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  1. Article ; Online: Prevalence, risk factors, and comorbidities of psychotic experiences in Afghanistan: a highly stressful environment.

    Kovess-Masfety, V / Sabawoon, A / Keyes, K / Karam, E

    Social psychiatry and psychiatric epidemiology

    2023  Volume 59, Issue 1, Page(s) 99–109

    Abstract: Objectives: To estimate the prevalence and demographic, psychiatric, and trauma-focused correlates of psychotic experiences (PEs) in the Afghan general population.: Methods: Data were drawn from a cross-sectional household survey implemented in eight ...

    Abstract Objectives: To estimate the prevalence and demographic, psychiatric, and trauma-focused correlates of psychotic experiences (PEs) in the Afghan general population.
    Methods: Data were drawn from a cross-sectional household survey implemented in eight regions of Afghanistan (N = 4445). The CIDI structured instrument was administered to adults to assess psychiatric disorders and psychotic experiences; life events and PTSD were assessed using validated instruments. Weighted multivariate models integrated socio-demographics, regions, traumas as determinants of PE.
    Results: PEs were frequently reported in the Afghan population: 27.50% of the population reported a lifetime PE. PEs were more common among specific ethnic groups, and were associated with lower income in adjusted regression models. PEs were associated with mental health problems including major depressive disorders (OR = 3.43), PTSD (OR = 5.08), generalized anxiety (OR = 4.2); lifetime suicidal attempts (OR 6.04), lifetime suicidal thoughts (OR = 3.42), addiction (OR = 2.18); and psychological distress and impairment due to mental health (OR = 2.95 and 2.46, respectively).
    Conclusion: Psychotic experiences in the Afghan general population confirm general population findings in other countries, that psychotic experiences are common and associated with economic and social marginalization, and part of a continuum of mental health problems experienced in populations. Efforts to reduce and treat psychotic experiences within a broad array of psychiatric conditions are needed.
    MeSH term(s) Adult ; Humans ; Psychotic Disorders/epidemiology ; Depressive Disorder, Major/epidemiology ; Prevalence ; Afghanistan/epidemiology ; Cross-Sectional Studies ; Mental Disorders/epidemiology ; Risk Factors
    Language English
    Publishing date 2023-08-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 623071-4
    ISSN 1433-9285 ; 0037-7813 ; 0933-7954
    ISSN (online) 1433-9285
    ISSN 0037-7813 ; 0933-7954
    DOI 10.1007/s00127-023-02539-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: We share more attributes than we think: the crucial input of epidemiology.

    Karam, Elie / Kovess Masfety, Vivianne

    World psychiatry : official journal of the World Psychiatric Association (WPA)

    2022  Volume 21, Issue 3, Page(s) 475–476

    Language English
    Publishing date 2022-09-08
    Publishing country Italy
    Document type News
    ZDB-ID 2236130-3
    ISSN 2051-5545 ; 1723-8617
    ISSN (online) 2051-5545
    ISSN 1723-8617
    DOI 10.1002/wps.21012
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Dysregulation of mood, energy, and social rhythms syndrome (DYMERS): A working hypothesis.

    Carta, Mauro Giovanni / Fornaro, Michele / Primavera, Diego / Nardi, Antonio Egidio / Karam, Elie

    Journal of public health research

    2024  Volume 13, Issue 2, Page(s) 22799036241248022

    Abstract: A syndrome centered on the dysregulation of behavioral rhythms (DBR) is discussed. Recent pandemic brought to observe: (1) Having a DBR affecting sleep patterns, eating habits, and social interactions, before the lockdown period, was a determinant for ... ...

    Abstract A syndrome centered on the dysregulation of behavioral rhythms (DBR) is discussed. Recent pandemic brought to observe: (1) Having a DBR affecting sleep patterns, eating habits, and social interactions, before the lockdown period, was a determinant for depressive episodes during the lockdown; (2) In tighter lockdowns, DBR triggered depressive episodes in bipolar patients; (3) DBR in healthcare workers under pressure was a determinant of burnout; (4) DBR influenced the course of chronic diseases by altering immune responses. In addition, it was found that scoring positive on the Mood Disorder Questionnaire (MDQ) was closely associated with the dysregulation of sleep rhythms. MDQ is a screening tool for bipolar disorder (BD), criticized for detecting too many false positives. Studies showed that positivity to the MDQ implied a severe impairment of quality of life even in people without psychiatric diagnoses. According to this evidence, three different hyperactivation levels could be proposed (from normality to pathology): firstly, an adaptive increase in energy (e.g. athletes performing well); secondly, a DBR determined from the continuous stimulation of stress hormones, with possible positive scores on the MDQ without a diagnosis of bipolar disorder, like in burnout syndromes and, thirdly, hyperactivity during manic episodes. The Dysregulation of Mood, Energy, and Social Rhythms Syndrome (DYMERS), the second level of the scale, is proposed as a working hypothesis. DYMERS is also seen as a vulnerable condition that may evolve in other disorders (including BD) according to the individual susceptibility (including genetic predisposition) and the specific nature/level of the stressor.
    Language English
    Publishing date 2024-04-25
    Publishing country United States
    Document type Journal Article
    ISSN 2279-9028
    ISSN 2279-9028
    DOI 10.1177/22799036241248022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Education as a protective factor for mental health risks among youth living in highly dangerous regions in Afghanistan.

    Kovess-Masfety, V / Frounfelker, R L / Keyes, K / Karam, E / Sabawoon, Ajmal / Sarwari, Bashir Ahmad / Husky, M / Kaur, N / Rousseau, C

    Child and adolescent psychiatry and mental health

    2023  Volume 17, Issue 1, Page(s) 12

    Abstract: Background: Children in Afghanistan live in dangerous areas, and have been exposed to traumatic events and chaotic education. Progress has been made on access to education for girls who were the most affected by traditional attitudes against engagement ... ...

    Abstract Background: Children in Afghanistan live in dangerous areas, and have been exposed to traumatic events and chaotic education. Progress has been made on access to education for girls who were the most affected by traditional attitudes against engagement in education.
    Objectives: The objectives were to evaluate the mental health of Afghan children living in regions of conflict and the association of mental health with school attendance for girls and boys.
    Method: The study included 2707 school aged children in eight regions of Afghanistan (16 provinces) residing in households recruited through a multi-stage stratified cluster sampling strategy in 2017. The level of terrorist threat was evaluated by the intensity of terrorist attacks recorded that year in each province. Child mental health was assessed with the parental report Strengths and Difficulties Questionnaire (SDQ) along with information on school attendance, sociodemographic characteristics and geographic location.
    Results: A total of 52.75% of children had scores above threshold for the SDQ total difficulties score, 39.19% for emotional difficulties, 51.98% for conduct challenges, and 15.37% for hyperactivity/inattention. Peer relationship problems were high (82.86%) and 12.38% reported that these problems impacted daily life. The level of terrorist threat was associated with SDQ total difficulties (Adjusted Odds Ratio [AOR] = 4.08, P < 0.0001), with youth in regions with high levels of terrorist threat more likely to have problems than youth in regions with low or medium levels of danger, independent of region and ethnicity. School attendance was negatively associated with emotional symptoms (AOR = 0.65, P < 0.0001) and mental health difficulties with impairment (AOR = 0.67, P = 0.007), but positively associated with peer relationships difficulties (AOR = 1.96, P > 0.0001). Conduct (AOR = 1.66, P < .0001) and SDQ total difficulties (AOR = 1.22, P = 0.019) were higher among boys. Overall, gender did not modify the relationship between school attendance and child mental health.
    Conclusion: Attending school is essential for children's mental health, across gender, and should be supported as a priority in Afghanistan despite the return of the Taliban.
    Language English
    Publishing date 2023-01-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2379599-2
    ISSN 1753-2000
    ISSN 1753-2000
    DOI 10.1186/s13034-022-00548-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The important role of mothers during displacement: Direct and indirect effects of the refugee context on Syrian refugee children's mental health.

    Popham, Cassandra M / McEwen, Fiona S / Karam, Elie / Pluess, Michael

    Child development

    2023  Volume 95, Issue 3, Page(s) e206–e223

    Abstract: Refugee children are at increased risk for mental health problems, including post-traumatic stress, depression, and externalizing problems. The refugee environment, maternal mental health, and parenting may reduce or exacerbate that risk. This study ... ...

    Abstract Refugee children are at increased risk for mental health problems, including post-traumatic stress, depression, and externalizing problems. The refugee environment, maternal mental health, and parenting may reduce or exacerbate that risk. This study investigated their direct and indirect associations with child mental health cross-sectionally in a sample of Syrian refugee child-mother dyads in Lebanon in 2017-19. Mediating pathways were tested using structural equation modeling with 1446 dyads (child: M
    MeSH term(s) Female ; Humans ; Male ; Mothers/psychology ; Mental Health ; Refugees/psychology ; Syria ; Stress Disorders, Post-Traumatic/psychology
    Language English
    Publishing date 2023-12-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 215602-7
    ISSN 1467-8624 ; 0009-3920
    ISSN (online) 1467-8624
    ISSN 0009-3920
    DOI 10.1111/cdev.14055
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  6. Article ; Online: Neither surveillance nor treatment showed significant survival benefit for lung metastases from colorectal cancer, imaging guided thermal ablation is a safe and efficient alternative to surgery.

    Karam, Elias / Tabutin, Mayeul / Dupré, Aurélien

    Journal of surgical oncology

    2022  Volume 127, Issue 3, Page(s) 513

    MeSH term(s) Humans ; Hyperthermia, Induced ; Catheter Ablation ; Diagnostic Imaging ; Lung Neoplasms/secondary ; Colorectal Neoplasms/pathology ; Liver Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2022-11-17
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.27148
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  7. Article: Objective Assessment of Covid-19 Severity Affecting the Vocal and Respiratory System Using a Wearable, Autonomous Sound Collar.

    Ishac, D / Matta, S / Bin, S / Aziz, H / Karam, E / Abche, A / Nassar, G

    Cellular and molecular bioengineering

    2021  Volume 15, Issue 1, Page(s) 67–86

    Abstract: Introduction: Since the outbreak began in January 2020, Covid-19 has affected more than 161 million people worldwide and resulted in about 3.3 million deaths. Despite efforts to detect human infection with the virus as early as possible, the ... ...

    Abstract Introduction: Since the outbreak began in January 2020, Covid-19 has affected more than 161 million people worldwide and resulted in about 3.3 million deaths. Despite efforts to detect human infection with the virus as early as possible, the confirmatory test still requires the analysis of sputum or blood with estimated results available within approximately 30 minutes; this may potentially be followed by clinical referral if the patient shows signs of aggravated pneumonia. This work aims to implement a soft collar as a sound device dedicated to the objective evaluation of the pathophysiological state resulting from dysphonia of laryngeal origin or respiratory failure of inflammatory origin, in particular caused by Covid-19.
    Methods: In this study, we exploit the vibrations of waves generated by the vocal and respiratory system of 30 people. A biocompatible acoustic sensor embedded in a soft collar around the neck collects these waves. The collar is also equipped with thermal sensors and a cross-data analysis module in both the temporal and frequency domains (STFT). The optimal coupling conditions and the electrical and dimensional characteristics of the sensors were defined based on a mathematical approach using a matrix formalism.
    Results: The characteristics of the signals in the time domain combined with the quantities obtained from the STFT offer multidimensional information and a decision support tool for determining a pathophysiological state representative of the symptoms explored. The device, tested on 30 people, was able to differentiate patients with mild symptoms from those who had developed acute signs of respiratory failure on a severity scale of 1 to 10.
    Conclusion: With the health constraints imposed by the effects of Covid-19, the heavy organization to be implemented resulting from the flow of diagnostics, tests and clinical management, it was urgent to develop innovative and safe biomedical technologies. This passive listening technique will contribute to the non-invasive assessment and dynamic observation of lesions. Moreover, it merits further examination to provide support for medical operators to improve clinical management.
    Supplementary information: The online version contains supplementary material available at 10.1007/s12195-021-00712-w.
    Language English
    Publishing date 2021-11-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2416037-4
    ISSN 1865-5033 ; 1865-5025
    ISSN (online) 1865-5033
    ISSN 1865-5025
    DOI 10.1007/s12195-021-00712-w
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  8. Article ; Online: The dynamic nature of refugee children's resilience: a cohort study of Syrian refugees in Lebanon.

    Popham, C M / McEwen, F S / Karam, E / Fayyad, J / Karam, G / Saab, D / Moghames, P / Pluess, M

    Epidemiology and psychiatric sciences

    2022  Volume 31, Page(s) e41

    Abstract: Aims: Children's responses to war and displacement are varied; many struggle, while others appear resilient. However, research into these outcomes disproportionately focuses on cross-sectional data in high-income countries. We aimed to (1) investigate ... ...

    Abstract Aims: Children's responses to war and displacement are varied; many struggle, while others appear resilient. However, research into these outcomes disproportionately focuses on cross-sectional data in high-income countries. We aimed to (1) investigate change in resilience across two timepoints in a highly vulnerable sample of Syrian refugee children in Lebanon, and (2) explore predictors of their mental health problems across time.
    Methods: In total, 982 Syrian child-caregiver dyads living in refugee settlements in Lebanon completed questionnaires via interview at baseline and follow-up one year later. We categorised children into groups based on their risk for mental health problems across both timepoints (stable high risk/SHR, deteriorating, improving, stable low risk) according to locally validated cut-offs on measures of post-traumatic stress disorder (PTSD), depression and behavioural problems. Analyses of covariance identified how the groups differed on a range of individual and socio-environmental predictors, followed up by cross-lagged panel models (CLPMs) to investigate the directionality of the relationships between significantly related predictors and symptoms.
    Results: The sample showed a meaningful amount of change in mental health symptoms from baseline to follow-up. Over half (56.3%) of children met SHR criteria and 10.3% deteriorated over time, but almost one-quarter (24.2%) showed meaningful improvement, and 9.2% were consistently at low risk for mental health problems at both timepoints. Several predictors differentiated the groups, particularly social measures. According to CLPMs, maternal acceptance (
    Conclusions: Our results show risk and resilience are dynamic, and the family environment plays a key role in children's response to war and displacement. Conversely, children also have a significant impact on the family environment and caregiver's own mental health. Interventions to promote resilience in refugee children should therefore consider family-wide mechanisms.
    MeSH term(s) Cohort Studies ; Cross-Sectional Studies ; Humans ; Lebanon/epidemiology ; Refugees/psychology ; Stress Disorders, Post-Traumatic/psychology ; Syria
    Language English
    Publishing date 2022-06-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 2607964-1
    ISSN 2045-7979 ; 2045-7960
    ISSN (online) 2045-7979
    ISSN 2045-7960
    DOI 10.1017/S2045796022000191
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  9. Article: The Golden Ratio in Pediatric Wrist Anatomy: A Divine Symmetry.

    Mamarelis, Georgios / Karam, Edward / Sohail, Mohammad Z / Key, Steve

    Cureus

    2022  Volume 14, Issue 7, Page(s) e26939

    Abstract: Introduction:  The golden ratio, which equals 1.61803…, and is usually defined by the Greek letter φ (phi), has attracted broad attention for a long time. It has been found in many phenomena in the universe including, body symmetry and locomotion. ... ...

    Abstract Introduction:  The golden ratio, which equals 1.61803…, and is usually defined by the Greek letter φ (phi), has attracted broad attention for a long time. It has been found in many phenomena in the universe including, body symmetry and locomotion. Within this context, the purpose of our study was to evaluate normal morphometric measurements of the wrist in the pediatric population and to identify if phi (φ) is part of the distal radioulnar joint.  Methods: We retrospectively reviewed the hospital records of all skeletally immature patients requiring surgical intervention for distal radius fracture in our unit between January 2010 and January 2017. We define and describe a reproducible method to measure the ratio of the distal radial and ulnar physes.
    Results:  A total of 268 patients were included with a mean age of 9.41 (3-16) years and a mode of 7 years. Some 63.4% were boys -- 43.3% were right-sided injuries and 56.7% were left-sided injuries. The ratio between the total width of the radial and ulnar growth plates and the radial growth plate closely approximated φ; the mean of this ratio in all the patients included was 1.619684 (1.5848-1.6643). Most of the injuries happened in the summertime, between May and August.
    Conclusion:  We found that the golden ratio exists in our body to play its harmony in the pediatric wrist joint. We believe that with the support of further studies, the golden ratio might yield diagnostic and prognostic implications in the treatment of distal radius/ulnar fractures or abnormalities in this population.
    Language English
    Publishing date 2022-07-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.26939
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  10. Article: Emotional Intelligence and Good Medical Practice: Is There a Relationship?

    Dott, Cameron / Mamarelis, George / Karam, Edward / Bhan, Kavyansh / Akhtar, Kash

    Cureus

    2022  Volume 14, Issue 3, Page(s) e23126

    Abstract: Emotional intelligence (EI) is defined as the ability to perceive and manage the emotions of oneself and others. Despite being one of the most highly used psychological terms in popular nomenclature, its understanding in the context of clinicians remains ...

    Abstract Emotional intelligence (EI) is defined as the ability to perceive and manage the emotions of oneself and others. Despite being one of the most highly used psychological terms in popular nomenclature, its understanding in the context of clinicians remains poor. There is a dearth of literature on this topic, and this submission examines the relationship between a clinicians' EI and the key domains of "Good Medical Practice" guidelines from the General Medical Council, United Kingdom. It aims to review and critically analyse the existing literature on EI and Good Medical Practice while attempting to establish a relationship between the two. This submission thus examines the relationship between emotional intelligence and a clinician's on-the-job performance. The findings demonstrate how emotional intelligence can aid the clinician in all aspects of their working life in the context of practising in line with General Medical Council (GMC) guidance. The authors also recommend exploring the possibility of inclusion of EI within a modern medical curriculum, as it may lead to improved practice in clinicians.
    Language English
    Publishing date 2022-03-13
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.23126
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