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Long-term results of hyperopic ablations using alcohol-assisted PRK and FS-LASIK: comparative study
No full textPurpose:To evaluate the long-term visual and refractive outcomes of hyperopic excimer ablation using alcohol-assisted photorefractive keratectomy (PRK) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).Setting:American University of Beirut Medical Center, Beirut, Lebanon.Design:Retrospective, matched comparative study.Methods:Eyes that underwent alcohol-assisted PRK were compared to matched eyes that underwent FS-LASIK. All patients were followed up for at least 3 years after surgery. The refractive and visual outcomes of each group were compared at different postoperative time points. The main outcome measures were spherical equivalent deviation from target (SEDT), manifest refraction, and visual acuity.Results:83 eyes underwent alcohol-assisted PRK and 83 matched eyes underwent FS-LASIK. Preoperative manifest refraction spherical equivalent was 2.44 ± 1.18 diopters (D) and 2.20 ± 0.87 D (P =.133) in the PRK and FS-LASIK groups, respectively. Preoperative manifest cylinder was -0.77 ± 0.89 D and -0.61 ± 0.59 D (P =.175) for the PRK and LASIK groups, respectively. 3 years postoperatively, SEDT was 0.28 ± 0.66 D and 0.40 ± 0.56 D for the PRK and LASIK groups, respectively (P =.222), whereas manifest cylinder was -0.55 ± 0.49 D and -0.30 ± 0.34 D for PRK and LASIK, respectively (P 1 D of manifest cylinder (P =.003).Conclusions:Both alcohol-assisted PRK and FS-LASIK are safe and effective for the treatment of hyperopia. PRK induces slightly more postoperative astigmatism than LASIK. Larger optical zones and recently introduced ablation profiles that lead to a smoother ablation surface might improve the clinical results of hyperopic PRK. © 2023 Elsevier Inc.. All rights reserved
Numerical and Data Analysis of Methane Leakage through Petroleum Wells
No full textSubsurface methane leakage around oil and gas wells contributes to fugitive greenhouse gas emissions and contamination of freshwater aquifers. The leakage can occur through natural or induced permeable pathways or due to poor cementation or degradation of the cement around petroleum wells. Accurate prediction of methane migration in the subsurface depends on knowledge of porosity and permeability of the conduits as well as flow system conditions. A two-dimensional, two-phase numerical model is employed using DuMux to simulate subsurface methane migration through the cemented wellbore that experienced temporal degradation. The simulations showed that methane migration patterns are affected by cement quality around boreholes, which dictates the rate and duration of methane leakage. Cement degradation accelerates methane upward migration, allowing it to travel faster and farther. In contrary, high-quality cement acts as a barrier to prevent methane migration to freshwater aquifers or to the surface. Moreover, the analysis of published data from petroleum wells in Alberta, Canada confirm that poor annular cementing is a possible contributor to methane leakage and migration to the atmosphere, and thus major contributor to climate change
Cannabis use and psychosis among patients hospitalized in psychiatric wards in Lebanon: a retrospective chart review
Get PDFBackground: Trends in cannabis use suggest a global increase in the past decade. Current evidence associates cannabis use with an increased risk of psychosis. This association has prompted a growing research interest in the association between cannabis use and psychiatric disorders, especially psychotic disorders. This study aims to gain a better understanding of the effect of cannabis on psychosis and its clinical progression. Results: We conducted a retrospective chart review of cannabis use in patients hospitalized for a psychosis episode over five years at the American University of Beirut Medical Center (AUBMC). Cannabis users were more likely to be young single males using other substances compared to non-cannabis users. Frequent cannabis use was associated with a higher likelihood of paranoia and legal problems. Other psychotic symptoms did not significantly differ between frequent cannabis users and non-users. The length of hospital stay and the duration of the psychotic episode did not significantly differ between cannabis users and non-users. Family stressors and family history of a psychotic disorder were associated with a higher likelihood of personal history of violence. Conclusions: This study is the first in Lebanon to reproduce findings supporting the association between cannabis and psychosis previously highlighted in other populations. Further prospective research is needed to better understand the effect of cannabis use on psychosis and to accordingly revise policies on cannabis legalization to reduce the global burden of psychotic disorders. © 2023, Okasha Institute of Psychiatry, Ain Shams University
Health aid displacement during a decade of conflict (2011–19) in Syria: an exploratory analysis
Get PDFBackground: Syria has been in continuous conflict since 2011, resulting in more than 874,000 deaths and 13.7 million internally displaced people (IDPs) and refugees. The health and humanitarian sectors have been severely affected by the protracted, complex conflict and have relied heavily on donor aid in the last decade. This study examines the extent and implications of health aid displacement in Syria during acute humanitarian health crises from 2011 to 2019. Methods: We conducted a trend analysis on data related to humanitarian and health aid for Syria between 2011 and 2019 from the OECD’s Creditor Reporting System. We linked the data obtained for health aid displacement to four key dimensions of the Syrian conflict. The data were compared with other fragile states. We conducted a workshop in Turkey and key informants with experts, policy makers and aid practitioners involved in the humanitarian and health response in Syria between August and October 2021 to corroborate the quantitative data obtained by analysing aid repository data. Results: The findings suggest that there was health aid displacement in Syria during key periods of crisis by a few key donors, such as the EU, Germany, Norway and Canada supporting responses to certain humanitarian crises. However, considering that the value of humanitarian aid is 50 times that of health aid, this displacement cannot be considered as critical. Also, there was insufficient evidence of health displacement across all donors. The results also showed that the value of health aid as a proportion of aggregate health and humanitarian aid is only 2% in Syria, compared to 22% for the combined average of fragile states, which further indicates the predominance of humanitarian aid over health aid in the Syrian crisis context. Conclusion: This study highlights that in very complex conflict-affected contexts such as Syria, it is difficult to suggest the use of health aid displacement as an effective tool for aid-effectiveness for donors as it does not reflect domestic needs and priorities. Yet there seems to be evidence of slight displacement for individual donors. However, we can suggest that donors vastly prefer to focus their investment in the humanitarian sector rather than the health sector in conflict-affected areas. There is an urgent need to increase donors’ focus on Syria’s health development aid and adopt the humanitarian-development-peace nexus to improve aid effectiveness that aligns with the increasing health needs of local communities, including IDPs, in this protracted conflict. © 2023, BioMed Central Ltd., part of Springer Nature
Tolerance of Patients Using Different Approaches in Laryngeal Office-Based Procedures
No full textObjective: To evaluate the tolerance, overall experience, procedure discomfort, and patient anxiety using different routes in office-based laryngeal procedures. Subjects and methods: We performed a retrospective analysis of patients undergoing office-based laryngeal procedures for the treatment or diagnosis of laryngeal lesions via transnasal, transoral, or percutaneous routes. Tolerability, overall experience, procedure discomfort, and patient's anxiety were evaluated and reported on a custom scale over 5. Results: A total 178 procedures performed on 154 patients were reviewed. The video-recordings and data on 15 procedures were missing. A total of 163 procedures were included in this study. These were stratified as follows; 128 procedures via the transnasal fiberoptic approach, 16 procedures via the transoral fiberoptic approach, and 19 procedures via the percutaneous approach. There was no significant difference in the mean score of overall experience across the three different approaches (P= 0.926). The mean overall experience score for the transnasal approach was 1.85, vs 1.93 and 1.94 for the transoral and percutaneous approach, respectively. Similarly, there was no significant difference in the mean score of tolerability across the three different approaches. The mean tolerability score was 1.68 using the transnasal approach, compared to 1.6 using the transoral approach, and 1.84 using the percutaneous approach (P= 0.77). Anxiety scores, and procedure discomfort scores did not differ either among the three groups (P= 0.138 and P= 0.656, respectively). Conclusions: There was no significant difference in tolerability, anxiety, procedure discomfort, and overall experience regarding the different approaches employed. © 2020 The Voice Foundatio
Molecular mechanisms targeting drug-resistance and metastasis in colorectal cancer: Updates and beyond
No full textColorectal cancer (CRC) is the third most diagnosed malignancy and a major leading cause of cancer-related deaths worldwide. Despite advances in therapeutic regimens, the number of patients presenting with metastatic CRC (mCRC) is increasing due to resistance to therapy, conferred by a small population of cancer cells, known as cancer stem cells. Targeted therapies have been highly successful in prolonging the overall survival of patients with mCRC. Agents are being developed to target key molecules involved in drug-resistance and metastasis of CRC, and these include vascular endothelial growth factor, epidermal growth factor receptor, human epidermal growth factor receptor-2, mitogen-activated extracellular signal-regulated kinase, in addition to immune checkpoints. Currently, there are several ongoing clinical trials of newly developed targeted agents, which have shown considerable clinical efficacy and have improved the prognosis of patients who do not benefit from conventional chemotherapy. In this review, we highlight recent developments in the use of existing and novel targeted agents against drug-resistant CRC and mCRC. Furthermore, we discuss limitations and challenges associated with targeted therapy and strategies to combat intrinsic and acquired resistance to these therapies, in addition to the importance of implementing better preclinical models and the application of personalized therapy based on predictive biomarkers for treatment selection. ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved
Glycemic Indicators and Mental Health Symptoms: Result from the Greater Beirut Area Cardiovascular Cohort.
Get PDFBackground: Mental health disorders are a growing public health priority; with the most common being depression and anxiety. These conditions also present high and complex comorbidity with diabetes; however, the exact mechanisms underlying their co-occurrence remain unknown.
Objective: This study aims to address the more direct links between metabolic indices (HbA1c and fasting blood glucose) and depression and anxiety symptoms in a community sample of middle-aged Lebanese adults.
Methods: The project is based on a secondary data analysis of the Greater Beirut Area Cardiovascular Cohort (GBACC). The GBACC sample was first examined in 2014 (n=501) and a five-year follow-up wave was completed in 2019 (n=198). Sociodemographic, lifestyle, medical, and biological data were collected at both waves and mental health was assessed only at the follow-up study examination. We investigated associations between glycemic indicators and continuous mental health scores using piecewise regression models to identify specific ranges of glycemic indicators where associations might potentially be different. Regression models were adjusted for Sociodemographic, lifestyle, and health characteristics.
Results: In bivariate analysis, there was a pattern for associations between higher FBG levels in 2014, having diabetes in 2014 and more depression and anxiety symptoms measured five years later. Graphical representations and piecewise regression models showed that there are different associations between glycemic indices in the diabetic/clinical versus non-diabetic range: Among participants with <126 mg/dl FBG range, higher baseline (2014) FBG levels were associated with lower depressive (beta=-0.093, 95%CI= [-0.0177, -0.009]; p=0.03) and anxiety symptoms (beta=-0.095, 95%CI= [-0.1763, -0.0147]; p=0.02). In contrast, among participants with FBG levels ≥ 126 mg/dl FBG, higher FBG levels in that range were significantly associated with higher anxiety symptoms (beta=0.054; 95%CI= 0.007, 0.101; p=0.02). Higher 2014 FBG levels in the ≥126 mg/dl range showed a trend -but not significant- for higher depressive symptoms. Although not significant, HbA1c levels in 2014 showed similar patterns of associations with negative associations with mental health symptoms in the below 6.5% range (beta= -1.436, 95%CI= [-3.477 0.604]; p=0.16) for depression and (beta= -1.526, 95%CI= [-3.520,0 .467];p= 0.133) for anxiety symptoms
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Conclusion: Our results showed that FBG levels are associated with worst mental health symptoms only in the clinical/diabetic range, and not in the normal range. Results also suggests the presence of delayed or longer-term associations, with baseline FBG and diabetes status being associated with depression and anxiety symptoms assessed five-years later. Together these findings highlight the importance of clinical and pathological changes in glycemic indicators for mental health and motivate further research into the diabetes-mental health co-morbidity
Respiratory Adverse Events after LMA® Mask Removal in Children: A Randomized Trial Comparing Propofol to Sevoflurane
Get PDFBACKGROUND: The removal of the laryngeal mask airway (LMA®) in children may be associated with respiratory adverse events. The rate of occurrence of these adverse events may be influenced by the type of anesthesia. Studies comparing total intravenous anesthesia (TIVA) with propofol and sevoflurane are limited with conflicting data whether propofol is associated with a lower incidence of respiratory events upon removal of LMA as compared to induction and maintenance with sevoflurane. We hypothesized that TIVA with propofol is superior to sevoflurane in providing optimal conditions and improved patient's safety during emergence. METHODS: In this prospective, randomized, double-blind clinical trial, children aged 6 months to 7 years old were enrolled in 1 of 2 groups: the TIVA group and the sevoflurane group. In both groups, patients were mechanically ventilated. At the end of the procedure, LMAs were removed when patients were physiologically and neurologically recovered to a degree to permit a safe, natural airway. The primary aim of this study was to compare the occurrence of at least 1 respiratory adverse event, the prevalence of individual respiratory adverse events, and the airway hyperreactivity score following emergence from anesthesia between the 2 groups. Secondary outcomes included ease of LMA insertion, quality of anesthesia during the maintenance phase, hemodynamic stability, time to LMA removal, and incidence of emergence agitation. RESULTS: Children receiving TIVA with propofol had a significantly lower incidence (10.8.% vs 36.2%; relative risk, 0.29; 95% CI [0.14-0.64]; P =.001) and lower severity (P =.01) of respiratory adverse outcomes compared to the patients receiving inhalational anesthesia with sevoflurane. There were no statistically significant differences in secondary outcomes between the 2 groups, except for emergence agitation that occurred more frequently in patients receiving sevoflurane (P <.001). CONCLUSIONS: Propofol induction and maintenance exerted a protective effect on healthy children with minimal risk factors for developing perioperative respiratory complications, as compared to sevoflurane. © 2023 Lippincott Williams and Wilkins. All rights reserved
Evaluation of orthodontic habits regarding the use of miniplates in the correction of Skeletal Class III
No full textAims: To determine the habits of Orthodontists in the management of moderate skeletal class III patients by using miniplates, and to assess the relationship between the factors that may hinder the implementation of such treatment. Material and Methods: A questionnaire was carried out using the Google Form® platform, which included 18 questions relating to the seniority of the practice of the orthodontists, the preferential treatment, the difficulties encountered, the results obtained, and the frequency of a relapse. Results: Experienced orthodontists (more than 10 years) treated skeletal class III malocclusion with the conventional facemask therapy, whereas orthodontists with less than 5 years of experience shifted to the miniplate technique which presented less dental effect and more skeletal correction with a decreased frequency of relapse. Conclusion: High financial cost and increased care load were considered the main obstacles regarding the placement of the titanium miniplates in treating skeletal class III patients. © 2023 Elsevier Masson SA
Shaping A Soft Future: Patterning Liquid Metals
No full textThis review highlights the unique techniques for patterning liquid metals containing gallium (e.g., eutectic gallium indium, EGaIn). These techniques are enabled by two unique attributes of these liquids relative to solid metals: (1) The fluidity of the metal allows it to be injected, sprayed, and generally dispensed. (2) The solid native oxide shell allows the metal to adhere to surfaces and be shaped in ways that would normally be prohibited due to surface tension. The ability to shape liquid metals into non-spherical structures such as wires, antennas, and electrodes can enable fluidic metallic conductors for stretchable electronics, soft robotics, e-skins, and wearables. This review summarizes the key properties of these metals with a focus on methods to pattern liquid metals into soft or stretchable devices. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved