Extended Spectrum Beta-Lactamase Carriage State among Elderly Nursing Home Residents in Beirut

Introduction. ESBL-producing Enterobacteriaceae can cause severe infections, but they are also isolated from the stool of asymptomatic subjects. Faecal carriage of such organism is poorly understood. Methods. First phase of the study was cross-sectional with prevalence and epidemiology of ESBL faecal carriage in two nursing homes in Beirut: 57 residents in the first (NH1) and 151 residents in the second (NH2). In second phase, faecal swabs from cohort of NH1 residents were examined for carriage at six-week intervals over three-month period. Residents’ charts were reviewed to assess carriage risk factors. Results. Over 3 consecutive samplings at NH1, 81% of residents were at least one-time carriers with 50% at the first round, 60.4% at the second, and 74.5% at the last one. At NH2, 68.2% of residents were carriers. Constipation (in NH1) and antibiotic intake (in NH2) were significantly associated with higher ESBL faecal carriage while the length of stay at the nursing home (in NH2) was associated with less carriage. Conclusion. Faecal carriage of ESBL-producing Enterobacteriaceae is high among nursing home patients in Beirut. The rate of carriage changes rapidly and significantly over time either with multiple factors playing a possible role like outbreak spreading, antibiotic, and health care system exposure

Distributed computing in space-based wireless sensor networks

This thesis investigates the application of distributed computing in general and wireless sensor networks in particular to space applications. Particularly, the thesis addresses issues related to the design of "space-based wireless sensor networks" that consist of ultra-small satellite nodes flying together in close formations. The design space of space-based wireless sensor networks is explored. Consequently, a methodology for designing space-based wireless sensor networks is proposed that is based on a modular architecture. The hardware modules take the form of 3-D Multi-Chip Modules (MCM). The design of hardware modules is demonstrated by designing a representative on-board computer module. The onboard computer module contains an FPGA which includes a system-on-chip architecture that is based on soft components and provides a degree of flexibility at the later stages of the design of the mission.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A pilot Citizens' Assembly on Electricity and Energy Justice in Hamra, Lebanon

The Citizens’ Assembly Pilot (CA) on energy justice and electricity was a conceptual and a methodological experiment conducted over five sessions over three days in the neighborhood of Hamra and Beirut in October and November 2020. The CA aimed at exploring meanings, dimensions, priorities of energy justice in a deliberative democratic setting. The CA tackled five main questions: How did we get to where we are? What is energy justice to us? What is the energy-mix we would like to have? What do we need to be doing as individuals and communities to achieve a better energy future? How should we move forward with our decisions on the above questions? The responses produced interesting findings for researchers and international stakeholders to consider further; such as skepticism over renewable energy targets, the interest in circular solutions to solve multiple intersecting service sectors like waste and water in particular. It also raised questions over decentralization as well as privatization at different scales of governance

The Case for Proto-Semitic and Proto-Arabic Case: A Reply to Jonathan Owens

NWODescriptive and Comparative Linguistic

Stock Market Reaction to Cash Dividend Announcement: Evidence from Palestine

In this study, we used the event study methodology to examine if cash dividend announcements affect the stock prices of companies listed on the Palestine Exchange. We studied 62 events announced from 1/1/2006 to 31/12/2015. Appropriate statistical tests were used to examine if the cumulative abnormal return is statistically significant around the announcement day, namely, 10 days before and 10 days after the event day. Results reveal that statistically significant differences exist between cumulative abnormal returns and zero. Thus, investors could realize abnormal returns during the event window for the study period. The findings also indicate that a statistically significant negative relationship exists between dividend announcements and abnormal returns starting from the day of dividend announcement. We conclude that the market reacts negatively to cash dividends after disclosure. Keywords: event study, abnormal return, cash dividend, Palestine Exchange, stock market reactio

A hybrid multi objective cellular spotted hyena optimizer for wellbore trajectory optimization

Cost and safety are critical factors in the oil and gas industry for optimizing wellbore trajectory, which is a constrained and nonlinear optimization problem. In this work, the wellbore trajectory is optimized using the true measured depth, well profile energy, and torque. Numerous metaheuristic algorithms were employed to optimize these objectives by tuning 17 constrained variables, with notable drawbacks including decreased exploitation/exploration capability, local optima trapping, non-uniform distribution of non-dominated solutions, and inability to track isolated minima. The purpose of this work is to propose a modified multi-objective cellular spotted hyena algorithm (MOCSHOPSO) for optimizing true measured depth, well profile energy, and torque. To overcome the aforementioned difficulties, the modification incorporates cellular automata (CA) and particle swarm optimization (PSO). By adding CA, the SHO\u27s exploration phase is enhanced, and the SHO\u27s hunting mechanisms are modified with PSO\u27s velocity update property. Several geophysical and operational constraints have been utilized during trajectory optimization and data has been collected from the Gulf of Suez oil field. The proposed algorithm was compared with the standard methods (MOCPSO, MOSHO, MOCGWO) and observed significant improvements in terms of better distribution of non-dominated solutions, better-searching capability, a minimum number of isolated minima, and better Pareto optimal front. These significant improvements were validated by analysing the algorithms in terms of some statistical analysis, such as IGD, MS, SP, and ER. The proposed algorithm has obtained the lowest values in IGD, SP and ER, on the other side highest values in MS. Finally, an adaptive neighbourhood mechanism has been proposed which showed better performance than the fixed neighbourhood topology such as L5, L9, C9, C13, C21, and C25. Hopefully, this newly proposed modified algorithm will pave the way for better wellbore trajectory optimization

Meta-Analysis on the Effects of Octreotide on Tumor Mass in Acromegaly

<div><h3>Background</h3><p>The long-acting somatostatin analogue octreotide is used either as an adjuvant or primary therapy to lower growth hormone (GH) levels in patients with acromegaly and may also induce pituitary tumor shrinkage.</p> <h3>Objective</h3><p>We performed a meta-analysis to accurately assess the effect of octreotide on pituitary tumor shrinkage.</p> <h3>Data Sources</h3><p>A computerized Medline and Embase search was undertaken to identify potentially eligible studies.</p> <h3>Study Eligibility Criteria</h3><p>Eligibility criteria included treatment with octreotide, availability of numerical metrics on tumor shrinkage and clear definition of a clinically relevant reduction in tumor size. Primary endpoints included the proportion of patients with tumor shrinkage and mean percentage reduction in tumor volume.</p> <h3>Data Extraction and Analysis</h3><p>The electronic search identified 2202 articles. Of these, 41 studies fulfilling the eligibility criteria were selected for data extraction and analysis. In total, 1685 patients were included, ranging from 6 to 189 patients per trial. For the analysis of the effect of octreotide on pituitary tumor shrinkage a random effect model was used to account for differences in both effect size and sampling error.</p> <h3>Results</h3><p>Octreotide was shown to induce tumor shrinkage in 53.0% [95% CI: 45.0%–61.0%] of treated patients. In patients treated with the LAR formulation of octreotide, this increased to 66.0%, [95% CI: 57.0%–74.0%). In the nine studies in which tumor shrinkage was quantified, the overall weighted mean percentage reduction in tumor size was 37.4% [95% CI: 22.4%–52.4%], rising to 50.6% [95% CI: 42.7%–58.4%] with octreotide LAR.</p> <h3>Limitations</h3><p>Most trials examined were open-label and had no control group.</p> <h3>Conclusions</h3><p>Octreotide LAR induces clinically relevant tumor shrinkage in more than half of patients with acromegaly.</p> </div

Management of acromegaly in Latin America: expert panel recommendations

Although there are international guidelines orienting physicians on how to manage patients with acromegaly, such guidelines should be adapted for use in distinct regions of the world. A panel of neuroendocrinologists convened in Mexico City in August of 2007 to discuss specific considerations in Latin America. Of major discussion was the laboratory evaluation of acromegaly, which requires the use of appropriate tests and the adoption of local institutional standards. As a general rule to ensure diagnosis, the patient’s GH level during an oral glucose tolerance test and IGF-1 level should be evaluated. Furthermore, to guide treatment decisions, both GH and IGF-1 assessments are required. The treatment of patients with acromegaly in Latin America is influenced by local issues of cost, availability and expertise of pituitary neurosurgeons, which should dictate therapeutic choices. Such treatment has undergone profound changes because of the introduction of effective medical interventions that may be used after surgical debulking or as first-line medical therapy in selected cases. Surgical resection remains the mainstay of therapy for small pituitary adenomas (microadenomas), potentially resectable macroadenomas and invasive adenomas causing visual defects. Radiotherapy may be indicated in selected cases when no disease control is achieved despite optimal surgical debulking and medical therapy, when there is no access to somatostatin analogues, or when local issues of cost preclude other therapies. Since not all the diagnostic tools and treatment options are available in all Latin American countries, physicians need to adapt their clinical management decisions to the available local resources and therapeutic options

Arabic and contact-induced change

This volume offers a synthesis of current expertise on contact-induced change in Arabic and its neighbours, with thirty chapters written by many of the leading experts on this topic. Its purpose is to showcase the current state of knowledge regarding the diverse outcomes of contacts between Arabic and other languages, in a format that is both accessible and useful to Arabists, historical linguists, and students of language contact