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Long-term burden of war injuries among civilians in LMICs: case of the July 2006 war in Lebanon
Get PDFIntroduction: Lebanon, a country located on the eastern shore of the Mediterranean Sea, is one of the world’s smaller sovereign states. In the past few decades, Lebanon endured a perpetual political turmoil and several armed conflicts. July 12, 2006, marked the start of a one-month war in Lebanon, which resulted in thousands of casualties. Little is known about the long-term consequences of war injuries inflicted on civilians during the July 2006 war. Methods: The objectives of this paper were to identify and evaluate: 1- civilians’ access to healthcare and medicine under conditions of war; 2- the long-term socioeconomic burden on injured civilians; and 3- their quality of life more than a decade post-war. We adopted a mixed-method research design with an emphasis on the qualitative component. We conducted interviews with patients, collected clinical and financial data from hospital medical records, and administered a self-rated health questionnaire, the EQ-5D-5L. Simple descriptive statistics were calculated using Excel. NVivo 12® was used for data management and thematic analysis. Results: We conducted 25 interviews. Injured civilians were mostly males, average age of 27. The most common mechanism of injury was blast injury. Most patients underwent multiple surgeries as well as revision surgeries. The thematic analysis revealed three themes: 1- recall of the time of the incident, the thousand miles journey, and patients’ access to services; 2- post-trauma sequelae and services; and 3- long-term impact. Patients described the long-term burden including chronic pain, poor mobility, anxiety or depression, and limited activities of daily living. Discussion: Civilians injured during the July 2006 war described the traumatising events they endured during the war and the limited access to medical care during and post-war. Up until this study was conducted, affected civilians were still experiencing physical, psychological, and financial sequelae. Acknowledging the limitations of this study, which include a small sample size and recall bias, the findings underscore the necessity for the expansion of services catering to civilians injured during wartime. Copyright © 2023 Kobeissi, Menassa, Honein-AbouHaidar, El Achi, Abdul-Sater, Farhat, Al Mohtar, Hajjar, Abdul-Khalek, Chaya, Elamine, Hettiaratchy and Abu-Sittah
Office-Based Laser Therapy for Vocal Fold Cyst: A Promising Alternative Therapy Using the 445 nm Blue Laser
No full textVocal fold cysts are benign lesions commonly encountered in laryngology practice. They are traditionally classified as mucus retention cysts and epidermoid cysts. The mainstay treatment is surgical excision with diligent dissection of the cyst wall. The authors of this manuscript report a series of two cases of vocal fold mucous retention cysts and one case of vocal fold pseudocyst treated with the blue laser (Wolf TruBlue 445 nm; A.R.C. Laser Company) in an office setting. All three cases had complete regression of the lesion with improved glottic closure and mucosal waves during phonation. The disease regression was associated with a decrease in the VHI-10 score, perceptual voice evaluation scores, and acoustic perturbation parameters. There was also an increase in maximum phonation time in all three cases. The authors advocate office-based blue laser therapy for vocal fold cysts as a promising treatment modality, particularly in patients at high risk for general anesthesia. Nevertheless, the possible increased risk of vocal fold scarring given the lack of binocular microscopic examination should not be underestimated. A larger study is needed to cast more information on the surgical outcome and long-term effects of blue laser therapy in the management of vocal fold cysts. © 2023 The Voice Foundatio
Development and application of a prioritization and rehabilitation decision support tool for uncontrolled waste disposal sites in developing countries
Get PDFThe uncontrolled dumping of solid waste is widespread in many developing countries with most of all generated wastes being indiscriminately disposed of in an unsanitary manner that entails significant environmental and public health risks. It is imperative to prioritize dumpsites based on their relative risks so that the necessary control and remedial measures can be undertaken. This research aimed to formulate a pragmatic prioritization and rehabilitation decision tool that can be utilized in low- and middle-income countries to guide decision makers in prioritizing dumpsites for remediation and in identifying the most suitable rehabilitation option for municipal as well as construction and demolition waste. The established prioritization model presents an integrated, risk-based approach to developing a decision-making tool for dumpsite prioritization and rehabilitation. The rehabilitation tool drew on a decision tree module to develop the appropriate remedial measures required for each site. The model proved to be effective in prioritizing uncontrolled solid waste disposal sites in Lebanon and for adopting control and remedial measures that can considerably improve decision-making. The improper disposal of solid waste adversely affects public health and the environment in, to a greater or lesser extent, almost all low- and middle-income countries. Considering that it is unfeasible to remediate all uncontrolled solid waste disposal sites at once, the proposed model facilitates the evaluation process by prioritizing sites for closure and remediation based on their relative risks. Integr Environ Assess Manag 2023;19:436–445. © 2022 SETAC. © 2022 SETAC
Conjugated Polyelectrolyte-Based Temperature Memory Probes for Applications at the Macro- and Nano-scale Levels
No full textTemperature memory probes have the potential to be indispensable in basic science research for their ability to couple temperature measurements with other techniques, both on the macro and nanoscale levels. Herein, we report the development of a fluorescent material with temperature memory properties. Unlike previously developed systems which can only report on a single triggering memory point, the conjugated polyelectrolyte-based sensor detects its exposure to a wide range of temperatures. To achieve this unique property, large poly (phenyl ethylene) (PPE-CO2) conjugated polyelectrolytes are destabilized and locked in a more emissive configuration using a large amphiphilic polymer (polyvinylpyrrolidone PVP) when exposed to heating. With the decrease in solution temperature, the large PVP polymer hinders the aggregation of the stiff and bulky PPE-CO2 back to its original conformation leading to a weaker intramolecular stacked structure with a significantly enhanced radiative emission decay. The temperature memory effect increased with the PVP molecular weight and concentration and was independent of the solution viscosity. The temperature memory effect was tested between 30 C and 70 C and it was retained for at least 24 hours.
As a proof of concept, magnetic nanoparticles were heated using an alternating magnetic field in the presence of the PPE-CO2/PVP sensor. These thermal measurements are often challenging due to the interference of the alternating magnetic field with traditional temperature probes. The fluorescent signal measured 45 minutes after the experiment was able to accurately report back on the maximum temperature solution achieved during the heating experiment.
The system was then studied with different polymers in order to gain further insight on the type of interactions between PPE-CO2-108 and the added polymer. We concluded that the interaction between the former and PVP is nuanced and very specific as only PVP-VA, out of all tested polymers, was able to convey a similar fluorescent behavior with temperature memory properties. Further experimentation must be done for better insight
Coping with the COVID-19 pandemic: A cross-sectional study to investigate how mental health, lifestyle, and socio-demographic factors shape students' quality of life
No full textThe dataset consisted of students' socio-demographic characteristics, lifestyle practices (cigarette and shisha smoking, alcohol intake, physical activity, sleeping hours, internet usage, follow a healthy diet, and overall health), mental health factors (depression, anxiety and stress) and quality of life
A BAYESIAN HIERARCHICAL SPATIO-TEMPORAL APPROACH TO MODEL PHOSPHORUS LOADING IN EIGHT OHIO WATERSHEDS
No full textAccurately estimating riverine nutrient loads remains an imperative step towards
mitigating and managing eutrophication-related impairments. However, load estimation
is often affected by the infrequent monitoring of riverine nutrient concentrations. In this
work, two novel Spatio-temporal Bayesian Hierarchical models (BHM), the ratio
estimator approach and the regression approach, are proposed, developed and validated.
The models are assessed with regards to their performance in estimating total phosphorus
loads between 2005 and 2020 across eight intensively monitored watersheds in Ohio,
USA. The two proposed BHMs incorporate watershed-level predictors that allow for the
partial-pooling of data collected from multiple watersheds over time. The proposed
models include two modelling hierarchies, namely one spatial and another temporal. The
spatial hierarchy attempts to model inter-station variability in loading by accounting for
watershed-level differences in land cover/land use (LULC), while the temporal hierarchy
attempts to capture the inter-annual variabilities in loads due to changes in flows. To
assess the skill of the two proposed models, the model estimates are compared to the "true loads" and to loads estimated using typical load estimation methods. Moreover, the
performance of the models is tested as a function of two different sampling frequencies.
Overall, the results showed that the BHM ratio estimator approach outperformed all other
load estimation methods. Moreover, its results proved to be invariant with the changes to
the sampling frequency which will allow for more efficient monitoring of watersheds, as
it can predict loads with a high degree of accuracy using as few as one sample every 10
days. This significantly reduces the cost and labor associated with monitoring, as well as
the potential for errors or inaccuracies. Finally, the results highlighted that accounting for
the spatial variabilities in LULC that existed between watersheds within the model hierarchical was significantly more important than accounting for the temporal
differences in flow
Discrete Optimal Transport
No full textWe introduce the Assignment Problem, which involves minimizing the cost of transporting goods from a finite number of sources to a finite number of targets. Due to the discrete nature of the assignment problem, a solution might be computed using a brute-force numerical approach; however, these are not efficient. In this thesis, we relax the assignment problem, and connect it to the infamous Kantorovich Problem and its Dual. Theoretically, the problem consists of maximizing concave functional under linear inequality constraints. We develop the needed theoretical background from Functional and Convex analysis to solve the assignment problem which allowed us to present more efficient numerical methods such as the Bertsekas’ auction algorithm, and the network simplex algorithm
Primary cells from patients with adult T cell leukemia/lymphoma depend on HTLV-1 Tax expression for NF-κB activation and survival
Get PDFAdult T cell leukemia/lymphoma (ATL) is an aggressive malignancy secondary to chronic infection with human T cell leukemia virus type 1 (HTLV-1). The viral oncoprotein Tax initiates T cell transformation through activation of critical cellular pathways, including NF-κB. Unexpectedly, Tax protein is not detectable in most ATL cells, in contrast to the HTLV-1 HBZ protein which antagonizes Tax effects. Here, we demonstrate that primary ATL cells from patients with acute or chronic ATL express very low levels of Tax mRNA and protein. Critically, survival of these primary ATL cells is dependent on continued Tax expression. Mechanistically, Tax extinction results in reversal of NF-κB activation, P53/PML activation and apoptosis. Tax drives interleukin-10 (IL-10) expression and recombinant IL-10 rescues the survival of tax-depleted primary ATL cells. These results demonstrate the critical role of continued Tax and IL-10 expression for the survival of primary ATL cells, highlighting their relevance as therapeutic targets. © 2023, The Author(s)
ANCA-Associated Vasculitis following the First Dose of Pfizer-BioNTech COVID-19 Vaccine
No full textCoronavirus disease (COVID-19) vaccine can alter the body's immunological balance leading to autoimmune disease in rare cases. Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is one of the autoimmune diseases which have been rarely reported to appear post-COVID-19 vaccine. Herein, we report the case of a 47-year-old woman who developed acute renal failure few days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. Corticosteroids along with azathioprine were used for the management. © 2022 Author
Hyaluronic Acid in Rhinology: Its Uses, Advantages and Drawbacks—A Review
No full textHyaluronic acid has been increasingly involved in recent research due to its many chemical and physical properties. This is a review of the literature for studies involving the use of hyaluronic acid in rhinology. Hyaluronic acid washes and irrigation have been increasingly used in chronic sinusitis medical therapy and post-operatively with mixed results. It has also been shown to play a role in the treatment of nasal polyposis, allergic rhinitis, acute rhinosinusitis and empty nose syndrome. Its effect on biofilm in many disease entities has also been studied. HA is being recently used as ancillary treatment for several rhinologic conditions such as post-operative endoscopy care and chronic sinonasal infections. The properties of HA have intrigued researchers over the past years particularly in biofilm management, healing and inflammation. © 2022, Association of Otolaryngologists of India