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Background The current applications of artificial intelligence (AI) in medicine continue to attract the attention of medical students. This study aimed to identify undergraduate medical students’ attitudes toward AI in medicine, explore present AI-related training opportunities, investigate the need for AI inclusion in medical curricula, and determine preferred methods for teaching AI curricula. Methods This study uses a mixed-method cross-sectional design, including a quantitative study and a qualitative study, targeting Palestinian undergraduate medical students in the academic year 2022–2023. In the quantitative part, we recruited a convenience sample of undergraduate medical students from universities in Palestine from June 15, 2022, to May 30, 2023. We collected data by using an online, well-structured, and self-administered questionnaire with 49 items. In the qualitative part, 15 undergraduate medical students were interviewed by trained researchers. Descriptive statistics and an inductive content analysis approach were used to analyze quantitative and qualitative data, respectively. Results From a total of 371 invitations sent, 362 responses were received (response rate = 97.5%), and 349 were included in the analysis. The mean age of participants was 20.38 ± 1.97, with 40.11% (140) in their second year of medical school. Most participants (268, 76.79%) did not receive formal education on AI before or during medical study. About two-thirds of students strongly agreed or agreed that AI would become common in the future (67.9%, 237) and would revolutionize medical fields (68.7%, 240). Participants stated that they had not previously acquired training in the use of AI in medicine during formal medical education (260, 74.5%), confirming a dire need to include AI training in medical curricula (247, 70.8%). Most participants (264, 75.7%) think that learning opportunities for AI in medicine have not been adequate; therefore, it is very important to study more about employing AI in medicine (228, 65.3%). Male students (3.15 ± 0.87) had higher perception scores than female students (2.81 ± 0.86) ( p  < 0.001). The main themes that resulted from the qualitative analysis of the interview questions were an absence of AI learning opportunities, the necessity of including AI in medical curricula, optimism towards the future of AI in medicine, and expected challenges related to AI in medical fields. Conclusion Medical students lack access to educational opportunities for AI in medicine; therefore, AI should be included in formal medical curricula in Palestine.

Understanding how hope can be protective against suicide may improve prevention efficiency by helping identify and target those most at risk for suicide, and develop individualized treatment strategies. However, no studies have yet focused on the processes underlying the relationship between hope and suicidality in war-affected populations. The objective of this study was to explore the direct and indirect effects of hope on suicidal ideation through perceived survival expectations in Palestinian adults who currently live in Gaza in the midst of war. This is a cross-sectional study that has adopted the snowball sampling method and used an Internet-based survey that was distributed during the month of September 2024. The target population consisted of 534 adult Gazan people from the general population who were aged over 18 years and were living in Gaza Strip at the time of data collection. 44.6% of participants had suicidal ideation. A total of 43%, 44% and 45% of participants perceived < 50% chances of living for the next year, the next 5 years, and the next 10 years, respectively. After adjusting for covariates (age, education status, and living arrangements), perceived survival expectations at 5 years (indirect effect: Beta = -0.004; Boot SE = 0.002; Boot CI -0.01; -0.001) and 10 years (indirect effect: Beta = -0.01; Boot SE = 0.004; Boot CI -0.02; -0.003) mediated the association between hope and suicidal ideation. Higher hope was significantly associated with higher perceived survival expectations at 5 years, and directly with lower suicidal ideation. Finally, higher perceived survival expectations at 5 and 10 years were significantly associated with lower suicidal ideation. Our findings contend that hope might confer protection against suicide through the indirect effect of perceived survival expectations in individuals living in a constantly life-threatened state. Future experimental research is warranted to test whether intervening on low perceived survival expectations can be successful in mitigating related psychopathological outcomes, including suicidal ideation.

The purpose of this research is to investigate the moderating role of corporate governance on the relationship between earnings management and debt level in capital structure. The paper used a hypothesis-testing research approach to gather data from the annual reports of 13 industrial companies listed on Palestine Exchange and 25 Jordanian companies listed on Amman Stock Exchange from 2013 to 2020. Descriptive and inferential statistics were employed, along with correlation analysis to evaluate linear relationships between variables. The fixed and random effect regressions were utilized to develop the research model. In the case of Palestinian manufacturing firms, the results revealed that Earnings Management (EM) had a significant negative impact on debt level. According to the moderating role of Corporate Governance (CG), larger boards and the existence of female members on the board of directors causes an increase in the high-leverage impact of EM, whereas CEO duality mitigates the high-leverage impact. However, in the case of Jordanian manufacturing firms, EM showed an insignificant impact on debt level. Regarding the moderating role of CG, it was proved that the presence of female members on the board of directors increased the firm’s reliance on debt financing as a result of EM practices, while institutional investors mitigate the effect of EM on debt financing, leading to a decrease in reliance on debt. The findings of this research are suitable for the regulators while formulating policies on the Corporate Governance and the Impact of Earnings Management on Capital Structure. These findings have guided the policymakers that they should enhance their focus on Palestine and Jordan companies to test Corporate Governance Moderates the Impact of Earnings Management on Capital Structure. This study is also helpful for the new researcher while investigating this area in the future.

Background The war in Gaza, coupled with severe restrictions on humanitarian access and assistance, have led to a rapid and large-scale exacerbation of food insecurity (FI) and water insecurity (WI) in Gaza, which can cause a myriad of deleterious effects on both physical and mental health. Previous evidence suggests that environmental stressors (such as FI and WI), coupled with lack of support, can compromise coping ability and trigger psychosis. Elucidation of these pathways can inform efforts to reduce the incidence of psychosis in war settings in particular, and in global communities more generally. This study aimed to assess the mediating role of social support on the association between food-water insecurities and psychotic experiences (PEs). Methods This study was carried-out over a period of one month (September 2024) by using a free online form builder. Data were collected at a single time point using snowball sampling. A total of 476 adults aged 18–35 years and living in Gaza at the time of the survey took part in this study. The Prodromal Questionnaire- Brief, the Food Insecurity Experience Scale, the Four-Item Household Water Insecurity Experiences Scale, and the Single Item Measure of Social Supports have been administered to participants. Results A total of 110 participants (23.1%) reported low tangible social support (i.e., having no or 1 person in the social support network), 27.3% were classified as moderately-to-severely food insecure and 41% were categorized as water-insecure. The mediation analysis was adjusted for the following covariates: marital status, living arrangement and age. Higher food-water insecurity experiences were significantly associated with lower social support. Higher food-water insecurity experiences were also significantly associated with higher PEs. Higher social support was significantly associated with lower PEs. The results of the mediation analysis showed that social support mediated the link of FI (indirect effect: Beta = 0.06; Boot SE = 0.03; Boot CI 0.01; 0.12) and WI (indirect effect: Beta = 0.04; Boot SE = 0.02; Boot CI 0.01; 0.08) to PEs. Conclusion Our findings support the case for bolstering social support networks in war-affected communities facing survival challenges such as FI and WI. This study points to the urgent need for increased food aid and improved water supplies in the short term, and sustainable food and water systems in the long term, to support mental health. In times of war, mental health prevention and interventions strategies might do well to increase social support and resources in order to help buffer such intense environmental stressors and prevent the emergence of psychosis. Clinical trial number Not applicable.

Background Since October 2023, the humanitarian crisis in Gaza has dramatically escalated and food insecurity (FI) has rapidly deteriorated. In the face of such situation, it has been recommended that accurate information on FI should be integrated in emergency reporting systems in order to better target and assess the impact of humanitarian aid. To achieve this, field practitioners, researchers and decision-makers should be equipped with user-friendly and psychometrically sound measures tailored to real-life war situations and the Palestinian context. Therefore, the present study aimed to test the psychometric properties of the Food Insecurity Experiences Scale (FIES) in a sample of Arabic-speaking community adults currently living in the Gaza Strip during the war. Methods This study used a cross-sectional design, snowball sampling as a recruiting strategy, and a self-administered online questionnaire to collect data from participants. It was performed during the period from September 1st to 30th, 2024. A total of 534 valid responses were received and were included in the final analysis. Results Approximately one out of two people in Gaza were experiencing any FI. Fit indices in confirmatory factor analysis indicated that a one-factor solution fit the data with acceptable factor loadings. Furthermore, our findings indicated that the Arabic version of the FIES presented an excellent level of reliability, with both Cronbach’s alpha and McDonald omega coefficients of 0.94. Cross-sex measurement invariance in the FIES was established at scalar and metric levels. Finaly, concurrent validity was evidenced by FIES’s positive correlations with water insecurity experiences, post-traumatic stress, depression and anxiety symptoms. Conclusion Altogether, our findings showed that the FIES fulfils requirements of validity and reliability. It may thus be considered as appropriate tool for assessing FI in Gazan war-affected populations currently suffering from acute FI emergency and requiring urgent action to meet their food needs. The FIES is simple, short, economic and time-effective. As a FI indicator, the Arabic FIES is useful in providing information that enables actions by policy makers and guides humanitarian-aid actors’ efforts aimed at decreasing, mitigating, or preventing severe FI, and saving lives or livelihoods. Clinical trial number Not applicable.

Background End-stage renal disease is a significant global health issue, and Peritoneal Dialysis (PD) is a vital treatment modality. The study aims to assess the Quality of Life (QoL) and pain levels in PD patients and explore potential influencing factors. Methods A cross-sectional study was conducted in 2022 involving 76 PD patients at a referral tertiary dialysis center in Palestine. The study evaluated patient demographics, clinical data, laboratory measures, quality of life as assessed by the KDQOL-SF36, and pain levels as determined by the Brief Pain Inventory. Statistical analyses, including multivariate linear regression, were employed to identify relevant associations. Results This study included 76 PD disease patients, with 68.4% being under the age of 60 and 53.9% being male. Almost one-third of the participants (34.0%) reported mild to severe pain, and 23.7% reported low to high interference levels. Pain severity was negatively correlated with supplement doses for both vitamin D3 ( p  = 0.049) and calcium ( p  < 0.01). Female patients reported higher pain severity ( p  = 0.001) and interference ( p  < 0.007) levels. The study revealed relatively higher QoL among our cohort of PD patients compared to previously published findings in similar settings, specifically for HD populations. Factors such as age, comorbid conditions, and duration of dialysis influenced QoL ( p  < 0.05). Pain severity and interference were negatively correlated with QoL ( p  = 0.01). Conclusion This study provides valuable insights into the QoL and pain experiences of PD patients in Palestine. It underscores the importance of effective pain management strategies and holistic care to improve QoL in this patient population. Addressing psychological and emotional well-being is vital for optimizing treatment adherence and long-term outcomes. Clinical trial number Not applicable.

Background: The dramatic increase in TikTok use over the past few years has generated a major challenge globally. Providing researchers with a valid, reliable, yet brief measure may stimulate large-scale epidemiological research that can help to clarify the mechanisms involved in susceptibility to TikTok addiction and guide the development of prevention strategies. The objective of our study was to design and validate a brief measure that we labelled the TikTok Addiction Test (TAT) using a multi-country sample, with a specific focus on measuring the 6 core features of addiction through 1 item each. Method: A multi-country survey with a cross-sectional design was conducted in February of 2025 among general population adults (N = 3362) from five Arab countries: Egypt, Jordan, Lebanon, Oman, and Palestine. Results: A single-factor solution was obtained in the Exploratory Factor Analysis and corroborated in the Confirmatory Factor Analysis, indicating an adequate goodness-of-fit indices, with all 6 items satisfactorily loading on the same latent variable. In addition, the internal consistency reliability indicators were excellent for the entire measure, with Cronbach’s alpha and McDonald’s omega values of 0.91. We found invariance in factor structure, factor loadings, and intercepts between sexes and for country groups. A total of 207 (6.2%) participants were identified as TikTok addicts. Females exhibited significantly higher mean TAT scores than males. Palestinian and Lebanese participants reported the highest TikTok addiction scores, followed by Egyptians, Jordanians, and Omani. Finally, significant positive associations were observed between TAT scores and smartphone addiction, depression, anxiety, and loneliness, supporting the concurrent validity of the scale. Conclusion: Results suggest that the TAT is a simple and useful instrument for measuring TikTok addiction of general population adults with only 6 items and 1 factor. As a brief self-report measure, the TAT can be highly valuable in time- and resource-pressured real-life settings, and offers a foundation for future research in this area.

Objective The Body Image-Acceptance and Action Questionnaire is a valid and reliable measure that assesses the extent to the degree of flexibility of an individual’s negative emotions and thoughts about their own bodies, and the extent to which they are able to engage in valued activity despite experiences of difficult body image internal. To date, there is no measure available and validated for Arabic-speaking adults for specifically assessing the concept of body image psychological flexibility. This study’s objective was to examine the psychometric properties of the Arabic version of the short 5-item form of the scale (BI-AAQ-5) in a sample of adults from Lebanon. Methods This study is cross-sectional, it enrolled 400 Arabic-speaking adults aged 18 and above using a snowball sampling technique (mean age: 25.93 ± 11.87 years and 65% females). The forward-backward translation method was adopted to obtain the Arabic version of the BI-AAQ-5. Psychometric properties were evaluated through confirmatory factor analysis (CFA), internal consistency analysis (Cronbach’s alpha and McDonald’s omega), and measurement invariance testing across sexes. Results The Arabic version of the BI-AAQ-5 demonstrated high internal consistency. The fit indices of originally proposed one-factor structure of the scale indicated that the measurement model fits the data well. The standardized estimates of factor loadings were all adequate. The results showed substantial evidence for configural, metric, and scalar invariance across male and female participants (males: 27.13 ± 6.96 vs. females: 25.73 ± 8.28; t(398) = 1.80, p  =.074). Conclusion The BI-AAQ-5 translated into Arabic appears to be a valid self-assessment measure to evaluate body image acceptance among the adults. Findings suggest that the scale appears suitable for use among Arabic-speaking adults.

Background and Aims This study had the main purpose of investigating the psychometric properties of the 9‐item Self‐Report Altruism scale (9‐SRA) in its translated Arabic‐language version among Palestinian HCWs in Gaza during war times. Methods This cross‐sectional study was performed between January 15 and April 15, 2025, among 615 HCWs at several hospitals and primary health care centers in the Gaza Strip. Results Our data adequately fitted this original hypothetical one‐factor model, with excellent internal consistency reliability coefficients (Cronbach's α = 0.92). The assumption of measurement invariance across sex groups of the Arabic version of the 9‐SRA was supported. Empathy scores were significantly and positively correlated with altruism scores. Finally, higher depression and anxiety were significantly associated with lower altruism. Conclusion Our research offers robust evidence in terms of reliability and validity to support the use of the 9‐SRA instrument to evaluate self‐reported altruistic behavior among Arabic‐speaking HCWs, especially in the context of war.