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Sustainability and energy efficiency are now two pivotal goals that society aims towards. Green roofs and facades have gained significant attention in this direction for innovative, sustainable solutions for enhancing building energy performance. With a focus on sustainable urban development and energy-efficient building practices, this study delves into the intricate relationship between these green infrastructure elements and the overall energy dynamics of constructed environments. Furthermore, a range of case studies from diverse geographical locations are presented to provide valuable insights into their practical implications as emerging technologies that contribute to improved insulation, reduced heat transfer, regulating indoor temperatures, and mitigation of urban heat island effects, thus reducing the need for artificial heating and cooling and optimizing overall energy consumption. This comprehensive review serves as a dataset for understanding and highlighting all the research findings of the numerical and experimental investigations invested in the field of greenery systems to encourage their integration, which is crucial for combating climate change and pollution. Previous research is often focused on isolated, short-term, or single-climate analyses of consumption; therefore, by providing an inclusive description of their practical benefits in both temperate and extreme climates, the gap in previous articles is tackled.

Acute pulmonary embolism is stratified into three groups: low-risk, moderate-risk, and high-risk. Highrisk PE, also known as massive pulmonary embolism (MPE), is defined as an acute PE with sustained hypotension, pulselessness, and persistent bradycardia. Herein, we present a case of a 44-year-old female presenting to the emergency department with shortness of breath, chest discomfort, and central cyanosis. She was found to have MPE and arrested twice during which she received alteplase and Advanced Cardiac Life Support. In the ICU, she arrested for the third time, was resuscitated, and a decision to initiate extracorporeal membrane oxygenation deemed reasonable. The patient deteriorated and was rushed to the operating room after detecting major intra-abdominal bleeding on FAST exam. Hepatic injury was suspected and liver packing was initiated. Patient was safely discharged home neurologically intact after a prolonged hospital stay.

Abstract Background Malakoplakia is a rare granulomatous inflammatory condition that can affect immunosuppressed patients. The genitourinary system is the most involved organ. We present a case of kidney failure caused by obstructing bladder lesions, clinically suspicious for malignancy and pathologically proven to be malakoplakia. Case presentation A 70-year-old woman presented with acute kidney injury and Escherichia coli (E.coli) bacteremia. Investigation showed bilateral hydronephrosis with thickening of the renal pelvises suggestive of urothelial malignancy. Cystourethroscopy revealed multiple bladder lesions completely obliterating both ureteral orifices. Pathology of the resected lesions confirmed the diagnosis of malakoplakia. Patient was treated with a prolonged antibiotic course over 6 months with recovery of her kidney function. Conclusion Malakoplakia can mimic invasive tumors, and the diagnosis is only attained through histopathology which uniquely demonstrates the pathognomonic Michaelis–Gutmann inclusions inside sheets of histiocytes. Treatment is largely dependent on prolonged antibiotics therapy that must cover the most common isolated pathogen, E.coli.

Abstract Background Several factors increase the risk of right-sided endocarditis. The tricuspid valve is usually involved in right-sided endocarditis cases. Infective endocarditis of the pulmonic valve is rare, and few cases of pulmonic valve endocarditis were reported previously. Case presentation Here we describe a case of a 81-year-old Middle Eastern male patient, admitted to our hospital three times in a period of 2 months for fever and cough. He had Streptococcus oralis bacteremia with vegetation that was on the pulmonic valve. We diagnosed him with pulmonic valve endocarditis, and he was treated successfully with intravenous antibiotics. Conclusion It is important to keep high suspicion for isolated pulmonic valve endocarditis in patients with respiratory symptoms. Adequate dental care is important in patients with risk factors for infective endocarditis.

The process of pulping and papermaking is a complicated, resource-demanding operation that requires energy, water, and chemicals. When not managed properly, the process can also contribute significantly to pollution. The washing process is one critical operation that impacts the process's economics and environmental footprint. Most mills utilize rotary vacuum washers to separate black liquor from pulp, ensuring clean pulp for further processing downstream. Numerous factors influence the efficiency of a brown stock washer, and the washing operation itself is intricate. This study employs the system dynamics modeling approach to examine the critical role of brown stock washing in the pulp and paper industry, emphasizing optimizing process parameters for improved efficiency and sustainability. In the first part of the paper, a single stage of the washer system is modeled by establishing mass balance equations for key streams, including pulp, liquor, and dissolved solids. Within the system dynamics environment, separate models are developed for each stream, allowing for a detailed analysis of their behavior. To enhance modeling efficiency, the brown stock washing process is divided into four distinct operations: dilution, pulp formation, washing, and filtration. Breaking down the process into these operations makes it possible to focus on optimizing each step for improved overall performance. Furthermore, a control strategy is implemented to ensure stability in critical areas such as dilution vat level, discharged pulp consistency, and filtration tank level. In the final phase of the research, a multistage countercurrent brown stock washing line comprising three washers is modeled. Researchers can gain insights into how different components interact and influence overall performance by evaluating various parameters and analyzing the line's efficiency. This comprehensive analysis enables them to identify potential improvements and optimize the washing process for enhanced productivity and quality output. The conclusions drawn from this work offer valuable guidance for optimizing water management practices in the pulp and paper sector, contributing to the industry's sustainability goals and regulatory compliance. [ABSTRACT FROM AUTHOR]

The building sector, one of the most energy-consuming, is among the most current topics due to the maturing concerns about the anthropogenic factor’s impact on CO2 quantities in the atmosphere and its association with global temperature rise. Using sustainable building materials is a promising alternative in building envelope applications to improve in-use energy efficiency. These materials, having a low environmental impact, the advantage of being renewable, and low embodied energy, contribute to global sustainability. This comprehensive literature review presents a broad overview of these materials’ hygrothermal characteristics, thermal performance, and energy use. The main goal is to compile the most important research findings on these materials’ capabilities for building construction and their contributions and effects on energy performance and thermal insulation.

Objectives: Bacterial bloodstream infections (BSIs) with resistant pathogens in patients with haematological malignancies are rising due to increased use of novel chemotherapeutic agents and prophylactic antibiotics. Our goal was to understand the epidemiology and resistance patterns of bacterial pathogens in patients with haematological malignancies to help tailor empirical antibiotics and to limit resistance. Methods: This was a retrospective chart review looking at bacterial BSI episodes between 2007–2017 in patients previously diagnosed with haematological malignancy at a tertiary-care centre in Lebanon. Results: Among 165 hospitalised patients with haematological malignancy and bacterial BSI over 10 years, Gram-negative bacteria (GNB) caused 65.0% of all episodes, with the most common pathogens being Escherichia coli (45.6%), 79.6% of which were ESBL-producers, Pseudomonas aeruginosa (7.5%) and Acinetobacter baumannii (4.0%). The majority of the organisms (61.0%) were multidrug-resistant (MDR), with ANC < 100 neutrophils/μL (OR = 0.12, 95% CI 0.03–0.54) identified as an independent marker for increased multidrug resistance. The risk factors associated with increased mortality included recent use of amikacin (p

Invasive fungal infections, notably candidemia, have been associated with COVID-19. The epidemiology of candidemia has significantly changed during the COVID-19 pandemic. We aim to identify the microbiological profile, resistance rates, and outcomes of COVID-19-associated candidemia (CAC) compared to patients with candidemia not associated with COVID-19. We retrospectively collected data on patients with candidemia admitted to the American University of Beirut Medical Center between 2004 and 2022. We compared the epidemiology of candidemia during and prior to the COVID-19 pandemic. Additionally, we compared the outcomes of critically ill patients with CAC to those with candidemia without COVID-19 from March 2020 till March 2022. Among 245 candidemia episodes, 156 occurred prior to the pandemic and 89 during the pandemic. Of the latter, 39 (43.8%) were CAC, most of which (82%) were reported from intensive care units (ICU). Non-albicans Candida (NAC) spp. were predominant throughout the study period (67.7%). Candida auris infection was the most common cause of NAC spp. in CAC. C. glabrata had decreased susceptibility rates to fluconazole and caspofungin during the pandemic period (46.1% and 38.4%, respectively). The mortality rate in the overall ICU population during the pandemic was 76.6%, much higher than the previously reported candidemia mortality rate observed in studies involving ICU patients. There was no significant difference in 30-day mortality between CAC and non-CAC (75.0% vs. 78.1%; p = 0.76). Performing ophthalmic examination (p = 0.002), CVC removal during the 48 h following the candidemia (p = 0.008) and speciation (p = 0.028) were significantly associated with a lower case-fatality rate. The epidemiology of candidemia has been significantly affected by the COVID-19 pandemic at our center. Rigorous infection control measures and proper antifungal stewardship are essential to combat highly resistant species such as C. auris.

Sustainability and energy efficiency are now two pivotal goals that society aims towards. Green roofs and facades have gained significant attention in this direction for innovative, sustainable solutions for enhancing building energy performance. With a focus on sustainable urban development and energy-efficient building practices, this study delves into the intricate relationship between these green infrastructure elements and the overall energy dynamics of constructed environments. Furthermore, a range of case studies from diverse geographical locations are presented to provide valuable insights into their practical implications as emerging technologies that contribute to improved insulation, reduced heat transfer, regulating indoor temperatures, and mitigation of urban heat island effects, thus reducing the need for artificial heating and cooling and optimizing overall energy consumption. This comprehensive review serves as a dataset for understanding and highlighting all the research findings of the numerical and experimental investigations invested in the field of greenery systems to encourage their integration, which is crucial for combating climate change and pollution. Previous research is often focused on isolated, short-term, or single-climate analyses of consumption; therefore, by providing an inclusive description of their practical benefits in both temperate and extreme climates, the gap in previous articles is tackled. [ABSTRACT FROM AUTHOR]

Abstract The present study aims to determine the carcinogenic and neurotoxic risks associated with acrylamide intake from cereal products. Analysis on a UPLC–MS/MS spectrometer revealed that oat-based and mixed cereals contain the highest amount of acrylamide among cereal products with levels as high as 271 and 348 μg/kg, respectively. Children were shown to exhibit both carcinogenic and neurotoxic risks regardless of the type of cereal product consumed. For adults above 50 years of age, only consumers of oat-based cereal products seem to exhibit carcinogenic and neurotoxic risks. To avoid a carcinogenic and neurotoxic risk among the Lebanese population, we propose that food processors set the maximum tolerable concentration for acrylamide in cereal products at 94.8 μg/kg product, a value which is threefolds lower than the average acrylamide levels found in this study. Alternatively, and unreasonably, the average Lebanese population and children among the Lebanese population may choose to cut down on cereal consumption by 1.7- and 7.2-folds respectively, should they want to avoid a health hazard as a result of acrylamide intake. The industry should also respond by optimizing the production process in a way to reduce acrylamide levels in cereals.

Infections are well‐known complications in patients following traumatic injuries, frequently leading to high morbidity and mortality. In particular, trauma occurring in disaster settings, both natural and man‐made, such as armed conflicts and explosives detonation, results in challenging medical conditions that impede the best management practices. The incidence of invasive fungal infections (IFI) is increasing in trauma patients who lack the typical risk factors like an immune compromised state or others. This narrative review will focus on IFI as a direct complication after natural disasters, wars, and man‐made mass destruction with a summary of the available evidence about the epidemiology, clinical manifestations, risk factors, microbiology, and proper management. In this setting, the clinical manifestations of IFI may include skin and soft tissue infections, osteomyelitis, visceral infections, and pneumonia. IFI should be considered in the war inflicted patients who are exposed to unsterile environments or have wounds contaminated with soil and decaying organic matter. [ABSTRACT FROM AUTHOR]

Arthrospira platensis (A. platensis) is a microalga with a wide range of commercial uses. One of the main concerns that needs to be addressed in microalgae biorefineries is the costs associated with the harvesting and concentration steps. Filtration has been shown to be an effective technique for concentrating microalgae and recent studies have attempted to enhance membrane filtration by applying an external electric field to the filtration cell. This study consisted of assessing the use of electrically assisted filtration (electrofiltration) at 60 A/m2 and 1 bar for the dewatering of A. platensis, as well as the effect of pretreating the microalgae with ultrasounds (US) on the filtration process. Untreated A. platensis exhibited better filtration kinetics than US-treated A. platensis, and electrofiltration was found to increase the cake dryness. More protein and pigments were present in the US-treated microalgae solution compared to the untreated microalgae, which led to the presence of higher concentrations of protein and pigments in the filtrate streams after pressure filtration at 1 bar without the application of an external electric field. Electrofiltration was found to consume less energy compared to traditional drying techniques used for A. platensis. However, electrofiltration degrades the biocompounds present in the filtrate and cake due to pH changes and other electrophoresis phenomena, which shows the need to optimize the process in future work.

In an effort to standardize practice, the European Confederation of Medical Mycology (ECMM) developed the European Confederation of Medical Mycology Quality of Clinical Candidaemia Management (EQUAL) Candida score. This study investigated the utility of the EQUAL Candida score in predicting mortality in patients with candidemia admitted between January 2004 and July 2019. A total of 142 cases were included in the study, and 43.6% died within 30 days of candidemia diagnosis. There were no significant differences between survivors and non-survivors in terms of comorbidities predisposing to candidemia, except for malignancy (p = 0.021). The overall mean EQUAL score was 11.5 in the total population and 11.8 ± 3.82 and 11.03 ± 4.59 in survivors and non-survivors, respectively. When patients with a central venous catheter (CVC) were considered alone, survivors were found to have significantly higher scores than non-survivors (13.1 ± 3.19 vs. 11.3 ± 4.77, p = 0.025). When assessing components of the EQUAL Score separately, only candida speciation (p = 0.013), susceptibility testing (p = 0.012) and echocardiography results (p = 0.012) were significantly associated with a lower case-fatality rate. A higher EQUAL Candida score was able to predict a lower case-fatality rate in patients with a CVC.

Abi-Ghanem Carine, Celine Mahfouz, Gaby Khalaf, Elie Najjar, Henri El-Zakhem and Rima Manneh. 2016. Pb, Cd and Cu distribution and mobility in marine sediments from two ports in Lebanon: Beirut army naval port and Tripoli fishing port. Lebanese Science Journal, 17(1): 59-75. Lead, cadmium and copper distribution and mobility in superficial sediments collected from the Beirut army navel port and Tripoli fishing port in Lebanon were studied. Results showed relatively high concentrations of Pb (181.4-518.9μg.g-1), Cd (1.33-6.7μg.g-1), and Cu (141-246.8μg.g-1) in sediments inside the port of Beirut. In Tripoli fishing port, Pb and Cd concentrations in sampled sediments were lower. However, higher Cu concentrations (up to 524.5 μg.g-1) were detected in Tripoli sediments. The extractability of Cd, Pb and Cu from the sediments of Beirut and Tripoli port were studied by applying EDTA 0.05M and CaCl2 0.01M extractions for two extraction times: 1h and 24h. These extractions showed that Cd and Pb were highly mobilized by EDTA. However, only Pb was mobilized by CaCl2 from sediments collected in Beirut military port.

Background: Candidemia is associated with a high mortality rate, and its incidence is increasing worldwide with a rise in non-albicans candidemia (NAC). Epidemiologic data from Arab countries are scarce and there are no data from Lebanon; Methods: This is a single-center retrospective chart review of patients with candidemia in a tertiary care center in Lebanon from 2004 to 2019. We extracted data on patient characteristics, isolated Candida species antifungal susceptibility, management and outcomes; Results: We included 170 cases of candidemia. NAC was more common than albicans candidemia (64.7% vs. 35.3%). C. glabrata was the most common non-albicans species (37 isolates) followed by C. tropicalis (14). Recent use of antifungals was a risk factor for NAC (OR = 2.8, p = 0.01), while the presence of a central venous catheter was protective (OR = 0.41, p = 0.02). Fluconazole resistance was 12.5% in C. albicans and 21.5% in non-albicans spp. Mortality at 30 days was 55.5%, with no difference between NAC and albicans candidemia. It was higher in older and critically ill patients but lower in patients whose central venous catheter was removed after detecting fungemia; Conclusions: Candidemia is associated with high mortality in Lebanon, with a predominance of NAC and high prevalence of C. glabrata.

Baseline chest computed tomography (BCT) in high-risk hematology patients allows for the early diagnosis of invasive pulmonary aspergillosis (IPA). The distribution of BCT implementation in hematology departments and impact on outcome is unknown. A web-based questionnaire was designed. International scientific bodies were invited. The estimated numbers of annually treated hematology patients, chest imaging timepoints and techniques, IPA rates, and follow-up imaging were assessed. In total, 142 physicians from 43 countries participated. The specialties included infectious diseases (n = 69; 49%), hematology (n = 68; 48%), and others (n = 41; 29%). BCT was performed in 57% (n = 54) of 92 hospitals. Upon the diagnosis of malignancy or admission, 48% and 24% performed BCT, respectively, and X-ray was performed in 48% and 69%, respectively. BCT was more often used in hematopoietic cell transplantation and in relapsed acute leukemia. European centers performed BCT in 59% and non-European centers in 53%. Median estimated IPA rate was 8% and did not differ between BCT (9%; IQR 5−15%) and non-BCT centers (7%; IQR 5−10%) (p = 0.69). Follow-up computed tomography (CT) for IPA was performed in 98% (n = 90) of centers. In high-risk hematology patients, baseline CT is becoming a standard-of-care. Chest X-ray, while inferior, is still widely used. Randomized, controlled trials are needed to investigate the impact of BCT on patient outcome.