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Epidemiology of Adult Injuries: A Multi-Center Study in Greater Beirut
Get PDFIntroduction: Injury accounts for nearly 4 million deaths and 63 million disabilities annually. The injury burden is disproportionally large in low- and middle-income countries (LMICs), including Lebanon. This study aims to examine the characteristics and patterns of adult injuries presenting at multiple emergency departments (ED) in Lebanon and further identifies factors associated with hospital admission. Materials and Methods: A retrospective cross-sectional study was conducted on adult patients (aged≥16) who presented with an injury to one of the five participating EDs from June 2017 to May 2018. Pan-Asia Trauma Outcomes Study (PATOS) variables were adopted for data collection. A descriptive analysis was performed, followed by bivariate and multivariate logistic regression to identify injury risk factors for hospital admission. Results: A total of 3,716 patients’ records were included. Most injuries were sustained by males (62.7%), patients aged between 16-35 years (16-25: 28%; 26-35: 22.7%), and above 65 years (15.6%). Most injuries were unintentional (94.9%). Falls were highly prevalent across all age groups (38.8%), more proclaimed among the older adults’ population (56-65:52.8%; ≥66:73.7%), followed by struck-by object (23.6%) and transport injuries (10.1%). Upper and lower extremity injuries were common across all ages. Most patients (80.9%) were treated and discharged at the ED, 11.4% were admitted to the hospital, 4.3% were transferred to other trauma care facilities, and 2 patients died in the ED. Factors positively associated with hospital admission included: older age (≥ 56 years); private insurance; spine and lower extremity injuries; fractures, cuts/open wounds, concussion, and organ injuries (p-value≤0.05; OR>1). Conclusion: Injury is a neglected public health problem in many LMICs, including Lebanon. While youth and the elderly are most affected, injuries occur across all age groups. This study lays the foundation for establishing a population-based injury surveillance system, crucial for designing tailored injury prevention programs to reduce injury-related deaths and disabilities. © 202
CHARACTERIZING THE HYDRODYNAMICS OF HIGH DENSITY CROWDS
Get PDFThe derivation of a hydrodynamic model for a certain physical system is normally done by utilizing symmetry arguments and first principles. The model is then validated through experimental observations. Such a classical process has been successful in characterizing a wide range of systems in physics and engineering, but not in complex sciences. To overcome these challenges, scientists have made use of the major advancements in video tracking technologies and sensors used in experiments to quantitatively characterize human crowd systems. The combination of such innovations with statistical learning techniques such as Non-Linear Regression and Neural Networks has facilitated the inference of the system's governing partial differential equations (PDEs) solely from time series data collected at different spatial points. Recently, influential work such as PDE-Find has proposed sparse regression techniques to infer the PDEs from spatiotemporal data. This approach determines the most prominent components in an equation via Penalized Linear Regression Methods and balances between accuracy and complexity.
In this thesis, we derive a hydrodynamic model for the collective behavior of runners in a marathon using the sparse regression approach. The motion is made up of millions of runners heading toward the start line guided by staff members who are performing a regular cycle of walks and stops. The motion is thus perfectly polarized with orientational fluctuations repressed. Furthermore, the runners' response to the staff's excitation causes the propagation of hybrid density and velocity waves spanning the entire system where the attenuation is small and the propagation is a longitudinal wave. Modeling the slow dynamics of the crowd's flow is beneficial in providing recommendations for crowd management to avoid hazardous and momentous events in marathons
PRevalence of the Eosinophilic Phenotype Among SeveRE asthma patients in Lebanon: results of the PREPARE study
Get PDFBackground: The prevalence of eosinophilic asthma in Lebanon, one of the most severe phenotypes among severe asthma, is not known. This study aimed at determining the prevalence of the eosinophilic phenotype defined as an eosinophil count ≥ 300 cells/mm3 among severe asthma patients in Lebanon. Methods: The Lebanese Chapter of the PREPARE study was a national, multicenter, cross-sectional observational study. Patients aged ≥ 12 years with severe asthma were identified and prospectively enrolled during clinic visits and completed the Global Initiative for Asthma (GINA) assessment of asthma control questionnaire. Patients’ health characteristics were collected from medical records and blood samples were obtained for measurement of serum IgE levels and blood eosinophils count. Results: Overall, 101 patients (with mean age of 46.3 ± 17.0 years and 73.27% females) with severe asthma were included and, among them, 37% had eosinophilic phenotype, 67.3% had atopic phenotype with IgE > 100 IU/mL and 25.7% patients had overlapping atopic and eosinophilic phenotypes. Close to 80% had late-onset asthma, beyond 12 years of age, and around 85% had at least one severe exacerbation in the 12 months prior to study enrolment. The majority of participants [64.4%] had uncontrolled asthma, 24.7% had partially controlled symptoms and 10.9% had controlled symptoms. 19.8% of participants were on chronic oral corticosteroids, 78.2% had short course treatment of corticosteroids and all were prescribed a combination of inhaled corticosteroids and long-acting beta-agonist. Conclusions: The majority of patients with severe asthma were uncontrolled of which 37% present with an eosinophilic phenotype, which should be taken into consideration for better management of these patients in view of the novel phenotype-specific therapeutic options. © 2023, Canadian Society of Allergy & Clinical Immunology
Un-sedated Office-Based Application of Blue Laser in Vocal Fold Lesions
Get PDFIntroduction: Office-based laser procedures in laryngology have gained a lot of popularity in the last decade with the use of the KTP, PDL and Thulium lasers. Preliminary investigations currently report on the use of the 445 nm wavelength Blue laser for the treatment of various laryngeal pathologies, given its dual photoangiolytic and cutting properties. Objective: We aim to investigate the safety and efficacy of the Blue laser for the treatment of vocal fold lesions. Methods: This is a retrospective chart review of eleven patients with a variety of vocal fold lesions (polyps, Reinke's edema, papilloma, and leukoplakia), that underwent un-sedated office-based treatment using the 445 nm blue laser. The primary outcome was to compare preoperative to postoperative Voice Handicap Index (VHI-10) score and self-reported voice improvement using a visual analog scale (VAS). We also compared fiberoptic laryngeal examination before and after treatment. Results: Eleven un-sedated office-based procedures using the blue laser were performed. There was improvement in the mean VHI-10 score (n = 8) with a decrease from 15.13 ± 8.77 to 3.50 ± 3.46 (P= 0.015). Similarly, the mean VAS score (n = 7) decreased from 6.14 ± 1.21 to 1.71 ± 1.60 (P< 0.003). All patients had a complete or partial regression of the vocal fold lesions on fiberoptic laryngeal examination. None of the patients had complications after the procedure. Conclusion: Blue laser therapy can be suggested as a safe and effective alternative treatment modality in office-based laryngology procedures for a variety of vocal fold lesions. A larger series is needed to better validate the efficacy of this laser as a new treatment modality. © 2021 The Voice Foundatio
Neurotrauma investigation through spatial omics guided by mass spectrometry imaging: Target identification and clinical applications
Get PDFTraumatic brain injury (TBI) represents one of the major public health concerns worldwide due to the increase in TBI incidence as a result of injuries from daily life accidents such as sports and motor vehicle transportation as well as military-related practices. This type of central nervous system trauma is known to predispose patients to several neurological disorders such as Parkinson's disease, Alzheimer's disease, chronic trauamatic encephalopathy, and age-related Dementia. Recently, several proteomic and lipidomic platforms have been applied on different TBI studies to investigate TBI-related mechanisms that have broadened our understanding of its distinct neuropathological complications. In this study, we provide an updated comprehensive overview of the current knowledge and novel perspectives of the spatially resolved microproteomics and microlipidomics approaches guided by mass spectrometry imaging used in TBI studies and its applications in the neurotrauma field. In this regard, we will discuss the use of the spatially resolved microproteomics and assess the different microproteomic sampling methods such as laser capture microdissection, parafilm assisted microdissection, and liquid microjunction extraction as accurate and precise techniques in the field of neuroproteomics. Additionally, we will highlight lipid profiling applications and their prospective potentials in characterizing molecular processes involved in the field of TBI. Specifically, we will discuss the phospholipid metabolism acting as a precursor for proinflammatory molecules such as eicosanoids. Finally, we will survey the current state of spatial neuroproteomics and microproteomics applications and present the various studies highlighting their findings in these fields. © 2021 John Wiley & Sons Ltd
Electrospun Metal-Organic Framework-Fabric Nanocomposites as Efficient Bactericides
Get PDFIn this work, we utilized electrospinning to develop advanced composite membranes of polyvinyl chloride (PVC) loaded with postmetalated metal-organic frameworks (MOFs), specifically UiO-66(COOH)2-Ag and ZIF-8-Ag. This innovative technique led to the creation of highly stable PVC/MOFs-Ag membrane composites, which were thoroughly characterized using various analytical techniques, including scanning electron microscopy, powder X-ray diffraction, thermogravimetric analysis, X-ray photoelectron spectroscopy, porosity analysis, and water contact angle measurement. The results verified the successful integration of MOF crystals within the nanofibrous PVC membranes. The obtained composites exhibited larger fiber diameters for 5 and 10% MOF loadings and a smaller diameter for 20% loading. Additionally, they displayed greater average pore sizes than traditional PVC membranes across most MOF loading percentages. Furthermore, we examined the antibacterial properties of the fabricated membranes at different MOFs-Ag loadings. The findings revealed that the membranes demonstrated significant antibacterial activity up to 95% against both Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureus) bacteria as the MOFs-Ag loading increased, even when maintaining a constant silver concentration. This indicates a contact-based inhibition mechanism. The outcomes of this study have crucial implications for the development of novel, stable, and highly effective antibacterial materials, which could serve as superior alternatives for face masks and be integrated into materials requiring regular decontamination, as well as potential water filtration systems. © 2023 The Authors. Published by American Chemical Society
The Years of oppression and isolation : the situation of human rights defenders in Egypt during the COVID-19 Pandemic
Get PDFArabic version: سنوات القمع والعزلة : أوضاع المدافعين والمدافعات عن حقوق الإنسان في مصر خلال جائحة كوفيد-19 http://hdl.handle.net/10938/24491This report seeks to document the situation of male and female defenders during the years of the pandemic by monitoring and analyzing the patterns of targeting defenders during those years, the impact of the pandemic on the life, work and safety of defenders, and the additional burdens imposed on them due to the pandemic. In addition to monitoring and analyzing legislative changes related to the work of defenders, and how the consequences of the pandemic contributed to shaping these legislative changes
Assessment of the Microbiological Acceptability of White Cheese (Akkawi) in Lebanon and the Antimicrobial Resistance Profiles of Associated Escherichia coli
Get PDFDairy foods are a staple in Lebanon, a low- and middle-income country that has been experiencing serious challenges to food safety and antimicrobial stewardship among other issues. The microbiological acceptability of dairy products has been of increasing concern. This is partially due to the failing economy and prolonged power outages that affect the quality of raw material and disrupt the dairy cold chain, respectively. Therefore, we assessed the microbiological acceptability of Akkawi, a popular white-brined cheese in Lebanon. For this purpose, we quantified the densities of Escherichia coli (a fecal indicator) and Staphylococcus aureus in cheeses collected from Lebanese retail stores. Additionally, we evaluated the antibiotic resistance profiles of the E. coli isolated from the cheese. E. coli and S. aureus were detected in 40 (80%) and 16 (32%) of the 50 cheese samples, respectively. Notably, 40 (80%) and 16 (32%) of the samples exceeded the maximum permissible limit of E. coli and S. aureus, respectively. A high percentage of the 118 E. coli isolated from the cheeses showed resistance to clinically and agriculturally important antibiotics, while 89 (75%) isolates were classified as multidrug-resistant (MDR). Given that Akkawi can be consumed without cooking, our findings highlight serious food safety and antimicrobial resistance problems that require immediate interventions. © 2023 by the authors
Incidental discovery of azoospermia on work-up of testicular tumour: a practice changing discovery
Get PDFTesticular tumours are increasing in incidence, especially in developed countries. This incidence increases specifically in the subpopulation of infertile men. This case highlights a young man incidentally diagnosed with a subcentimetric testicular lesion, who was discovered to have concomitant azoospermia. The authors review management strategies in this challenging case, as treatment options for men with infertility and concomitant testicular tumours vary from men who are fertile. Level of evidence: Not applicable for this multicentre audit. © British Association of Urological Surgeons 2021