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Levant Drought Occurrence, Lebanon Case

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Atmospheric and Climate Sciences 2024年第1期14卷 118-127页

作者： Ihab Jomaa Mariam choker Nisrine El Haj Marie Therese Abi saab Matteo Funaro Simone Mereu Department of Irrigation and AgroMeteorology (DIAM) of the Lebanese Agriculture Research Institute (LARI) Tal Amara Lebanon Climate and Water Unit Lebanese Agricultural Research Institute Fanar Lebanon CMCC—Centro Euro-Mediterraneo sui Cambiamenti Climatici IAFES Division Sassari Italy

Rainfall data is probably one of the longest-recorded climatic parameters in Lebanon. On the central coast of Lebanon, the Beirut weather station started collecting rainfall data in 1876. However, the recorded data is not available at one data provider source. Published data is found in historical documents but it reaches the early 1970s and then appears a data gap till 1990. Still the data is available, but it might be found to be saved privately. This study investigated the SPI variability on annual time scale between the years 1876 and 2021. The SPI was computed using R-Stat software to compare every year between 1876 and 2021. The majority (about 70% of the years) of the years are near normal in the precipitation rate. The Standardized Precipitation Index (SPI) demonstrated a normal distribution of years. Dry and wet years constitute about 15% of the total 146 years (1876-2021). Extremely dry years might appear in two consecutive years between 50 to 60 years count. After 1991, there were no wet years it was only near normal and few dry years. The last 30 years showed a trend of increasing drought years without any occurrence of wet years. This study demonstrated the importance of keeping records of at least rainfall data and it must be recorded on a daily basis or intensity on time. It is highly important on a managerial basis and for water security reasons to understand the drought event occurrence and investigate the changes in rainfall rates. Climate change scenarios always forecast a decrease in rainfall rates which will not appear without such studies.

关键词： Climate change Standardized Precipitation Index (SPI) Beirut Rainfall Gag-es

Editorial comment on:“Systemic treatment of hepatocellular carcinoma:an EASL position paper”

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 112-114页

作者： Daniel H.Ahn Tanios Bekaii-saab Division of Hematology/Medical Oncology Mayo Clinic ArizonaPhoenixAZUSA

Hepatocellular carcinoma is the most common cancer of the liver and worldwide,the sixth most common cancer and the third most common cause of cancer related deaths(1).The management and treatment of this disease requires a multi-disciplinary approach,which is observed in the staging and *** 1999,the development of the Barcelona Clinic Liver Cancer(BCLC)classification system helped to guide the appropriate treatments based on *** patients with stage A disease would be candidates for locoregional treatment including surgical resection,liver transplantation or liver directed therapy,treatment in patients with intermediate(B)or advanced(C)stage disease would be palliative,where the recommendation would for systemic therapy.

关键词： classification. treatment cancer

COVID-19 in Liver Transplant Recipients

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Journal of Clinical and Translational Hepatology 2021年第4期9卷 545-550页

作者： Ravina Kullar Ankur Prakash Patel Sammy saab Expert Stewardship Inc.Newport BeachCAUSA David Geffen School of Medicine at the University of California at Los Angeles Los AngelesCAUSA

Background and Aims:Coronavirus disease 2019(COVID-19)has infected over 93 million people worldwide as of January 14,*** studies have gathered data on liver transplant patients infected with ***,we discuss the presentation of COVID-19 in immunosuppressed patients with prior liver *** also evaluate patient outcomes after ***:We searched the PubMed database for all studies focused on liver transplant patients with ***:We identified eight studies that evaluated COVID-19 infection in liver transplant patients(n=494).Hypertension was the most prevalent comorbidity in our *** inhibitors were the most common immunosuppressant medications in the entire *** average time from liver transplant to COVID-19 infection in our cohort was 74.1 *** and cough,at 70%and 62%respectively,were the most common symptoms in our *** total,50%of the patients received hydroxychloroquine as treatment for *** next most prevalent treatment was azithromycin,given to 30%of patients in our *** total,80%of the patients were admitted to a hospital and 17%required intensive care unit-level care,with 21%having required mechanical *** mortality was 17%in our ***:Given the immunocompromised status of liver transplant patients,more intensive surveillance is necessary for severe cases of COVID-19 *** liver transplantations have been restricted during the COVID-19 pandemic,further investigation is warranted for studying the risk of COVID-19 infection in liver transplant patients.

关键词： COVID-19 Liver transplantation Immunosuppression

University-School Partnership in china:Teachers’Personal Factors,Working Conditions,and Principal Leadership That Explain Their Development in Teaching

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Frontiers of Education in china 2020年第4期15卷 621-646页

作者： Xin ZHANG Wilfried ADMIRAAL Nadira saab Graduate School of Teaching Leiden University2300 AX Leidenthe Netherlands

In china,the university-school partnership(USP)is a community of continuous professional development(PD)for teachers,involving teacher educators who visit *** study explores teachers’personal factors,school working conditions,and principal leadership in order to explain differences in teachers’learning when they have participated in the training *** a one-group pretest-posttest design,375 teachers from 12 primary schools in Shanghai *** learning performances are measured by changes in their teaching quality as evaluated by their *** of regression analyses show that teachers generally receive higher scores on teaching quality after the program than *** factors are significantly and negatively related to the changes in quality:teachers’educational level,the extent to which teachers feel emotional pressure in their profession,and the support from their school *** for school leaders and policymakers are discussed.

关键词： university-school partnership(USP) teaching quality principal leadership development in teaching professional development(PD) school working conditions

Diagnosis and Management of Obesity: A Joint Statement by Practicing Endocrinologists

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Journal of Diabetes Mellitus 2023年第2期13卷 77-92页

作者： Maya Barake Akram Echtay Kamal Hirbli ch.rles saab Rita Medlej Paola Atallah Division of Endocrinology Clemenceau Medical Center Beirut Lebanon Division of Endocrinology Rafic Hariri University Hospital Beer Hassan Beirut Lebanon Division of Endocrinology LAU Medical Center-Rizk Hospital Beirut Lebanon Division of Endocrinology Sacré-Coeur Hospital Beirut Lebanon Division of Endocrinology H&#244tel-Dieu de France Hospital-USJ University Hospital Beirut Lebanon Division of Endocrinology Saint George Hospital University Medical Center Beirut Lebanon

Obesity is not always recognized as a primary disease, leading to shortage of insurance coverage, clear dispositions about therapeutic strategies, prevention programs and legislation. Worldwide, physicians face the challenge to design affordable and effective treatments against obesity, to improve patient health and wellbeing and reduce the burden on healthcare systems. While international guidelines for obesity management are available, straightforward recommendations applicable in developing countries are needed. In order to develop local consensus recommendations, a panel of endocrinologists with experience in overweight and obesity convened and provided opinions about obesity aetiology, diagnosis, and management, in a structured discussion. Opinions were then developed into recommendations. There was unanimous agreement on recognizing obesity as a disease, which could be diagnosed by any trained physician and best managed by endocrinologists or obesity-trained physicians. The panel reiterated that lifestyle and behaviour changes remain the cornerstone of treatment;underscoring, however, the need for pharmacotherapy or bariatric surgery in some cases. They also identified stakeholders in the fight against obesity (ministries, third-party payers, healthcare providers and others). The establishment of an obesity registry was encouraged, which will pave the way for enhanced obesity research and prevention programs. These recommendations, endorsed by the World Obesity Federation, would be of interest to clinicians worldwide. .

关键词： Obesity Nutrition Clinical Management Developing Countries Consensus

Hepatitis C Screening: Barriers to Linkage to Care

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Journal of Clinical and Translational Hepatology 2019年第3期7卷 226-231页

作者： Sammy saab Youssef Pchallita Lisa MNajarian Rong Guo Satvir SSaggi Gina choi Departments of Surgery University of California at Los AngelesLos AngelesCAUSA Departments of Medicine University of California at Los AngelesLos AngelesCAUSA Departments of Medicine Statistics Core University of California at Los AngelesLos AngelesCAUSA

Background andAims:Hepatitis C(HCV)is a medical and public health *** infected individuals are identified,management includes not only education but also the use of antiviral *** screening for HCV is readily available,barriers exist which prevent assessment and treatment in individuals potentially infected with ***:This is a retrospective study of patients screened for HCV within the University of California,Los Angeles Health Care System between February 22 and July 9,*** defined linkage to care as:1)confirmatory HCV RNA test after screening HCV antibody test found a positive result;and 2)follow-up appointment for treatment was established with a *** and baseline laboratory values were *** potentially associated with prohibiting linkage of care were ***:During the study period,17,512 individuals were screened for HCV.A total of 238(1.35%)were found to have detectable HCV *** the individuals with detectable HCV antibodies,48(20%)did not undergo confirmatory testing with viral *** the 190 individuals who underwent further testing,70 patients were noted to be *** them,17 of the 70(24%)were not linked to a specialist for further *** patients(p=0.02)and people who inject drugs(p=0.02)were less likely to be referred for specialty ***:The results of our study highlight that younger patients and people who inject drugs are less likely to be referred to specialty care for HCV *** are needed to engage these populations.

关键词： Hepatitis C Screening Linkage

Human immunodeficiency virus and nodular regenerative hyperplasia of liver: A systematic review

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World Journal of Hepatology 2014年第1期6卷 55-63页

作者： Archita Sood Mariana Castrejón Sammy saab Department of Medicine Olive View Medical Center Department of Surgery University of California at Los Angeles Medical Center Departments of Medicine and Surgery University of California at Los Angeles Medical Center

AIM: To investigate the diagnosis, pathogenesis, natural history, and management of nodular regenerative hyperplasia(NRH) in patients with human immunodeficiency virus(HIV). METHODS: We performed a systematic review of the medical literature regarding NRH in patients with HIV. Inclusion criteria include reports with biopsy proven NRH. We studied the clinical features of NRH, in particular, related to its presenting manifestation and laboratory values. Combinations of the following keywords were implemented: "nodular regenerative hyperplasia", "human immunodeficiency virus", "noncirrhotic portal hypertension", "idiopathic portal hypertension", "cryptogenic liver disease", "highly active antiretroviral therapy" and "didanosine". The bibliographies of these studies were subsequently searched for any additional relevant ***: The clinical presentation of patients with NRH varies from patients being completely asymptomatic to the development of portal hypertension – namely esophageal variceal bleeding and ascites. Liver associated enzymes are generally normal and synthetic function well preserved. There is a strong association between the occurrence of NRH and the use of antiviral therapies such as didanosine. The management of NRH revolves around treating the manifestations of portal hypertension. The prognosis of NRH is generally good since liver function is preserved. A high index of suspicion is required to make a identify NRH. CONCLUSION: The appropriate management of HIVinfected persons with suspected NRH is yet to be outlined. However, NRH is a clinically subtle condition that is difficult to diagnose, and it is important to be able to manage it according to the best available evidence.

关键词： Human immunodeficiency virus Nodular regenerative hyperplasia Ascites Systematic review Liver complications

Risk of Cardiovascular Events in Patients with Primary Biliary cholangitis-Systematic Review

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Journal of Clinical and Translational Hepatology 2018年第2期6卷 119-126页

作者： Duminda Suraweera christina Fanous Melissa Jimenez Myron J.Tong Sammy saab Department of Medicine Olive-View Medical CenterSylmarCAUSA Department of Surgery at the University of California at Los Angeles Los AngelesCAUSA Huntington Research Institute PasadenaCAUSA Department of Medicine at the University of California at Los Angeles Los AngelesCAUSA

Background and Aims:Hypercholesterolemia is a common finding in patients with primary biliary cholangitis(PBC)and is a well-defined risk factor for cardiovascular ***,studies have been mixed on whether PBC patients do,in fact,have higher cardiovascular *** aim of this study is to review the current literature and provide an evidence-based assessment of cardiovascular risk in PBC ***:We performed a systematic literature search on PubMed re-garding patients with PBC and cardiovascular events from the database inception to July 1,2017.A total of 33 articles ful-filling our inclusion criteria were ***:The majority of the studies evaluated yielded no statistically significant dif-ference in cardiovascular disease in the PBC population com-pared to the general ***,some reports found a statistically significantly increase in coronary artery *** studies have looked at the specific lipid profile of pa-tients with PBC with *** these lipid ab-normalities differ by stage of disease,there is evidence to suggest that the specific lipid profile in PBC may have lower atherogenicity than in patients with hypercholesterolemia without *** looking at patients with PBC with other risk factors for cardiovascular disease,such as hypertension and metabolic syndrome,have consistently found a higher risk for cardiovascular disease in these *** treat-ment is effective in reducing lipid levels and possibly improv-ing endothelial inflammation in patients with PBC with ***:There is not enough evidence to suggest an increased risk of cardiovascular dis-ease in patients with PBC with hypercholesterolemia,except for those individuals with concomitant features of metabolic *** patients with PBC with no additional cardiovas-cular risk factors,individual risk/benefit discussion on lipid-lowering treatment should be considered.

关键词： Primary biliary cholangitis(PBC) Cardiovascular risk Hypercholesterolemia

Managerial Counseling

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chinese Business Review 2017年第9期16卷 429-435页

作者： saab Horriyah Manal Spanioli West University of Timisoara Timisoara Romania