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The state of cancer research in fragile and conflict-affected settings in the Middle East and North Africa Region: A bibliometric analysis
Get PDFBackground: Cancer represents a disproportionate burden in LMICs, especially conflict-affected countries in the MENA region. Research output on cancer fails to match the growing burden in the region. This bibliometric study aims to examine the status and trends of cancer research in fragile and conflict-affected settings in the MENA region from 2000 to 2021, while also incorporating economic and demographic indicators as additional factors of analysis. Methods: The Web of Science databases were searched for publications related to cancer research in Iraq, Lebanon, Libya, Palestine, Syria, and Yemen from January 1, 2000, to December 31, 2021. The retrieved publications were screened based on preset eligibility criteria and the final list was analyzed using the Bibliometrix Package in R to generate the annual scientific production and citations, journals, institutions, authors, collaborations, keywords, and title co-occurrence. Each country’s annual scientific production was analyzed against its annual GDP per capita. Results: A total of 4,280 documents met the inclusion criteria in this research. The annual number of publications revealed a significant increase over the past 20 years. These publications were mostly published in international journals that had impact factors rated in the 3rd or 4th quartiles. The overall contribution of researchers from Fragile and Conflict-Affected Settings (FCS) to cancer research was 6.5% of the MENA cancer research productivity, despite comprising around 23% of the total MENA region’s population. Lebanon had the highest publication productivity at the country level, followed by Iraq and Syria. GDP per capita was not significantly correlated with cancer research across the countries under investigation. At the institutional level, the American University of Beirut was the most prolific institution and had the highest number of collaborations and the widest range of cooperative partners. Most first authors were male researchers. There is an interest in cancer expression, prevalence, diagnosis, and management in terms of commonly researched topics. Conclusion: This study underscores the need for a concerted effort to improve cancer research outcomes in FCS, which can be achieved through targeted research, increased investment in research infrastructure and capacity-building initiatives, and greater regional and global collaboration. Copyright © 2023 Sater, Farhat, Elsayed, Youssef, Husain, Kaddoura, Jaber, Mukherji and Taher
COVID-19 Burden of Disease Amidst Water, Sanitation, and Hygiene (WASH) Challenges and Preparedness: A Scoping Review
No full textBackground: COVID-19 is an infectious disease caused by the novel coronavirus (SARS-CoV-2), highly transmissible through liquid droplets, and leading to varying health outcomes. However, the rate of morbidity and mortality is exacerbated in patients with chronic diseases. The WHO continues to monitor viral transmissibility and community variants, with explicit guidelines on the implementation of infection prevention and control (IPC) measures, as well as the importance of adequate hygiene and handwashing behavior. Still, basic WASH services are lacking, mostly in developing many countries, constituting a major public health threat. On the other hand, considering the proven effectiveness of WASH services in controlling the transmission of diarrheal and other waterborne illnesses, mostly developed countries are already using the Wastewater-Based Epidemiology (WBE) approach to track and monitor disease prevalence.
Objectives: This scoping review maps out the evidence assessing countries’ implementation of WASH interventions and the use of WBE monitoring in the COVID-19 pandemic, to reflect on the role of WASH preparedness in pandemics.
Methods: This scoping review follows the methodology outlined by the Joanna Briggs Institute (JBI) and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews (PRISMA-ScR) guidelines. We employed a comprehensive search strategy to identify international evidence from three databases: Medline (Ovid), CINAHL, and Embase. The search was limited to studies published as of November 2019. We included quantitative and qualitative primary studies discussing COVID-19 health outcomes and assessing countries' implementation of WASH interventions. Titles, abstracts, and full articles were independently screened in duplicate by two reviewers, and based on pre-defined eligibility criteria. Data abstraction and analysis was carried out by one reviewer. The studies were classified into two basic themes of WASH services and interventions, and the use of WBE surveillance tool.
Results: Sixty-five out of screened 15,913 studies met our inclusion criteria. Eighty-nine percent of these studies were published in 2021 and 2022. Seventy-three percent of the WASH studies were cross-sectional, while ninety-six percent of the WBE studies were experimental. Most WASH studies were conducted in LMICs, whereas WBE studies were conducted in HICs.
The results of the studies highlighted mostly WASH and WBE challenges during the COVID 19 pandemic. 27.27% of WASH studies focused on water scarcity, and 63.63% addressed the limited access to drinking water, and hygiene facilities and supplies. Additionally, 54.54% of WASH studies addressed sanitation challenges, and 18.18% just focused on the exposure of water sources to contaminants.
For WBE studies, 81.48% emphasized the significance of this tool for COVID-19 surveillance. Additionally, 55.55% and 25.93% addressed WBE limitations and challenges, respectively. Only 3.7% proposed means for improving this surveillance tool, and provided evidence of its potential use in detecting enhanced adherence to hand hygiene by communities.
Conclusion and recommendations: This scoping review shows that WASH studies are minimal and primarily published in developing countries that are still lagging behind on WASH infrastructures. This suggests that the preparedness of these countries, in the context of future pandemics and epidemics particularly waterborne, is inadequate and WHO recommendations are still considered aspirational, and are not feasible and context specific.
As for the use of WBE surveillance tool, its application favors developed countries with well-established WASH infrastructure. Notably, WBE studies align with WASH study findings reflecting on limited progress towards achieving SG6 WASH targets. Subsequently, morbidity and mortality rates would continue to rise exacerbated by the cumulative effects of climate change.
Additionally, the implementation of WBE complements the provision of WASH, and realistically not applicable in humanitarian emergency settings, lacking WASH infrastructures, like those in Lebanon and other developing countries. The identified gaps in WBE information necessitate further research into its application in humanitarian emergency settings, such as the situation in Lebanon.
Thus, additional studies are required to document evidence on the impact of WASH interventions and associated burden of disease, particularly for vulnerable populations such as climate migrants and refugees
Novel trans-2,3-enoyl-CoA reductase–like variant associated with catecholaminergic polymorphic ventricular tachycardia type 3
Get PDFVaccination in pregnancy
Get PDFThe evidence indicates that pregnancy is associated with increased severity of some infectious diseases. Given the high maternal morbidity associated with influenza in pregnancy and the high neonatal morbidity and mortality associated with pertussis, the traditionally two recommended vaccines during pregnancy were those against influenza and Tdap (tetanus toxoid, reduced diphtheria toxoid and acellular pertussis) vaccines. The recent COVID-19 pandemic introduced a third vaccine that after much debate is now recommended for all pregnant women. Other vaccines can be offered based for high-risk pregnant women, and only when the benefits of receiving them outweigh the risks. The soon expected vaccines against group B streptococcus infection and respiratory syncytial virus infection will be a breakthrough in reducing perinatal mortality. In this paper, the recommendations for administration of each vaccine during pregnancy are discussed. © 2023 International Federation of Gynecology and Obstetrics
Assessing the Hybridization Effect of Fibers on the Mechanical Properties and Durability of Concrete
No full textFiber-reinforced concrete has gained wide attention in the past years. The need for a high-performance and ductile construction material led to the advance in research and application of fibrous concrete. Fibers are short filaments that can be natural, metallic, glass, or polymers (like polypropylene or polyvinyl alcohol). The addition of one type of fibers could improve the performance of concrete. Yet, the incorporation of more than one fiber type in the concrete mixture can create a synergetic effect that could further enhance concrete’s properties. A multi-phase research program was conducted at the American University of Beirut to study fiber-reinforced concrete. The first phase examined the properties of single-fiber-reinforced concrete with variable fiber types and dosages. Four master students worked on that phase and reported the results in their theses. Based on the findings of the first phase, a second phase was designed in which seven mixtures incorporating different combinations of hybrid fibers were tested for: (1) mechanical properties including compressive strength, splitting tensile strength, flexural strength, and elastic modulus; (2) durability properties including resistance to rapid freezing and thawing, thermal conductivity, and water absorption; and (3) shear strength, bond strength, and ductility of the mode of failure of structural members. The fiber types included in the study are Basalt (B), Steel (S), Polyvinyl alcohol (PVA), Polypropylene Econo-Net (PP), and Glass (G). Test results of the hybrid fiber-reinforced concrete mixtures were analyzed and compared with the plain concrete and single fiber concrete mixtures. This thesis reports on Parts 1 and 2 of the above-described scope. Results indicated that whereas hybridization of fibers imposed a negative effect on the compressive strength, however it significantly enhanced the tensile and flexural strengths and remarkably improved the durability of the tested concrete specimens
Reproductive health of Syrian refugee women in Lebanon: a descriptive analysis of the Sijilli electronic health records database
Get PDFBackground: The Syrian conflict has been responsible for the highest exodus of refugees, with Lebanon hosting the greatest number of refugees per capita, which placed a significant strain on an already overburdened healthcare system. Women are the most vulnerable group in times of conflict and displacement, with sexual and reproductive health and rights often neglected. This study focuses on the obstetric characteristics and pregnancy outcomes of Syrian Refugee (SR) women in Lebanon, in Comparison to their pre-displacement data. Methods: This study is a secondary analysis of de-identified data from the Sijilli database. The data reported and analyzed were the refugees’ socio-demographics, obstetric history, pregnancy outcomes, experienced maternal and neonatal complications, breastfeeding history and duration, and contraception use and types. Data were reported in both frequencies and means/medians. Chi-square test, t-test, and ANOVA tests were used to compare pregnancies in Syria to those that happened in Lebanon. Results: A total of 1065 female records were included in this study, with 634 ever-pregnant women and the total number of pregnancies being 3272. SR women were shown to get pregnant in Lebanon at a younger age compared to cases in Syria. The number of gravidities is equal in women who got pregnant in Syria and those who moved later to Lebanon. The mean spacing between pregnancies has decreased comparing SR women who got pregnant in Syria only versus those who got pregnant in Lebanon only. Among the mixed group, the mean spacing between pregnancies as well as the prevalence of spontaneous abortions significantly increased after displacing to Lebanon. C-section rate was higher among SR women after moving to Lebanon. Also, maternal complications and not breastfeeding have increased after moving to Lebanon. A prior pregnancy was significantly associated with higher contraception use rate. The most common methods of contraception were oral contraceptive pills and intra-uterine devices. Conclusion: The C-section deliveries, spontaneous abortions and maternal complications have all increased among SR women after being displaced to Lebanon. While the age at first pregnancy, mean spacing between their pregnancies and breastfeeding rates have decreased after moving to Lebanon. SR women are less likely to use contraceptives after their displacement. It is necessary to address access to reproductive healthcare and antenatal care delivery among displaced refugee women living in informal tented settlements. © 2023, The Author(s)
Human Object Interaction Detection in Paintings using Multi-Task Learning
No full textHuman Object Interaction (HOI) detection provides valuable insights into the meaning
and interpretation of a painting, as the interactions between humans and object
reveal information about the scene, characters, and story depicted in the artwork.
Automatically detecting HOI in paintings is a challenging task, as the paintings
often contain complex scenes with intricate details and variations in artistic style.
Additionally, unlike in real-world images, the context and physics of the painting
may not follow physical rules, which can further complicate the detection process.
The proposed system addresses the complexities of this task, considering the
intricate details and variations in artistic style found in paintings. It incorporates
a model that captures discriminative information by extracting visual features from
detected humans, objects, and the Region of Interest. The model analyzes spatial
arrangements to understand the relationships and interactions between elements.
Moreover, the model integrates contextual knowledge and semantic relationships
using a knowledge graph based on Graph Convolution Network to capture the underlying
meaning and story depicted in artwork.
However, relying solely on appearance and context may not be enough to accurately
infer HOIs in paintings. To overcome this challenge, multitask learning is employed
by introducing four supplementary classification tasks. These tasks provide
complementary information that enhances the HOI detection process, leveraging
shared representations across multiple tasks. The proposed system introduces the
SemArt-HOI benchmark dataset, augmenting the SemArt dataset with instance detection
annotations and interaction classes. Experimental results demonstrate that
the proposed model outperforms the state-of-the-art one-stage transformer-based
HOI detection model in both single-task and multi-task settings by 1.19% and
1.51% respectively. Furthermore, the system exhibits superior efficiency, training
four times faster and requiring fewer resources. This makes it suitable for practical
and large-scale HOI detection in paintings
The Magical Bookshelf
No full textIn this story, a group of five students with a passion for science and experimentation struggle with a lack of motivation towards reading and literature. Their teacher takes them on a field trip to the local library in hopes of sparking their interest in reading. Upon arrival, the students are unimpressed, but a magical book on the shelf catches their attention and leads them on a journey through the discoveries and inventions of Lebanese scientists. Through their experience, the students learn the importance of reading and exploring the wonders of the world
Latency-Sensitive Parallel Multi-Path Service Flow Routing with Segmented VNF Processing in NFV-Enabled Networks
No full textIn the context of Software Defined Networking (SDN) scenarios, the deployment of multi-path routing has been trending as one of the practical approaches. It serves the two-fold objective of improving the reliability of Service Function Chains (SFCs) and reducing end-to-end delays through parallel processing; this latter being this paper’s focal point given it is one of the fundamental objectives of 6G. The literature encloses numerous publications revolving around the exploitation of Virtual Network Function (VNF) duplication and optimal placement to enable parallel processing. However, very little attention has been allocated to segmented VNFs with parallel multi-path data traffic flow routing to catalyze service completion. In reality, the application of segmented task processing is now widely used in our internet life (e,g, real-time video on Youtube). In order to realize the ultra-low end-to-end delay of SFC, we introduce the segmented VNF processing window and implement VNF processing tasks in batches/windows with multi-path routing. Herein, a novel Parallel Multi-Path service flow Routing with processing Windows (PMPRW) scheme is proposed. The PMPRW is formulated as a Mixed Integer Linear Program (MILP), owing to the complexity of which, a Column-Generation (CG) based framework is developed to generate accurate sub-optimal solutions that achieve the same performance as the optimal solution. In order to accelerate the process and enhance the performance, we propose an extended Column Fixing (CF) strategy to help generate new columns in CG. Extensive simulations are conducted to gauge the merit of PMPRW and demonstrate its superiority (as opposed to single-path routing). PMPRW achieves desirable performance by concurrently reducing the overall end-to-end delay (e.g., 22% through parallel dual-path routing). IEE