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A Proposal for a Transitional Care Program for Effective Stroke Recovery: Feasibility and Acceptability of the Program Implementation at AUBMC
No full textProject. M.S.N. American University of Beirut. Rafic Hariri School of Nursing, 2025.Introduction and Background: Stroke is a major public health concern, and it is the second leading cause of death in Lebanon. In addition to the numerous potential post-stroke complications, and challenges faced by the stroke patient population during their discharge from the hospital, the Lebanese stroke population specifically, faces a series of barriers that prevent them from achieving optimal recovery. One effective method of overcoming these obstacles and improving stroke care was the implementation of evidence-based APRN-led “Transitional Care Programs”.
Goals: The project had two main goals. The first goal is to propose a “Stroke Transitional Care Program” for stroke patients to ensure a seamless transition from hospital care to home recovery. The second goal was to assess the feasibility and acceptability of implementing the “Stroke Transitional Care Program” at AUBMC from the perspective of healthcare providers.
Methods: A qualitative study was conducted whereby which neurology residents and registered nurses working in neuro-med and neuro-ICU units were interviewed regarding the feasibility and acceptability of implementing a “Stroke Transitional Care Program” at AUBMC. Invitations to participate in the study were sent via “LimeSurvey”; overall 9 healthcare providers were interviewed: 5 registered nurses and 4 neurology residents. The interview guide consisted of 9 open-ended questions that were developed based on similar studies assessing for feasibility and acceptability of such programs at other institutions. Each interview lasted approximately 30-40 minutes.
Results: The results of the interviews were promising. All the participants agreed that “Stroke Transitional Care Program” is very comprehensive and it is a great addition to the services already provided in the hospital. However, some barriers regarding the feasibility of implementing such a program were identified. The participants reported that the lack of available APRN, staff shortages and lack of available educational pamphlets within the hospital, are significant barriers that can affect the implementation of such a program.
Conclusion: Due to its comprehensive nature, the program was regarded as highly acceptable and a great addition to stroke services available at AUBMC, however, the feasibility of implementing such a program was a potential issue
Co-producing Al-Masar Al-Akhdar: Methodological Investigations Towards Collaborative Urban Design
No full textOver the past decades, urban designers have increasingly adopted co-production as an approach that brings various dimensions of the "public," the state, on the one hand, and communities, on the other, to work towards an improved living environment (Pimentel Walker, Arquero de Alarcón, Friendly, Barbosa, Ribeiro de Souza, & Nobre, 2023). Yet, in divided societies, tensions within communities and across arms of the state challenge this possibility. These tensions were directly experienced in the aftermath of the Beirut port blast in 2020 when several projects that sought to introduce public space interventions, a critical element of any healthy post-disaster recovery (Al-Harithy, 2010; Vale & Campanella, 2005), were faced with strong resistance that ultimately led to their failure (Beirut Urban Lab, 2024). As a result, the contentious nature of the "public" undermined the possibility of recovery.
Building on this experience, and given that any intervention that seeks to upgrade public spaces would have to confront the reality of a highly divided city where the dominant rhetoric is antagonistic to public planning, distrustful of public agencies, and wary of whom a public space will attract to the neighborhood, the thesis began with the premise that the design of public spaces cannot be limited to adequate technical design considerations. Instead, urban designers and planners need to set processes that bring residents together and restore trust in the collective and the public agencies entrusted with protecting this collective, knowing that state agencies and communities are rife with unequal power relations.
The thesis articulates a co-production methodology for implementing Al-Masar Al-Akhdar, a 'latent' project in Beirut (Lebanon), with nearly a decade of collaboration between activists, professionals, academics, and city authorities. The project transforms the site of the projected Fouad Boutros highway into an integrated space for greening, soft mobility, and recreation that materially enables an improved urban life. The thesis's main argument is that co-production is not merely a process of mending divisions between state actors on the one hand and local communities on the other. Instead, it argues that co-production needs to involve mending across state institutions and community groups and between these conflicting interests. To this end, the thesis proposes, first, to integrate within the planning process a mapping of power and social divisions that inform co-production processes. The thesis further proposes to unbundle the co-production process, allowing multiple configurations of co-production that account for divergent power and interests between actors and institutions. Finally, the thesis confirms the recent attention to intermediation as a critical element of co-production (Deboulet & Lipietz, 2024). By identifying actors who have been involved in mediation initiatives (e.g., professionals, activists, advocates, academics), the thesis proposes multiple roles for these actors whereby power differentials are addressed through efforts at mediation that borrow from existing practices (e.g., awareness-raising, capacity building, coalition building, and advocacy). This step allows meditation for power and raises awareness about the possible climate and social interests attached to the project. The thesis is part of a larger project at the Beirut Urban Lab exploring the politics and possibilities of planning in contested cities
A Decade in Review: A Systematic Analysis of Factors Affecting Medication Adherence Among Geriatric Patients with Chronic Diseases Using the Health Belief Model (2014-2024)
No full textProject. M.S.N. American University of Beirut. Rafic Hariri School of Nursing, 2025.Background: Medication adherence among older adults is an important determinant of
chronic disease management outcomes. Since the publication of Yap et al.’s 2016
review, numerous new studies have emerged, requiring an updated synthesis to reflect
transitioning factors in a rapidly aging and medically complex global population. Given
the unique challenges that older adults are faced with—including polypharmacy,
cognitive decline, cultural influences, and shifting beliefs about illness—an updated
synthesis based on the Health Belief Model (HBM) offers a comprehensive lens for
understanding behavioral adherence’s barriers and facilitators that can specifically be
targeted with evidence-based interventions.
Methods: This systematic review is an update of Yap et al.’s 2016 review, incorporating
literature published between 2014 and 2024. The aim was to identify factors influencing
medication adherence among adults aged 65 and older with at least one of the most
common chronic conditions—namely hypertension, diabetes mellitus, and dyslipidemia.
Two electronic databases (OVID-MEDLINE and Embase) were searched for peer-
reviewed studies reporting adherence-related factors among older adults. From 25,016
records, 42 studies met the inclusion criteria. A thematic synthesis was performed,
categorizing factors into five domains used by Yap et al. (2016): patient-related,
medication-related, physician-related, system-based, and other contextual factors. These
domains were then mapped into the six constructs of the Health Belief Model:
perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues
to action, and self-efficacy.
Results: Key findings emphasized the central role of perceived barriers such as cost,
complexity of regimens, and forgetfulness. Perceived facilitators included belief in
medication efficacy, supportive cues (e.g., reminders or health worker interventions),
and trust in healthcare providers. The updated literature confirmed the persistence of
previously identified barriers while highlighting newer insights into the importance of
self-efficacy and individualized health beliefs in adherence behavior.
Conclusion: The updated evidence reveals important opportunities for intervention
through personalized care, education, and tailored strategies to enhance self-efficacy
and reduce perceived barriers among older adults. Simultaneously, strengthening
perceived facilitators—such as trust in providers and belief in treatment efficacy—can
further improve medication adherence. These findings underscore the utility of the
Health Belief Model in guiding adherence-focused interventions for aging populations
with chronic conditions
Desiccant dehumidification and evaporative cooling conditioning of canopy shaded space for improved outdoor thermal comfort in hot humid climates
No full textClimate change and increased urbanization are resulting in elevated outdoor ambient
temperatures. When combined with high humidity levels and intense solar radiation in
outdoor spaces, a major deterioration in outdoor thermal comfort (OTC) is happening.
This study proposes a novel strategy to enhance OTC in hot and humid climates by
integrating sustainable technologies, such as desiccant dehumidification and evaporative
cooling, which can operate on solar energy. These technologies are used to condition hot,
humid ambient air and supply it as cool, dry air under a shaded canopy, providing
localized thermal comfort in semi-outdoor settings for a seated individual. A
computational fluid dynamics (CFD) model, validated experimentally, was created to
study the interaction between cold, dry jets of varying temperatures, humidity, and flow
rates with the existing ambient air. This model was used to assess improvements in
thermal comfort through a thermal comfort assessment tool, the universal thermal
climatic index (UTCI). To design and size the air conditioning system, mathematical
models for the dehumidification and evaporative cooling processes were implemented.
Regeneration energy requirements for system operation at different supply and ambient
conditions were calculated. Then, ANN was combined with GA to optimize the operation
of the system in terms of energy consumption. To make the study more comprehensive,
a case study was conducted to assess the impact of supply angle on OTC under the
canopy. Results showed that the proposed system effectively reduced temperature and
humidity levels and enhanced airflow under the canopy across all ambient conditions
studied, thereby lowering UTCI by up to 6.3 ℃. This reduction in UTCI led to decreases
in heat stress, shifting conditions from "very strong" and "strong" to "moderate" and,
under certain supply conditions, even to "no thermal stress”. The implemented
optimization allows for achieving the lowest possible heat stress levels for all ambient
combinations at optimal thermal energy requirement where the reduction in thermal
energy required for operation reached a maximum of almost 67%
Stacking Large Language Models is All You Need: A Case Study on Phishing URL Detection
No full textPrompt-engineered Large Language Models (LLMs) have gained widespread adoption across various applications due to their ability to
perform complex tasks without requiring additional training. Despite their impressive performance, there is considerable scope for improvement,
particularly in addressing the limitations of individual models. One promising avenue is the use of ensemble learning strategies, which
combine the strengths of multiple models to enhance overall performance. In this study, we investigate the effectiveness of stacking ensemble
techniques for chat-based LLMs in text classification tasks, with a focus on phishing URL detection. Notably, we introduce and evaluate
three stacking methods: (1) prompt-based stacking, which uses multiple prompts to generate diverse responses from a single LLM; (2) modelbased
stacking, which combines responses from multiple LLMs using a unified prompt; (3) hybrid stacking, which integrates the first two
approaches by employing multiple prompts across different LLMs to generate responses. For each of these methods, we explore meta-learners
of varying complexities, ranging from Logistic Regression to BERT. Additionally, we investigate the impact of including the input text as
a feature for the meta-learner. Our results demonstrate that stacking ensembles consistently outperform individual models, achieving superior
performance with minimal training and computational overhead
The Utility of Biomarkers in Radiation-Induced Salivary Gland Damage
No full textProject .M.S. American University of Beirut. Faculty of Medicine. Department of Anatomy, Cell Biology and Physiological Sciences, 2025.Although radiation therapy aims to target cancer cells, it results in inevitable nearby normal tissue damage. Xerostomia (i.e., dry mouth) is a common complication for patients with head and neck cancer, often caused by salivary gland dysfunction after radiotherapy cessation. The resulting hyposalivation negatively impacts the patients’ quality of life by leading to oral pain, mastication and swallowing difficulties, dental decay, impaired speech, and interrupted sleep schedules. Despite the recent technological advancements in radiotherapy, radiation oncologists still face the challenge of delivering tumoricidal doses while sparing nearby healthy tissues. Future approaches that maximize the therapeutic outcome of radiotherapy rely on assessing the individual’s radiosensitivity before and during the treatment course. Extensive research on biomarkers of radiation injury is in progress to achieve personalized radiotherapy or predict the molecular response to ionizing radiation (IR). The field of biomarkers has shown an accuracy in distinguishing pre- and post- IR states of high dose impact on irradiated tissues. Several studies on body fluid biomarkers showed a promising contribution in predicting and monitoring the disease prognosis and collateral normal tissue injury. The importance of body fluid biomarkers lies in their non-invasiveness, convenience, reflectiveness of tissue biopsy, and ease of multiple collections. In this paper, we summarize current knowledge about radiation-induced toxicity of salivary glands with an overview of the significance of body fluid biomarkers in its detection. Moreover, we pay particular attention to saliva as a potential diagnostic tool for radiation injury of salivary glands
Assessing the Adoption of Alternative Renewable Energy in Zambia: Policy and Institutional Analysis
No full textProject. M.S.E.S. American University of Beirut. Interfaculty Graduate Environmental Sciences Program, (Environmental Policy Planning), 2025.Zambia's energy sector is predominantly reliant on hydropower, which accounts for
80.8% of the nation's electricity supply. However, hydropower's vulnerability to climate
change-induced variability, such as irregular rainfall patterns, poses a significant threat
to energy security. Despite Zambia’s vast renewable energy potential, including solar,
wind, geothermal, and biomass. The transition towards a diversified energy mix remains
slow due to policy gaps, financial limitations, and political constraints. This research
examines Zambia’s National Energy Policy (NEP) 2019 in addressing these challenges,
with a specific focus on the effectiveness of policy implementation and governance in
promoting alternative renewable energy sources.
The study employs a qualitative research methodology, utilizing policy document
analysis and comparative case studies to assess the barriers and opportunities in Zambia’s
renewable energy transition. The findings reveal that inconsistent regulatory frameworks,
inadequate investment incentives, and a policy landscape historically skewed towards
large-scale hydropower projects have hindered the adoption of alternative energy
technologies. Furthermore, political dynamics and governance issues have created an
environment where financial constraints and policy inconsistencies continue to deter
private sector investment.
By analyzing the interplay between policy, governance, and investment in Zambia’s
energy sector, this study aims to contribute to academic knowledge on energy policy
reforms and sustainable energy transitions. The research offers recommendations for
enhancing renewable energy governance, including policy harmonization, strengthened
regulatory support, and financial incentives to attract private investment. These insights
align with Zambia’s commitment to Sustainable Development Goal 7 (Affordable and
Clean Energy) and the Paris Agreement on climate change of 2015. The findings are
expected to inform policymakers, investors, and energy stakeholders on effective
strategies for achieving a resilient and sustainable energy future in Zambia
The Impact of Connexin 43 Modulation on the Metastatic Potential of Triple Negative MDA-MB-231 Breast Cancer Cells to the Bone
No full textBackground: Triple-negative breast cancer (TNBC) is an aggressive subtype of breast
cancer, and a leading cause of cancer-related mortality among women. As TNBC
progresses, the cancerous cells detach from the breast and colonize to a secondary
tumor site, often the bone, in a process called metastasis. Connexin 43 (Cx43), a gap
junction protein, is crucial in tumor progression and has been linked to TNBC's
metastasis to the bone.
Aim: The study aims to investigate the role of Connexin 43 (Cx43) modulation in
regulating key genes and epithelial-mesenchymal transition (EMT) proteins involved in
TNBC progression and metastasis.
Methods: Light and fluorescence microscopy were used to assess cell morphology and
confirm successful transfection in modified MDA-MB-231 cells respectively. qPCR
and Western blot assays were applied to validate the modification of Cx43 expression.
The key gene NPM1, and EMT markers, E-cadherin, N-cadherin, Twist, and Snai1 were
evaluated by qPCR to assess the metastatic potential of the modified cells.
Immunofluorescence was used to visualize and localize the target proteins, Cx43 and
NPM1.
Results: Microscopic evaluation, qPCR and Western Blot assays confirmed the up-
regulation of Cx43 in MDA-MB-231 cells (Cx43D), which exhibited an epithelial-like
phenotype, as well as the down-regulation of Cx43 in MDA-MB-231 cells (shCx43),
which exhibited a mesenchymal-like phenotype. Cx43D manifested an increase in E-
cadherin and decreased NPM1, N-cadherin, Twist, and Snail expression on the
transcriptional level, indicating a possible shift towards a less metastatic phenotype.
Conclusion: The modulation of Connexin 43 affects the metastatic characteristics of
MDA-MB-231 TNBC cells.
Keywords: triple negative breast cancer, connexin43, metastasis, epithelial-to-
mesenchymal transition, EMT, Cx43D, shCx43
