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A multicenter, prospective study evaluating the impact of the clinical pharmacist-physician counselling on warfarin therapy management in Lebanon
No full textInternational audienceBACKGROUND:Health care professionals (HCP) are known key elements of effective patient's counselling and education. For patients taking warfarin, education about the dose, side effects, and toxicity is clearly identified as a cornerstone of achieving improved health and quality of life. The study objective was to evaluate the patients' knowledge about warfarin and assess the impact of the health care professionals' counselling in enhancing patients' knowledge in achieving warfarin therapeutic outcomes.METHOD:A six-month prospective multicentered study was conducted in three hospitals, enrolling 300 patients admitted to the cardiac care unit and internal medicine departments. Patients' warfarin knowledge and INR levels were assessed before and after the clinical pharmacist counselling. The main therapeutic outcome was the impact of the clinical pharmacist-physician counselling on improving patient's education and achieving therapeutic INR level.RESULTS:A higher mean knowledge about warfarin score was found after counselling as compared to before counselling (4.82 vs 13.2; p < 0.001). Likewise, the drug dose (1.05 vs 1.88), drug toxicity (0.41 vs 1.92), drug-drug and food-drug interactions (0.02 vs 1.89), therapeutic INR and general drug knowledge scores (2.66 vs 4.68) were significantly higher after as compared to before counselling (p < 0.001 for all variables). The percentages of patients who achieved therapeutic INR levels pre/post counselling was 37.2% and 74.4% respectively (p < 0.001).CONCLUSION:Based on the study findings, HCP play a major role in enhancing patients' knowledge about the factors that affect warfarin therapeutic outcomes. This study highlights the need to establish and develop strategies for appropriate warfarin utilization in Lebanon
Identification of metabolic pathway disturbances using multimodal metabolomics in autistic disorders in a Middle Eastern population
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Obesity and emergency care in the French CONSTANCES cohort
No full textInternational audienceCONTEXT - Obese patients are raising specific questions in emergency care such as equipment issues or urgent procedures. Even though obesity prevalence and subsequent health expenditure are increasing worldwide, there is scarce literature about their specific resource utilization of Emergency Departments (ED). These few studies do not take into account both socio-economic situation and comorbidities which are well-known factors influencing healthcare use. Our objective was to assess the emergency care resource utilization of obese individuals (Body Mass Index (BMI) ≥ 30kg.m-2) compared to normal-weight individuals taking into account comorbidities and social-economic situations. METHODS - The French CONSTANCES epidemiologic cohort is a randomly selected sample of French adults. Participants data are linked to the National Health Insurance Database collecting all medical acts. The rate of ED visits of obese (and each obesity class) and normal-weight participants were compared considering confounding factors (comorbidities, various socio-economic data). The primary endpoint was to have visited the ED between 2010 and 2013. Sex-separated analysis and multivariate logistic regression models were performed and adjusted odds-ratios [OR] (95% Confidence Intervals [CI]) were calculated. RESULTS - We included 21,035 normal-weight and 5,003 obese participants. Obese participants visited the ED more often than normal-weight participants (men: 30.5% vs. 26.7%; women: 30.3% vs. 24.4%, P<0.001). Obese participants presented more comorbidities and a lower socio-economic situation than normal-weight participants. After adjustment, obese participants had a higher risk of visiting ED (men: OR = 1.18; 95% CI: 1.04–1.33; and women: OR = 1.36; 95% CI: 1.22–1.52), with a higher risk for class III participants (BMI ≥ 40 kg.m-2) (men: OR = 2.18; CI 95%: 1.32–3.63; and women: OR = 1.85; 95% CI: 1.38–2.49). CONCLUSION - Obese individuals have a higher level of emergency care resource utilization than normal-weight individuals and it increases with severe obesity. Further studies are needed to better understand their healthcare pathways leading to EDs
Investigation of Origanum libanoticum Essential Oils Chemical Polymorphism by Independent Components Analysis (ICA)
No full textInternational audienceThe essential oils obtained from Origanum libanoticum Boiss., a plant endemic to Lebanon, were analyzed by GC/MS. Seventy compounds were identified, covering till 99.8% of the total oil composition. All samples were p-cymene and/or beta-caryophyllene chemotype, with variable percentage of other compounds such as alpha-pinene, myrcene, a-phellandrene, limonene, etc. Compared to traditional drying method, lyophilized samples provided the highest essential oil (EO) yields and yields were higher at flowering stage (Chouwen: 0.33% in 2013 and 0.32% in 2014; Qartaba: 0.27% in 2013 and 0.37% in 2014). According to independent components analysis (ICA), date and site of harvest, altitude and drying technique had no effect on the variation of O. libanoticum EO, chemical composition. An annual variation of EOs composition was observed since a particular variation in some major components concentration was revealed monthly and annually between 2013 and 2014
Oil Thickness Estimation Using Single-and Dual-Frequency Maximum-Likelihood Approach
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Characterization of spatial and temporal patterns in surface water quality: a case study of four major Lebanese rivers
No full textInternational audienceIn this work, four major Lebanese rivers were investigated, the Damour, Ibrahim, Kadisha, and Orontes, which are located in South, Central, and North Lebanon and Bekaa Valley, respectively. Five sampling sites were considered from upstream to downstream, and 12 sampling campaigns over four seasons were conducted during 2010–2011. Thirty-seven physicochemical parameters and five microbial tests were evaluated. A principal component analysis (PCA) was used for data evaluation. The first PCA, applied to the matrix-containing data that was acquired on all four rivers, showed that each river was distinct in terms of trophic state and pollution sources. The Ibrahim River was more likely to be polluted with industrial and human discharges, while the Kadisha River was severely polluted with anthropogenic human wastes. The Orontes and Damour rivers seemed to have the lowest rates of water pollution, especially the Orontes, which had the best water quality. PCA was also performed on individual data matrices for each river. In all cases, the results showed that the springs of each river have good water quality and are free from severe contamination. The other monitoring sites on each river were likely exposed to human activities and showed important spatial evolution. Through this work, a spatiotemporal fingerprint was obtained for each studied river, defining a “water mass reference” for each one. This model could be used as a monitoring tool for subsequent water quality surveys to highlight any temporal evolution of water quality
The Influence of Organs on Biochemical Properties of Tunisian Thuja occidentalis Essential Oils
No full textInternational audienceIn this study, the chemical composition and biological activities of the essential oil (EO) extracts (from leaves and cones) of the Tunisian Thuja occidentalis were evaluated. The composition of the leaf EO extract was more complex than that of the cones. The major components of the leaf EO extract were α-Pinene (34.4%), cedrol (13.17%), and β-Phellandrene (8.04%), while the composition of the cone EO extract was characterized by the predominance of α-Pinene (58.55%) and 3-Carene (24.08%). All EO extracts showed much better antioxidant activity than Trolox against 2, 2-diphenyl-1-picryl hydrazyl (DPPH) radical scavenging, but EOs extracted from leaves exhibited the highest total antioxidant activity. All EOs showed strong antibacterial and antifungal activities against nine tested foodborne microorganisms (Bacillus cereus American Type Culture Collection (ATCC) 1247, Listeria monocytogenes ATCC 7644, Staphylococcus aureus ATCC 29213, Aeromonas hydrophila EI, Escherichia coli ATCC 8739, Pseudomonas aeruginosa ATCC 27853, Salmonella typhimurium NCTC 6017, Aspergillus flavus (foodborne isolate), and Aspergillus niger CTM 10099. The highest antimicrobial activities by disk diffusion assay were recorded for the EOs extracted from leaves, while no difference in potency was marked between leaf and cone EO extracts by the agar dilution method. The most potent antimicrobial activity was recorded among fungi. This study confirms the strong antimicrobial and antioxidant potential of EO extracts from the Tunisian T. occidentalis (from the Sidi Bou Said site), highlighting its potential as a natural preservative against foodborne pathogens, particularly against E. coli and S. typhimurium
User distribution to sub-bands in multiple access communications systems
No full textDemandeurs : Institut Mines Télécom, Université Libanaise, Université Saint-Esprit de KaslikDate de dépôt : 28/03/2018 N° de dépôt : EP20180305353A method of determining a performance metric for a selection of a first user and a second user among a set of candidate users for attribution to a sub-band in a multiple access communications system based on Non-Orthogonal Multiple Access (NOMA), is provided wherein the first user () and the second user () are selected as the pair of candidate users corresponding to an extremum of the ratio between a first term reflecting the total throughput achievable by any pair of the candidate users assigned to the sub-band (s) under consideration, and a second term reflecting the known throughput achieved by that same pair of candidate users over a predetermined preceding period. Implementations include a method of determining a performance metric is presented for attributing users to one or more of a plurality of sub-bands in a multiple access communications system, in which in an initial assignment phase for a specific sub-band, a first user is selected for that band on the basis of one or more criteria such as user priority. Then a second sub-band user maximizing or minimizing the performance metric
