Time In Lebanon Research Articles

Shortage of Plastic Surgeons in Lebanon: Impact of the 2019 Economic Crisis.

Lebanon's ongoing economic crisis since 2019 has seen an unprecedented migration of professional healthcare workers. This article analyzes the adequacy of registered plastic surgeons in Lebanon in 2023. A list of registered plastic surgeons was obtained from the Lebanese Order of Physicians. Registered plastic surgeons were contacted via email or phone and were asked to fill in a survey questionnaire addressing their work status. Additionally, the number of plastic surgeon graduates, between 2018 and 2022, was obtained from Lebanese medical schools. Of the 162 plastic surgeons registered with the Lebanese Order of Physicians in 2023, 158 responded to the survey (97.5%). The work settings of the active plastic surgeons fell into three categories: working in Lebanon full time, splitting work between Lebanon and abroad, and exclusively working abroad. The ratio of plastic surgeons practicing full time in Lebanon is 1.11 per 100,000 inhabitants, which is significantly below the recommended ratio of 2.01. Twenty eight percent of the plastic surgeons working in Lebanon are aged between 65 and 75 years. Meanwhile, an average of only three graduates (2018-2022) enter the workforce annually after completing training in plastic and reconstructive surgery residency. Among the various subspecialties within plastic and reconstructive surgery, aesthetic surgery was the most commonly practiced by those surveyed. There is a relative shortage of plastic surgeons in Lebanon that is compounded by a significant focus on aesthetic procedures. Implementation of strategies is needed to bridge this gap and meet the needs of the underserved people of Lebanon.

Bridging Turmoil and Transformation: A Comprehensive Review of the Lebanese Banking Sector from 2000 to 2018

This article provides a thorough analysis of the Lebanese banking industry from 2000 to 2018. It looks at the major innovations, difficulties, and changes that have shaped the sector and shed light on the technological, economic, and regulatory factors that affect how well it performs. This study offers insights into opportunities and challenges faced by Lebanese banks within the domestic and regional financial landscape by analyzing trends, policies, and reforms. Between 2001 and 2019, data from published Bilanbanques were gathered, and this information is now being used to build theoretical foundations, empirical models, and a practical understanding of banking systems in emerging economies. The article's importance stems from its coverage of a crucial time in Lebanon marked by political transitions, economic downturns, and regional instability. It highlights how banks navigated difficult times and underwent transformative changes by thoroughly examining the banking industry within this context. Lebanese banks remained liquid, managed risks, and embraced modernization despite the recessionary conditions, positioning themselves for further expansion. Their perseverance during political unrest and economic downturns highlighted depositors' and investors' confidence, which was supported by adherence to international best practices. The Lebanese banking industry played a crucial role as a financial intermediary, catalyst, and partner throughout the years under consideration, promoting the expansion and stability of the economy. It was able to investigate domestic and international expansion opportunities thanks to its strong financial position, dedication to ethical business practices, and commitment to risk management. The sector's performance demonstrates how important it is to Lebanon's economy, serving as a rock of confidence and support for customers and investors in the face of local and regional unrest.

New records of introduced species in the Mediterranean Sea (April 2023)

This Collective article reports 17 introduced species and 22 new locations for these species in the Mediterranean Sea. The reports are from three different Marine Strategy Framework Directive (MSFD) subregions (Aegean-Levantine Sea, Adriatic Sea and Western Mediterranean Sea) and the Sea of Marmara and cover ten different countries. The goal of consistent and detailed reporting of introduced species is to complement the existing species inventories and serve as a basis for establishing monitoring strategies and other conservation measures. Some of the reports from this article are the first species records for the Mediterranean Sea, namely the green alga Udotea flabellum from the Aegean Sea (Turkey) and the deepbody boarfish Antigonia capros from the Balearic Sea (Spain). In addition, new records of introduced species are included for different seas, namely the moon crab Matuta victor for the Aegean Sea (Greece), the whale shark Rhincodon typus and the lionfish Pterois miles for the Alboran Sea (Spain), the almaco jack Seriola rivoliana for the Tyrrhenian Sea (Italy), and the hound needlefish Tylosurus crocodilus for the Adriatic Sea (Italy). Furthermore, reports on first country records are included: the red alga Colaconema codicola from Slovenia, the nudibranch Melibe viridis from Bosnia and Herzegovina, the lionfish Pterois miles from Montenegro, and the goldstripe sardinella Sardinella gibbosa from Syria, which also represents a second record for the Mediterranean Sea. Furthermore, the occurrence of the scleractinian coral Oculina patagonica was noted in Gulf of Lion (France). Four polychaete species, namely Leodice antennata, Timarete punctata and Branchiomma bairdi, are reported from the vermetid reef habitat and two of them (L. antennata and B. bairdi) are also recorded for the first time in Lebanon. Evidence for established populations of the Asian date mussel Arcuatula senhousia in the Sea of Marmara (Turkey) and the rayed pearl oyster Pinctada radiata around the island of Sardinia (Italy) is provided.

Aspen Plus designing and optimizing the hospital wastewater treatment by wet air oxidation method

Healthcare establishments, pharma industries, and medical laboratories generate various waste materials, collectively called hospital or healthcare waste. Waste management regulations differ depending on the laws and acts adopted by the authorities and their level of compliance. For instance, in the United States of America, hospitals follow the rules set by the Environmental Protection Agency. In Europe, hospitals adhere to guidelines and standards set by the European Environmental Agency, while globally, the World Health Organization has established standardized policies and regulations. As a result, waste treatment technologies have become more prevalent for making medical waste non-infectious. These treatments include thermal treatment using microwave technologies (e.g., Wet air oxidation), steam sterilization, electro-pyrolysis, and chemical and mechanical systems. This research aims to model the treatment of hospital wastewater by wet air oxidation method using Aspen Plus for the first time in Lebanon. The simulation showed that the reaction conversion yield for thiols or mercaptans was 89.7% and 83.8% for sodium hydrosulfide, and the COD and BOD5 levels were reduced by 79.1% and 88%, respectively.

Martha Sharp Joukowsky, 1936–2022

Martha Sharp Joukowsky, 1936–2022

47 Effect of Summer Heat Stress on Internal Parasite Populations in Lebanese Baladi Goats

Abstract Gastrointestinal nematode (GIN) infections affecting ruminants pose serious problems whenever management systems are deficient with inappropriate nutrition and sanitation. The Lebanese Baladi goat, reared under very challenging transhumant conditions, is recently being challenged with nutrient availability due to the recent economic crisis. Therefore, prevalence of helminth parasites was studied in 90 Baladi does raised under three different management systems (Man) of intensive/managed (M), extensive/pastoral (P) or semi-intensive/agro-pastoral (AP). A 5-point score assessment of fat and muscle covering using Body Condition Score (BCS), anemic state revealed by conjunctivae mucosal color using FAMACHA, nostril discharge, stool character and bottle jaw edema were recorded twice for each system at two predetermined summer periods of heat stress (HS) with THI of 20 and 24 respectively, and fecal samples collected. Fecal nematode eggs (FEC) and protozoan oocyst count (FOC) were analyzed using a modified McMaster method. Results showed that BCS were not altered (P > 0.05) between heat stress periods, but decreased in M. FAMACHA did not differ (P > 0.05) between M, P and AP. All fecal samples tested showed strongyles nematodes, while 98% showed Eimeria spp. with occasional occurrence of Scrjabinema and Moniezia. Parasitic burden of GIN was low at 17%, while Eimeria was high at 98 %. Further, there was a significant (P < 0.001) Man x HS for HOTC, with 5-fold (P < 0.05) greater in AP but not M or P in late summer, indicating a contaminated and overgrazed agro-pastoral land. Though summer heat stress effect was not obvious on endoparasite prevalence in Lebanese Baladi goats, the confounding effects of resilience to GIN, nutritional and heat stress in these locally resilient goats require further investigation. This study reports, for the first time in Lebanon, the prevalence of GIN using the McMaster method and 5-point score in Local Baladi goats, and therefore these methods require further validation for on-farm use.

The relationship between self-leadership and employee engagement in Lebanon and the UAE: the moderating role of perceived organizational support

PurposeAs the work context is dynamically changing, enhancing employee engagement through personal and organizational means is still capturing the attention of organizations as well as human resources researchers and practitioners. Thus, the purpose of this paper is to examine the relationships between self-leadership, employee engagement, and perceived organizational support and to test the moderating effect of perceived organizational support.Design/methodology/approachData were collected through an online self-reporting questionnaire, with a total of 225 employees from Lebanon and 251 employees from the United Arab Emirates (UAE). Moderating analysis was conducted using Process v3.3 on both samples.FindingsResults have shown that self-leadership and perceived organizational support were positively related to employee engagement in both countries. However, perceived organizational support served to enhance self-leadership and employee engagement in the UAE, but not in Lebanon.Practical implicationsThe findings of this study can be used to help organizations as well as human resources and regional managers operating in the Middle East in giving insights about investing in self-leadership strategies and positively influence employee perception of organizational support to strengthen employee engagement.Originality/valueThis study is unique in exploring the moderating role of perceived organizational support on the relationship between self-leadership and engagement, and original in theoretically proposing and empirically examining the interaction between perceived organizational support and self-leadership. The context of the study in which the proposed relationships were tested for the first time in Lebanon and the UAE, is also novel as both countries are distinguished from other Middle Eastern countries.

First Record of Hooded Wheatear Oenanthe monacha in Lebanon 2021

The Hooded Wheatear Oenanthe monacha is a small insectivorous passerine (L 15 ½ - 17 cm) that was formerly classed as a member of the thrush family Turdidae, but is now more generally considered to be an Old World flycatcher, Muscicapidae. It has an extremely large range and a population that is suspected to be stable in the absence of evidence for any declines or substantial threats. It’s a resident breeder in unvegetated desert from eastern Egypt through the Arabian peninsula (it used to be in UAE and Oman a scarce breeder in Hajar mountains) to Iran and Pakistan. It occurs at elevations from sea-level to around 1,400 meters. This species is named for the distinctive white plumage on the top of the head and the back of neck, which resembles a hood. It also has a long thinnish beak, a large head and short legs. This bird was seen for the first time in Lebanon on the 17th of April 2021, in Hilan, Zgharta District, North Lebanon on an altitude of 400 meters, during a routine bird conservation patrol shift in the area.

Second Records of the Caspian Tern Hydroprogne caspia in Lebanon 2022

Caspian Tern Hydroprogne caspia is a monotypic, cosmopolitan species occurring in North America, North Europe, Africa, Madagascar, Asia, Australia, and New Zealand. There are only three European populations of approximately 4,500 breeding pairs along the coasts of the Caspian, Black, and Baltic Seas. It’s the largest of the terns, with a wingspan averaging. It has a body length of 48 - 56 cm, a weight of 570-780 gram and a wing span of 127-140 cm. Its size, stout red bill, and lack of a deeply forked tail distinguishes it from other white terns found in the state. Its black cap, large red bill, and tern-like habit of flying slowly with its bill pointed downward separates it from the gulls. The low harsh call of the Caspian tern sounds similar to karrr or kraa-ah and is given frequently while in flight. The orange feet of immature birds distinguish them from fall-plumaged adults which have black feet. Recently it was recorded for the first time in Lebanon in 15th of September 2021 and the second record was made in 18th of January 2022, both records were made by Michel Sawan in north Lebanon.

First Records of the Caspian Tern Hydroprogne caspia in Lebanon 2021

Caspian Tern Hydroprogne caspia is a monotypic, cosmopolitan species occurring in North America, North Europe, Africa, Madagascar, Asia, Australia, and New Zealand. There are only three European populations of approximately 4,500 breeding pairs along the coasts of the Caspian, Black, and Baltic Seas. It’s the largest of the terns, with a wingspan averaging. It has a body length of 48 - 56 cm, a weight of 570-780 gram and a wing span of 127-140 cm. Its size, stout red bill, and lack of a deeply forked tail distinguishes it from other white terns found in the state. Its black cap, large red bill, and tern-like habit of flying slowly with its bill pointed downward separates it from the gulls. The low harsh call of the Caspian tern sounds similar to karrr or kraa-ah and is given frequently while in flight. The orange feet of immature birds distinguish them from fall-plumaged adults which have black feet. Recently it was recorded for the first time in Lebanon in 15th of September 2021 at Cheikh Zennad, Akkar District, North Lebanon by Michel Sawan.

SEROTYPING AND ANTIMICROBIAL RESISTANCE OF SALMONELLA (Spp). ISOLATED FROM FOOD MATRICES AND CLINICAL SPECIMENS FROM LEBANON

Salmonella (spp) is a genus of bacteria responsible for the most frequently reported cases of foodborne illnesses worldwide. In this study, serotyping was done by using highly specific manufactured antisera, to identify circulating Salmonella serovars isolated from food samples and clinical specimens. Antibiotic susceptibility testing was also performed to determine the level of resistance of these serotypes. This was done by using the disk diffusion method by testing 14 clinically important antibiotics on the Salmonella (spp) isolates. A total of 85 Salmonella (spp) strains, preidentified by biochemical testing, were collected over the course of 1 year. Serotyping of the isolates revealed the presence of 14 serotypes in the food samples with S. Infantis and S. Enteritidis, being the most common and 6 serotypes in the clinical samples with S. Enteritidis and S. Typhimurium being the most common. Antimicrobial susceptibility testing results showed resistance of isolates from both sample types to conventional antibiotics like Ampicillin and Piperacillin, and almost total resistance of the food isolates to a broad-spectrum antibiotic Imipenem, belonging to the Carbapenem class. Higher resistance was observed in food samples than in clinical ones. Moreover, 13 and 3 multidrug resistant serotypes of Salmonella (spp) were identified for the first time in Lebanon in the food and clinical samples respectively, with three of them were isolated from imported food samples.

New Invasive Insects Associated with Oak Forests in Lebanon

Oak forests (Fagaceae) are native in Lebanonand occupy the largest areas of approximately 40,000 ha. The most common species are Quercus calliprinos, Q. infectoria, Q. cerris var. pseudo cerris andQ.brantii. Due to climate change and human activities, oak forests have become more vulnerable to native and exotic invasive pests. A total of 26insect species associated with oak trees were recently identified in Lebanon. The most dangerous insect pestisthe gypsy moth Lymantria dispar (Lepidoptera), onQ. calliprinos andQ. Cerris. The oak leafminer Phyllonorycter libanotica (Lepidoptera)and the Eriophidae(Accari) arethe most species recorded on Q. infectoriaand Q.calliprinosfollowed by the giant mealybug Ceroputo pilosellae(Hemiptera) on Q. infectoriaand Q.calliprinosandthe oak mothThaumetopoea sp.(Lepidoptera) on Q. calliprinos and Q. Cerris. Eightnew species were recorded for the first time in Lebanon on oak and are listed in this paper. Fivespecies of Cinipidae (Hymenoptera): Andricus caputmedusae, A. cecconi, A. sternlichti, Plagiotrochus quercusilicisand Neuroterus quercusbaccarum, one speciesof Scolytidae,Xylosandrus compactus(Coleoptera),one species ofKermesidaeKermes echinatus (Hemiptera)and one species of Diaspididae,Koroneaspis aegilopos(Hemiptera).Keywords: Lebanon, oak, forest decline, invasive species, outbreak

New records of vascular plants for the flora of Lebanon: a rare species rediscovered after seventy years, Daphne pontica L. (Thymelaeaceae), and three new occurrences, Atropa bella-donna L. (Solanaceae), Circaea lutetiana L. (Onagraceae), and Euonymus latifolius (L.) Mill. (Celastraceae)

During a series of surveys in two valleys of Mount Lebanon between 2014 and 2020, four new occurrences of vascular plants were detected. Atropa bella-donna L. (Solanaceae, Spermatophyte), Circaea lutetiana L. (Onagraceae, Spermatophyte), and Euonymus latifolius (L.) Mill. (Celastraceae, Spermatophyte) were recorded for the first time in Lebanon, while Daphne pontica L. (Thymelaeaceae, Spermatophyte), thought to be extirpated in Lebanon was rediscovered after 70 years. The updated distribution and ecology of these four Euro-Siberian elements, relics of the Quaternary glaciations, are presented.

Cesarean section rates in a tertiary referral hospital in Beirut from 2018 to 2020: Our experience using the Robson Classification.

To evaluate the cesarean section rate using the Robson Classification for the first time in Lebanon, at Hôtel-Dieu de France University Hospital, a tertiary referral center in Beirut. Routine medical record data that included all live births from January 1, 2018 to September 30, 2020 was investigated. The overall cesarean section rate was recorded, and the size, cesarean section rate, and absolute and relative contributions were calculated within each group. The overall cesarean section rate was 56.8%. The highest relative contribution to this rate came from Robson groups 5, 2 and 10, respectively. A decrease in cesarean section rate was noted in 2020 among women admitted for induction of labor (groups 2 and 4) following the implementation of new department policies and the restrictions caused by the coronavirus disease 2019 pandemic. More than 50% of the deliveries in our department were by cesarean sections (CS). Strategies to reduce this rate should include stricter departmental policies for avoidance of unindicated primary CS and raising practitioners' and patients' awareness about trial of labor after cesarean section.

The excuse is worse than the fault: It's time now to improve road safety in Lebanon

Road safety management and regulations have been neglected since a long time in Lebanon. Some efforts were made to reduce the number of casualties related to road crashes, but they were insufficient for curbing the evolution. With the increased population, the number of cars per household and the continuous deterioration of the country’s infrastructure, now it’s the time more than ever for the government to step up and put the appropriate measures the country needs. This paper examines the problems related to poor institutional, organizational and financial management of road safety in Lebanon. It focuses on the historical challenges and provides a critical analysis of road accidents statistics. It highlights the main actors fighting against road insecurity. It also seeks to provide an insight into how constrained funding and hindered policies may affect the effectiveness of the road safety management system. Finally, this article aims to raise awareness on road insecurity making the Lebanese government wanting to invest even more in improving the current situation.

Whole-genome characterisation of TEM-1 and CMY-2 β-lactamase-producing Salmonella Kentucky ST198 in Lebanese broiler chain

ObjectivesSalmonella enterica subsp. enterica serovar Kentucky has been associated with the worldwide ciprofloxacin-resistant (CIPR) Salmonella Kentucky sequence type 198 (ST198) epidemic clone, mostly recovered from poultry farms and products. The aim of this study was to examine whether this expanding clone exists in the Lebanese broiler chain. MethodsEight CIPR and extended-spectrum cephalosporin-resistant Salmonella Kentucky isolates previously recovered from Lebanese broilers were genetically characterised by whole-genome sequencing. ResultsSeven of the eight isolates belonged to ST198 and were phylogenetically closely related. They all harboured mutations in the chromosomal quinolone resistance genesgyrA and parC with double and single substitutions, respectively. The blaTEM-1B and blaCMY-2 genes were both detected in six isolates. Insertion sequence ISEcp1 was located upstream of blaCMY-2, harboured by IncI1 plasmids in four strains. An IS10 transposition coupled to homologous recombination at transposition sites mediated CMY-2 plasmid integration into the chromosome of one strain. Resistance genes to aminoglycosides [aadA7 and aac(3)-Id], tetracyclines [tet(A)] and sulfonamides (sul1) were detected in five strains, among which four were positive for the presence of Salmonella genomic island 1 (SGI1) variant SGI1-K. All studied isolates harboured a variety of Salmonella pathogenicity islands (SPIs) as well as common regulatory and virulence genes. ConclusionHere we report for the first time in Lebanon the detection and dissemination of the emerging highly drug-resistantSalmonella Kentucky ST198. Our findings shed new light on this clone as a potential public-health threat.

First Detection of Tobacco Mosaic Virus in Tobacco Fields in Northern Lebanon.

Tobacco mosaic virus (TMV) is the most known virus in the plant mosaic virus family and is able to infect a wide range of crops, in particular, tobacco, causing a production loss. Herein, and for the first time in Lebanon, we investigated the presence of TMV infection in crops by analyzing 88 samples of tobacco, tomato, cucumber and pepper collected from different regions in North Lebanon. Double-antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA), revealed a potential TMV infection of four tobacco samples out of 88 crop samples collected. However, no tomato, cucumber and pepper samples were infected. The TMV+ tobacco samples were then extensively analyzed by RT-PCR to detect viral RNA using different primers covering all the viral genome. PCR results confirmed those of DAS-ELISA showing TMV infection of four tobacco samples collected from three crop fields of North Lebanon. In only one of four TMV+ samples, we were able to amplify almost all the regions of viral genome, suggesting possible mutations in the virus genome or an infection with a new, not yet identified, TMV strain. Our study is the first in Lebanon, revealing TMV infection in crop fields and highlighting the danger that may affect the future of agriculture.

Spoligotyping of Mycobacterium tuberculosis isolates using Luminex®-based method in Lebanon.

Data about the genotypes of circulating Mycobacterium tuberculosis isolates (MTB) in Lebanon are scarce. This study was undertaken to reveal the spoligotypes of MTB isolates recovered from patients in Lebanon. MTB isolates from 49 patients living in Lebanon were recovered and identified. The samples were heat killed and subjected to DNA extraction. Spoligotyping was performed using microbeads from TB-SPOL Kit and the fluorescence intensity was measured using Luminex 200®. Generated patterns were assigned to families using the SITVIT2 international database of the Pasteur Institute of Guadeloupe and compared. The spoligotyping of the 49 MTB isolates revealed that 31 isolates belonged to Lineage 4 (Euro-American, 63.3%), 12 to Lineage 3 (East- African Indian, 24.5%), 3 to Lineage 2 (East Asian, 6%) and 2 were unknown. Over half of the genotypes (16 of 30) harbored SIT127 supposed to belong to the L4.5 sublineage. One isolate belonging to the rare Manu-Ancestor SIT523 was recovered for the first time in Lebanon, being associated with highly virulent extensively drug-resistant (XDR) MTB phenotype. The application of the Spoligotyping Multiplex Luminex® method is an efficient, discriminatory and rapid method to use for first-lane genotyping of MTB isolates. Though humble numbers were tested, this study is one of the first to describe the genomic diversity and epidemiology of MTB isolates of Lebanon, and suggests an increasing prevalence of SIT127 in the country.

PM2.5 characterization of primary and secondary organic aerosols in two urban-industrial areas in the East Mediterranean

Primary and secondary organic aerosols in PM2.5 were investigated over a one-year campaign at Zouk Mikael and Fiaa, Lebanon. The n-alkanes concentrations were quite similar at both sites (26-29 ng/m3) and mainly explained by anthropogenic emissions rather than natural ones. The concentrations of total Polycyclic Aromatic Hydrocarbons (PAHs) were nearly three times higher at Zouk Mikael (2.56 ng/m3) compared to Fiaa (0.95 ng/m3), especially for indeno[1,2,3-c,d]pyrene linked to the presence of the power plant. A characteristic indeno[1,2,3-c,d]pyrene/(indeno[1,2,3-c,d]pyrene + benzo[g,h,i]perylene) ratio in the range 0.8-1.0 was determined for heavy fuel oil combustion from the power plant. Fatty acids and hopanes were also investigated and were assigned to cooking activities and vehicular emissions respectively. Phthalates were identified for the first time in Lebanon with high concentrations at Zouk and Fiaa (106.88 and 97.68 ng/m3 respectively). Moreover, the biogenic secondary aerosols revealed higher concentrations in summer. The total terpene concentration varied between 131 ng/m3 at Zouk Mikael in winter to 469 ng/m3 at Fiaa in summer. Additionnally, the concentrations of the dicarboxylic acids especially for adipic and phthalic acids were more influenced by anthropogenic sources.The analysis of molecular markers and diagnostic ratios indicated that the sites were strongly affected by anthropogenic sources such as waste open burning, diesel private generators, cooking activities, road transport, power plant, and industrial emissions. Moreover, results showed different pattern during winter and summer seasons. Whereas, higher concentrations of biogenic markers were clearly encountered during the summer period.

Syntaxonomy of open oak forests on basalt formations in north Lebanon

This phytosociological study of the Dreib Region in Akkar-Lebanonis the first on basaltic bedrockin Lebanon. Thesynusial methods isused and compared bynumerical classification. The latter shows satisfactory results when compared to the synusial manual classification. The followingplant associations are defined:Quercetum veneris–ithaburensis, Calicotomo villosae –Rhamnetum punctati, Eryngio cretici –Echietum angustifolii and Sileno aegyptiacae –Isatidetum lusitanicae.Consequently, the alliance Quercion ithaburensi is stated for the first time in Lebanon. Vegetationseries for progressive and regressive successions are also produced. Further relevés are required to consolidate additional associations that are depicted from both synusial and numerical vegetation classifications.