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Consensus and Controversial Aspects of Vitamin D and COVID-19
Get PDFObjective: This work aims to review and discuss controversial topics in the field of vitamin D, SARS-CoV-2 infection, and COVID-19. Methods: The International Conferences “Controversies in Vitamin D” are a series of workshops that started in 2017 featuring international experts and leaders in vitamin D research and clinical practice. The fifth annual conference was held in Stresa, Italy, September 15 to 18, 2021. Evidence: Before the event, participants reviewed available studies on their assigned topic, drafted a related abstract, and presented their findings at the time of the conference. Relevant literature that became available since was also discussed within the panel and updated accordingly. Consensus: Before the event, the drafted abstracts had been merged to prepare a preliminary document. After the conference presentations, in-depth discussions in open sessions led to consensus. The document was subsequently modified according to discussions and up-to-date literature inclusion. Conclusions: There is quite consistent evidence for an association between low 25 OH vitamin D (25(OH)D) levels and poor COVID-19 outcomes, despite heterogeneous publications of variable quality. However, the low vitamin D status in COVID-19 patients might also reflect reverse causality. Vitamin D supplementation might have a positive role in COVID-19 prevention. The evidence supporting a beneficial effect of vitamin D treatment in decreasing the risk of COVID-19 complications is conflicting. Conclusive statements regarding the beneficial effect of vitamin D in this context await high-quality, randomized controlled trials. © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved
Postpartum Depression and Anxiety among Lebanese Women: Correlates and Scales Psychometric Properties
Get PDFBackground: We found that it was important to fill a gap in the literature and check the psychometric properties of the Edinburgh Postnatal Depression Scale (EPDS) and Perinatal Anxiety Screening Scale (PASS) in the Arabic language and delineate factors associated with postnatal depression (PPD) and anxiety (PPA) among Lebanese women 4–6 weeks after delivery. Methods: This cross-sectional study carried out between July 2018 and March 2019 enrolled 295 participants who came for a postnatal checkup at four clinics. Results: The EPDS and PASS scales’ items converged over two- and four-factor solutions, explaining 62.51% and 53.33% of the variance, respectively (KMO EPDS = 0.816, αCronbach EPDS = 0.826; KMO PASS = 0.878, αCronbach PASS = 0.920; Bartlett’s test of sphericity p < 0.001). Higher postpartum anxiety (Beta = 0.256), higher postpartum insomnia (Beta = 0.079), having hypotension during pregnancy (Beta = 2.760), and having a second (Beta = 1.663) or a third baby or more (Beta = 2.470) compared with the first one were significantly associated with higher postpartum depression. Higher postpartum depression (Beta = 1.33) was significantly associated with higher postpartum anxiety, whereas having a baby through a planned pregnancy (Beta = −4.365) and having a baby who ate regularly (Beta = −3.639) were significantly associated with lower postpartum anxiety. Conclusion: Depression and anxiety prevalence rates in the Lebanese population were higher compared with other countries, which may be due in part to the differences in regional, social and environmental culture. © 2023 by the authors
Trust Repair Strategies along the Claim/Dispute Timeline
No full textClaims and disputes are inevitable in construction projects. Focusing on non-contractual mechanisms such as trust contributes to minimizing the occurrence of disputes. The existence of trust between project participants enhances the project performance and contributes to successfully delivering the project smoothly. However, several aspects may cause trust deterioration between the participants of the project. The main subjects that may lead to trust deterioration among the project participants are delays in work progress, delays in releasing payments, opportunistic behaviors, and rework due to change orders. The presence of claims causes trust to deteriorate between the parties. A demand is made by either party pursuant to the contract conditions, such an action by either party is taken to protect its entitlement under the contract. Either party may perform violated action(s) during the administration process of claims and disputes, causing trust to further deteriorate between the parties. Trust deterioration is felt at the individual level, and it is felt differently among the project participants. The conflict between the participants may reach a level where the project participants (employer, engineer, and contractor) commit back-and-forth violated actions during the administration process of claims and disputes, leading to a cycle of violated actions. In this regard, it is significant to implement trust repair strategies to repair the broken trust between the parties and to preserve trust through the project period.
Researchers have discussed how trust is established, deteriorated, and repaired in construction projects, but no research has yet discussed both trust deterioration and trust-repair strategies in the context of the claim/dispute timeline. This research aims to classify and highlight the possible actions that contribute to trust deterioration in relation to the stages offered in the standard claim/dispute timelines, specifically FIDIC 2017, and to explore the interjection of trust-repair strategies along the claim/dispute timeline to repair trust between the participants of the project
Non-invasive Ventilation and High-Flow Nasal Cannula in Head/Brain Injury with Risk of Pneumocephalus: Is There a Potential Application?
Get PDFNon-invasive ventilation application in neurocritical care with risk of pneumocephalus is controversial. Non-invasive ventilation-related increased intrathoracic pressure increases intracranial pressure via direct transmission of intrathoracic pressure to the intracranial cavity. In addition, increased thoracic pressure decreases venous return to the heart and increases vena jugularis interna pressure, thereby increasing cerebral blood volume. Pneumocephalus is one of the major concerns after non-invasive ventilation application in head/brain trauma patients. Non-invasive mechanical ventilation may be performed in limited conditions in head trauma/brain surgery with appropriate and close monitoring. High-flow nasal cannula oxygen therapy can provide higher FiO2 as manifested by a larger increase in PaO2 /FiO2 ratio and provide the theoretical basis in pneumocephalus because augmenting the PaO2 more effectively would accelerate nitrogen (N2) washout. As a result, non-invasive mechanical ventilation may be performed in limited manner in head trauma/ brain surgery with appropriate and close monitoring. © Author(s)
Uniformity of palatal volume and surface area in various malocclusions
No full textAims: To assess palatal volume, surface area and linear dimensions across sagittal and vertical components of malocclusion. Methods: Pre-treatment cephalographs and dental casts of 178 non-growing patients (88 males, 90 females, age 25.81 ± 8.23 years) were used for classification in sagittal malocclusion groups: Class I (n = 48), Class II division 1 (n = 42), Class II division 2 (n = 40) and Class III (n = 48); and in vertical divergence groups based on the MP/SN angle: hypodivergent (n = 35), normodivergent (n = 95) and hyperdivergent (n = 48). Dental casts were scanned and palatal measurements recorded: palatal width, depth and interdental distances; palatal surface area (PSA, mm2) and volume (PV, mm3). A 3-way ANOVA was used to compare palatal dimensions across groups. Pearson product-moment correlations were employed to assess associations among variables. Results: PSA and PV (in both sex groups) were not statistically significantly different across sagittal malocclusions and vertical patterns. Significant differences were depicted more among the vertical divergence groups than sagittal groups. Correlations between PSA and PV and palatal dimensions were low to moderate. Predictability of PSA and PV ranged between 15 and 18%. Conclusion: The finding of similar palatal volume and surface area, on average, across malocclusions possibly underscores the limitations of environmental influences within the inherited orofacial phenotype. The vertical facial pattern seems to be more interactive with palatal dimensions than sagittal relations. Studies of palatal changes following orthodontic and orthognathic treatments are warranted. © 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
The Substitution of Fifty Percent of Combustible Tobacco Smoke Exposure With Either Electronic Cigarettes or Heated tobacco Products Did Not Attenuate Acute Lung Injury in an Animal Model
No full textBackground: To reduce the harmful health effects of combustible cigarette smoke (CS), some (CS) users attempt to substitute CS with electronic cigarettes (ECIG) and/or heated tobacco products (HTP). In this animal study, we evaluated the acute effects of substituting CS consumption with ECIG or HTP thus mimicking the dual users' approach, on the lungs of a mouse model. Methods: C57BL/6 mice were divided into Control, ECIG, HTP, CS, ECIG + CS, HTP + CS, and HTP + ECIG groups. Animals were exposed for 3 hours in AM and PM sessions to either air, CS, ECIG, or HTP for seven days. Lung injury was assessed by: wet to dry (W/D) ratio, albumin concentration in bronchoalveolar lavage fluid, expression of IL-1β, IL-6, and TNF-α, histopathology examination, reactive oxygen species (ROS) production, and assessment of cellular apoptosis. Results: W/D ratio was significantly increased in mice exposed to CS only. Albumin leak and expression of IL-1β, IL-6, and TNF-a were elevated in CS, ECIG + CS, and HTP + CS. Histological examination revealed significant inflammatory cells infiltration, as well as collagen deposit in CS, ECIG + CS, HTP + CS. ROS production was significantly increased in CS, ECIG + CS, HTP + CS. Finally, cell death was also significantly increased in CS, ECIG + CS, and HTP + CS. Conclusion: In this animal model, substituting 50% of daily CS exposure by either ECIG or HTP exposure did not result in significant attenuation of acute lung injury. © 2023 The Author(s). Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved
Armenia: Growth Spillovers through Geography, Institutions, Trade and Linguistic Distance
Get PDFThis research paper studies the importance of spatial interaction and dependence of 11 countries on each other to pursue economic growth during 1995-2019. Two spatial models were conducted, the SAR and SEM models, using four spatial weighting matrices: geography, institutions, trade and linguistic distance.
The results generated from this methodology showed that geography and trade are the most significant channels of growth spillovers between two countries. Armenia’s and its neighboring countries’ GDP per capita growths decreased during this period, the reason can be due to increasing government spending and growth convergence.
The study concludes with a summary of the whole paper and some open ended questions on the ongoing Russia-Ukraine and Armenia-Azerbaijan-Turkey wars, and the importance in integrated a political aspect when conducting a spatial analysis
Office-Based Blue Laser Posterior Cordectomy in Patients with Bilateral Vocal Fold Paralysis: A Novel Approach
No full textObjective: Bilateral vocal fold paralysis can be a disabling condition with an adverse impact on quality of life. Various glottal widening procedures to secure the airway have been described. These include total or partial arytenoidectomy with or without reinnervation, cordotomy, arytenoidopexy, and others. A review of the literature shows one case of office-based partial arytenoidectomy that was performed successfully using the thulium laser but no other in-office procedures for the treatment of bilateral vocal fold paralysis. Study design: Retrospective case series with literature review. Methods: This report presents two patients with bilateral vocal fold paralysis who underwent office-based blue laser posterior cordectomy. The blue laser is a new photoangiolytic laser (wavelength of 445 nm) with good hemostatic and cutting properties. The surgical technique of office-based posterior cordectomy using the blue laser is described with a review of the literature on arytenoidectomy/posterior cordectomy. Results: Both procedures were well tolerated and patients showed marked improvement in breathing manifested by an increase in glottal gap on laryngeal examination with no worsening in voice quality. Long-term follow-up showed no interval changes in both cases. Conclusion: The authors of this manuscript advocate office-based posterior cordectomy using the laser in patients who are at high risk for general anesthesia or who refuse to go to the operating room, and potentially for other patients. © 202
Combined tricuspid atresia- AV septal defect—a rare congenital cardiac abnormality
No full textIntroduction: Congenital heart diseases (CHDs) are one of the most common birth defects worldwide with a prevalence of 1%. CHDs can be classified into cyanotic and acyanotic diseases based on the presence or absence of the characteristic bluish discoloration of skin and mucus membranes. A subset of cyanotic diseases is single ventricle malformations. This group of disorders comprises 1% of all CHDs. A remarkable yet rare and underreported entity of single ventricle malformations is combined tricuspid atresia (TA) and atrioventricular (AV) septal defect which is characterized by the anatomical features of both entities. Combined TA-AV septal malformation was first anatomically described in 1953 and further explored through echocardiography and cardiac catheterization in 1987 and then 1991. Since then, no studies have been documented in the literature prompting us to share our findings. Methods: Herein we are describing a rare and underreported cardiac lesion based of a retrospective revision of medical charts at the American University of Beirut Medical Center (AUBMC) Children's Heart Center, a tertiary medical center in the Middle East. Results: Out of 200 cases with confirmed single ventricle physiology, we identified a few patients with characteristics of combined TA-AV septal defect. Our patients exhibited characteristic echocardiographic findings of primum ASD, VSD, atretic RAVV, and clefted LAVV. Conclusion: In short, TA-AV septal defect is a rare, underreported congenital malformation. Tracking our patients’ clinical profiles will help improve our understanding of the prognosis of this entity. Our findings may also improve treatment modalities since replacing the left-sided valve is often overlooked if the defect is inaccurately diagnosed. In addition, such findings can help shed light on the embryological development of the rarely encountered variation of AV septal malformation. © 2023 Wiley Periodicals LLC
Shifting Narratives: Outcome Document on Importance of Women’s Economic Empowerment and Current Legal and Policy Challenges Women Face in Lebanon
No full textProject Description
The Embassies of Denmark, Finland, Norway, and Sweden in Lebanon, UN Women, and the Asfari Institute for Civil Society and Citizenship at the American University of Beirut are working on a project aimed at enhancing women’s political and economic empowerment in Lebanon that is supported by the Nordic Council of Ministers.
Acknowledging the underrepresentation of women in these spheres, the project focused on targeted advocacy and the identification of new political initiatives. Recognizing the macroeconomic impact of gender equality, the collaboration aims to address the low rates of women’s labor market participation and political representation in Lebanon. The project seeks to build on existing Nordic collaboration on gender issues in the country.There are 2 billion unpaid workers in the world with women making up 76% of them. They contribute three times more than men do in unpaid care work. This huge contribution from women takes away many opportunities for them to participate in the economy. This is true in the Arab World as well, where women shoulder most of the burdens of unpaid care work. In this region, women spend anywhere from 17 to 34 hours weekly on unpaid care work while men only spend a few hours.
Although some care workers receive payment for their labor under the formal sector, the majority remain unpaid or grossly underpaid. This further exacerbates the gender disparity and contributes to the perpetuation of unpaid care work as a predominantly female responsibility.
In Lebanon, women’s participation in the labor force is dishearteningly low, barely reaching 28%5. This is largely due to the fact that women are shouldering around 94% of childcare responsibilities, hindering their ability to pursue economic opportunities and actively participate in the workforce. Recognizing these challenges, Dr. Inaya Ezzedine, the Chair of the Women and Children Parliamentary Committee, has recently proposed amendments to the Lebanese Labor Law, aiming to provide women with more flexible work arrangements. Such changes would alleviate the burdens of unpaid care work and empower women to take an active role in the country’s economic life.
Another pressing issue in the Arab World is the exploitation faced by migrant domestic workers, who are predominantly women. The Kafala system, which governs their work conditions, allows employers to sponsor these workers, leading to their vulnerability to underpaid care work and exploitation. In Lebanon, migrant domestic workers who work in people’s homes are excluded from the protection of the Lebanese Labor Code, as stated in article 7. This restrictive system ties their residency in the country to their sponsors or employers, leaving them at the mercy of their employers’ whims and subjecting them to the risk of deportation or detention for any actions without their employers’ permission.
To address these pressing concerns and promote women’s economic empowerment, the Embassies of Denmark, Finland, Norway, and Sweden in Lebanon, in collaboration with the Asfari Institute for Civil Society and Citizenship at the American University of Beirut and UN Women, organized a workshop on July 10th, 2023. The workshop focused on the importance of women’s economic empowerment and shed light on the existing legal and policy challenges faced by women in Lebanon. This event comes at a critical time, given the worsening conditions of care workers and the care economy, exacerbated by the ongoing economic crisis and the proposed amendments to the Lebanese Labor Law by Dr. Inaya Ezzedine. The project, supported by the Nordic Council for Ministers, aims to empower women economically and politically in Lebanon.UN Women, Nordic Council of Ministers, Embassy of Sweden Beirut, Embassy of Denmark Beirut, Embassy of Finland Beirut, Norwegian Embassy Beiru