Recent publications
This paper investigates the influence of Socially Responsible Human Resource Management (SRHRM) practices on nurses’ intention to stay in Lebanon. It focuses on the impact of selected practices, including training, performance evaluation, compensation, work–family balance, and occupational health and safety. Survey data was collected from 389 nurses from public and private sector hospitals. Structural equation modeling was used for analysis. The findings reveal that sector type has no effect on the impact of SRHRM practices on nurses’ intention to stay in Lebanese healthcare. At the academic level, it provides supplementary literature for the under-researched sector in Lebanon. It might thus open up additional research opportunities that aim to broaden the perspective of the topic. At the practical level, the findings offer hospitals the tool to be competitive in retaining nurses in both public and private sectors. It is also expected to aid policy-makers and HR practitioners in placing measures for better retention of nurses in both the public and the private sectors. The study presents limitations and future research to enhance understanding and implementation of SRHRM practices in healthcare. It might be considered among the first studies to investigate the mentioned topic.
Background:
The role of community pharmacies has been transitioning from traditional drug dispensing methods to include more patient-centred services such as pharmacotherapeutic monitoring. With the increasing complexity of medication regimens and the rising prevalence of chronic diseases, pharmacotherapeutic monitoring plays a crucial role in preventing medication-related problems. This study aims to review patient outcomes of community pharmacies’ involvement in pharmacotherapeutic monitoring services. It also highlights advances in the monitoring process, the challenges involved, and relevant solutions.
Methods:
A narrative review was conducted from 8 April 2024 to 9 May 2024, where data was extracted from multiple research studies indexed in PubMed, EBSCOHost, and Google Scholar databases. This review included only previous articles written in English and had information relevant to community pharmacy, patient care, innovations in pharmacotherapeutic monitoring, and challenges associated with the monitoring process in community pharmacies.
Results:
Implementation of pharmacotherapeutic monitoring in community pharmacies improves patient outcomes and satisfaction. It minimizes adverse events by ensuring optimal dosing and patient adherence, which in turn reduces medical expenses and duration of hospitalization. However, factors such as inefficient analytical resources, lack of skilled personnel, and huge financial costs complicate implementation of pharmacotherapeutic monitoring in community pharmacies.
Conclusion:
Community pharmacies’ participation in therapeutic drug monitoring is a promising development that prioritizes tailored patient care, eliminating the need for hospital visits. We recommend a multidisciplinary collaboration, robust electronic medical record systems, and large-scale research studies to provide sufficient evidence on the application of therapeutic drug monitoring in community pharmacies, to leverage this service. Also, policy and decision-makers should facilitate this practice by investing more in pharmacotherapeutic monitoring tools and training for community pharmacists.
Background
Minimally invasive surgery (MIS) has proven to be a successful, developing improvement in surgical practice. Allowing surgeons to operate with minimal incisions, ensures the completion of such procedures with minimal damage to the patient and provides recovery in a shorter time. The use of MIS in the pediatric population has also been growing with the increased involvement of surgeons in the evaluation of training and expertise. In Africa, however, the growth of MIS in the pediatric population faces some obstacles which are in research and innovation, cost, and affordability. Additionally, to the scarcity of resources, the limited number of pediatric surgeons available leads to a substantial workload that affects the quality of care. This paper aims to evaluate the challenges facing MIS in Africa and assess its potential in the future.
Methods
Data were collected through online databases such as PubMed, Google Scholar, Ovid MEDLINE, and Embase. The research team reviewed all relevant articles regarding MIS in Africa and pediatrics.
Results
The utilization of MIS in the pediatric population in Africa faces some major challenges. In addition to the limited resources, there is a significantly disproportionate number of physicians per population, and the training received by pediatric surgeons rarely incorporates minimally invasive techniques. This leaves a lot of work to be done to allow better access to MIS on the African continent. The recent advances by Africans in minimally invasive and endoscopic surgical training programs, as well as the establishment of minimally invasive centers, show great promise in the attempt to increase the utilization of MIS in Africa.
Conclusions
The work done to grow the field of MIS application in Africa is commendable, but efforts need to be strengthened and focus needs to be given to ensure the sustainability of these programs. Furthermore, the work accomplished by countries like Egypt, Senegal, and Nigeria will serve as a huge teaching point to increase the technical expertise of surgeons in the region.
Introduction
Hydatid illness is caused by the parasite tapeworm Echinococcus. Spinal hydatid disease without visceral involvement is a rare condition. Symptoms of spinal hydatid disease are not specific and typically stem from spinal cord compression. Back pain is common, while radicular pain is observed in 25% to 95% of patients. Paraparesis is noted in 25% to 77% of individuals.
Case presentation
We present a case of an isolated spinal hydatid cyst in the lumbar spine in a 13-year-old girl presented with progressive bilateral lower limb paraparesis. The radiological, laboratory, and clinical findings were consistent with a diagnosis of brucellosis. However, the symptoms persisted despite treatment, and it was later revealed through surgery and pathological examination that the child had isolated hydatid cysts in the vertebrae.
Discussion
While primary spinal hydatid cysts are rare, the incidence of these lesions might be higher if cases that resembled other cystic lesions on radiological scans but were conservatively managed, especially in endemic regions, are considered. When determining a surgical approach, it is important to consider hydatid disease as a possibility for certain bone cystic lesions.
Conclusion
Hydatid cysts should be considered in any child with a history of paralysis, especially if the child comes from an endemic area. In our case, the child was initially diagnosed with brucellosis, but it was later found that isolated hydatid cysts in the vertebrae caused the paralysis.
Introduction
Cancer-associated stroke (CAS) is a serious complication in cancer patients, particularly those with lung cancer. This case highlights a 76-year-old male with metastatic squamous cell carcinoma of the lung who developed obstructive shock and a transient ischemic attack (TIA) due to intracardiac metastasis.
Case presentation
The patient, with a history of coronary artery disease, chronic atrial fibrillation, and obstructive sleep apnea, was diagnosed with stage IIIB squamous cell carcinoma of the lung. Imaging revealed a tumor thrombus in the left atrium, extending from the right lower lobe of the lung via the pulmonary vein. The patient presented with hemodynamic instability and a fall. A TIA with right facial droop and left pronator drift developed, which resolved within six hours. Given his poor performance status (ECOG 3), he was started on palliative radiation therapy and discharged to hospice care.
Clinical discussion
Intracardiac metastasis is a rare complication of lung cancer, leading to severe hemodynamic issues and neurological events like stroke. In this case, the tumor thrombus caused obstructive shock and increased the risk of ischemic stroke. Cancer-associated stroke is more common in patients with thoracic malignancies, underscoring the need for a multidisciplinary approach to manage these complex cases.
Conclusion
This case highlights the importance of early recognition and a multidisciplinary approach in managing cancer-associated strokes, particularly in patients with advanced lung cancer. Palliative care is essential for symptom management and improving quality of life. Further research is needed to explore targeted treatments for cancer-associated thrombosis.
Pharmacogenomics has transformed the way we approach the treatment of the most common diseases worldwide, especially cardiovascular. In this article, we highlight the main categories of drugs involved in major cardiovascular diseases (CVD), related genetic variability and their effects on metabolism in each case of contrastive operability. This not only explains disparities in treatment outcomes but also unfolds customised management based on genomic studies to improve efficiency and limit side effects. Genetic variations have been identified that impact the efficacy, safety, and adverse effects of drugs commonly used in the treatment of CVDs, such as Angiotensin converting Enzyme Inhibitor (ACEI), Angiotensin Receptor Blocker (ARBs), calcium channel blockers, antiplatelet agents, diuretics, statins, beta-blockers, and anticoagulants. It discusses the impact of genetic polymorphisms on drug metabolism, efficacy, and adverse reactions, highlighting the importance of genetic testing in optimizing treatment outcomes. Pharmacogenomics holds immense potential for revolutionizing the management of CVDs by enabling personalized medicine approaches tailored to individual genetic profiles. However, challenges such as clinical implementation, cost-effectiveness, and ethical considerations need to be addressed to completely incorporate pharmacogenomic testing into standard clinical practice. Continued research and clinical diligence are required for the utilization of pharmacogenomics to improve therapeutic outcomes and reduce the burden of CVD globally.
In the manufacturing of some sectors, such as marble and brick, certain byproducts, such as sludge, powder, and pieces containing valuable chemical compounds, emerge. Some concrete plants utilize these byproducts as mineralogical additives in Turkey. The objective of the experimental study is to ascertain whether the incorporation of waste from the marble and brick industries, in powder form, into cement manufacturing as a mineralogical additive or substitute is a viable option. The materials used in this study were marble and brick wastes, CEM I 42.5 N cement, CEM I 42.5 clinker, water and CEN standard sand. as a replacement for the cement and a substitution for the clinker, the waste marble sludge powder and calcined clay brick powder was separately replaced with either CEM I 42.5 N cement or CEM I 42.5 clinker To determine the usability of marble and brick wastes in conventional cement and clinker production. To this end, there were prepared twenty-four different binder constituents at 0, 6, 10, 20, 21, and 35%. Then the hardened mortar samples were prepared with the new twenty-four different binders, standard drinkable water, and standard mortar sand. Besides, to evaluate pozzolanic activity, the construction lime was mixed with the marble and brick wastes. The microstructure of the marble and brick waste was analyzed using X-ray fluorescence, scanning electron microscopy and energy dispersive spectroscopy. In addition to the microstructure analyses, the chemical features of the marble and brick wastes, including oxides, loss on ignition, pH, total organic content and clay content, were determined in accordance with current standards. The physical and pozzolanic features of the wastes, such as their fineness, density, specific surface area, water permeability, and flexural and compressive strengths, were also evaluated using up-to-date standards. The results of the chemical experiments indicate that the total oxides of calcium, silica, alumina, and ferrite in marble powder and brick powder are more than 54% and 82%, respectively. Marble powder and brick powder are more finely ground than a few mineralogical materials, such as fly ash and silica fume, according to the residue amounts on sieves. Consequently, marble and brick powders can be used as water reducers in mortar, grout, and concrete. Moreover, marble and brick powder have a higher density than many mineralogical materials, making them suitable for applications requiring a higher binder feature of cement, higher strength, and improved durability of mortar and concrete. The specific surface area and water permeability of the marble and brick powders provide compelling evidence to support the inferences previously made about the fineness and density of these materials. Additionally, the pozzolanic properties of the brick powder were three and fourteen times greater than those of the marble powder, as evidenced by its compressive and flexural strengths, respectively. It can be reasonably deduced from the experimental results that marble powder is a latent hydraulic mineralogical natural additive or substitute, while brick powder is an unnatural mineralogical pozzolanic additive or substitute for cement-making processes.
The genome editing methods have unlocked new possibilities for targeted, significant trait improvement in various crops, such as industrial crops, fruit crops, ornamental crops, and all agricultural crops. However, these genome editing technologies have not been limited to agricultural crops; they have been carried out in various categories of living things, like microorganisms as well as animals, and also in numerous areas such as industries, basic research, and life science. This biotechnologically innovative tool is the favored option for the alterations of genetic material in various categories of living things due to its better level of advanced efficiency and accuracy and overall decrease in off-target gene alterations compared with zinc finger nucleases (ZFNs) and transcription activator-like effector nucleases (TALENs). Although the clustered regularly interspaced short palindromic repeat-based genome editing system has not required any regulatory tests or ethical issues related to these plants being accepted by the public compared with transgenic technology. This genome editing technology is successfully applied to enhance several genetic traits in horticultural and industrial crops, like increasing biotic and abiotic tolerance, transforming plant architecture, and increasing the accumulation of desired metabolites. CRISPR-Cas9 is now being used in many laboratories to mutate specific genomic DNA sequences. This book chapter discusses the potential of the CRISPR-based genome editing process for enhancing commercially valuable traits like higher nutritional value, protein content, and vitamin content, as well as the advancement of useful industrial products like rubber, biofuel, fiber products, and medicines.
Background
Polycystic Ovarian Syndrome (PCOS) is an endocrine disorder associated with increased risk of kidney and liver damage. Current treatments have shown contradictory outcomes, and their long-term use causes unwanted side effects. G. tournefortii could serve as a complementary medicine to current PCOS treatments.
Purpose
This study evaluates the effect of G. tournefortii in alleviating liver and kidney damage induced by PCOS via the regulation of oxidative stress pathways.
Study Design
PCOS was induced in female Balb/c mice using dehydroepiandrosterone over 21 days. They included a Sham group, a Vehicle group, a group treated with the extract only, and an untreated PCOS mice group. Positive Controls were treated with Metformin. The other PCOS groups were either co-treated while inducing PCOS or treated with the extract post-disease induction.
Methods
Histological analysis was performed. Serum liver and kidney biochemical markers, levels of oxidative stress, and two pro-inflammatory markers were measured. NLRP3 and its associated genes (caspase-1 and ASC) gene expression was assessed.
Results
The extract restored normal kidney and liver histology post-PCOS induction. It decreased ALT and AST levels by 50% and the oxidant marker malondialdehyde (MDA) by 65% ( P < .05). Superoxide dismutase (SOD)/catalase (CAT) activities were normalized in PCOS treated group. IL-1β/TNF-α significantly decreased (80% and 68%, respectively, P < .05) in the post-treated group. NLRP3 genes decreased in kidney tissues post-treatment with G. tournefortii extract.
Conclusion
G. tournefortii reduced oxidative stress by modifying the ASC/caspase-1/IL-1β signaling pathway, thus protecting livers and kidneys highlighting the herb as a potential preventative and complementary agent in mitigating PCOS associated damage.
Background
Methicillin-resistant Staphylococcus aureus (MRSA) is still a growing concern in the field of antimicrobial resistance due to its resistance to conventional antibiotics and its association with high mortality rates. Mesenchymal stromal cells (MSCs) have been shown as a promising and attractive alternative treatment for bacterial infections, due to their antibacterial properties and potential to bypass traditional resistance mechanisms. This study aims to shed light on the antibacterial potential of adipose-derived mesenchymal stromal cell (AD-MSC) secretome against clinical isolates of Staphylococcus spp., including MRSA strains.
Methods
Using the Kirby-Bauer disk diffusion method, broth microdilution assays, and colony-forming unit (CFU) counting, the antibacterial activity of AD-MSC secretome was assessed. These tests were first conducted on Staphylococcus (S.) aureus ATCC 25923, then on 73 clinical isolates including MRSA strains. Further molecular analysis was performed to identify resistant genes in MRSA isolates.
Results
The AD-MSC secretome demonstrated significant antibacterial activity against S. aureus ATCC with a 32 mm inhibition zone. 96% of the collected staphylococcal clinical isolates showed susceptibility to the secretome with 87.5% inhibition observed in MRSA isolates, along with 100% in MSSA, MSSE, and MRSE strains. Molecular analysis revealed that MRSA strains resistant to the secretome harbored mecA, ermA, and ermB genes. Additionally, the mecA-negative MRSA strains remained susceptible to the secretome, suggesting alternative resistance mechanisms.
Conclusion
These findings emphasize the ability of AD-MSCs secretome as a promising alternative for treating antibiotic-resistant infections, with potential applications in combating MRSA. However, further research is required to explore its clinical applications as a complementary or standalone therapy for resistant infections.
African communities that have been forced to leave their homes experience a considerably greater susceptibility to malaria as a result of densely populated living conditions, restricted availability of healthcare, and environmental influences. Internally displaced individuals frequently live in large settlements with restricted availability to drinking water, essential sanitation, and medical services, intensifying the spread of malaria. As a result, the occurrence of malaria is significantly more common among refugees and internally displaced individuals compared to those who are not displaced. This leads to greater rates of illness and death, especially among young people. Insufficient monitoring worsens the condition, leading to delayed identification and medical intervention, and contributing to a higher incidence of severe malaria and deaths. Furthermore, these communities are faced with economic consequences that contribute to the continuation of poverty and the worsening of socio-economic inequalities. Furthermore, the psychological impact of malaria, which is marked by feelings of anxiety and uncertainty, is particularly severe in vulnerable populations such as displaced children and pregnant women, aggravating the overall burden. Hence, addressing malaria in displaced populations in Africa requires comprehensive and well-coordinated strategies. Advanced diagnostic and surveillance technologies are essential for promptly identifying and treating malaria, providing chances to monitor and control its spread effectively. Collaboration among healthcare, policy, and humanitarian sectors is crucial for implementing comprehensive solutions that incorporate enhanced diagnostics, surveillance, and socio-psychological support. Active involvement of the community, usage of Community Health Workers, and regular collection of surveillance data are crucial in increasing awareness, directing control efforts, and tackling the specific difficulties encountered by displaced groups. Moreover, the implementation of environmental management, the incorporation of health services, and the utilization of adaptable healthcare interventions are essential for reducing the effects of malaria. To mitigate the impact of malaria and improve health outcomes among displaced populations in Africa, it is crucial to focus on these specific areas.
Background: Gender identity awareness is increasing in medicine, yet data collection in Lebanon remains largely binary. This study examines gender identity trends among medical trainees and physicians. Methods: A cross-sectional survey was conducted among final-year medical students, residents, fellows, and attending physicians at all six private Lebanese medical schools and affiliated hospitals. The gender question included "male," "female," and "prefer not to answer" to ensure IRB approval. Results: Among 278 respondents (17.46% response rate), 13 (4.7%) chose "prefer not to answer"—6.1% of students, 8.1% of residents/fellows, and only 1.2% of attending physicians. Nearly all were trainees. Conclusion: A trend toward expressing non-binary gender identity appears more common among younger medical professionals and doctors in training in Lebanon. Further research is needed to explore this shift and its implications for medical education and practice.
Background:
Neurosurgical nursing involves the provision of pre- and post-operative care to neurologic patients. Specialized nurses in the field of neurosurgery are vital for patient outcomes and wellbeing. Nevertheless, there is underestimation and limited access to neurosurgical nursing in low- and middle-income countries (LMICs). This review primarily aims to shed light on the significance of nursing in the neurosurgical department of LMICs. It provides insight into the healthcare systems, the collaborative approaches that emerged in this concern, and the issues pertaining to integrating neurosurgical nursing in these countries.
Methods:
Literature search was conducted from March 2024, where the articles were retrieved from PubMed/Medline, EBSCOhost, Google Scholar, and Embase. The terms “neurosurgical nursing,” “neurosurgery,” “neurosurgical care,” “neurosurgical nurses,” and “low- and middle-income countries OR LMICs” were used to search relevant studies. Previous articles discussing neurosurgical care in LMICs were considered in this review.
Results:
Nurses participate in 90% of interactions between healthcare providers and patients. They provide holistic care by considering the physical, cultural, and psychosociological needs pertaining to their patients. Furthermore, they possess ability to establish rapport via communication with patients which improves the standard of care delivered. To achieve results satisfactory to the wellbeing of affected populations, neurosurgical disciplines necessitate the aid of skilled nursing colleagues. However, there is a lack of relevant technology, innovations, and funding alongside human resources in LMICs.
Conclusion:
Education, training, and dynamic collaboration are crucial factors for neurosurgical nurses to provide the best quality of care to patients. It is also pivotal to focus on research concerning the present issue, implement further policies which encourage dynamic cooperation between the neurosurgical multidisciplinary team, and collaborate on a global level to enhance neurosurgical nursing in LMICs.
Vortex shedding and aeroacoustic interaction in flow around flat bodies is an important field that grabbed researchers’ attention. Industrial applications of this flow include axial flow compressors, finned heat exchangers, and ducting systems. Aeroacoustic coupling in such systems affects their performance and structural fatigue. Building a solid understanding of flow regimes and predicting the occurrence of aeroacoustic resonance is crucial for avoiding excessive acoustic vibrations and reducing undesirable noise. This paper presents a review of various studies to gain an understanding of the identification of flow regimes, principles of aeroacoustic coupling, and prediction of aeroacoustic resonance in flow around single and two flat plates in tandem. The paper also highlights the research gaps in these areas. The review found that while the understanding of flow regimes around single flat plates is well-established, significant research gaps remain in identifying flow regimes in flow around two flat plates. In addition, a research gap exists in predicting aeroacoustic resonance as both numerical and experimental approaches have some limitations, particularly in the accurate prediction of resonant flow velocities and the accounting for deviations in Strouhal numbers values.
In the present work, the effect of adding Ba0.4Sr0.4Ca0.2Fe12O19 hard nanoparticles and the immersion in seawater for different durations (0, 2, 6, 12, and 24 h) on the mechanical characteristics of the Bi, Pb-2223 superconductor phase were studied. A conventional solid-state reaction method was used to produce the (Ba0.4Sr0.4Ca0.2Fe12O19)x/(Bi1.6, Pb0.4)-2223 composites (0.00 ≤ x < 0.40 wt%). X-ray diffraction (XRD) confirmed the primary phase formation of the tetragonal (Bi1.6, Pb0.4)-2223. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) studies were also carried out to demonstrate the microstructural analyses of the samples during seawater immersion. Compared to the pure (Bi1.6, Pb0.4)-2223 phase, SEM and EDX verified the improvement of the adsorption of seawater elements upon adding the nanoparticles. This resulted in faster grain size reduction in the (Bi1.6, Pb0.4)-2223 phase than in the pure sample before immersion. Vickers microhardness () Measurements were performed for 30 s at room temperature, with applied stresses ranging from 0.49 to 9.80 N after immersion in the seawater for different durations (0, 2, 6, 12, and 24 h). For the sample with x = 0.04 wt%, values enhanced with percentages of 67.72% and 98.44%, before and after immersion in seawater for 24 h, respectively. This suggests that the mechanical properties of the (Bi1.6, Pb0.4)-2223 phase were enhanced by a small addition of these nanoparticles and the salts of seawater adsorbed on the sample’s surface. The modified proportional sample resistance (MPSR) model offered the most accurate theoretical analysis in the plateau limit region, before and after seawater immersions, with a less than 5% variance. Furthermore, the incorporation of Ba0.4Sr0.4Ca0.2Fe12O19 into the superconductor had a positive impact on several mechanical characteristics, including fracture toughness (K), yield strength (Y), and elastic modulus (E). All these mechanical parameter values followed the same trend, increasing with the increase in immersion time. However, they are at their height with the presence of 0.04 wt% of these nanoparticles. The toughness increased by 27.31% of the pure sample at this point. After that, when the immersion time rose from 0 to 24 h, this number increased by 42.59%.
Introduction
Androgenetic alopecia (AGA) is a multifactorial and age-related dermatological disease that affects both males and females, usually at older ages. Traditional hair repair drugs exemplified by minoxidil have limitations such as skin irritation and hypertrichosis. Thus, attention has been shifted to the use of repurposing drugs. Metformin is an anti-diabetic drug, that can promote hair follicle regeneration via upregulation of the hair-inductive capability. Hence, the current study aims to fabricate a safe and effective nanoemulsion to improve metformin efficacy in targeting AGA.
Methods
Rosemary oil was selected as the oily phase due to its ability to increase blood flow and hair growth. Rosemary-based nanoemulsions were statistically optimized by Box-Behnken experimental design, loaded with metformin, and incorporated into a hydrogel to form a nanoemulgel. Metformin-loaded nanoemulsions were assessed for their diametric size, uniformity, zeta potential, and metformin characteristics within the formulated nanosystem. The nanoemulgel was then evaluated in terms of its pH, percentage drug content, and in-vitro release performance. In-vivo study assessed the nanoemulgel’s ability to augment hair growth in rats.
Results
The experimental design displayed that using 50%w/w, 20%w/w, and 10%w/w of Cremophor®, Labrafil®, and deionized water, respectively, resulted in nanoemulsion formulation with the smallest globule size (125.01 ± 0.534 nm), unimodal size distribution (PDI=0.103), negative surface charge (−19.9 ± 2.01 mV) with a spherical morphological structure. Rosemary-based nanoemulgel displayed acceptable physicochemical characterizations namely; a neutral pH value of 6.7±0.15, high drug content (92.9± 2.3%), and controlled metformin in-vitro release. Besides, the formulated nanoemulgel significantly increased the number of hair follicles in the animal model compared with other controls and tested groups.
Conclusion
The designed nanoemulgel is a promising approach for treating androgenic alopecia.
The widespread adoption of artificial intelligence (AI) tools in academic settings has the potential to revolutionize learning experiences, enhance educational outcomes, and streamline academic processes. The aim of this research was to explore the perceptions of Lebanese health sciences students regarding the use of generative AI in higher education. A qualitative descriptive research design informed by descriptive phenomenology was employed. Semi‐structured interviews were carried out among 23 health sciences students at one major private university in Beirut. Inductive thematic analysis was conducted over the period of 3 months. The inductive thematic analysis generated two themes, and eight subthemes highlighting the benefits and concerns in using AI; customized, self‐paced, and autonomous learning, improved language and writing skills, development of innovative concepts, enhanced efficiency, accuracy of information, overreliance on AI, equitable access, unclear policies. Results from this study emphasized the importance of combined efforts across sectors to close access gaps, encourage inclusiveness, and develop well framed policies that enable students to utilize these new technologies for their maximum benefits.
Background
We aimed to identify the central lifestyle, the most impactful among lifestyle factor clusters; the central health outcome, the most impactful among health outcome clusters; and the bridge lifestyle, the most strongly connected to health outcome clusters, across 29 countries to optimise resource allocation for local holistic health improvements.
Methods
From July 2020 to August 2021, we surveyed 16 461 adults across 29 countries who self-reported changes in 18 lifestyle factors and 13 health outcomes due to the pandemic. Three networks were generated by network analysis for each country: lifestyle, health outcome, and bridge networks. We identified the variables with the highest bridge expected influence as central or bridge variables. Network validation included nonparametric and case-dropping subset bootstrapping, and centrality difference tests confirmed that the central or bridge variables had significantly higher expected influence than other variables within the same network.
Results
Among 87 networks, 75 were validated with correlation-stability coefficients above 0.25. Nine central lifestyle types were identified in 28 countries: cooking at home (in 11 countries), food types in daily meals (in one country), less smoking tobacco (in two countries), less alcohol consumption (in two countries), less duration of sitting (in three countries), less consumption of snacks (in five countries), less sugary drinks (in five countries), having a meal at home (in two countries), taking alternative medicine or natural health products (in one country). Six central health outcomes were noted among 28 countries: social support received (in three countries), physical health (in one country), sleep quality (in four countries), quality of life (in seven countries), less mental burden (in three countries), less emotional distress (in 13 countries). Three bridge lifestyles were identified in 19 countries: food types in daily meals (in one country), cooking at home (in one country), overall amount of exercise (in 17 countries). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05).
Conclusions
In 29 countries, cooking at home, less emotional distress, and overall amount of exercise emerged as common central lifestyle, health outcome, and bridge lifestyle factors, respectively. However, notable regional variations necessitate tailored interventions and resource allocations to effectively address unique local key variables and promote holistic health in each locale. The study's cross-sectional design and self-reported data may limit generalisability, emphasising the need for cautious interpretation and further longitudinal research.
Keywords
global; across-country comparisons; lifestyle; health outcomes; network analysis
In a world grappling with heightened carbon levels, the imperative for mankind to coordinate efforts toward a carbon-reduced future has reached a critical juncture. Against this backdrop of ecological urgency, the emergence of renewable energy harmonizes as a crucial note, promising a melodic progression in the collective journey toward sustainability, decarbonization, and climate change mitigation. This comprehensive review navigates through the literature, offering a panoramic exploration of the historical, contemporary, and prospective landscapes of renewable energy sources. It delves into their merits, drawbacks, research gaps, and various storage and transmission methods. The study deeply compares the efficiency of renewable sources, considering factors such as the levelized cost of electricity, capacity factor, and installation costs. Additionally, it highlights the practical applications of renewables through insightful case studies. The central focus is on assessing the status of renewables in the energy mix, elucidating its holistic capacity amidst rising energy demands, and examining prevailing policies, research investments, and the contributions of oil companies to the renewable industry. The review envisions renewables claiming a larger share in electricity generation than fossils, but recommends alliances with hydrogen energy and carbon capture, utilization, and storage for a low-carbon future. It stresses continuous advancements in renewable technologies and enhancing efficiency, reliability, and scalability to accelerate the transition to sustainability.
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