PERCEPTION OF NARRATIVE MEDICINE AMONG MEDICAL STUDENTS IN LEBANON

The physician-patient relationship has evolved over the years. A good relationship necessitates mutual commitment from both parties, and narrative medicine can be considered as a tool that can aid in improving this relationship, as it helps to improve listening to patients’ stories and turning the patients’ subjective words into objective information, which help physicians to understand the nature of patients’ illnesses, improve the quality of patient care and leads to a better therapeutic effect. A descriptive cross-sectional study was planned. Data collection was done via convenience sampling. Beirut Arab University medical students were asked to fill a paper-based questionnaire between ­­­­­August 2019 and February 2020. The study collected demographic information about the participants including the age, the gender, current academic year, and the cumulative grade point average, and assessed their knowledge about narrative medicine and its importance to be implemented in the medical school curriculum. Data were collected, entered, and analyzed on SPSS software version 23.1. 361 medical students participated. Around 60% thought that narrative medicine helps to promote reflection and empathy, and 80% thought that narrative medicine is essential for enhancing the quality of patient care and that listening to patients’ stories would enhance physician-patient communication. Females tended to have a better understanding of narrative medicine’s importance. The majority agreed that narrative medicine should be an integral part of the medical school curriculum. Medical students were found to be lacking adequate knowledge about narrative medicine. However, the majority agreed on the need for implementation of humanity courses in the current curriculum

Ebola virus outbreak returns to the Democratic Republic of Congo:An urgent rising concern

On April 23, 2022, the Ministry of Health of the Democratic Republic of the Congo announced an EVD outbreak after discovering 2 confirmed cases and identifying 267 contacts. With collaboration from the WHO, the MoH are taking many interventions to prevent further expansion of this outbreak. Forty-six years ago, the Ebola virus was first discovered in 1976 near the Ebola River in the DRC. Since then, 13 outbreaks of EVD have occurred in the DRC and, in 2020, it witnessed the second largest EVD outbreak in the world, resulting in 3481 cases and 2299 mortalities. This article discusses the epidemiology of the current DRC outbreak by examining the etiology of EVD, the number of affected cases, and the subsequent case index. Considering these data, this paper discusses measures taken by the MoH, WHO, CDC, and UNICEF to mitigate the Ebola outbreak, such as supporting local teams to provide essential care, training medical staff, and raising awareness for vaccination. Finally, by comparing the gravity of the situation to current measures, this article provides recommendations for individuals and governments to protect themselves and mitigate future outbreaks

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

The Sixties in Berlin and in Hollywood: City with a Wall in Its Center—The Attempt to Erase the German Past

Berlin was the location in which most of the intelligence operations in Europe have taken place in the first twenty years of the conquest and the Cold War. In November 27, 1958, Khrushchev issued a formal letter to the Allies, demanding that the western Allies evacuate Berlin and enable the establishment of an independent political unit, a free city. He threatened that if the West would not comply with this, the soviets would hand over to the East Germany’s government the control over the roads to Berlin. In the coming months Moscow conducted a war of nerves as the last date of the end of the ultimatum, May 27, 1959, came close. Finally the Soviets retreated as a result of the determination of the West. This event reconfirmed the claims of the West that “the US, Britain and France have legal rights to stay in Berlin.” According to Halle: “These rights derive from the fact that Germany surrendered as a result of our common struggle against Nazi Germany.” (Note 2) The Russians have done many attempts to change Berlin’s status. In 1961 Berlin Wall was constructed, almost without response on the part of the West, and by so doing, the Soviets perpetuated the status quo that had been since 1948. In July 25, 1961 Kennedy addressed the Americans on television, saying that “West Berlin is not as it had ever been, the location of the biggest test of the courage and the will power of the West.” (Note 3) On June 26, 1963, Kennedy went out to Berlin, which was divided by the wall, torn between east and west, in order to announce his message. In his speech outside the city council of West Berlin, Kennedy won the hearts of the Berliners as well as those of the world when he said: “Ich bin ein Berliner”, I’m a Berliner. The sixties were years of heating of the conflict with the Soviet Block. In 1961 the Berlin Wall was constructed. Then Kennedy came into power, there was the movement for human rights and the political tension between whites and blacks in America. The conflict increase as the Korean War started, and afterwards when America intervened in Vietnam. There was also the crisis in the Bay of Pigs in Cuba, which almost pushed the whole world into a nuclear war and catastrophe. During the 28 years of the Berlin Wall, 13.8.61-9.11.89, this was notorious as an example of a political border that marked the seclusion and freezing more than freedom of movement, communication and change. At the same time there was the most obvious sign of the division of Germany after WWII and the division of Europe to East and West by the Iron Curtain. The wall was the background of stories by writers from east and west. The writers of espionage thrillers were fascinated by the global conflict between east and west and the Cold War with Berlin as the setting of the divided city. Berlin presented a permanent conflict that was perceived as endless, or as Mews defined it: “Berlin is perfect, a romantic past, tragic present, secluded in the heart of East Germany.” (Note 4) The city presented the writers with a situation that demanded a reassessment of the genres and the ideological and aesthetic perceptions of this type of writing. This was the reason that the genre of espionage books blossomed in the sixties, mainly those with the wall. The wall was not just a symbol of a political failure, as East Germany could not stop the flow of people escaping from it. The city was ugly, dirty, and full of wires and lit by a yellow light, like a concentration camp. A West German policeman says: “If the Allies were not here, there would not have been a wall. He expressed the acknowledgment that the Western powers had also an interest in the wall as a tool for preventing the unification of Germany. But his colleague answers: If they were not here, the wall would not have been, but the same applies for Berlin. (Note 5) Berlin was the world capital of the Cold War. The wall threatened and created risks and was known as one of the big justifications for the mentality of the Cold War. The construction of the wall in August 1961 strengthened Berlin’s status as the frontline of the Cold War and as a political microcosmos, which reflected topographical as well as the ideological global struggle between east and west. It made Berlin a focus of interest, and this focus in turn caused an incentive for the espionage literature with the rise of neorealism with the anti-hero, as it also ended the era of romanticism. (Note 6) The works of le Carré and Deighton are the best examples of this change in literature. Both of them use the wall as the arena of events and a symbol in their works. Only at the end of the fifties, upon the final withdrawal of McCarthyism and the relative weakening of the Cold War, there started have to appear films with new images about the position and nature of the Germans and the representations of Nazism in the new history. The films of the Cold War presented the communists as enemies or saboteurs. Together with this view about the Soviets, developed the rehabilitation of the German image. Each part of the German society was rehabilitated and become a victim instead of an assistant of the Nazis. The critic Dwight MacDonald was impressed by the way in which the German population” has changed from a fearful assistant of one totalitarian regime to the hero opponent of another totalitarian regime”. (Note 7) This approach has to be examined, and how it influenced the development of the German representation, since many films I have investigated demonstrate a different approach of the German representation.

Using Grey Wolf Optimization Algorithm and Whale Optimization Algorithm for Optimal Sizing of Grid-Connected Bifacial PV Systems

The shift towards renewable energies is driven by the shortage of fossil fuels for electricity generation and the associated harmful impacts. Grid-connected PV systems are a reliable and effective choice for power production across different uses, making them a key player in the global renewable energy landscape. Consequently, the careful selection of components for these systems is a crucial and widely studied aspect in this area of research. This paper introduced using gray wolf optimization algorithm GWO whale optimization algorithm WOA for determining the optimal number of grid - connected bifacial photovoltaic PV systems in Babylon Hilla. The considered factors included available space, desired energy production, radiation, dihedral factor, budget constraints, and grid connectivity requirements. The mathematical formulation of the problem and implementation details of the algorithms are presented. In addition, two cases studied are performed one for a residential area, and the other for a single house. The results demonstrated the efficiency and effectiveness of both algorithms in identifying optimal solutions for determining the size of systems in the area under study. However, the WOA surpassed the GWO in meeting the optimization criteria. The proper selection of these systems resulted in higher power generation, lower costs, improved energy management, and the advancement of sustainable solar energy solutions

Nationwide Assessment of Water Quality in Rivers across Lebanon by Quantifying Fecal Indicators Densities and Profiling Antibiotic Resistance of Escherichia coli

The use of contaminated water has been associated with severe disease outbreaks. Due to widespread pollution with untreated sewage, concerns have been raised over water quality in Lebanon, a country with well-documented challenges in infrastructure. Here, we evaluated the water quality of major rivers in Lebanon by quantifying the densities of fecal indicator bacteria (fecal coliforms and Escherichia coli). Additionally, we assessed the dissemination of antibiotic-resistant E. coli in river water. Composite water samples (n = 132) were collected from fourteen rivers, and 378 E. coli were isolated and analyzed. Fecal coliforms and E. coli were detected in 96.29% and 95.5% of the samples, respectively. Additionally, 73.48–61.3% and 31.81% of the samples exceeded the microbiological acceptability standards for irrigation and the fecal coliform limit for recreational activities, respectively. The E. coli exhibited resistance to ampicillin (40% of isolates), amoxicillin + clavulanic acid (42%), cefepime (4%), cefotaxime (14%), cefalexin (46%), cefixime (17%), doripenem (0.3%), imipenem (0.5%), gentamicin (6%), kanamycin (9%), streptomycin (35%), tetracycline (35%), ciprofloxacin (10%), norfloxacin (7%), trimethoprim-sulfamethoxazole (32%), and chloramphenicol (13%). Notably, 45.8% of the isolates were classified as multidrug resistant (MDR). Our results highlight the need to urgently address fecal pollution and the dissemination of antibiotic resistance in Lebanese rivers

Food Regulations and Enforcement in Qatar

Food safety and regulation are exceedingly important topics in the Gulf countries, including Qatar. The latter is influenced by a rapid population growth and constraints to local food production caused by a harsh climate and a limited water supply. This article provides an overview of the food regulatory framework and laws, guidelines, and associated enforcement in the state of Qatar. In addition, the fundamental food safety and labelling compliance requirements in the production and sale of food in Qatar are summarized

Bacillus subtilis NDmed, a model strain for biofilm genetic studies

The Bacillus subtilis strain NDmed was isolated from an endoscope washer-disinfector in a medical environment. NDmed can form complex macrocolonies with highly wrinkled architectural structures on solid medium. In static liquid culture, it produces thick pellicles at the interface with air as well as remarkable highly protruding ‘‘beanstalk-like’’ submerged biofilm structures at the solid surface. Since these mucoid submerged structures are hyper-resistant to biocides, NDmed has the ability to protect pathogens embedded in mixed-species biofilms by sheltering them from the action of these agents. Additionally, this non-domesticated and highly biofilm forming strain has the propensity of being genetically manipulated. Due to all these properties, the NDmed strain becomes a valuable model for the study of B. subtilis biofilms. This review focuses on several studies performed with NDmed that have highlighted the sophisticated genetic dynamics at play during B. subtilis biofilm formation. Further studies in project using modern molecular tools of advanced technologies with this strain, will allow to deepen our knowledge on the emerging properties of multicellular bacterial life