American University of Beirut

To explore the association between dysfunctional toileting behaviors (TB) and recurrent urinary tract infections (RUTI) in premenopausal women using a validated behavioral assessment scale. We conducted a case-control study at the American University of Beirut Medical Center between 2020 and 2023. A total of 294 premenopausal women were recruited, comparing 98 women with RUTI and 196 controls without RUTI. Participants completed a structured questionnaire, including demographic data and responses to the Toileting Behaviors-Women's Elimination Behavior (TB-WEB) scale, assessing five behavioral domains: place preference, premature voiding, delayed voiding, straining, and position preference. Statistical analysis involved t-tests, chi-square tests, and multivariable logistic regression adjusting for potential confounders. Women with RUTI were more likely to prefer crouching rather than sitting on toilet seat during micturition, both at home and in public restrooms. Women with RUTI showed significantly higher mean scores for dysfunctional TB when compared to those without RUTI in the following domains: place preference for voiding, premature voiding, delayed voiding, and straining. At least 62.5% of women with RUTI reported that these behaviors had been habitual prior to their diagnosis suggesting that these practices could have contributed to the development of RUTI. This study identifies a significant association between "dysfunctional" TB and RUTI in premenopausal women. The findings underscore the importance of further research to explore the causal mechanisms underlying this relationship and to develop targeted interventions aimed at modifying TB to try to curb the incidence of RUTI.

Background: Identifying patients most likely to benefit from immune checkpoint inhibitors (ICIs) remains a significant challenge in advanced melanoma. We evaluated the association between tumor somatic mutations and clinical outcomes, focusing on relapse-free survival (RFS) and overall survival (OS) in locoregionally advanced melanoma patients treated with neoadjuvant ipilimumab. Methods: Tumor specimens and matched peripheral blood samples from 22 patients underwent whole-exome sequencing (WES) to identify non-synonymous somatic mutations. Tumor mutational burden (TMB) was quantified, and specific mutations were analyzed for associations with survival outcomes. Results: The analysis revealed a mutational landscape dominated by single-nucleotide missense mutations with a median TMB of 11.4 mutations/MB. BRAF and NRAS mutations were detected in 73% of patients and exhibited mutual exclusivity and concurrence patterns (p < 0.05). Positional clustering identified NRAS and SLC35B4 as key contributors to melanoma (FDR p-value < 0.05). Log-rank analysis indicated that mutations in ODZ1, USP34, CEP192, EML5, KIAA1797, ATAD5, and ANKHD1-EIF4EBP were associated with shorter survival outcomes (RFS or OS). The associations remained significant in both univariate and multivariable Cox regression models adjusted for TMB. These genes can be broadly grouped into functional categories relevant to tumor progression and immune modulation. In applying multiple testing correction, none maintained statistical significance, indicating that these findings should be interpreted as exploratory and require validation in independent cohorts. Conclusions: This study identified tumor genomic alterations associated with clinical outcomes in melanoma patients treated with neoadjuvant ipilimumab, suggesting their potential role in anti-tumor immunity. These findings warrant further investigation in larger cohorts and across other ICIs in melanoma and other malignancies.

This review synthesizes recent empirical and theoretical studies from 2024 to 2025 that examine the psychological effects of war, displacement, and siege on Palestinian children in the Gaza Strip. It focuses on the interconnected issues of death anxiety, post-traumatic stress disorder (PTSD), grief, and resilience, aiming to frame mental health outcomes within structural and political contexts rather than within individual pathology. Studies indicate that between 70 and 90% of children in the Gaza Strip meet criteria for PTSD or exhibit significant symptoms of depression and anxiety. Continuous traumatic stress stems from prolonged bombardment, displacement, and loss, exacerbated by the collapse of mental health services. Qualitative evidence reveals widespread death anxiety, anticipatory grief, and moral injury. However, resilience rooted in family cohesion, faith, education, and Sumud (steadfastness) remains a key protective factor. Community-based interventions show potential but lack sustainability amid systemic destruction. Decolonial scholarship further challenges Western trauma models, treating children’s stories as acts of agency and epistemic resistance. The psychological impact of the military siege and sustained attacks in the Gaza Strip on children is profound and enduring. Effective responses should integrate psychosocial, educational, and justice-oriented approaches to rebuild community systems and explicitly acknowledge the political conditions that shape children’s lives. Future research should employ longitudinal, participatory, and culturally grounded methods that link psychological recovery to social reconstruction and the restoration of dignity.