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COVID-19 has dramatically reshaped the way global education is delivered. Millions of learners were affected by educational institution closures due to the pandemic, which resulted in the largest online movement in the history of education. With this sudden shift away from classrooms in many parts of the globe, universities had to rapidly shift to virtual and digital strategies. Many believe that the adoption of online distance learning will persist after pandemic. A new hybrid model of education is expected to emerge, and, given the digital divide, new shifts in education approaches could widen equality gaps. This is one of the first empirical studies investigating the effect of the sudden shift from face-to-face to online distance learning due to COVID-19 lockdown at one of the universities in Egypt. Comparison of grades was made between 376 business students who completed a face-to-face course in spring 2019 and 372 students who completed the same course but fully online via distance learning mode in spring 2020 during the lockdown. T-test was conducted to compare grades of quizzes, course work, and final exam for the two groups. Chi-square test was used to compare grade distribution for both groups. The effect of gender, credit hours, age, and CGPA was assessed. The results suggested that there was no statistically significant difference in students’ grades. In addition, the unplanned and rapid move to online distance learning at the time of pandemic did not result in a poor learning experience as was expected. The study also included a survey of 435 students and interviews with a sample of professors about their learning and teaching experience during the lockdown. The results of this study provide specific recommendations for universities, instructors, and higher education portal designers about future application of online distance learning. Since Egypt decided to make the shift to online distant learning in all future higher education plans, the results of this research would be especially vital for universities in Egypt and other developing countries. If administered correctly, this shift could lead to a larger learner population, more cost efficiencies, and more university revenue.

The Metaverse is an end-users-oriented integration of various layers of Information Technology (IT), where Human–Computer Interaction (HCI) would be the core technology. With the rapid development of IT, the Metaverse would allow users to connect, work, conduct business, and access educational resources, all in a technology-mediated environment in new interaction ways. The Metaverse can play a major role in the future of online learning and enable a rich active learning environment, where learners have the opportunity to obtain first-hand experiences that might not be accessible in the physical world. While currently there is a severe shortage in Metaverse-Learning studies, such research strands are expected to soon emerge. The main objective of this paper is to investigate challenges and opportunities for human-centric Metaverse technology in the learning sector, hence accelerating research in this field. A phenomenological research method was used, including semi-structured in-depth interviews, essays written by participants, a focus group discussion with 19 experts in the areas of HCI, intelligent interactive technologies, and online learning. The individual interviews took place in May 2022, with a focus group meeting held online in June 2022 to formulate a collective opinion of the 19 experts. Five challenges were identified for the Metaverse-Learning context: immersive design, privacy and security, universal access, physical and psychological health concerns, and governance. While the research provided suggestions to overcome those challenges, three Meta-Learning opportunities were identified: hands-on training and learning, game-based learning, and collaboration in creating knowledge. The findings of this research contribute to understanding the complexity of the online learning in the Metaverse from the Human–Computer Interaction point of view. These findings can be used to further research the Metaverse as a virtual communication environment and potential business and learning platform.

Mobile health apps are seeing rapid growth in the potential to improve access to healthcare services for disadvantaged communities, while enhancing the efficiency of the healthcare delivery value chain. Still, the adoption of mHealth apps is relatively low, especially in developing countries. In Egypt, an initiative for national-level healthcare coverage was launched in 2021, accompanied by a rise in mHealth start-ups. However, many of these projects did not progress beyond the pilot stage, with very little known about the antecedents of mHealth adoption for the Egyptian user. Semi-structured interviews were conducted with 22 Egyptians, aiming to uncover factors affecting the use of mHealth apps for Egyptian citizens. Some of these factors were introduced by previous studies, such as Perceived Service Quality, Perceived Risk, Perceived Ease of Use, and Trust. Others were not well established in the mHealth research strand, such as Perceived Reputation and Perceived Familiarity, while Governance, Personalized Experience, Explain-ability, Interaction, Language, and Cultural Issues, are novel factors introduced by the current research. The effect of these suggested independent variables on the willingness to adopt mHealth apps was validated using a survey administered to 150 Egyptians, confirming the significant positive effect of most of these factors on mHealth adoption in Egypt. This research contributes to methodology by introducing novel constructs in the mHealth research context, which might be specific to the target developing country. Practical implications were suggested for designers and healthcare service providers might increase the adoption of their apps in developing countries, such as Egypt.

Pathogenic bacteria can enter into a viable but non‐culturable (VBNC) state under unfavourable conditions. Proteus mirabilis is responsible for dire clinical consequences including septicaemia, urinary tract infections and pneumonia, but is not a species previously known to enter VBNC state. We suggested that stress‐induced P. mirabilis can enter a VBNC state in which it retains virulence. P. mirabilis isolates were incubated in extreme osmotic pressure, starvation, low temperature and low pH to induce a VBNC state. Resuscitation was induced by temperature upshift and inoculation in tryptone soy broth with Tween 20 and brain heart infusion broth. Cellular ultrastructure and gene expression were examined using transmission electron microscopy (TEM) and quantitative real‐time polymerase chain reaction (qPCR), respectively. High osmotic pressure and low acidity caused rapid entry into VBNC state. Temperature upshift caused the highest percentage of resuscitation (93%) under different induction conditions. In the VBNC state, cells showed aberrant and dwarf morphology, virulence genes and stress response genes (envZ and rpoS) were expressed (levels varied depending on strain and inducing factors). This is the first‐time characterization of VBNC P. mirabilis. The ability of P. mirabilis pathogenic strains to enter a stress‐induced VBNC state can be a serious public health threat.

Background The prolonged psychiatric disorders rate following coronavirus disease 2019 (COVID-19) could surpass that of severe acute respiratory syndrome (SARS) as well as Middle East Respiratory Syndrome (MERS) as a result of variations in viral disease treatment as well as societal circumstances throughout the outbreaks. This work aimed to investigate the COVID-19 prolonged psychiatric effects on survivors without psychiatric diseases before infection. Methods This cross-sectional research was conducted on 1254 patients of which 700 patients (55.8%) were positive for psychiatric complications based on the general health (GHQ-28) questionnaire and 554 patients (44.1%) were negative, aged above 18 years old who had been infected with COVID19 (PCR swab confirmed) and recovered since less than 6 months without previous history of any psychiatric disease. Results Smoking, medical comorbidities, hospitalization, and cortisone in treatment were significantly higher in GHQ-28 positive than GHQ-28 negative ( p  < 0.05). Psychiatric disorders and Beck’s Depression Inventory (BDI) grades showed a significant association between smoking and hospitalization and Taylor Manifest Anxiety scales and smoking, hospitalization, and treatment with cortisone). Smoking, medical comorbidities, hospitalization, and cortisone in treatment were the most significant predictors of positive GHQ-28. However, multivariate analysis demonstrated that medical comorbidities, hospitalization, and cortisone in treatment were the best independent predictors of GHQ-28 positive ( p  = 7.055, p  = 0.007, p  = 0.043, p  = 0.047, respectively). Conclusions COVID-19 cases without pre-existing psychological disorders exhibited a significant increase in psychiatric disorders occurrence 6 months following recovery. Anxiety disorders represented the predominant mental diagnoses documented.

Background Repetitive transcranial magnetic stimulation showed some evidence for improving symptoms of ADHD along with its relative safety, thus could serve as a treatment strategy or an alternative to stimulant medication. Accordingly, 60 children with ADHD were assessed, and 30 participants were allocated to the rTMS group and received 15 sessions of rTMS over the right dorsolateral prefrontal cortex combined with Atomoxetine 1.2 mg/kg/day. The other 30 participants were allocated to the Sham group and received 15 sessions of sham rTMS and atomoxetine 1.2 mg/kg/day. Clinical assessments of ADHD symptoms and severity were done and compared at 3 points, before treatment, after receiving 15 sessions of rTMS and follow-up 1 month after the last rTMS session, using Conner’s Parent Rating Scale-Revised-Long form, Children’s Global Assessment Scale, and Clinical Global Impression. Results The two groups show significant improvement in the T scores of all CPRS subscales, CGI and CGAS. However, the rTMS group had a significantly more improvement than the sham group in inattention, total ADHD severity, CGI, and CGAS after rTMS and continued to the follow-up after 1 month. Conclusions rTMS is an efficacious intervention for treating ADHD, and combined rTMS and atomoxetine is superior to atomoxetine alone in improving attention deficit symptoms and total ADHD symptoms severity. Trial registration PACTR, PACTR202110558451583 . Registered 25 June 2021. Approved 29 October 2021- Retrospectively registered, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=15968 .

Background Attention-deficit/hyperactivity disorder (ADHD) is a childhood neurodevelopmental disorder that persists into adulthood . ADHD is a well-known risk factor for substance use disorder (SUD). However, the actual contribution of comorbidity is largely unknown. The current study investigated the prevalence of ADHD in a sample of abstinent patients compared to healthy controls. Compared to 51 healthy controls, 51 patients seeking medical treatment for SUD were abstinent from any substance for at least 1 month, interviewed by the use of the ICD-10 symptom checklist, the Social Classification Scale, the Addiction Severity Index, Conners adult ADHD Rating Scales Self-Report (CAARS-S:L), and the Kiddie-Sads-Present and Lifetime Version (K-SADS-PL). Results Using CAARS-S:L, the ADHD index showed that 9 subjects (17.6%) were diagnosed with adult ADHD. Using K-SADS-PL, 8 of the participants (15.7%) were found to have an adult ADHD diagnosis. Lower scores of the ADHD index are related to increased patients’ age, while increased scores of the ADHD index are related to more alcohol-related problems of the patients. The strongest predicting factors of increased ADHD index were drug problems and legal status. Conclusions The current study provides evidence of an increased diagnosis of adult ADHD in patients with substance use disorder, regardless of the type of substance abuse.

Background Tobacco smoking is considered currently a global public health concern among youth especially school students. There is a scarcity of data about the impact of this global phenomenon in Middle Eastern countries. This study assesses the prevalence of tobacco smoking, including conventional cigarettes, E-cigarettes, and water pipe and its sociodemographic and psychiatric correlates among a sample of general secondary school students in Cairo, Egypt. Results A convenient sample of 391 Egyptian general secondary students from different areas of Greater Cairo were assessed using the Socioeconomic scale, Fagerstrom Test For Nicotine Dependence, The Lebanon Water pipe Dependence Scale, questionnaire for electronic cigarette use, Barratt impulsivity scale 11, and The MINI International Neuropsychiatric Interview for Children and Adolescents. 12.8% ( n = 50) were smokers. There is a significant relation between family history of smoking and substance use and smoking and significant relation between smoking, impulsivity, and mood symptoms. Conclusions Prevalence of tobacco smoking in Egyptian adolescents was 12.8% with significant relation between smoking and impulsivity and mood symptoms.

Background Early detection of perinatal depression and its cultural determinants could reduce its sequalae on mothers and their babies. This study investigated the prevalence of perinatal depression in Egyptian mothers and compare women with and without perinatal depression regarding the psychosocial factors. Three-hundred one women were recruited (166 were pregnant and 135 were in postpartum period) from a primary healthcare unit. Full sociodemographic data, Social Classification Scale, Dyadic Adjustment Scale (DAS), and the Edinburgh Postnatal Depression Scale (EPDS) were completed. Subjects with EPDS score > 9 answered the structured clinical interview (SCID-I) for diagnosis of depression and Hamilton Rating Scale for Depression (HRSD) for depression severity. Results Depression with mild to moderate severity was reported in 5.4% and 3.7% of women during pregnancy and postpartum period, respectively. There was a statistically significant association between depression and employment ( p = 0.031), mother-in-law disputes ( p = 0.002), stigma of being the second wife ( p = 0.047), and having financial burdens ( p = 0.001). Marital satisfaction was a protective factor for depression ( p < 0.001). Conclusions Prevalence of perinatal depression was comparable to other developing countries. It was strongly linked to culturally related factors including marital women’s employment, mother-in-law disputes, being the second wife, and socioeconomic burdens. Early detection of perinatal depression and its culturally related factors is important for its management.

Background Several studies pointed to immune dysregulation abnormalities linked to autism spectrum disorders (ASD). Of those, several autoantibodies had been identified. Recent findings of N-methyl d -aspartate (NMDA) antibodies in autoimmune encephalitis suggested that it caused symptoms like autistic regression. Thus, the purpose of the study was to test for the presence of anti-NMDAR antibodies in the ASD disorder population and to correlate this with the clinical findings. Results Eighty-seven autistic children, 4–12 years old, were enrolled in the study and were matched with sixty typically developing children used as controls. The diagnosis of cases was confirmed by ADOS-2 and clinical evaluation. None of the control children had positive anti-NMDAR antibodies, while 26.4% (23 children) of the patients’ group were positive for serum anti-NMDA receptor antibodies (> 200 pg/ml, p = 0.0157). The positive anti-NMDAR antibody was statistically correlated with better speech stage ( p = 0.017), more severe stereotyped behavior ( p ≤ 0.001), and abnormal EEG findings ( p = 0.025). Conclusions There is a possibility of the presence of anti-NMDAR antibodies in the autism spectrum disorder population with certain characteristics, especially the severity of the stereotyped behaviors.