Mohamed Baklola

Abstract Background Artificial intelligence (AI) has made significant advances in recent years, and its applications in psychiatry have gained increasing attention. The use of AI in psychiatry offers the potential to improve patient outcomes and provide valuable insights for healthcare workers. However, the potential benefits of AI in psychiatry are accompanied by several challenges and ethical implications that require consideration. In this review, we explore the use of AI in psychiatry and its applications in monitoring mental illness, treatment, prediction, diagnosis, and deep learning. We discuss the potential benefits of AI in terms of improved patient outcomes, efficiency, and cost-effectiveness. However, we also address the challenges and ethical implications associated with the use of AI in psychiatry, including issues of accuracy, privacy, and the risk of perpetuating existing biases in the field. Results This is a review article, thus not applicable. Conclusion Despite the challenges and ethical implications of using AI in psychiatry, the potential benefits of this technology cannot be ignored. Further research and development are required to address the limitations and ensure the safe and ethical integration of AI in the field of psychiatry. By doing so, AI has the potential to greatly improve patient outcomes and enhance the delivery of mental healthcare services.

BACKGROUND: Mental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students. METHODS: A cross-sectional study was conducted across ten Egyptian universities during the academic year 2022-2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ). RESULTS: Among 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help. CONCLUSION: The findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common digestive problem in adults particularly medical students, who are one of the most vulnerable groups. Many variables, including lifestyle changes and psychological stress, increase the prevalence of GERD among undergraduate medical students. Therefore, this study aims to assess the prevalence, and risk factors of GERD, and its relationship with perceived stress among medical students in Egypt. METHODS: In November and December of 2022, a cross-sectional descriptive study with an analytical component was carried out among medical students from six different universities. An online self-reported questionnaire was used to collect data. The questionnaire included data on sociodemographic characteristics, risk factors, lifestyle, the Arabic version of GerdQ, and the Arabic version of Cohen's Perceived Stress Scale (PSS). RESULTS: The questionnaire was filled out by 964 medical students, the majority of whom were female (64%). Overall, 17.1% of participants reported symptoms of GERD. Logistic regression showed that smoking, high perceived stress, and a family history of GERD were the independent predictors of having GERD symptoms, with odds ratios of 4.1, 3.9, and 2.2, respectively. CONCLUSION: GERD is a frequent condition among Egyptian medical students, affecting around one-fifth of them. In the fight against GERD, university-based smoking cessation and stress management programs may be influential.

BACKGROUND: Mental health disorders are a major public health concern especially among undergraduates, globally and within Egypt. Most individuals suffering from mental illnesses either do not seek care at all or seek it only after a large delay. It is therefore critical to identify the barriers that prevent them from seeking professional help to solve the problem from its roots. Thus, the objectives of the study were to assess the prevalence of psychological distress, the need for professional mental health care, and the barriers to seeking available services among undergraduate students in Egypt. METHODS: A proportionate allocation technique was used to recruit 3240 undergraduates from 21 universities. Symptoms of psychological distress were evaluated using the Arabic General Health Questionnaire (AGHQ-28) and a score of above nine was used to identify positive cases. The pattern for utilization of mental health care was assessed using a multi-choice question and barriers to mental health care were assessed using the Barriers to Access to Care Evaluation (BACE- 30) tool. Logistic regression was adopted to identify the predictors of psychological distress and seeking professional health care. RESULTS: The prevalence of psychological distress was 64.7% and the need for professional mental health care was 90.3% of those with psychological distress. The top barrier to receiving professional mental health services was wanting to solve the problem on their own. Logistic regression revealed that female sex, living away from family and positive family history of mental disorders were independent predictors of psychological distress. Students from urban backgrounds were more likely to seek help than students from rural ones. While age above 20 and positive family history of mental disorders were independent predictors for seeking professional help. There is no significant difference between medical and non-medical students in terms of psychological distress. CONCLUSION: The findings of the study showed there is a high prevalence of psychological distress and a lot of instrumental and attitudinal related barriers to seeking mental health care and highlighted the urgent need to develop interventions and preventive strategies to address the mental health of university students.

Since the initial report of the coronavirus disease 2019 (COVID-19) in December 2019, subsequent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has generated serious concerns [1]. The World Health Organization (WHO) categorized notable SARS-CoV-2 variants into three groups for monitoring purpose, inclusive of variants of concern (VOCs), variants of interest (VOIs), and variants under monitoring (VUMs). Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2) were previously identified VOCs until late October 2021 [2]. In November 2021, a substantial surge in COVID-19 cases was detected in South Africa's Gauteng province. This upsurge was accompanied increased S-gene target failure (SGTF) observation during TaqPath-based Reverse-Transcriptase Polymerase Chain Reaction (PCR) testing. Hence, this novel finding suggested a genetically distinct lineage of SARS-CoV-2 has spread in the community. Concurrently, in Gaborone, Botswana, unexpected viral sequences from samples obtained from a group of visitors were observed [3]. On November 24, 2021, these SARS-CoV-2 genomes from South Africa and Botswana were designated as belonging to a new PANGO lineage (B.1.1.529) [4]. On November 26, 2021, WHO announced the newly discovered Omicron variant (B.1.1.529) as a Variant of Concern (VOC), making it the fifth on the list. This novel variant, like other SARS-CoV-2 variants, comprises of several sublineages. Up to August 24, 2022, more than 300 Pango lineages were associated with the Omicron variant. Some prominent subvariants are BA.1, BA.1.1, BA.2, BA.3, BA.4 and BA.5 [4]. Following South Africa and Botswana, more than 150 countries have reported containing the Omicron variant since January 20, 2022 [5]. Omicron and its subvariants provide additional obstacles in the fight against the COVID-19 pandemic. 1. Genetic structure and mutations The Omicron variant has fifty shared mutations compared to the standard strain of SARS-CoV-2, including 43 substitutions, six deletions, and one insertion of the nucleotide. At least 27 of these mutations occurred at the S protein, predicted to cause accumulations around the receptor-binding motif [6]. In addition to the 50 shared mutations, ten other locations exhibited high-frequency mutations, including seven non-synonymous and three synonymous nucleotide substitutions [6]. Fig. 1 illustrates the details of spike protein mutations. The other four VOCs showed significantly fewer mutations, with 22, 18, 23, and 29 mutations for Alpha, Beta, Gamma, and Delta, respectively [6].Fig. 1.: Details of spike protein mutations in Omicron B.1.1.529.2. Transmissibility The SARS-COV-2 Omicron variant caused a quicker spread of COVID-19 than any preceding variants [7]. The Centers for Disease Control and Prevention (CDC) states that anyone infected with Omicron, regardless of vaccination status or the presence of symptoms, poses a greater risk of spreading the virus to others [8]. Spike (S) protein of Omicron variant has receptor binding domain (RBD) mutations that increase its affinity to the human ACE2 receptor, allowing the virus to enter human cells more efficiently. It causes a relatively higher effective reproduction number than the Delta variant, approximately 3.19 times (95% CI 2.82–3.61) [7,9]. Thus, due to the significant expansion of transmissibility and infectivity, Omicron cases have increased rapidly shortly after its introduction. This variant causes several manifestations, which is generally mild and classified as flu-like symptoms. These include fever, sore throat, cough, fatigue, and pains. In addition, symptoms such as muscle or joint pain, loss of taste (anosmia) or smell (ageusia), and runny nose were also typical of earlier variants [10–12]. The Omicron form, on the other hand, has the potential to increase the number of deaths due to its great transmission ability [8]. 3. Fear of co-infection and re-infection, and vaccine efficacy against B.1.1.529 Study findings have found the risk of co-infection and reinfection associated with Omicron infestation, even after they have fully recovered from COVID-19 [8]. Omicron emergence (November 1-30, 2021) could increase the reinfection ratio by 1.75 times (95% CI: 1.48 to 2.10) compared with the first wave of COVID-19 spread (June–September 2020) [13]. One study has reported that the SARS-CoV-2 Delta/Omicron co-infections are not uncommon (found in 6 out of 7 samples), especially during high virus co-circulation periods [14]. Co-infections could lead to extended disease duration and severity. Vaccination is the most recognized public health measure to counteract COVID-19 infection [8]. It is advised for everyone without any absolute contraindications to having their primary round of shots, as well as booster doses. Available vaccines are able to reduce the risk of complications, hospitalizations, and deaths from the Omicron variant [15]. Primary immunization with two doses of ChAdOx1 nCoV-19 (AstraZeneca) or BNT162b2 (Pfizer-BioNTech) vaccine provided only little protection against the Omicron variant's symptomatic disease. After either the ChAdOx1 nCoV-19 or BNT162b2 primary course, a BNT162b2 or mRNA-1273 (Moderna) booster significantly enhanced protection, but that protection faded over time [16]. 4. Recommendations and implications To combat the spread of the Omicron variant (and any other possibly emerging variants), sufficient pandemic preparedness, mutation surveillance, and control measures should be used with caution. It is suggested that governments do the following: notify WHO of any new cases or clusters of cases involving VOC infection as soon as possible, conduct field investigations and laboratory assessments to better understand the potential effects of the VOC on COVID-19 epidemiology, severity, diagnostic methods, immune responses, antibody neutralization, or other relevant characteristics, as well as evaluating the efficacy of public health and social measures, [4]. In addition, more effort should be put into monitoring and sequencing the spread of SARS-CoV-2 mutations. Finally, the results of complete genome sequences and associated metadata can be deposited into a freely accessible resource like Global Initiative on Sharing All Influenza Data (GISAID). Individuals should be guided to practice public health and social measures that have been shown to reduce the risk of acquiring COVID-19 [4]. These include washing their hands frequently, keeping their distance from others, using adequate ventilation in enclosed spaces, limiting their time spent in crowded areas, using face mask, and getting vaccinated. In conclusion, humanity may be forced to live with COVID-19; thus, vaccination campaigns must continue, and appropriate routine behavioral changes will become increasingly crucial for adopting safety measures and other necessary disease prevention and control measures as the "new normal" lifestyle of our world. Ethical approval N/A. Sources of funding None. Author contribution RAF: the conception and design of the study. RAF, MB and TPU: made the first draft. RAF: updated the manuscript. RAF and TPU: reviewed the final draft and edited final. All authors have critically reviewed and approved the final draft and are responsible for the content and similarity index of the manuscript. Consent N/A. Registration of research studies Name of the registry: N/A. Unique Identifying number or registration ID: N/A. Hyperlink to your specific registration (must be publicly accessible and will be checked): N/A. Guarantor All authors Provenance and peer review Not commissioned, externally peer reviewed. Declaration of competing interest None declared.