Epidemiology of burns in a humanitarian setting: A national study among refugees in Lebanon.

INTRODUCTION: Burns represent one of the leading causes of morbidity worldwide and disproportionately impact women, children, and socioeconomically disadvantaged individuals. Syrian refugees who fled conflict to land in overcrowded informal settlements across Lebanon are a particularly vulnerable population. This study aims to assess the etiology and risk factors for burns in this population. METHODS: This cross-sectional, cluster-based population study adopted the Surgeons Overseas Assessment of Surgical Need (SOSAS) version 3.0 to capture data from refugees residing in informal settlements in multiple regions across Lebanon. The tool was contextualized and used to collect detailed information on burn cases sustained by refugees during the last 12 months prior to data collection. Univariate logistic regression models were performed to assess the relationship between burns and associated risk factors. RESULTS: From the 1468 households surveyed, a total of 223 households experienced a burn in the last 12 months. Over 63% of burns occurred in children under the age of ten years and almost 57% of burns occurred in females. More than 70% of burns resulted from hot liquid, while 17% were caused by direct heat contact. Over 3/4ths of burns occurred while preparing food (77.4%). Approximately 32% of those burned did not seek healthcare, of which almost 85% noted the cause was mainly due to financial limitations. CONCLUSION: Burns are a common injury in the Syrian refugee population living in Lebanon. Children and women are particularly impacted, often during cooking. Multi-level interventions are necessary to reduce burn injuries and improve care for those affected by burns. Community kitchens can be used to separate cooking and living environments and get stoves and hot liquids off the floor. Importantly, policies should allow for refugees to receive medical care when necessary without a major financial burden.

The state of cancer research in fragile and conflict-affected settings in the Middle East and North Africa Region: A bibliometric analysis.

Background: Cancer represents a disproportionate burden in LMICs, especially conflict-affected countries in the MENA region. Research output on cancer fails to match the growing burden in the region. This bibliometric study aims to examine the status and trends of cancer research in fragile and conflict-affected settings in the MENA region from 2000 to 2021, while also incorporating economic and demographic indicators as additional factors of analysis. Methods: The Web of Science databases were searched for publications related to cancer research in Iraq, Lebanon, Libya, Palestine, Syria, and Yemen from January 1, 2000, to December 31, 2021. The retrieved publications were screened based on preset eligibility criteria and the final list was analyzed using the Bibliometrix Package in R to generate the annual scientific production and citations, journals, institutions, authors, collaborations, keywords, and title co-occurrence. Each country's annual scientific production was analyzed against its annual GDP per capita. Results: A total of 4,280 documents met the inclusion criteria in this research. The annual number of publications revealed a significant increase over the past 20 years. These publications were mostly published in international journals that had impact factors rated in the 3rd or 4th quartiles. The overall contribution of researchers from Fragile and Conflict-Affected Settings (FCS) to cancer research was 6.5% of the MENA cancer research productivity, despite comprising around 23% of the total MENA region's population. Lebanon had the highest publication productivity at the country level, followed by Iraq and Syria. GDP per capita was not significantly correlated with cancer research across the countries under investigation. At the institutional level, the American University of Beirut was the most prolific institution and had the highest number of collaborations and the widest range of cooperative partners. Most first authors were male researchers. There is an interest in cancer expression, prevalence, diagnosis, and management in terms of commonly researched topics. Conclusion: This study underscores the need for a concerted effort to improve cancer research outcomes in FCS, which can be achieved through targeted research, increased investment in research infrastructure and capacity-building initiatives, and greater regional and global collaboration.

Oxidized carbide-derived carbon as a novel filler for improved antifouling characteristics and permeate flux of hybrid polyethersulfone ultrafiltration membranes.

Polyethersulfone (PES) is a widely used polymer for ultrafiltration (UF) membrane fabrication. In the current study, carbide-derived carbon (CDC) oxidized by acid treatment was utilized as a filler to fabricate a novel PES composites UF membranes. The successful oxidation of CDC was validated from presence of oxygen containing functional groups and improved oxygen content, from 5.08 at.% for CDC to 26.22 at.% for oxidized CDC (OCDC). The OCDC PES UF membranes were prepared at different loadings of OCDC between 0.5 and 3.0 wt%. The membrane porosity, pore size and surface free energy found to be improved while a noticeable reduction in water contact angle was observed with OCDC loading implying the improved hydrophilicity of PES membranes. Consequently, the pure water flux found to improve from 151.6 to 569.6 (L/(m2. h)) for the 3.0 wt% modified OCDC membrane (M-3) which is 3.8 folds of the bare PES membrane. The antifouling characteristics were evaluated by humic acid (HA) filtration. The results revealed a significant enhancement in HA rejection with OCDC loading, the highest rejection was 96.8% for M-3 membrane. Additionally, the adsorption capacity of OCDC modified membranes found to decrease with OCDC loading indicating improved rejection of HA from the membrane surface. Moreover, M-3 demonstrated the maximum flux recovery ratio (FRR) of 92.3%. Reusability of the fabricated membranes was evaluated by deionized water/humic acid cycling filtration. The FRR was higher than 86.7% over three cycles of pure water/HA filtration for 140 min, indicated the excellent stability and reusability of the membranes. Overall, the OCDC was an effective filler for enhancing the PES UF membranes antifouling and permeability properties.

A Comparative Analysis of the Effect of Carbonaceous Nanoparticles on the Physicochemical Properties of Hybrid Polyethersulfone Ultrafiltration Membranes.

Numerous studies have been previously reported on the use of nanoscale carbonaceous fillers, such as multi-walled carbon nanotubes (MWCNTs) and graphene oxide (GO), in polymeric ultrafiltration (UF) membranes; however, no insight has been clearly reported on which material provides the best enhancements in membrane performance. In this study, a comparative analysis was carried out to establish a comprehensible understanding of the physicochemical properties of hybrid polyethersulfone (PES) UF membranes incorporated with MWCNTs and GO nanoparticles at various concentrations. The hybrid membranes were prepared via the non-solvent-induced phase separation process and further characterized by field emission scanning electron microscopy and atomic force microscope (AFM). The AFM images showed homogeneous membrane surfaces with a reduction in the membrane surface roughness from 2.62 nm for bare PES to 2.39 nm for PES/MWCNTs and to 1.68 nm for PES/GO membranes due to improved hydrophilicity of the membranes. Physicochemical properties of the hybrid PES membranes were assessed, and the outcomes showed an enhancement in the porosity, pore size, water contact angle, and water permeability with respect to nanoparticle concentration. GO-incorporated PES membranes exhibited the highest porosity, pore size, and lowest contact angle as compared to PES/MWCNTs, indicating the homogeneous distribution of nanoparticles within the membrane structure. PES/MWCNTs (0.5 wt.%) and PES/GO (1.0 wt.%) hybrid membranes exhibited the highest water flux of 450.0 and 554.8 L m-2 h-1, respectively, at an applied operating pressure of 1 bar. The filtration and antifouling performance of the PES hybrid membranes were evaluated using 50 mg L-1 of humic acid (HA) as a foulant at pH = 7. Compared to the bare PES membrane, the MWCNTs and GO-incorporated PES hybrid membranes exhibited enhanced permeability and HA removal. Moreover, PES/MWCNTs (0.5 wt.%) and PES/GO (1 wt.%) hybrid membranes reported HA rejection of 90.8% and 94.8%, respectively. The abundant oxygen-containing functional groups in GO-incorporated PES membranes resulted in more hydrophilic membranes, leading to enhanced permeability and fouling resistance. The antifouling properties and flux recovery ratio were improved by the addition of both nanoparticles. Given these findings, although both MWCNTs and GO nanoparticles are seen to notably improve the membrane performance, PES membranes with 1 wt.% GO loading provided the highest removal of natural organic matter, such as HA, under the same experimental conditions.