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Non-vanishing of derivatives of L-functions associated to cusp forms of half-integral weight in the plus space
Get PDFWe show a non-vanishing result for the derivatives of L-functions associated to cuspidal Hecke eigenforms of half-integral weight in plus space. In particular, we show that for large weights, ∑j=1d1⟨fk,j,fk,j⟩dndsn[L∗(fk,j|W4,s)]does not vanish at any point s= σ+ it with t= t, k/ 2 - 1 / 4 < σ< k/ 2 + 3 / 4. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature
Exploring the dynamics of Food Security in the Karantina Neighborhood in Relation to the Beirut Port Explosion
Get PDFIn 2020, prices of food and all commodities, increased drastically, due to the deterioration of the national currency, the Lebanese Lira, and this increase in prices directly affected households’ purchasing power and access to food. On August 4th, 2020, a massive explosion hit the Port of Beirut, destroying Lebanon’s capital, killing over 200 people and wounding more than 5,000. Now, three years after the devastating port explosion, the impact of the economic crisis still echoes more than ever before. With the lack of urgent economic reforms and an uncaring corrupted government, more Lebanese and refugee families are being pushed further into poverty, with nearly three million in Lebanon needing humanitarian assistance.
This research aimed to assess the food security status of the permanent residents of Karantina neighborhood after the Beirut port explosion in Lebanon. It examined whether the food and nutrition security situation of the permanent residents of Karantina improved after the explosion, with all the assistance received, and whether the improvement lasted in the long-term.
A sample consisting of 100 randomly selected households, or 33% of the Karantina population, was surveyed. A questionnaire was administered, including five parts: the socio-demographics of the Karantina population, the Food Insecurity Experience Scale (FIES) to study food security, the Food Consumption Score (FCS) to study diet diversity and quality, the Livelihood Coping Strategies, and the assistance received after the explosion. The data was gathered during three time points, six months before the explosion, six months after the explosion, and two years after the explosion.
The results showed that the percentage of food secure households decreased from 71% six months after the explosion, to 2% two years after the explosion. And the percentage of households with acceptable food consumption, decreased from 96% six months after the explosion, to 30% two years after the explosion. There has been a significant decrease in people's incomes and employment status two years after the explosion, in addition, the percentage of people who were in debt also significantly increased. 95% of the population were adopting crisis coping strategies, making them more vulnerable to future shocks. All the households received food assistance six months after the explosion, and 76% received cash assistance, however, these stopped after 6 months to 1 year after the explosion. Household size, debt, the head of the household’s educational attainment and employment, increased income, and receiving cash assistance were all positively correlated with being food secure and having acceptable food consumption score.
In conclusion, the assistance received by the permanent residents of Karantina after the explosion was associated with better food security and food consumption score at the time of the incident but not with long term food security and food consumption. This is explained by the deterioration of the economic situation in Lebanon since 2020, the multiple crises that affected the country, disabled the Karantina population from being able to cope properly. Most of the households fell deeper into poverty in 2022, many lost their source of income, most of them were falling into debt and this worsened their food security status
Resilience in childhood vaccination: Analysing delivery system responses to shocks in Lebanon
Get PDFIntroduction Despite rapidly growing academic and policy interest in health system resilience, the empirical literature on this topic remains small and focused on macrolevel effects arising from single shocks. To better understand health system responses to multiple shocks, we conducted an in-depth case study using qualitative system dynamics. We focused on routine childhood vaccination delivery in Lebanon in the context of at least three shocks overlapping to varying degrees in space and time: large-scale refugee arrivals from neighbouring Syria; COVID-19; and an economic crisis. Methods Semistructured interviews were performed with 38 stakeholders working at different levels in the system. Interview transcripts were analysed using purposive text analysis to generate individual stakeholder causal loop diagrams (CLDs) mapping out relationships between system variables contributing to changes in coverage for routine antigens over time. These were then combined using a stepwise process to produce an aggregated CLD. The aggregated CLD was validated using a reserve set of interview transcripts. Results Various system responses to shocks were identified, including demand promotion measures such as scaling-up community engagement activities and policy changes to reduce the cost of vaccination to service users, and supply side responses including donor funding mobilisation, diversification of service delivery models and cold chain strengthening. Some systemic changes were introduced-particularly in response to refugee arrivals-including task-shifting to nurse-led vaccine administration. Potentially transformative change was seen in the integration of private sector clinics to support vaccination delivery and depended on both demand side and supply side changes. Some resilience-promoting measures introduced following earlier shocks paradoxically increased vulnerability to later ones. Conclusion Flexibility in financing and human resource allocation appear key for system resilience regardless of the shock. System dynamics offers a promising method for ex ante modelling of ostensibly resilience-strengthening interventions under different shock scenarios, to identify-And safeguard against-unintended consequences. © 2023 BMJ Publishing Group. All rights reserved
Vertebral body tethering: An alternative to posterior spinal fusion in idiopathic scoliosis?
Get PDFIntroduction: Skeletally immature patient with adolescent idiopathic scoliosis (AIS) whose curves continue to progress despite bracing should be treated surgically. Vertebral body tethering (VBT) is a non-fusion, compression-based, growth preserving alternative to posterior spinal fusion (PSF) based on the concept of ‘growth modulation’ to prevent possible functional complications secondary to fusion while correcting scoliotic deformity. This review aims to shed light on the indications of VBT, short- and medium-term outcomes, describe the surgical technique and associated complications, and to compare its efficacy to that of PSF. Methods: A review of peer-reviewed literature on VBT as a surgical technique, its indications, outcomes, complications, and comparison with other surgical interventions to correct AIS was conducted in December 2022. Results: Indications remain controversial and mainly include stage of skeletal maturity based on radiographic markers, curve location, magnitude and flexibility, and presence of secondary curve. Assessment of VBT clinical success should not be restricted to improvement in radiographic parameters but should include functional results and patient-centered outcomes, improved body image and pain, and durability of outcomes. In contrast to fusion, VBT seems to be associated with preserved spinal growth, shorter recovery, potentially better functional outcomes, less motion loss but possibly less curve correction. Discussion: Yet still, with VBT there exists a risk of overcorrection, construct breakage or failure of procedure which require revision and at times conversion to PSF. Patient and family preferences must be accounted for acknowledging gaps in knowledge, attributes and drawbacks of each intervention. 2023 Hammad, Balsano and Ahmad
The culturally and contextually sensitive assessment of mental health using a structured diagnostic interview (MINI Kid) for Syrian refugee children and adolescents in Lebanon: Challenges and solutions
Get PDFElevated rates of mental health difficulties are frequently reported in conflict-affected and displaced populations. Even with advances in improving the validity and reliability of measures, our knowledge of the performance of assessment tools is often limited by a lack of contextualization to specific populations and socio-political settings. This reflective article aimed to review challenges and share lessons learned from the process of administering and supervising a structured clinical interview. We administered the MINI International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) and used the Clinical Global Impression (CGI) severity scale with N = 119 Syrian refugee children (aged 8–17) resident in ITSs in Lebanon. Qualitative data were derived from supervision process notes on challenges that arose during assessments, analyzed for thematic content. Five themes were identified: (1) practical and logistical challenges (changeable nature of daily life, competing demands, access to phones, temporary locations, limited referral options); (2) validity (lack of privacy, trust, perceptions of mental health, stigma, false positive answers); (3) cultural norms and meaning (impact of different meanings on answers); (4) contextual norms (reactive and adaptive emotional and behavioral responses to contextual stress); and (5) co-morbidity and formulation (interconnected and complex presentations). The findings suggest that while structured assessments have major advantages, cultural and contextual sensitivity during assessments, addressing practical barriers to improving accessibility, and consideration for inter-connected formulations are essential to help inform prevalence rates, treatment plans, and public health strategies. © The Author(s) 2022
Gender diversity and inclusive representation as a means to decolonise museums
Get PDFDecolonising museums has become a popular issue in recent years as many museums have recognised the need to address how they have historically perpetuated colonialism and exclusion. One way in which museums can work towards gender diversity and inclusion is by actively seeking and amplifying the voices and perspectives of women and under-represented groups. This can be done through exhibitions, programming, and hiring practices that prioritise diverse perspectives and experiences. An important aspect of decolonising museums is re-evaluating how artefacts and collections are presented and interpreted. Museums have often reinforced patriarchal and colonial narratives in the past, and it is important to work actively towards a more inclusive and equitable representation of history. This can include re-contextualising artefacts to highlight the perspectives and contributions of marginalised groups, as well as actively seeking and acquiring artefacts that represent a more diverse range of perspectives. This paper will examine examples of museums that have successfully started decolonising their spaces through exhibitions on matriarchal societies and/or the representation of women in the Ancient World, with a focus on the American University of Beirut Archaeological Museum. © 2023 Oxfam KEDV
Challenges Facing Viral Hepatitis C Elimination in Lebanon
Get PDFHepatitis C is a hepatotropic virus that causes progressive liver inflammation, eventually leading to cirrhosis and hepatocellular carcinoma if left untreated. All infected patients can achieve a cure if treated early. Unfortunately, many patients remain asymptomatic and tend to present late with hepatic complications. Given the economic and health burdens of chronic hepatitis C infection, the World Health Organization (WHO) has proposed a strategy to eliminate hepatitis C by 2030. This article describes the epidemiology of hepatitis C in Lebanon and highlights the challenges hindering its elimination. An extensive search was conducted using PubMed, Medline, Cochrane, and the Lebanese Ministry of Public Health–Epidemiologic Surveillance Unit website. Obtained data were analyzed and discussed in light of the current WHO recommendations. It was found that Lebanon has a low prevalence of hepatitis C. Incidence is higher among males and Mount Lebanon residents. A wide variety of hepatitis C genotypes exists among various risk groups, with genotype 1 being the most predominant. In Lebanon, many barriers prevent successful hepatitis C elimination, including the absence of a comprehensive screening policy, stigma, neglect among high-risk groups, economic collapse, and a lack of proper care and surveillance among the refugees. Appropriate screening schemes and early linkage to care among the general and high-risk populations are essential for successful hepatitis C elimination in Lebanon. © 2023 by the authors
The status of bladder cancer research worldwide, a bibliometric review and recommendations
Get PDFBackground: Healthcare system costs associated with bladder cancer treatment are among the highest of curable malignancies, and prognosis in advanced disease remains poor. This scoping review examines the worldwide status of bladder cancer research by systematically mapping publications, exploring research topics, support, gaps and limitations that need to be addressed. Methods: We searched the Web of Science database for publications using controlled vocabulary. Results were limited between 2000–2020, and were included in our study based on pre-specified eligibility criteria. Data used for analysis included author’s names, country of affiliation, language, journal, citations, and funding. Analysis was conducted using Biblioshiny R and SPSS. Research topics were identified according to sub-filters of title words and strings pre-determined by authors. Results: 40,657 results were retrieved, of which 19,976 original articles and reviews met the pre-specified criteria. 92% of the publications originated from 20 countries and were included in the analysis. Trends show an increase across the world, most of which is due to increasing contributions from USA and China. An increase by 1000% in funded publications has been achieved. Studies focused on Surgery, Pathology, and Diagnosis, while Radiotherapy, Palliative care, quality of life and Epidemiology were the least described. Genetics had the most increase while being the most funded. GDP, incidence, prevalence and mortality were each significantly positively correlated with overall bladder cancer research output. Conclusion: This review described the evolution of bladder cancer research. It also identified significant gaps and limitations that need to be highlighted as priority areas for research investment. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
Uncovering a novel role of focal adhesion and interferon-gamma in cellular rejection of kidney allografts at single cell resolution
No full textBackground: Kidney transplant recipients are currently treated with nonspecific immunosuppressants that cause severe systemic side effects. Current immunosuppressants were developed based on their effect on T-cell activation rather than the underlying mechanisms driving alloimmune responses. Thus, understanding the role of the intragraft microenvironment will help us identify more directed therapies with lower side effects. Methods: To understand the role of the alloimmune response and the intragraft microenvironment in cellular rejection progression, we conducted a Single nucleus RNA sequencing (snRNA-seq) on one human non-rejecting kidney allograft sample, one borderline sample, and T-cell mediated rejection (TCMR) sample (Banff IIa). We studied the differential gene expression and enriched pathways in different conditions, in addition to ligand-receptor (L-R) interactions. Results: Pathway analysis of T-cells in borderline sample showed enrichment for allograft rejection pathway, suggesting that the borderline sample reflects an early rejection. Hence, this allows for studying the early stages of cellular rejection. Moreover, we showed that focal adhesion (FA), IFNg pathways, and endomucin (EMCN) were significantly upregulated in endothelial cell clusters (ECs) of borderline compared to ECs TCMR. Furthermore, we found that pericytes in TCMR seem to favor endothelial permeability compared to borderline. Similarly, T-cells interaction with ECs in borderline differs from TCMR by involving DAMPS-TLRs interactions. Conclusion: Our data revealed novel roles of T-cells, ECs, and pericytes in cellular rejection progression, providing new clues on the pathophysiology of allograft rejection. Copyright © 2023 Halawi, El Kurdi, Vernon, Solhjou, Choi, Saad, Younis, Elfekih, Mohammed, Deban, Weins, Abdi, Riella, De Serres, Cravedi, Greka, Khoueiry and Azzi
Generalized Machine Learning Based Network Traffic Classification
No full textWith the exponential rise in online activity, Internet Service Providers (ISPs) have prioritized network traffic classification in order to dynamically adapt their networks to best serve their customers while increasing their gains. While most work on machine learning based classification studied different models and the best techniques to solve the issue, none studied the effect of the traffic capture location on the model and whether a model could be generalized to work effectively with different flow capture directions. The aim of this work is to find the best approach in creating network traffic classification models that are, from one side, capable of generalizing to different environments, while being able to target narrower classes in internet traffic and from the other side, adaptive, scalable and performant in different production environments. While most previous work attempted separating general classes such as SSH traffic, VPN traffic and HTTP/HTTPS, we attempt to separate very similar classes related to gaming that use common protocols and backends with the added complexity of background noise traffic. Another contribution of this work is tackling the traffic direction problem, which is directly related to the traffic capture location. Since no multi location dataset was available, this work is limited in this regards. This problem was addressed by training and testing our models versus each of the directions of the flows apart followed by the full flow comparison. To this end, our approach to solve this issue is two-fold. From one side we attempt to tackle generalizability loss versus traffic capture direction. We thus attempt to create several models and test their generalizability. From the other side, we tackle another issue with generalizability which is the applicability of the same machine learning models used in previous work in classifying narrower classes. Using the Gaming Network Traffic Dataset, we attempt to classify gaming network traffic with much narrower user activity classes than previous work. We create several models: random forest the state-of-the-art algorithm, with pre-engineered features such as interarrival times, packet length and other flow statistics, as a baseline, which obtained a testing accuracy of 44.14%. The second Convolutional Neural Network (CNN) based deep learning model, also created based on previous work, having as input raw network traffic converted into either a grayscale or RGB image, where the optimal bi-flow grayscale model resulted with a testing accuracy of 47.24%. The third model, a deeper CNN-Long Short Term Memory (LSTM) based version that takes into consideration the temporal dimension of consecutive flows obtained a testing accuracy of 52.27% surpassing both the random forest and CNN state-of-the-art models. This model also consistently showed significant increase in accuracy versus the client-server side traffic where traffic categories are harder to separate. Finally, our proposed semi supervised stacked CNN – random forest model obtained a testing accuracy of 53.4%. We then analyze and compare the results of the proposed simple CNN model and the proposed semi-supervised CNN-random forest architecture for different datasets. The proposed algorithm proved to perform best versus the Gaming Network Traffic Dataset in specific surpassing both the CNN state-of-the-art algorithm and our previous LSTM-based model. This result was however bound to the dataset, provided it showed very slight improvement versus timeseries based datasets but worse results in regular image classification tasks where it also fell behind models mentioned in previous work.
Model generalizability will have huge impact in future model development and large-scale deployment and adaptation to different networks. Future work will study further model optimization for the Gaming Network Dataset, the collection of a multi location dataset with a bigger number of samples on internet service provider premises, work on improved generalizability and the application of other possible more complex recurrent network structures from one side and unsupervised clustering algorithms from the other side in choosing the initial model class subgroups used