Beirut Arab University

Functional asymmetry and sensorimotor control impairments often persist in patients following total knee arthroplasty (TKA), yet they remain under-evaluated in routine clinical settings using simple, scalable tools. Understanding the relationship between these deficits and postoperative outcomes is critical for optimizing rehabilitation strategies. To assess the prevalence and degree of functional asymmetry in individuals 6-12 months post-TKA using standardized physical therapy assessments, and to evaluate the predictive value of asymmetry and sensorimotor deficits on both functional performance and patient-reported outcomes. A cross-sectional study was conducted on 125 patients aged 55-80 years, 6-12 months after unilateral primary TKA. Functional asymmetry was measured using the Single-Leg Sit-to-Stand (SLSST), Step-Down Test, and modified Star Excursion Balance Test (mSEBT). Functional outcomes included the Timed Up and Go (TUG) and 30-Second Chair Stand Test (30CST). In contrast, self-reported outcomes were assessed he KOOS-ADL and the KOOS-Function in Sport and Recreation (KOOS-Sport/Rec) subscales were administered. Correlations and multiple regression models were used to analyze relationships between asymmetry measures and outcomes. Significant correlations were found between asymmetry measures and both functional and self-reported outcomes (e.g., SLSST asymmetry and TUG: r = 0.47, p = 0.005; KOOS-ADL: r = -0.45, p = 0.007). Regression models identified SLSST, Step-Down, and mSEBT asymmetry as significant predictors of TUG (R2 = 0.48, p < 0.001) and KOOS-ADL (R2 = 0.53, p < 0.001). Patients with high asymmetry exhibited significantly poorer outcomes across all measures (all p < 0.01). Functional asymmetry and sensorimotor deficits are independently associated with poorer mobility and self-reported function post-TKA and can be effectively identified using clinically accessible tools, supporting their integration into routine postoperative assessment and rehabilitation planning.

Rapid and accurate segmentation of tumors in medical images is of primary importance for cancer diagnosis and treatment designs. Though advancements have been made with autoencoding 3D images and U-Net-like architectures, the segmentation boundary precision problem is still persistent with complex, oddly shaped tumors under constrained input conditions. Advancing boundary precision remains one of the field’s most important open challenges. This study proposes an improvement to the 3D autoencoder by incorporating a hybrid model. We improve feature extraction through the addition of a hybrid attention (HA) mechanism, which combines channel-wise and learned query structural attention. We also include a differentiable learnable thresholding (DLT) layer, which provides data-driven segmentation boundary control and segmentation boundary refinement for segmentation. The model was evaluated on the Brain Tumor Segmentation (BraTS) 2020 dataset and achieved a 92.0 dice score on the whole tumor. The defined metrics serve as robust evidence for accuracy and demonstrate the improvement of the proposed model over existing state-of-the-art benchmarks. Increased precision and accuracy offered by the proposed system surpasses the current computerassisted diagnostic systems for medical imaging. This study pushes the boundary of existing knowledge as it helps to resolve the challenging issue of pinpointing the location of tumors in 3D medical volumes.

As crises, both natural and man-made, continue to escalate in frequency and complexity, the need for effective and timely humanitarian interventions has become increasingly critical. Artificial intelligence (AI) has emerged as a transformative tool in enhancing humanitarian aid, addressing all stages of the crisis management cycle. Despite growing interest in AI's application within the humanitarian field, the existing literature remains fragmented, with limited synthesis of its overall impact. This study adopts a systematic literature review approach to provide a comprehensive analysis of AI's utilization in humanitarian aid across the crisis cycle, as well as its role in broader humanitarian settings outside of immediate crisis contexts. Based on 60 selected studies, the findings reveal that AI applications in both the pre- and post-crisis phases can be grouped into four specific categories, and that AI's role in broader humanitarian contexts can similarly be divided into four focus areas. Specifically, the categories in the pre-crisis phase include site selection, medical services enhancement, early warning, and information flow, and the categories in the post-crisis phase include distribution and delivery, damage assessment, online and textual insights, and routing optimization. The review highlights AI's significant potential to enhance the effectiveness and efficiency of humanitarian efforts, offering valuable insights for organizations seeking to harness AI's transformative power. • This study provides an overview of the current state of knowledge on the AI-humanitarian aid nexus and outlines a roadmap for future research. • Two research questions guide this review: exploring how AI is applied during crises, and examining its broader use in the humanitarian context. • Understanding the AI-humanitarian link is critical considering how heavily the world relies on aid being effective every time a crisis occurs. • This is the first comprehensive synthesis to examine AI's role in humanitarian aid across multiple crisis types and phases.

AimThis systematic review and meta-analysis aimed to evaluate the fracture resistance of permanent teeth restored with polyethylene fiber-reinforced composite resin restoration.Material and methodsThe following PICOS framework used was: Population, permanent teeth requiring restorative treatment; Intervention, polyethylene fiber use; Control, composite resin restorations without fiber reinforcement, or conventional fiber posts; Outcome, fracture resistance (in Newtons); Study design, in vitro studies. A literature search was conducted independently by two reviewers up to May 18, 2025, using electronic databases (PubMed, ISI Web of Science, SciELO, Scopus, and Embase). In vitro studies examining the fracture resistance of permanent teeth restored with polyethylene fiber-reinforced resin composite restorations were included. Meta analyses were performed by comparing the standardized mean differences in the fracture resistance of teeth restored using polyethylene fibers and the teeth restored only with resin composite. Additional analysis was performed comparing the risk difference of the number of unfavorable fractures. Separate analyses were performed when fiber posts were used. A p-value of less than 0.05 was considered statistically significant.ResultsThe fracture resistance of polyethylene fiber-reinforced restorations was higher compared to non-fiber reinforced composite restorations (p < 0.001). Also, the number of unfavorable fractures were significant lower when polyethylene fibers were used (p < 0.001).ConclusionThe findings suggest that the fracture resistance of permanent teeth may be improved with the use of polyethylene fibers. However, clinical performance outcomes are necessary to validate these in vitro results.Systematic Review RegistrationThe protocol for the systematic review was developed a priori and can be accessed at: https://doi.org/10.17605/OSF.IO/5K8XB.

Abstract Background Despite the availability of multiple COVID-19 vaccines, challenges remain in prevention and control. This systematic review and meta-analysis assess the safety and efficacy of BCG vaccination in COVID-19 prevention. Methods A comprehensive search was conducted in PubMed, Cochrane, Scopus, Web of Science, and Embase until March 2024. Primary outcomes included COVID-19 infection rate, mortality, hospitalization rate, and ICU admission. Secondary outcomes focused on adverse events. Results Fifteen RCTs with 16,347 participants were included. BCG vaccination did not significantly reduce COVID-19 infection (RR = 1.06, 95% CI [0.96–1.17], p = 0.27), ICU admission (RR = 0.44, 95% CI [0.14–1.42], p = 0.17), or hospitalization rate (RR = 0.90, 95% CI [0.60–1.36], p = 0.62). There were fewer deaths in the BCG group (RR = 0.52, 95% CI [0.25–1.08], p = 0.08). Regarding adverse events, BCG vaccination was strongly associated with erythema and may slightly increase cough risk, while other systemic symptoms (nausea, muscle/joint pain, sore throat) showed no significant association. Conclusion BCG vaccination does not significantly reduce the risk of COVID-19 infection, hospitalization, or ICU admission. While there is a potential reduction in mortality, the result is not statistically significant. Adverse event analysis confirms a strong association with erythema and a slight increase in cough risk, but no consistent association with other systemic symptoms. These findings suggest that BCG vaccination does not provide substantial protection against COVID-19 but is generally well tolerated. Disclosures All Authors: No reported disclosures

Cornflakes are a globally popular breakfast cereal, commonly consumed in the United Arab Emirates (UAE). Given the UAE's dependence on imported food products, including cornflakes, ensuring the safety of consumers through vigilant monitoring of pesticide residues is crucial. Following a market screening of major UAE retail markets, this study identified 76 cornflakes stock-keeping units (SKUs) and analyzed them using the quick, easy, cheap, effective, rugged, and safe (QuEChERS) extraction method coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS). Three pesticide residues, azoxystrobin, chlorpyrifos, and tebuconazole, were detected at trace levels, all below the limit of quantification (LOQ). None of the residues exceeded the maximum residue limits (MRLs) established by UAES MRL 1:2024, which follows a hierarchical approach using Codex Alimentarius (CODEX) and European Union (EU) MRLs. The detection of chlorpyrifos, an organophosphate insecticide, and the fungicides azoxystrobin and tebuconazole, reflects their widespread agricultural use, yet their low levels demonstrate the impact of food processing steps, such as milling, extrusion, and toasting, and effective regulatory oversight. These findings indicate that cornflakes available in the UAE market are safe with respect to pesticide residues, though routine surveillance remains essential.

Fermented (red) rooibos tea (Aspalathus linearis) has been widely consumed for its well-known health-promoting effects and represents an important dietary source of natural polyphenols. Yet, compared with unfermented (green) rooibos tea, fermented rooibos tea has received limited investigation, particularly regarding the optimization of its aqueous extraction and the systematic evaluation of its chemical composition and bioactivities. This study aimed to optimize polyphenol extraction from commercial red rooibos tea using response surface methodology (RSM), followed by assessment of the antioxidant, antibacterial, and anticancer activities of the optimized extract. In addition, the phenolic profile of the extract was characterized using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC–QTOF–MS). The solid-to-liquid extraction using a water bath was optimized for extraction temperature and time factors. The extract was evaluated for total phenolic content (TPC) using the Folin–Ciocalteu assay, and for antioxidant activity using the DPPH (2,2-diphenyl-picrylhydrazyl) assay. RSM analysis indicated that temperature was the dominant factor influencing both TPC and DPPH activity, with time showing a secondary temperature-dependent effect. At the optimized conditions (90 °C, 10 min), the optimum rooibos tea extract (RTE) showed a TPC of 49.94 mg GAE/g DM and an antioxidant activity of 101.90 mg TE/g DM. UHPLC–QTOF–MS analysis identified 43 metabolites in the RTE, mainly isoorientin, rutin, aesculetin, and aspalathin among others. The RTE produced inhibition zones of 12 mm against Staphylococcus aureus and 10 mm against Pseudomonas aeruginosa in the disc diffusion assay, while no inhibition zones were observed for Bacillus cereus, Listeria monocytogenes, Escherichia coli, or Salmonella Typhimurium. Broth microdilution assays yielded Minimum Inhibitory Concentration/Minimum Bactericidal Concentration (MIC/MBC) values of 25/25 mg/mL for S. aureus, 25/50 mg/mL for L. monocytogenes, 50/50 mg/mL for P. aeruginosa, and 50/100 mg/mL for E. coli, whereas B. cereus and S. typhimurium showed resistance to RTE under the tested conditions. For the anticancer activity, evaluated using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, the extract did not achieve 50% inhibition across the concentrations tested (50–700 μg/mL) against H460, HT-29, and Caco-2 cancer cell lines. This study is the first to integrate RSM-based optimization of aqueous red rooibos extraction with chromatographic profiling and in vitro biological assays. Future studies may compare red and green rooibos tea, and explore product variability, in vivo relevance, and alternative processing strategies.

Environmental exposure significantly influences mental well-being. Green spaces offer psychological benefits, while noise exposure is a recognized environmental stressor. However, their effects on mental health outcomes such as depression, anxiety, and stress remain underexplored in Lebanon. This study investigates the influence of green space and noise exposure on mental health in the Lebanese population. A cross-sectional study was conducted using an online survey distributed across the Lebanese population. A total of 653 participants aged 18-65 years completed the questionnaire, which assessed socio-demographics, green space exposure, noise exposure, and mental health using the Arabic versions of the validated scales for depression (PHQ-9), anxiety (GAD-7), and stress (PSS-10). Data was analyzed using SPSS version 25. Higher green space exposure-such as proximity to greenery, views of natural environments, and more frequent visits-was significantly associated with lower levels of depression, anxiety, and stress (p < 0.05). Conversely, greater noise exposure at home or work, and symptoms such as sleep disturbance, irritability, or difficulty concentrating due to noise, were significantly associated with higher scores across all three mental health domains (p < 0.001). Multiple linear regression showed that some noise-related symptoms were consistently associated with higher depression, anxiety, and stress. Environmental exposures play a critical role in shaping the mental health. Increasing access to green spaces and reducing noise pollution may serve as effective public health interventions to decrease levels of depression, anxiety, and stress among Lebanese residents. Urban planning and public policy should integrate these findings into mental health promotion strategies.