RES-Q an Ongoing Project on Municipal Solid Waste Management Program for the Protection of the Saniq River Basin in Southern Lebanon

Lebanon is currently facing an unprecedented mix of social, economic, and political crises, which exacerbate many public health and environmental health problems. Among these, solid waste management (SWM) is considered one of the biggest challenges that Lebanon has been facing for the past two decades. In the absence of national guidelines and ministerial action, SWM is a responsibility of local municipalities. In this paper, we describe the development of a technology-based Waste Management System (WMS) in an area of 43 villages in southern Lebanon. The project is inspired to the paradigms of circular economy and smart cities, and it aims to define affordable and efficient strategies to address SWM. The driving factor in defining the strategies is economic and environmental sustainability, as Lebanon imports most of its resources in hard currency, which is becoming less and less available. The lessons learned from this project can be transposed in other areas and countries with limited financial resources, representing an important paradigm for the WMSs in many areas of the world

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)