the first results of new excavations at Palegawra conducted in 2016–2017 by the Eastern Fertile Crescent (EFEC) project, a research collaboration of the University of Liverpool and the Sulaymaniyah Directorate of Antiquities and Heritage. Our research has produced the first radiometric evidence pushing back the chronology of the NW Zagros Epipalaeolithic to the Last Glacial Maximum, thus fully aligning it with Epipalaeolithic facies until now known only from the Levant and the south Anatolian coast. We have also unearthed, for the first time in the Palaeolithic of the Zagros, direct archaeobotanical evidence for hitherto elusive Zarzian plant exploitation and the vegetation of the NW Zagros piedmont zone from the LGM to the end of the Lateglacial (~19,600–13,000 cal BP). The new Palegawra chronology alongside our detailed studies of its material culture and faunal and botanical assemblages suggest that the prevailing Epipalaeolithic habitation pattern in the NW Zagros (centred on generalised persistent occupations of small caves and rock-shelters alongside task-oriented ephemeral open-air campsites) remained an enduring characteristic of the Zarzian horizon throughout this period. The Palegawra data clearly show that neither resource levels and climate conditions nor geographic and/or cultural isolation provide adequate explanations for the stability and longevity of Zarzian lifeways during this long timespan. More fieldwork is required, including the discovery, excavation and intensive sampling of other Zarzian sites, for reaching a data-informed understanding of the nature and evolution of the NW Zagros Epipalaeolithic. [ABSTRACT FROM AUTHOR]

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem. There is limited information regarding the genetics of MRSA strains among the native Iraqi and incoming Syrian refugee communities. We aimed to characterize the genotypes and different virulence factors of MRSA in strains isolated from these two communities. Frozen MRSA strains (125) isolated from the native Iraqi and Syrian refugee communities were used in this study. PCR (singleplex and multiplex) and agr typing was used for the genotypic analysis of different virulence genes. We tested for the presence of virulence genes including pvl, arcA, tst, lukE/lukD, hla, hlb, eta, etb and agr. Prevalence of arcA MRSA in the Iraqi community (56.58%) was significantly higher (p = 0.008) than that in the Syrian refugee community (32.66%). Prevalence of lukE-lukD was also significantly higher (p = 0.001) in the Iraqi (82.89%) compared to that in the Syrian refugee community (57.14%). Further, prevalence of hla MRSA in the Iraqi community was (93.4%) and in the Syrian refugee community was (71.4%); (p = 0.0008). No significant differences were observed in the prevalence of pvl, tst, eta, etb and hlb. The most dominant agr types in both Iraqi (76.1% and 10.5%) and Syrian refugee (44.9% and 18.37%) communities were I and III. To sum up, no significant differences were observed between the groups for a majority of virulence factors. This is the first investigation of MRSA genotypes and virulence in both these communities. These results could be useful for further studies that assess the genetic relatedness of strains in the region for epidemiological and monitoring purposes, which would be crucial to limiting the spread of MRSA. [ABSTRACT FROM AUTHOR]

Renewed excavations at the Neolithic site of Beisamoun (Upper Jordan Valley, Israel) has resulted in the discovery of the earliest occurrence of an intentional cremation in the Near East directly dated to 7031–6700 cal BC (Pre-Pottery Neolithic C, also known as Final PPNB, which spans ca. 7100–6400 cal BC). The funerary treatment involved in situ cremation within a pyre-pit of a young adult individual who previously survived from a flint projectile injury. In this study we have used a multidisciplinary approach that integrates archaeothanatology, spatial analysis, bioanthropology, zooarchaeology, soil micromorphological analysis, and phytolith identification in order to reconstruct the different stages and techniques involved in this ritual: cremation pit construction, selection of fuel, possible initial position of the corpse, potential associated items and funerary containers, fire management, post-cremation gesture and structure abandonment. The origins and development of cremation practices in the region are explored as well as their significance in terms of Northern-Southern Levantine connections during the transition between the 8th and 7th millennia BC. The bones are distributed throughout the bottom of the pit, partly superimposed one on the other to a thickness of 40 cm. However, the density of remains was not very marked except at the centre of the pit (Fig 6). If there was an apparent anatomical disorder at first glance, by looking at the details some interesting patterning could be observed. Cranial and mandibular fragments were found only in the southern half of the structure. Next to the south wall on the upper level, we found the base of the skull (mandible reversed and occipital fragments); the rest of the cranial vault and face (frontal, maxillars, parietals and temporals) were found slightly lower down at the centre of the pit. Conversely, the cervical vertebrae were dispersed out from the centre to the northern half of the pit. The thoracic column and some of the ribs were concentrated in the centre, roughly following a west-east direction. The lumbar vertebrae were found in the middle and against the south-western wall of the structure with several vertebral fragments in close proximity to the sacrum, coccyx and the left coxal. The right coxal is found diametrically opposite to this coherent group, lying almost complete not far from the north-eastern wall of the pit. Altogether, despite an absence of articulated joints and dispersion of certain elements, the bones of the axial skeleton show some anatomical coherence. [ABSTRACT FROM AUTHOR]

Brucellosis is an endemic disease in food-producing animals in Mosul, Iraq. The objectives of the study reported here were: (i) to identify and assess the evidence and knowledge gaps in published studies that have examined brucellosis in different food-producing animals in Mosul, Iraq; using systematic review approach, and (ii) to quantify the seroprevalence of brucellosis in the city using meta-analysis approach. Google Scholar was used as a search engine to track pertinent peer-reviewed research reports. The search was conducted on November 24, 2019. Keywords used were: brucella, animal, Mosul, Iraq. Peer-reviewed published studies, MSc theses, and PhD dissertations written in Arabic or English were included. Duplicate records were removed, and the screening process was conducted at three levels: titles, abstracts, and full-text articles. Identified studies that have reported the seroprevalence of brucellosis were included in a meta-analysis to calculate an overall prevalence. A total of 214 records were initially identified. Seventeen research reports were added from personal contact and qualified articles' references list. Thirty six articles were qualified for review after removing 35 duplicate records, 155 titles, 11 abstracts, and 5 full text articles. Seventeen studies reported the prevalence of brucellosis, 11 studies assessed different serological tests for diagnosis of brucellosis, 9 studies isolated Brucella spp. from animal specimens and/or animal products, and 4 studies assessed vaccination procedures against brucellosis. The overall seroprevalence of brucellosis in food-producing animals in Mosul over a period of 40 years was 14.14%, including 14.46% for sheep, 12.99% for goats, 11.69% for cattle, and 22.64% for buffalo. The study concluded that the disease is evident in the city with increasing trends over the years, buffalo shows high seroprevalence, the degree of agreement of Rose-Bengal test as a screening test is fair compared to more accurate serological tests such as ELISA; and the disease constitutes a public health concern in the city. Additional studies are important to identify the overlooked predisposing factors, estimate the abortion rate attributable to brucellosis in food-producing animals, and evaluate efficacy of vaccination programs in reducing the prevalence of brucellosis and/or abortion rate. [ABSTRACT FROM AUTHOR]

Objectives: While the general practitioner (GP) in the Netherlands is the first point of entry to and gatekeeper of the healthcare system, no study exists to explore the experiences of women with female genital mutilation or cutting (FGM/C) in general practice. Therefore, the aim of this study is to look into the experiences of women with FGM/C in Dutch general practice. Methods: Semistructured interviews were held with 16 women with FGM/C. Sampling was purposeful. The interview guide and thematic analysis were based on the Illness Perception Model and Kleinman's Explanatory model. Interviews were held in English or Dutch. All data were anonymized, and recordings were transcribed verbatim. Transcripts were coded and thematically analyzed. Results: The women considered FGM/C to be connected to a range of health problems, for which not all of them sought medical care. They had difficulty discussing such a sensitive topic with their GP, did not know their problems could be relieved or perceived GPs to have insufficient knowledge of FGM/C. Lack of time during consultations and overall dissatisfaction with Dutch GP care hampered trust. They strongly preferred the GP to be proactive and ask about FGM/C. Conclusion: There is room for improvement as most women would like their GP to discuss their health problems related to FGM/C. GPs should take a proactive attitude and ask about FGM/C. In addition, to develop the trusted relationship needed to discuss sensitive topics and provide culturally sensitive person-centered care, sufficient time during consultations is needed. [ABSTRACT FROM AUTHOR]

Changes in parasite communities might result in new host-parasite dynamics and may threaten local fish populations. This phenomenon has been suggested for acanthocephalan parasites in the river Rhine and Danube where the species Pomphorhynchus tereticollis is becoming replaced by the Ponto-Caspian P. laevis. Developing knowledge on morphologic, genetic and behavioural differences between such species is important to follow such changes. However, disagreements on the current phylogeny of these two acanthocephalan species are producing conflicts that is affecting their correct identification. This study is offering a clearer morphological and genetic distinction between these two species. As P. tereticollis is found in rhithral tributaries of the Rhine, it was questioned whether the local salmonid populations were hosts for this species and whether P. laevis was expanding into the Rhine watershed as well. In order to test for this, brown trout, Salmo trutta, and grayling, Thymallus thymallus from South-Western Germany watersheds have been samples and screened for the occurrence of acanthocephalan parasites. For the first time, both species were confirmed to be hosts for P. tereticollis in continental Europe. P. tereticollis was found to be common, whereas P. leavis was found only at a single location in the Danube. This pattern suggest either that the expansion of P. laevis through salmonid hosts into rhithral rivers has not yet occurred, or that not yet ascertained biotic or abiotic features of rhithral rivers hinder P. laevis to spread into these areas. [ABSTRACT FROM AUTHOR]

Background: Health care workers (HCWs) are essential for the delivery of health care services in conflict areas and in rebuilding health systems post-conflict. Objective: The aim of this study was to systematically identify and map the published evidence on HCWs in conflict and post-conflict settings. Our ultimate aim is to inform researchers and funders on research gap on this subject and support relevant stakeholders by providing them with a comprehensive resource of evidence about HCWs in conflict and post-conflict settings on a global scale. Methods: We conducted a systematic mapping of the literature. We included a wide range of study designs, addressing any type of personnel providing health services in either conflict or post-conflict settings. We conducted a descriptive analysis of the general characteristics of the included papers and built two interactive systematic maps organized by country, study design and theme. Results: Out of 13,863 identified citations, we included a total of 474 studies: 304 on conflict settings, 149 on post-conflict settings, and 21 on both conflict and post-conflict settings. For conflict settings, the most studied counties were Iraq (15%), Syria (15%), Israel (10%), and the State of Palestine (9%). The most common types of publication were opinion pieces in conflict settings (39%), and primary studies (33%) in post-conflict settings. In addition, most of the first and corresponding authors were affiliated with countries different from the country focus of the paper. Violence against health workers was the most tackled theme of papers reporting on conflict settings, while workforce performance was the most addressed theme by papers reporting on post-conflict settings. The majority of papers in both conflict and post-conflict settings did not report funding sources (81% and 53%) or conflicts of interest of authors (73% and 62%), and around half of primary studies did not report on ethical approvals (45% and 41%). Conclusions: This systematic mapping provides a comprehensive database of evidence about HCWs in conflict and post-conflict settings on a global scale that is often needed to inform policies and strategies on effective workforce planning and management and in reducing emigration. It can also be used to identify evidence for policy-relevant questions, knowledge gaps to direct future primary research, and knowledge clusters. [ABSTRACT FROM AUTHOR]

The two alkaloids gramine and hordenine have been known for playing a role in the allelopathic ability in barley (Hordeum vulgare L.). These allelochemicals can be both found in leaves and roots in some barley cultivars whereas in others one seems to exclude the other. In this study eighteen accessions of barley from the Middle-East area, one accession from Tibet and the modern spring cultivar Barke, already used as parental donor in a nested associated mapping (NAM) population, were screened for their gramine, hordenine and N-methyltyramine (the direct precursor of hordenine) content in leaves, roots and exudates. Moreover, the toxicity of the three allelochemicals on root growth inhibition on lettuce (Lactuca sativa L.) was evaluated. Results of this study showed the preferential production of gramine and hordenine in leaves and roots, respectively, in the nineteen barley accessions. On the other hand, in the modern barley cultivar Barke, the highest content of hordenine in roots and the general lack of gramine suggests a favored biosynthesis of the former. Gramine was not detected in the root exudates. In additions, different metabolomic profiles were observed in wild relatives compared to modern barley genotypes. The results also showed the phytotoxic effects of the three compounds on root growth of lettuce seedlings, with a reduction in root length and an increase of root surface area and diameter. In conclusion, this study highlighted the impact of the domestication effects on the production and distribution of the two allelopathic alkaloids gramine and hordenine in barley. [ABSTRACT FROM AUTHOR]

The fishes, which have currently named Aphanius Nardo, 1827 are the relict of the ancient ichthyofauna of the Tethys Sea. For a long time since 1827, the genus name has been subjected to revision by several researchers using mainly morphological features. Until recently, no comprehensive single- or multi-locus DNA barcoding study has been conducted on whole members of the family Aphaniidae. In the present study, by applying four conceptually different molecular species delimitation methods, including one distance-based method, one network-based and two topology-based methods, we examined a single-locus DNA barcode library (COI) diversity for the 268 sequences within the family Aphaniidae from the Old World (57 sequences are new in the present study and 211 sequences were retrieved from NCBI database). The molecular analyses revealed a clearer picture of intra-family relationships and allowed us to clarify the generic names, and also describe a new genus for the family Aphaniidae. Results supported distinction of three major clades related to three genera within this family: i) the first clade includes the A. mento group which are placed in a new genus, Paraphanius gen. nov., found in the Orontes (= Asi) and Tigris-Euphrates River drainage, the Levant in coastal waters and the Dead Sea basin, western Jordan, and in southern Turkey in the Mediterranean basins as well as in central Turkey. This clade positioned at the base of the phylogenetic tree, (ii) the second clade contains the A. dispar-like brackish water tooth-carps which are transferred to the genus Aphaniops Hoedeman, 1951 (type species, Lebias dispar), distributed in the coastal waters around the Red Sea and the Persian Gulf basins; and (iii) the third clade, the genus Aphanius Nardo, 1827 (type species Aphanius nanus = A. fasciatus) contains all the inland and inland-related tooth-carps, which are mainly distributed in the inland waters in Turkey and Iran and also in the inland-related drainages around the Mediterranean basin. [ABSTRACT FROM AUTHOR]