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Keeping up with the Joneses? Evidence from Peer Performance in the Banking Industry
Get PDFThis paper traces the reaction of US banks to ROE underperformance on liquidity creation, equity capital, and loan loss provisions. We find that banks change their structures in the subsequent quarter after underperformance by increasing their on-balance and off-balance sheet liquidity creation to increase profitability. Banks tend to increase their equity capital and improve their loan quality by lowering non-discretionary loan loss provisions to become safer. Banks signal their ability to overcome underperformance by increasing their discretionary loan loss provisions. Our results reveal that large banks rely mainly on off-balance sheet liquidity creation as their primary tool to recover from underperformance while medium-size and small banks adjust their equity capital to increase their safety. © 2023 New York University Salomon Center
The Ophthalmology Workload during the Lebanese Crisis and Pandemic
Get PDFPURPOSE: The purpose is to to explore the effects of the Lebanese economic crisis on the ophthalmology workload in Lebanon, and the concomitant influence of the COVID-19-related lockdown and Beirut port explosion. METHODS: Data pertaining to all the clinic visits to the Ophthalmology Department at the American University of Beirut Medical Center between January 01, 2019, and December 31, 2021, were extracted. Completed visits to different subspecialties were used to analyze the different parameters. All parameters were compared across the 3 years. RESULTS: We included 102,810 completed visits in this study. A total decrease of 15.3% occurred in visits between 2019 and 2020. The mean number of patients per month decreased significantly between 2019 and 2020 in retina/uveitis and glaucoma/anterior segment clinics. The same trend was observed in pediatric/neuro-ophthalmology and cornea/refractive surgery, although it did not reach statistical significance. For oculoplastics, the workload actually tended to increase from 2019 to 2021. During the pandemic-related lockdown (March, April, and May 2020), the workload decreased by 37.8% in oculoplastics, 63.4% in pediatric/neuro-ophthalmology, 52.8% in retina/uveitis, 60.2% in cornea/refractive surgery, and 50.7% in glaucoma/anterior segment. After the Beirut port explosion in August 2020, an overall decrease of 30.2% was found in the number of patient visits in all sub-specialties, while the number of patients in oculoplastics remained nearly unchanged. CONCLUSION: The ophthalmology workload was strongly affected by the economic crisis in all subspecialties especially with the pandemic in 2020, except for oculoplastics. During the pandemic, the most affected subspecialty was the pediatric/neuroophthalmology, while oculoplastics was the least affected. © 2024 Middle East African Journal of Ophthalmology
Mannose Inhibits the Pentose Phosphate Pathway in Colorectal Cancer and Enhances Sensitivity to 5-Fluorouracil Therapy
Get PDFColorectal cancer (CRC) is one of the leading cancers and causes of death in patients. 5-fluorouracil (5-FU) is the therapy of choice for CRC, but it exhibits high toxicity and drug resistance. Tumorigenesis is characterized by a deregulated metabolism, which promotes cancer cell growth and survival. The pentose phosphate pathway (PPP) is required for the synthesis of ribonucleotides and the regulation of reactive oxygen species and is upregulated in CRC. Mannose was recently reported to halt tumor growth and impair the PPP. Mannose inhibitory effects on tumor growth are inversely related to the levels of phosphomannose isomerase (PMI). An in silico analysis showed low PMI levels in human CRC tissues. We, therefore, investigated the effect of mannose alone or in combination with 5-FU in human CRC cell lines with different p53 and 5-FU resistance statuses. Mannose resulted in a dose-dependent inhibition of cell growth and synergized with 5-FU treatment in all tested cancer cell lines. Mannose alone or in combination with 5-FU reduced the total dehydrogenase activity of key PPP enzymes, enhanced oxidative stress, and induced DNA damage in CRC cells. Importantly, single mannose or combination treatments with 5-FU were well tolerated and reduced tumor volumes in a mouse xenograft model. In summary, mannose alone or in combination with 5-FU may represent a novel therapeutic strategy in CRC. © 2023 by the authors
Redefining Cancer Research Priorities in Low- and Middle-Income Countries in the Post-COVID-19 Global Context: A Modified Delphi Consensus Process
Get PDFPURPOSE: The post-COVID-19 funding landscape for cancer research globally has become increasingly challenging, particularly in resource-challenged regions (RCRs) lacking strong research ecosystems. We aimed to produce a list of priority areas for cancer research in countries with limited resources, informed by researchers and patients. METHODS: Cancer experts in lower-resource health care systems (as defined by the World Bank as low- and middle-income countries; N = 151) were contacted to participate in a modified consensus-seeking Delphi survey, comprising two rounds. In round 1, participants (n = 69) rated predetermined areas of potential research priority (ARPs) for importance and suggested missing ARPs. In round 2, the same participants (n = 49) rated an integrated list of predetermined and suggested ARPs from round 1, then undertook a forced choice priority ranking exercise. Composite voting scores (T-scores) were used to rank the ARPs. Importance ratings were summarized descriptively. Findings were discussed with international patient advocacy organization representatives. RESULTS: The top ARP was research into strategies adapting guidelines or treatment strategies in line with available resources (particularly systemic therapy) (T = 83). Others included cancer registries (T = 62); prevention (T = 52); end-of-life care (T = 53); and value-based and affordable care (T = 51). The top COVID-19/cancer ARP was strategies to incorporate what has been learned during the pandemic that can be maintained posteriorly (T = 36). Others included treatment schedule interruption (T = 24); cost-effective reduction of COVID-19 morbidity/mortality (T = 19); and pandemic preparedness (T = 18). CONCLUSION: Areas of strategic priority favored by cancer researchers in RCRs are related to adaptive treatment guidelines; sustainable implementation of cancer registries; prevention strategies; value-based and affordable cancer care; investments in research capacity building; epidemiologic work on local risk factors for cancer; and combatting inequities of prevention and care access
Longitudinal Impact of the COVID-19 Pandemic on Stress and Occupational Well-Being of Mental Health Professionals: An International Study
Get PDFBackground: Increased levels of occupational stress among health professionals during the COVID-19 pandemic have been documented. Few studies have examined the effects of the pandemic on mental health professionals despite the heightened demand for their services. Method: A multilingual, longitudinal, global survey was conducted at 3 time points during the pandemic among members of the World Health Organization's Global Clinical Practice Network. A total of 786 Global Clinical Practice Network members from 86 countries responded to surveys assessing occupational distress, well-being, and posttraumatic stress symptoms. Results: On average, respondents' well-being deteriorated across time while their posttraumatic stress symptoms showed a modest improvement. Linear growth models indicated that being female, being younger, providing face-to-face health services to patients with COVID-19, having been a target of COVID-related violence, and living in a low- or middle-income country or a country with a higher COVID-19 death rate conveyed greater risk for poor well-being and higher level of stress symptoms over time. Growth mixed modeling identified trajectories of occupational well-being and stress symptoms. Most mental health professions demonstrated no impact to well-being; maintained moderate, nonclinical levels of stress symptoms; or showed improvements after an initial period of difficulty. However, some participant groups exhibited deteriorating well-being approaching the clinical threshold (25.8%) and persistently high and clinically significant levels of posttraumatic stress symptoms (19.6%) over time. Conclusions: This study indicates that although most mental health professionals exhibited stable, positive well-being and low stress symptoms during the pandemic, a substantial minority of an already burdened global mental health workforce experienced persistently poor or deteriorating psychological status over the course of the pandemic. © 2023 The Author(s). Published by Oxford University Press on behalf of CINP
ER Negative Breast Cancer and miRNA: There Is More to Decipher Than What the Pathologist Can See!
Get PDFBreast cancer (BC), the most prevalent cancer in women, is a heterogenous disease. Despite advancements in BC diagnosis, prognosis, and therapeutics, survival rates have drastically decreased in the metastatic setting. Therefore, BC still remains a medical challenge. The evolution of high-throughput technology has highlighted gaps in the classification system of BCs. Of particular interest is the notorious triple negative BC, which was recounted as being heterogenous itself and it overlaps with distinct subtypes, namely molecular apocrine (MA) and luminal androgen (LAR) BCs. These subtypes are, even today, still misdiagnosed and poorly treated. As such, researchers and clinicians have been looking for ways through which to refine BC classification in order to properly understand the initiation, development, progression, and the responses to the treatment of BCs. One tool is biomarkers and, specifically, microRNA (miRNA), which are highly reported as associated with BC carcinogenesis. In this review, the diverse roles of miRNA in estrogen receptor negative (ER−) and androgen receptor positive (AR+) BC are depicted. While highlighting their oncogenic and tumor suppressor functions in tumor progression, we will discuss their diagnostic, prognostic, and predictive biomarker potentials, as well as their drug sensitivity/resistance activity. The association of several miRNAs in the KEGG-reported pathways that are related to ER-BC carcinogenesis is presented. The identification and verification of accurate miRNA panels is a cornerstone for tackling BC classification setbacks, as is also the deciphering of the carcinogenesis regulators of ER − AR + BC. © 2023 by the authors
Office-Based Laser Therapy in Vocal Fold Polyps: A Systematic Review and Meta-Analysis
Get PDFObjectives: To analyze voice outcomes and lesion regression in patients with vocal fold polyps treated in-office using lasers. Study design: Systematic review and meta-analysis. Methods: The search was performed in the Medline, Embase, and Cochrane databases using the preferred reporting items for systematic review and meta-analyses framework. There were no limitations to the year of publication and the search included studies looking at voice outcomes and lesion evolution of in-office laser treatment for vocal fold polyps measured through voice-handicap index, GRB, acoustic analysis or aerodynamics measures. Risk of bias was assessed using Cochrane's ROBINS-I tool for observational studies. Data analysis was performed SPSS software with a significance level of 5%. Results: We identified 167 articles, 10 of which met the inclusion criteria and were analyzed. The total number of participants was 242. Meta-analysis showed significant improvement in voice handicap index-10 scores (95% CI, [0.86; 1.45]) and decrease in GRB score (95% CI, [1.09; 4.13]) after in-office laser therapy. It also showed significant improvement in percent shimmer (95% CI, [0.26; 1.01]), and significant increase in maximum phonation time (95% CI, [-0.92; -0.18]). Conclusions: Laser therapy an outpatient office setting is a reliable alternative to classical phono-microsurgery. Results show Office-based laser therapy of vocal fold polyps results in a significant improvement in subjective voice outcomes measures. This subjective improvement in voice quality is associated with partial or complete disease regression on laryngeal examination and an increase in maximum phonation time. Ovlaryngeal examination in patients with polyps treated with in-office laser. © 2023 The Voice Foundatio
A Novel Deadline-/Interference-Aware Cooperative Data Transmission Scheduling Scheme for Optimizing AoI in Wireless Networks
Get PDFIn knowledge-freshness-sensitive wireless networking scenarios, a major identified gap lies in overlooking the notable impact of physical link interference and the validity duration (i.e. deadline) of newly acquired knowledge on the network-wide achieved Age of Information (AoI). This paper aims at closing this gap not only through accounting for deadline and interference constraints but also through proposing efficient mechanisms leveraging inter-nodal cooperativeness to work around them and, indeed, migrate the achieved network-wide average AoI to its next lower level. First, a Deadline-constrained Interference-aware Cooperative data transmission Scheduling (DICS) framework is presented. This framework encloses a mathematical formulation of the cooperative data transmission scheduling optimization problem as an Integer Linear Program (ILP) that accounts for deadline and interference constraints and has the two-fold objective of: i) investigating the impact of integrating auxiliary Secondary Nodes (SNs) in the network to assist Primary Nodes (PNs) in improving their overall achieved AoI, and ii) evaluating the effect of altering various network-wide parameter values on the network's AoI performance. Owing to the ILP's remarkable complexity, a GReedy Algorithm (GRA) is proposed, which generates acceptable sub-optimal schedules (error of 5.222%) but is found to be non-scalable. To address GRA's scalability issue, a Reinforcement Learning Actor-Critic Algorithm (RL-ACA) is developed, which, is found to outperform GRA by 2.849% in terms of accuracy. Thorough simulations and numerical analyses are conducted to gauge the merit of the proposed DICS's RL-ACA and highlight its AoI performance improvement as compared to existing benchmarks. © 1967-2012 IEEE
Awareness and Attitude among Nonmedical University Students on Epilepsy in Lebanon: A Cross-Sectional Study
Get PDFBackground Several studies addressed the awareness and knowledge of epilepsy among students and teachers that indicated unfavorable levels of awareness, but none in Lebanon. Aim The aim of this study is to determine the level of awareness and attitude toward epilepsy among nonmedical university students. Methods A survey-based questionnaire was conducted among 1,000 nonmedical students. SPSS was used for data analysis. Results Participants claimed 78.5% having some knowledge about epilepsy (78.5%), with only 20.1% of the participants attaining their knowledge through university courses. Alarmingly, negative beliefs were noticed in our study such as considering person with epilepsy (PWE) as disabled (34.9%), epilepsy is a genetic disorder (40.9%), and it would lead to insanity (43.1%). Moreover, participants think that a PWE is unable to get married (29.5%), nor have children (25.2%), and they would even refuse to marry someone with epilepsy (35.7%). On the other hand, participants showed some positive behaviors such as the fact that epilepsy is not contagious (81%), would accept to accompany a colleague with epilepsy (72.1%), and believing that PWE can succeed at jobs (82.2%). When it comes to providing first aid, wrong practices were reported such as believing that something should be placed in the mouth during a seizure to avoid biting their tongue (58.1%). Conclusion Lack of knowledge, acceptance, and first aid practices have been observed in our study. Thus, efforts in including epilepsy within university curriculums, as well as raising awareness different platforms and campaigns should be done, as the social burden is even higher on PWE. © 2023 Georg Thieme Verlag. All rights reserved
Assessment of mycotoxins in cornflakes marketed in Lebanon
No full textCornflakes are a popular and convenient breakfast cereal made from corn and widely consumed worldwide, including in Lebanon. However, they are susceptible to mycotoxin contamination, which can have harmful effects on human health. Our study evaluated the occurrence of five mycotoxins (AFB1, OTA, FUM, ZEA, DON) levels in packed cornflakes marketed in Lebanon. A market screening identified 35 different cornflake stock-keeping units (SKU) in the Lebanese market, originating from 10 different brands and having different tastes and shapes. SKUs were collected and tested for five mycotoxins in triplicates using enzyme-linked immunosorbent assay technique. The results showed the presence of the five mycotoxins in the samples. The average levels of AFB1, OTA, ZEA and FUM among positive samples (above limit of detection) were 1.58, 1.2, 15.1 and 774.1 μg/kg, respectively, and were below the EU limits. On the other hand, the average level of DON was 1206.7 μg/kg, exceeding the EU limit. Furthermore, out of the positive samples, 60%, 17%, 9%, 14%, and 6% exceeded the EU limits for DON, OTA, AFB1, FUM, and ZEA, respectively. Notably, SKUs made in Lebanon had significantly (p 0.05) effect on the levels of the five mycotoxins detected in the samples. AFB1, FUM and ZEA levels differed significantly among SKUs (p > 0.05). Considering these findings, further studies should be conducted to assess the exposure to mycotoxins from the consumption of cornflakes in Lebanon, especially among children. © 2023, The Author(s)