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Jonathan Wright is a British journalist and literary translator, known for bringing many works of Arab fiction to new audiences via translation for the past fifteen years. His recent works, however, seem more connected to Iraq: in addition to The Iraqi Christ by Hassan Blasim and Frankenstein in Baghdad by Ahmed Saadawi, he has translated The Book of Collateral Damage by Sinan Antoon (Yale University Press, 2020) and God 99 by Blasim (Comma Press, 2020). Jonathan is currently working on a semi-biographical novella by Iraqi writer Ali Bader and on works by Palestinian activist and fiction writer Ghassan Kanafani yet to be translated or retranslated, into English. In this interview, Ruth Abou Rached and Jonathan Wright discuss the experiences of Wright translating Iraqi and Arabic fiction and Wright offers his thoughts and recommendations.

The moduli space of Abelian differentials on Riemann surfaces admits a natural action by $\mathrm{SL}\left(2,\mathbb{R}\right)$. This thesis is concerned with using the classification of invariant measures for this action due to Eskin and Mirzakhani, to study the growth of closed geodesics in the support of an invariant measure coming from the closure of an orbit for the $\mathrm{SL}\left(2,\mathbb{R}\right)$-action. These are always subvarieties of moduli space. For $0 \leq \theta \leq 1$, we obtain an exponential bound on the number of closed geodesics in the orbit closure, of length at most $R$, that have at least $\theta$-fraction of their length in a region with short saddle connections.

People who inject drugs (PWIDs) are prone to a number of blood-borne viral infections. Hepatitis B virus (HBV) and hepatitis C virus (HCV) constitute an important public health concern in this high risk group.We aimed to determine the prevalence of HBV and HCV antibody among PWIDs in Lebanon.We conducted a prospective cross-sectional study between June 2015 and June 2016 on PWIDs recruited through Lebanese nongovernmental organizations in collaboration with the Lebanese Ministry of Public Health. The participants were tested for HBs antigen and HCV antibody using rapid test kits. The prevalence of each virus was then calculated. The correlation between both infections and other possible risk factors was also analysed.A total of 250 people were included in our study, of whom 98% were males. Mean age was 31.9 (standard deviation 8.7) years. The prevalence of HBsAg and anti-HCV among PWIDs was 1.2% and 15.6%, respectively. Older age, longer duration of drug use and lack of awareness were significantly correlated with a higher rate of HCV infection (P0.01). The high rate of needle sharing among our PWIDs significantly affected the prevalence of anti-HCVAb.PWIDs remain the subpopulation most affected with chronic HCV in Lebanon.معدل انتشار فيروس التهاب الكبد B وفيروس التهاب الكبد C في صفوف الأفراد الذين يتعاطون المخدرات حقنا في الفئات السكانية في لبنان.أنطوان أبو راشد، ماري نخول، كارين ريكا، عفيف جريج، بيير أبي حنا، وليد عمار.إن الأشخاص الذين يتعاطون المخدرات حقنا معرضون للإصابة بعدد من العداوى الفيروسية المنقولة عن طريق الدم. ويشكل فيروس التهاب الكبد B وفيروس التهاب الكبد C مصدرا للقلق البالغ على مستوى الصحة العامة ضمن هذه الفئة المعرضة لخطر مرتفع.هدفنا إلى تحديد معدل انتشار فيروس التهاب الكبد B وفيروس التهاب الكبد C في صفوف الأشخاص الذين يتعاطون المخدرات حقنا في لبنان.أجرينا دراسة استباقية مقطعية بين يونيو/حزيران 2015 و يونيو/حزيران 2016 على الأشخاص الذين يتعاطون المخدرات حقنا، والذين حشدتهم المنظمات غير الحكومية اللبنانية بالتعاون مع وزارة الصحة العامة في لبنان. وخضع المشاركون في اختبار لمستضدات التهاب الكبد B وأضداد فيروس التهاب الكبد C باستخدام عتائد الاختبار السريع. ثم تم احتساب معدل انتشار كل فيروس على حدة. كما جرى تحليل العلاقة الارتباطية بين كلا النوعين من العدوى وعوامل خطر أخرى محتملة.ضمت الدراسة عددا إجماليا بلغ 250 شخصا، %98 منهم من الذكور. وكان متوسط العمر 31.9 سنة (بانحراف معياري 8.7). وبلغ معدل انتشار مستضدات التهاب الكبد B وأضداد فيروس التهاب الكبد C في صفوف الأشخاص الذين يتعاطون المخدرات حقنا %1.2 و %15.6 على التوالي. وظهر ارتباط قوي بين كل من تقدم العمر، واستطالة مدة تعاطي المخدرات، ونقص الوعي بارتفاع معدل الإصابة بعدوى فيروس التهاب الكبد C(0.01P). وأدى ارتفاع معدل التشارك في استخدام الإبر في صفوف الأشخاص الذين يتعاطون المخدرات حقنا في لبنان إلى التأثير بصورة يُعتدُّ بها على معدل انتشار أضداد فيروس التهاب الكبد C.يظل الأشخاص الذين يتعاطون المخدرات حقنا هم الفئة الفرعية من السكان الأشد تأثرا بالتهاب الكبد C المزمن في لبنان.Prévalence des virus de l’hépatite B et de l’hépatite C chez les consommateurs de drogues injectables dans la population libanaise.Les consommateurs de drogues injectables sont exposés à un certain nombre d’infections virales transmises par le sang. Les virus de l’hépatite B (HBV) et de l’hépatite C (HCV) constituent une préoccupation de santé publique majeure dans ce groupe à risque élevé.La présente étude avait pour objectif de déterminer la prévalence du HBV et du HCV chez les consommateurs de drogues injectables au Liban.Entre juin 2015 et juin 2016, nous avons mené une étude transversale prospective sur des consommateurs de drogues injectables recrutés par l’intermédiaire d’organisations non gouvernementales libanaises, en collaboration avec le ministère de la Santé publique libanais. Les participants ont été soumis à des tests de dépistage des antigènes de surface de l’hépatite B et des anticorps anti-HCV à l’aide de kits de dépistage rapide. La prévalence de chaque virus a ensuite été calculée. La corrélation entre les deux infections et d’autres facteurs de risque possibles a également été examinée.Au total, 250 personnes ont été incluses dans l’étude, dont 98 % d’hommes. L’âge moyen était de 31,9 ans (écart type 8,7). La prévalence des antigènes de surface du virus de l’hépatite B et des anticorps anti-HCV, parmi les consommateurs de drogues injectables, était respectivement de 1,2 % et de 15,6 %. On a observé une corrélation significative entre l’âge, une durée plus longue de consommation de drogue, le manque de sensibilisation et le taux plus élevé d’infection à HCV (p0,01). Le taux élevé de partage de seringues chez les consommateurs de drogues injectables avait une incidence significative sur la prévalence des anticorps anti-HCV.Les consommateurs de drogues injectables restent la sous-population la plus touchée par l’hépatite C chronique au Liban.

Introduction The pandemic of coronavirus disease 2019 (COVID-19) has caused over four million deaths, depleting resources and healthcare workers; therefore, in an attempt to stratify patients, the relationship between liver enzymes and clinical outcome was studied. This study aimed to assess the pattern and impact of liver enzymes on the clinical outcome of hospitalized patients with COVID-19 in Lebanon and look for possible confounding factors. Methodology This was a single-centered retrospective cohort study conducted between December 2020 and March 2021 on 230 patients diagnosed with COVID-19. Liver function tests (LFTs) and other laboratory values on admission and peak hospitalization were analyzed using SPSS. Results The prevalence of abnormal liver tests among the sample population with severe COVID-19 infection were as follows: aspartate aminotransferase (AST), 77%; alanine aminotransferase (ALT), 49%; alkaline phosphatase (ALP), 12%; and gamma-glutamyl transferase (GGT), 37%. A severe COVID-19 infection was more likely present in patients with abnormal levels of AST (p = 0.015), ALP (p = 0.03), and GGT (p = 0.022). ANOVA test revealed no significant relationship between AST levels at peak hospitalization and the treatments received by the patient. Conclusion Abnormal liver function tests of patients at admission may be an indicator of more severe disease. In the context of scarce resources created by the pandemic, it becomes essential to establish a reliable predictor for a severe outcome of COVID-19 infection and manage accordingly.

A translation of Ibn Khaldun’s Journey (1406), including commentary.

Histiocytosis is a condition resulting from the abnormal proliferation of dentritic cells of the mononuclear phagocytic system. Previously classified as Langerhans cell histiocytosis and non-Langerhans cell histiocytosis, and recently into 5 categories (L, C, R, M and H), it can be localized to an organ or have a systemic manifestation, affecting most commonly the bone, skin and lymph nodes. Gastrointestinal involvement is extremely rare especially for the non-Langerhans group. We report a rare case of a non-Langerhans cell histiocytosis affecting the rectum, manifesting as a large, nodular, ulcerated, continuous lesion found during a colonoscopy, in an elderly man with initial presentation of rectorrhagia and abdominal pain. The importance of this case report is to highlight the manifestations of digestive involvement by a non-Langerhans histiocytosis, in addition to the characteristic features of histiocytosis on trans-rectal endoscopic ultrasound.

Giant inflammatory polyps (GIPs) are a rare complication of IBD resulting from chronic regenerative and healing processes leading to a polypoid formation on inflamed mucosa. We reported a case of GIP in a patient with long standing left-sided ulcerative colitis (UC); a well circumscribed sessile GIP was found during a colonoscopy for colorectal cancer screening on a normal colonic mucosa in the cecum. After a severe flare of the left-sided colitis and due to partial response to steroids patient was treated with adalimumab; new colonoscopy after 6 months shows complete disappearance of the GIP previously described. It is the first case report of GIP in normal macroscopic mucosa with complete disappearance after biologic treatment.

BACKGROUND Proton pump inhibitors (PPIs) are the most potent gastric agents for most acid-related disorders. Their effectiveness has led to their overutilization, leading to potential risks on patients and significant economic implications. The aim of this study was to determine the frequency of PPI overuse in Lebanon. Hence, the economic impact of this overutilization, if proven to be present, can be inferred. METHODS An epidemiological descriptive cross-sectional study was conducted in pharmacies all around Lebanese governorates over a 1-year period, using questionnaires handed out to 1000 participants coming to buy PPIs. Subjects taking PPIs for inappropriate indications or in inappropriate dosages or durations were considered abusing PPIs. PPIs are indicated for multiple gastric disorders and for prophylaxis of gastrointestinal injury when taking gastro-toxic medications. RESULTS 71.4% of subjects were overusing PPIs. Approximately 25 million US dollars were being wasted annually. Three categories of overuse were inferred (indication, dosage, and duration). Gastro protection was the most common reason for taking PPIs. Demographic variables and doctors’ prescriptions did not influence PPI overuse. CONCLUSION PPIs are massively overused in Lebanon, leading to a huge burden on the health care system. Adhering to evidence-based guidelines and educational programs is highly recommended to enhance the quality and efficiency of prescriptions.

PubMed: 29599078, 2-s2.0-85044540918, Background: The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods: In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Findings: We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3·9% (95% uncertainty interval [UI] 3·4–4·6), corresponding to 291 992 000 (251 513 000–341 114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4·8 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1·8 (1·6–2·2) million infections were in children aged 5 years, with a prevalence of 1·4% (1·2–1·6). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birth-dose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation: Our estimate of HBV prevalence in 2016 differs from previous studies, potentially because we took into account the effect of infant prophylaxis and early childhood vaccination, as well as changing prevalence over time. Although some regions are well on their way to meeting prophylaxis and prevalence targets, all regions must substantially scale-up access to diagnosis and treatment to meet the global targets. Funding: John C Martin Foundation. © 2018 Elsevier Ltd, H28-kansei-ippan-001 National Academy of Sciences, NAS Novartis Roche World Health Organization, WHO Gilead Sciences Alnylam Pharmaceuticals AbbVie Meso Scale Diagnostics, MSD British Microcirculation Society, BMS Japan Society for the Promotion of Science, JSPS: 17H03589 Ministry of Health, Labour and Welfare, MHLW Vetenskapsrådet, VR Siemens Universiteit Antwerpen OLL-683801, DR-S, IGa, SB, SMB, CE, KM, HMN, KP, KR-S, SR, JDS, and HR report grants from John C Martin Foundation, during the conduct of the study, and grants from Gilead Sciences, AbbVie, WHO, National Academy of Sciences, Intercept Pharmaceuticals, and Boehringer Ingelheim, outside the submitted work. MHN reports grants and personal fees from Bristol-Myers Squibb (BMS), Gilead Sciences, and Janssen, and personal fees from Novartis, Anylam, and Dynavax, outside the submitted work. PVD acts as chief and principal investigator for vaccine trials done on behalf of the University of Antwerp, Belgium, for which the University obtains research grants from vaccine manufacturers; speaker's fees for presentations on vaccines are paid directly to an educational fund held by the University of Antwerp, and PVD receives no personal remuneration for this work. ACA reports personal fees from Mylan Pharmaceuticals, outside the submitted work. JEA reports fees paid to his hospital for participation on the advisory boards of Gilead Sciences, ViiV Healthcare, BMS, Janssen, and AbbVie, and grants from BMS, Merck Sharp & Dohme (MSD), AbbVie, and ViiV Healthcare, outside the submitted work. TB reports grants, personal fees, and non-financial support from AbbVie and Gilead Sciences; grants and personal fees from BMS, Janssen, Roche, MSD, and Sequana Medical; and personal fees from Bayer, Vertex, Tibotec, Intercept, Sirtex, and Alexion, outside the submitted work. PB reports grants and personal fees from AbbVie, Gilead Sciences, and MSD, outside the submitted work. MBr reports personal fees from BMS, Gilead Sciences, and Janssen, and grants from BMS, outside the submitted work. HLYC reports personal fees from Gilead Sciences, BMS, AbbVie, Roche, MedImmune, and Intellia, outside the submitted work. PBC reports grants from AbbVie, Gilead Sciences, and MSD, outside the submitted work. VC reports personal fees from AbbVie, BMS, Gilead Sciences, and MSD, and grants from BMS, outside the submitted work. MCor reports personal fees from AbbVie, BMS, Boehringer Ingelheim, Biogen Idec, Falk Foundation, Gilead Sciences, Janssen, MSD, Roche Diagnostics, Roche Pharma, and Siemens, outside the submitted work. SD and PJ report personal fees and non-financial support from AbbVie and Gilead Sciences, and personal fees from MSD, outside the submitted work. MHE-S is an advisory board member for Perspectum Diagnostics, and reports grants and non-financial support from Gilead Sciences, and non-financial support from AbbVie and Quadri Pharma, outside the submitted work. RF reports grants, personal fees, and non-financial support from Roche and Gilead Sciences, and personal fees and non-financial support from BMS, outside the submitted work. GBG reports grants and personal fees from Gilead Sciences, outside the submitted work. JG-S reports grants and personal fees from Gilead Sciences, and personal fees from MSD, Abbvie, Janssen, and BMS, outside the submitted work. JGer reports grants and personal fees from AbbVie, Gilead Sciences, Janssen, MSD, BMS, and ViiV Healthcare, outside the submitted work. RG reports grants from New South Wales Ministry of Health and provided project advice regarding viral hepatitis treatment to Gilead Sciences, outside the submitted work. AHa reports unrestricted grants from AbbVie, MSD, Gilead Sciences, BMS, and Novartis, and non-financial support from Gilead Sciences, outside the submitted work; he was also on advisory boards for AbbVie, Gilead Sciences, and BMS. CH reports personal fees from AbbVie, BMS, Gilead Sciences, Janssen, and MSD, outside the submitted work. JJ reports personal fees and non-financial support from Gilead Sciences and AbbVie, and personal fees from Roche and BMS, outside the submitted work. MK reports grants from Roche, Siemens, Hologic, and Boerhinger Ingleheim, outside the submitted work. JVL reports grants and personal fees from Gilead Sciences and personal fees from Cepheid, outside the submitted work. MMan reports personal fees from Roche, BMS, GlaxoSmithKline, Aevi Genomic Medicine, ENYO Pharma, and CureVac, and grants and personal fees from Gilead Sciences and Novartis, outside the submitted work. SMau reports personal fees and non-financial support from Gilead Sciences and BMS, outside the submitted work. CM reports grants and personal fees from AbbVie, Gilead Sciences, and BMS; personal fees from MSD; and grants from Roche, outside the submitted work. BM reports grants and personal fees from Gilead Sciences and personal fees from AbbVie, MSD, BMS, Bayer, Intercept, and Sigma-Tau, during the conduct of the study. FN reports personal fees and non-financial support from Gilead Sciences, during the conduct of the study. AR reports grants and personal fees from AbbVie, Gilead, and MSD, and personal fees form BMS, Celgene, Janssen, Intercept, and Lupin, outside the submitted work. HWR reports grants and personal fees from AbbVie, BMS, Boehringer Ingelheim, ENYO Pharma, Gilead Sciences, Janssen, MSD, PRA Health Sciences, Regulus, and Roche; personal fees from Alnylam and R-Pharm; and grants from Replicor, outside the submitted work. LRR reports grants from the Center for Clinical and Translational Science and the Swedish Research Council (Ghana), during the conduct of the study. LRR also reports grants from Gilead Sciences, BTG, Ariad, and Wako, outside the submitted work, and was a consultant and advisory board member for Wako, Medscape, Axis, OncLive, Bayer, Tavec, and Grail. SDR has served as an advisory board member and speaker for Gilead Sciences, AbbVie, and MSD. OS has served as a consultant and on advisory boards for MSD; received research grants from AbbVie, BMS, MSD, Boehringer Ingelheim, R-Pharm, and Hepatera; and served as a speaker for Abbott, AbbVie, BMS, Gilead Sciences, Janssen, MSD, and R-Pharm. JFS-A reports personal fees from AbbVie and grants from Gilead Sciences and Janssen, outside the submitted work. CSa reports personal fees from Gilead Sciences and BMS, outside the submitted work. PS reports grants and personal fees from Gilead Sciences, AbbVie, and BMS, and personal fees from Intercept, outside the submitted work. CSt has consulted with and served on advisory boards for Gilead Sciences, AbbVie, and MSD. VSy reports grants and personal fees from Gilead Sciences, personal fees and non-financial support from AbbVie, and personal fees from Janssen, outside the submitted work. KT reports grants and personal fees from AbbVie, Gilead Sciences, and BMS; personal fees from MSD and Alfa Wasserman; and grants from Janssen, outside the submitted work. AJvdM reports grants and personal fees from Gilead Sciences and personal fees from AbbVie, outside the submitted work. IW reports personal fees from AbbVie, Gilead Sciences, Janssen, Marcyrl, Mylan, Onxio, and Pharco, outside the submitted work. NW reports personal fees paid to her department from AbbVie, BMS, Gilead Sciences, and MSD, outside the submitted work. VWW reports personal fees from Gilead Sciences, BMS, and MSD, outside the submitted work. M-FY was a speaker or advisory board member for AbbVie, BMS, Gilead Sciences, Roche, GlaxoSmithKline, Fujirebio, Biocartis, and MSD, outside the submitted work. SZ reports consultancy and lecture fees from AbbVie, Gilead Sciences, and MSD, and consultancy fees from Intercept, outside the submitted work. All other authors declare no competing interests., This study was funded by the John C Martin Foundation through the Polaris Observatory. We thank the Research on Hepatitis group (H28-kansei-ippan-001 and H25-kanen-ippan-010; led by JT), funded by the Ministry of Health, Labour and Welfare of Japan, for their provision of country-level data for Japan, and Örebro County Council for providing ALF grants (OLL-683801) to A-SD, which allowed collection of country-level data for Sweden.

Iraqi women writers have worked for decades to make Iraqi women and Iraqis visible and heard, including via pathways of translation. The pathways of their stories into English are nuanced and varied, as are the politics of literary expression interweaving them. In this chapter, I focus on Alia Mamdouh’s novel Open image in new window [Mothballs] (1986/2000), the first novel by an Iraq woman writer to be published twice in English translation. The first version, Mothballs (1995) translated by Peter Theroux, was published in the UK as part of the Arab Women’s Writer Series, edited by Fadia Faqir. The second version was published by New York Feminist Press (NYFP) in 2005 as: Naphtalene: A Novel of Baghdad: still Peter Theroux’ translation but with dramatically different paratexts in terms of blurb, foreword and afterword. The changing representations of Mamdouh’s story in English (para) translation raises questions on what may have impacted on how this story came to be re-packaged twice: whose voices creating the story appear to be foregrounded in each version’s paratexts, that is the materials surrounding the story? Which voices do we have to work harder to see or hear? How are the politics of this novel re-presented in each English-language version? To guide my exploration of such questions, I draw on the notion of feminist paratranslation, an analytical framework of feminist translation which focuses on paratexts while interrogating the geopolitical scope of doing so. I also show how we can revisit the nuances of Mamdouh’s iconic novel and why it still calls to be read, in whichever language or version that we find it.

Background and study aims Gastrointestinal (GI) cancer is one of the top five common cancers in Lebanon. To implement a strategy for screening and early diagnosis through the initiation of prevention programs, a detailed study of GI cancers in Lebanon was conducted by focusing on the frequency and characteristics of each type. Patients and Methods This retrospective study was conducted in Lebanon between 2001 and 2015 and included patients diagnosed with different GI cancer types. Data were collected from the registry of the National Institute of Pathology (NIP). The frequency of each type was calculated according to sex, age at diagnosis, anatomic location, histological type, and stage. Results The total number of patients diagnosed with GI cancers who had their histology done at the NIP between 2001 and 2015 was 5239. The sex (male/female) ratio was 1.016, with a mean age of 62.2 years. Colorectal cancer ranked first among GI cancers, with more than half of the cases (53.4%). More than 70% of the cases were located on the left side, followed by gastric (15.5%) and pancreatic (12.7%) cancers. Regarding gastric cancer, cardia became the dominant location. A shift from squamous cell carcinoma to adenocarcinoma in esophageal cancer was found during this period. Also, most GI cancers in Lebanon were diagnosed in the late stages. Conclusion This study is the first to evaluate GI cancers in Lebanon, which will help in screening strategies and burden studies.

Antoine Abou Rached,1 Selim Abou Kheir,1 Jowana Saba,1 Salwa Assaf,2 Georges Kassis,3 Yuri Sanchez Gonzalez,4 Olivier Ethgen5,6 1Faculty of Medicine, School of Medicine, Lebanese University, Beirut, Lebanon; 2Abbvie Biopharmaceuticals GmbH, Beirut, Lebanon; 3Abbvie Biopharmaceuticals, Paris, France; 4AbbVie Inc., North Chicago, IL, USA; 5SERFAN Innovation, Namur, Belgium; 6Department of Public Health, Epidemiology and Health Economics, University de Liège, Liège, Belgium Purpose: To analyze the hepatitis C virus (HCV) burden in Lebanon and the value of comprehensive screening and treatment for different age groups and fibrosis stages. Methods: We used a multicohort, health-state-transition model to project the number of HCV genotype 1 and 4 patients achieving a sustained virologic response 12 weeks after treatment or progressing to compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), or liver-related death (LrD) from 2016 to 2036. In the low/medium/high screening scenarios, the proportion of patients screened for HCV was projected to increase to 60%/85%/99%, respectively, by 2036. We analyzed four treatment strategies: 1) no treatment, 2) all-oral direct-acting antivirals (DAAs) given to F3–F4 (CC) patients only, 3) all-oral DAAs to F2–F3–F4 (CC) patients, and 4) all-oral DAAs to all fibrosis patients. Results: Low, medium, and high HCV screening scenarios projected that 3,838, 5,665, and 7,669 individuals will be diagnosed with HCV infection, respectively, from 2016 to 2036, or 40% of those aged 18–39 years, and 60% of those aged 40–80 years. With no treatment, the projected number of patients reaching CC, DCC, HCC, or LrD in 2036 was 899, 147, 131, and 147, respectively, for the 18–39 years age group. For the 40–80 years age group, these projections were substantially greater: 2,828 CC, 736 DCC, 668 HCC, and 958 LrD. The overall economic burden without treatment reached 150 million EUR. However, introducing DAAs for F0–F4 patients was projected to increase the proportion of remaining life-years spent in sustained virologic response 12 weeks after treatment by 43% and 62% compared to DAAs given at F2–F4 or F3–F4 only, respectively. Conclusion: An enhanced screening policy combined with broader access to DAAs can diminish the future clinical and economic burden of HCV in the Lebanese population and, for the middle-aged and elderly, provide the greatest health benefit with net cost savings. Keywords: hepatitis C, epidemiology, burden of disease, screening, Lebanon, HCV treatment, screening and treatment policies

The dry reforming of toluene (DRT) has been studied on Cerium and Lanthanum-promoted Ni–Al catalysts derived from hydrotalcites precursors in the temperature range 300–800 °C. X-ray powder diffraction (XRD) and thermogravimetric and differential thermal analyses (TGA-DSC) of as-prepared samples confirmed the formation of the hydrotalcite structure. Temperature programmed reduction (TPR) and desorption (CO2-TPD) indicated that Ni phase reducibility and basicity of the catalysts were influenced by the presence of the promoters. Ce-promoted catalyst was reducible at lower temperatures and had higher total basicity than the La-promoted and non-promoted catalysts. Furthermore textural property of solid was modified after cerium incorporation. These factors played a key role in the enhancement of the catalytic activity and suppression of carbon deposition. Post-reaction characterization of the catalysts by Temperature Programmed Oxidation (TPO) and TGA-DSC evidenced a better resistance towards carbon deposition for the Ce and La promoted catalysts. The promoted and non-promoted catalysts showed similar toluene conversion but promoted catalysts presented lower carbon deposition after test. Benefit effect of Cerium promotion catalyst was related by its characteristic which greatly influenced the activity. Lanthanum promoted exhibited a similar textural and physico-chemical characteristic than non-promoted catalyst but showed a higher performance than this latter. Promotion-activity relationship of the La containing catalyst was related by the presence of La2O3 on Ni based catalyst which could influence the transport and the adsorption of the CO2 onto the active sites surface.

Background The worldwide epidemiology of Inflammatory Bowel Disease (IBD) is changing. Increasing Crohn’s disease (CD) and Ulcerative Colitis (UC) incidence and prevalence have been recorded. In Lebanon, the current status of IBD is not well known. Methods The aim is to report patients’ characteristics newly diagnosed with IBD in Lebanon based on Montreal classification and to report the prevalence and the incidence of IBD in the Lebanese population during a period of 20 years. This is a retrospective study conducted in collaboration with the National Institute of Pathology, from January 2001 till December 2020 were reviewed. Patients were characterized based on: sex, age at diagnosis, year of diagnosis, location and extension of the disease. Results A total of 3101 new IBD cases were identified (1504 UC, 1597 CD), mean age for UC and CD was 41.05 years and 36.5 years, respectively. sex ratio (M/F) of 1.15 and 1.29 in UC and CD, respectively. In UC, the 3 age groups distribution, ≤ 16 years, 17–40 years and > 40 years were 5.72%, 47.83% and 40.45%, respectively. Regarding the location distribution, E3 was the most prevalent (55.6%), followed by E1 (24.6%) and E2 (19.8%); with no difference between male and female. Similar pattern of location distribution was noted in the 3 age groups. There was no difference in age of diagnosis but a significant increase of E3 from 40% (2001–2010) to 60% (2011–2020) was noted. In CD, 5.54%, 58.93% and 35.53% of patients were aged ≤ 16 years, 17–40 years and > 40 years, respectively. L1, L2, L3 and L4 represented 57.8%, 16.72%, 23.42% and 1.88% of the location distribution, respectively; without difference between male and female. L1 is significantly higher in the young age groups (≤ 16 years: 68.75% and 17–40 years: 67.72%) compared to the older age group (> 40 years: 39.06%) whereas L2 and L3 were higher in the older age group. When divided into two 10-year periods, there was a significant increase of L1 (63%) in the last 10 years (2010–2020) compared to the 10 years before (40%) and an increase of the disease incidence in the age group 17–40 years. Based on all these data, we calculated the incidence of UC and CD and their progression during this period of 20 years. We noted a progressive increase of the incidence of IBD, especially for CD in the last 3 years. The cumulative incidence of UC and CD were 4.686 and 4.582, respectively. The prevalence of UC and CD were 69.9 par 100000 and 68.35 per 100000, respectively. Conclusion The mean age of IBD in Lebanon is higher than that described in Europe and North America. Pancolitis in UC and ileal involvement in CD remain the most common forms found. There was an increase of the incidence of IBD during the last 20 years and especially of CD during the last 3 years

Background and study aims The prevalence of hepatitis C in Lebanon is low. It is estimated at 0.2% of the total population. The aim of our study is to evaluate the exact prevalence of each genotype on a large scale population and in each potential source of infection. Patients and methods We reviewed all the data in the Ministry of Public Health related to patients who have submitted their file for treatment during a period of 9 years ranging from January 2005 till December 2013. Results The genotype distribution in 1031 Lebanese patients was as following: Genotype 1 was the most predominant representing 47% followed by genotype 4 representing 34% then genotype 3 representing14%. Concerning sex distribution and routes of infection, there was a male predominance in intravenous drug users (IVDU), whereas approximately equal distribution was noted in haemodialysis and transfusion groups. A female predominance was noted in the “unknown” mode of infection. Concerning age distribution and routes of infection, a mean age of 27 was noted in the IVDU group, whereas mean age of 60 in the transfusion group and 50 in the haemodialysis group. In patients who acquired the infection post transfusion or during haemodialysis, genotype 1 was the most predominant, whereas in IVDU, genotype 3 was the most predominant. Concerning sub-genotyping: subtype 1b was the most predominant (84%) in genotype 1. in genotype 2 subtype b with 75%, all genotype 3 were subtype a, in genotype 4 subtype a represents 50% of genotype followed by subtype e in 30%. Conclusion Our data concerning Lebanese population demonstrate that genotype 1 is the most prevalent genotype followed by genotype 4. In IVU, we noted genotype-3 and -1 being the most prevalent in relation to clustering in this high risk group. This distribution differs from most surrounding countries and all other Arab countries.