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Chronic liver diseases are a major global health concern. Aims: this study investigated the links between medical, clinical, anthropometric, and dietary factors with dysfunction-associated steatotic liver disease (MASLD) in the Lebanese population using a case-control approach to uncover factors influencing visceral obesity, sarcopenia, and sarcopenic obesity. Methods and Materials: a total of 120 participants (20–70 years old) were divided into case and control groups based on liver disease diagnosis. Patient information was gathered through a questionnaire encompassing demographics, medical history, and beverage consumption. Anthropometric and body composition data were collected in a clinical setting. Results: our findings indicated a clear association between the presence of MASLD and obesity, hypertension, and diabetes. The positive association with higher body mass index and all three conditions remained consistent even when data was stratified by case and control groups. A greater proportion of MASLD patients exhibited sarcopenic obesity. Furthermore, MASLD cases showed higher consumption of sugary beverages and a reduced intake of milk and water in their diets. Conclusions: this study shed light on the health attributes and diets of the Lebanese population with liver diseases and suggested more research in this area and in a more ethnically diverse population. [ABSTRACT FROM AUTHOR]

Purpose: The paper explores the inflationary consequences of the Lebanese economic and financial crises on Lebanese society. The study investigates the distribution of inflationary harm across various demographic characteristics, including age, marital status, educational level, employment type, region of residence, income range and type. It also identifies the different coping mechanisms adopted by the Lebanese people to survive during the inflationary period. Design/methodology/approach: The study surveys 168 Lebanese citizens to determine which groups of people are most affected by inflation, its impact on their quality of life and the different coping mechanisms the citizens employ to endure the period of growing prices. Findings: The results show that some groups of Lebanese citizens are more influenced than others by rising prices. The categories of people who suffer the most from inflation are the elderly, the widowed, those characterized by low educational and low-income levels, the unemployed, the retired and public sector employees, as well as homemakers. Originality/value: This study provides policymakers with substantial information regarding the economic and social well-being of Lebanese citizens by highlighting the categories of people in need for special financial and social support. The findings can guide targeted policy interventions to support vulnerable populations. The study can also inform future research on the impact of the crisis and the effectiveness of policies. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-11-2022-0736 [ABSTRACT FROM AUTHOR]

Propolis, with its distinctive chemical composition, has been known for therapeutic potential in treating numerous diseases. This study investigated whether propolis has an antibacterial effect on bacteria in Lebanon. Twenty-eight samples of gram-negative and gram-positive bacteria were collected from Raii Hospital and Al-Taakhi Medical Center in Gazieh, South Lebanon. Each sample was streaked on three different Petri dishes with different percentages of propolis under aseptic conditions. The results were recorded visually and confirmed by Gram staining after incubation for 24 h at 37°C. The obtained results show that propolis inhibited the growth of 18% of the total number of collected bacteria. The majority of bacteria on which propolis had an inhibitory effect were gram-positive bacteria, which inhibited 50% of them, whereas it only inhibited the growth of 9% of the gram-negative bacteria. Propolis was also shown to have an antifungal effect. [ABSTRACT FROM AUTHOR]

Introduction: Adolescents react differently to challenging negative life events. Resilience, a dynamic characteristic of individuals, was studied to be a protective factor against such events. In order to study the resilience among Arabic-speaking adolescent populations, age-appropriate measures that are fully apprehended by younger respondents are needed. In this context, the present study aimed to examine the psychometric properties of an Arabic translation of the Resilience Scale for Adolescents (READ) in a community sample of native Arabic–speaking adolescents aged 13–18 years. Methods: A sample of 546 community Arabic-speaking adolescents from Lebanon was recruited (n = 328 females, with a mean age of 15.76 ± 1.65 years). Through an online questionnaire, participants were requested to complete the READ, Depression, Anxiety and Stress Scale (DASS-8) and the 13-item Children's Impact of Event Scale (CRIES-13). Results: Following the exploratory and confirmatory factor analysis (EFA-to-CFA) strategy, a unidimensional model of the Arabic version of the READ was met after 10 items were removed from the scale, and showed strong internal consistency (Cronbach's alpha of 0.943). Additionally, the one-factor solution of the Arabic version of the READ was identical across male and female adolescents at the three levels of invariance (Configural, Metric and Scalar). Finally, higher resilience scores were significantly correlated with lower levels of psychopathology, namely depression, anxiety, stress and PTSD, thus attesting to the concurrent validity of the Arabic READ. Conclusion: Findings lend support to the psychometric reliability and validity of the Arabic version of the READ, and therefore its suitability for use among Arabic-speaking adolescents. The availability of this tool facilitates the implementation of interventions that foster resilience, especially in adolescents who have faced a number of negative life events. [ABSTRACT FROM AUTHOR]

Lockdown measures were taken since February 2020 in Lebanon, a country already going through a socio-economic crisis, to fight the new coronavirus pandemic. The aim of this study is to evaluate the psychological impact of the lockdown in Lebanon. A cross-sectional, online survey was conducted during the lockdown period in order to punctually assess depression, anxiety symptoms as well as eating and substance use disorders using self-rating scales (the DASS-21, SCOFF and CAGE-AID respectively), while identifying factors that might affect those outcomes. Overall, 1133 participants completed the questionnaire. The DASS-21 score was positively correlated with the impact of lockdown on participants' lifestyle and lockdown duration. A highest effect on DASS-21 score was related to the intensity of other stressful life events that have happened during the last 3 months. Linear regression analysis also showed that age, monthly income, professional status, the SCOFF and CAGE-AID scores, the intensity of the lockdown's impact on lifestyle and having been through other stressful life events unrelated to the lockdown per se, were risk factors affecting significantly the DASS-21 score. Lockdown, as well as other stressful life event that have happened during the last 3 months, were therefore associated with higher depression, anxiety, and stress symptoms. These findings may guide future policy making strategies in order to prevent mental health problems in case of a pandemic concomitant with other critical stressors. [ABSTRACT FROM AUTHOR]

This paper describes the current state of science education in Arab states and anticipates some of the challenges faced by those states as they reform their science education. After discussing problems of illiteracy, access and quality we provide contextual information about the structure of the educational systems and describe recent efforts to reform them. We focus on issues pertaining to science curriculum and textbooks, language, religion, student learning in science, science teacher education and science education research and summarise the challenges and opportunities for research faced in each area. We conclude the paper by proposing a set of policy and research recommendations that could aid in the development of lasting solutions for recurring problems. (Contains 2 tables and 16 notes.)

Type 2 diabetes (T2D) is a global health problem accompanied by an elevated risk of complications, the most common being cardiac and renal diseases. In Lebanon, the prevalence of T2D is estimated at 8–13%. Local medical practice generally suffers from clinical inertia, with gaps in the yearly assessment of clinical manifestations and suboptimal screening for major complications. The joint statement presented here, endorsed by five Lebanese scientific medical societies, aims at providing physicians in Lebanon with a tool for early, effective, and comprehensive care of patients with T2D. Findings from major randomized clinical trials of antidiabetic medications with cardio-renal benefits are presented, together with recommendations from international medical societies. Optimal care should be multidisciplinary and should include a multifactorial risk assessment, lifestyle modifications, and a regular evaluation of risks, including the risks for cardiovascular (CV) and renal complications. With international guidelines supporting a shift in T2D management from glucose-lowering agents to disease-modifying drugs, the present statement recommends treatment initiation with metformin, followed by the addition of sodium-glucose cotransporter 2 inhibitors or glucagon-like peptide-1 receptor agonists due to their CV and renal protection properties, whenever possible. In addition to the selection of the most appropriate pharmacological therapy, efforts should be made to provide continuous education to patients about their disease, with the aim to achieve a patient-centered approach and to foster self-management and adherence to the medical plan. Increasing the level of patient engagement is expected to be associated with favorable health outcomes. Finally, this statement recommends setting an achievable individualized management plan and conducting regular follow-ups to monitor the patients' glycemic status and assess their risks every 3–6 months. [ABSTRACT FROM AUTHOR]

Purpose: This study refines theory of social capital by nesting it within a cultural context. More specifically, it aims at describing, explaining, and predicting the role of wasta, a social capital concept, as a moderator in the relationship between employees' ethical idealism and work engagement in Lebanon. Design/methodology/approach: Based on a survey questionnaire translated from English into Arabic, 317 responses were collected from employees in Lebanon. Confirmatory factor analysis and hierarchical regression analysis were employed to test the hypothesized relationships among the examined variables. Findings: Ethical idealism was found to be positively related to work engagement, and wasta was found to moderate the relationship between ethical idealism and work engagement. Work engagement levels of employees who displayed high levels of ethical idealism were less influenced by the negative effect of wasta than work engagement levels of employees who displayed low levels of ethical idealism. Practical implications: Human resource managers, international negotiators, and global executives in Lebanon may use the findings of this study to update corporate human resources systems, such as employee recruitment and selection, handbooks, orientation, training programs, and performance appraisal, to better address employee attitudes toward the practice of wasta. Originality/value: The study adds ethical idealism as an antecedent of work engagement, demonstrating the significant impact that wasta, with its positive and negative characteristics, has on the engagement of employees from the Arab world. [ABSTRACT FROM AUTHOR]

In Lebanon, a country with the highest per capita refugee population in the world, roughly one in four persons is forcibly displaced. Early marriage is highly prevalent among Syrian refugees in Lebanon and qualitative studies suggest an unmet need for sexual and reproductive health (SRH) information and services in this community. Adolescent Syrian refugee girls in Lebanon are a vulnerable population at risk of negative SRH outcomes related to early sexual debut, which occurs primarily in the context of early marriage. Despite this need, cultural norms and gender roles generally restrict adolescent girls' access to SRH resources. To address this need for comprehensive sexuality education, our team developed a novel, rightsbased, peer-led, adolescent SRH educational curriculum that is specific to the context of Syrian displacement in Lebanon. This curriculum was developed to be administered as part of Project Amenah, a communitybased, multi-component intervention that aims to reduce early marriage and improve SRH among adolescent Syrian refugee girls displaced in Lebanon. The curriculum, which features eight discreet age-appropriate units, is based on extensive formative work conducted in this community, as well as adaptations of early marriage programs implemented in low-resource settings elsewhere. Topics covered include, but are not limited to, gender and human rights, communication, negotiation and decision-making, reproductive anatomy, puberty and menstruation, sexually transmitted infections, family planning and modern contraception, and adolescent pregnancy. We encountered several challenges when developing this curriculum, including those related to community acceptability, varying levels of literacy levels among participants, and limited engagement with married adolescents, who may experience mobility restrictions that preclude their participation. We recommend that investigators developing adolescent SRH interventions in similar settings utilize a behavior-determinant-intervention logic model to guide their study design, elucidate community priorities and capacity by conducting preliminary qualitative work and assembling a community advisory board, and follow a peer-led model, which has shown to be effective for adolescent SRH interventions. [ABSTRACT FROM AUTHOR]

Pneumococcal disease affects people across all ages but is more prevalent in young children and the elderly. Despite the availability of the pneumococcal vaccine for adults, the disease burden and mortality associated with it remains a challenge. A few studies conducted in Lebanon have reported epidemiology of pneumococcal disease, concurring the high burden among adults and older adults in the region. The pneumococcal vaccine is a part of the routine immunization schedule for children, but there are no recommendations for adult vaccination. A medical advisory board was hence conducted in September 2020 to discuss the burden of pneumococcal disease (PD) among adults in Lebanon. The participants were experts from the fields of internal medicine, family medicine, hematology, cardiology, oncology, endocrinology, pulmonology, and infectious diseases. The experts reached a consensus that there is a need to take steps to increase the rate of adult vaccination uptake and create awareness among physicians, pharmacists, caregivers, and patients. The physicians should be trained on adult immunization and should actively discuss the importance of the pneumococcal vaccine, especially with high-risk adult patients. Implementing adult vaccination as a routine practice and involving various stakeholders to address the gaps can help in reducing the burden of pneumococcal disease in adults. [ABSTRACT FROM AUTHOR]

The absence of nationally accepted typology to classify and describe habitats has been an obstacle to the development of coordinated research in this field and to the implementation of conservation actions; therefore, a classification of the natural and semi-natural terrestrial habitat types existing in Lebanon is presented and adapted to the hierarchical structure of the European Nature Information System (EUNIS) habitat classification. The harmonisation with an international classification system is essential to facilitate communication and research throughout the Mediterranean Basin. A total of 1597 sites surveyed throughout Lebanon between 2013 and 2020 were classified and described based on the analysis of the physiognomic parameters and specific composition of their vegetation. The analysis yielded 190 habitat types for Lebanon, including 12 coastal habitats (category N), 35 related to inland surface waters (C), 6 wetland habitats (Q), 20 grasslands (R), 54 scrublands and heaths habitats (S), 27 types of woodlands (T), 17 inland unvegetated habitats (U), and 19 vegetated man-made habitats (V). Sixty-one habitats characteristic of Lebanon, not previously included in the EUNIS classification, were described and proposed in this typology. Those habitats include shrublands (23), woodlands (18), coastal habitats (6), wetlands (1), grasslands (9), sparsely vegetated habitats (2) and man-made vegetation (2). [ABSTRACT FROM AUTHOR]

Introduction: The increasing incidence of infections caused by multidrug-resistant bacteria is considered a global health problem. This study aimed to investigate this resistance in Gram-negative bacteria isolated from patients hospitalized in North-Lebanon. Methodology: All isolates were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was achieved using disk diffusion, E-test and Broth microdilution methods. Phenotypic detection of carbapenemase was carried out using the CarbaNP test. RT-PCR, standard-PCR and sequencing were performed to detect resistance genes and oprD gene. Conjugal transfer was carried out between our isolates and Escherichia coli J53 to detect the genetic localization of resistance genes. MLST was conducted to determine the genotype of each isolate. Results: Twenty-three carbapenem-resistant Enterobacterales of which eight colistin-resistant Escherichia coli, and Twenty carbapenemresistant Pseudomonas aeruginosa were isolated. All isolates showed an imipenem MIC greater than 32 μg/mL with MICs for colistin greater than 2 mg/L for E. coli isolates. All the Enterobacterales isolates had at least one carbapenemase-encoding gene, with E. coli isolates coharboring blaNDM-4 and mcr-1 genes. Moreover, 16/20 Pseudomonas aeruginosa harbored the blaVIM-2 gene and 18/20 had mutations in the oprD gene. MLST revealed that the isolates belonged to several clones. Conclusions: We report here the first description in the world of clinical E. coli isolates coharboring blaNDM-4 and mcr-1 genes, and K. pneumoniae isolates producing NDM-6 and OXA-48 carbapenemases. Also, we describe the emergence of NDM-1-producing E. cloacae in Lebanon. Screening for these isolates is necessary to limit the spread of resistant microorganisms in hospitals. [ABSTRACT FROM AUTHOR]

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The objective of the EAF baseline report was to provide the necessary baseline information to pilot an EAF on the PSSF in Lebanon. This decision was based on the advances that the country has made in the fisheries sector in the past decade which paved the way for the introduction of the latest management approaches in fisheries. In-depth background research on the PSSF was undertaken by the Marine and Coastal Resources Program at the Institute of Environment, University of Balamand (MCR-IOE-UOB) which covered national and regional documents deemed beneficial for the project objectives. Additional documents and information were provided by the EastMed Project and, at national level, by the Directorate of Fisheries and Wildlife (DFW) within the MOA. These documents included material relating to the laws regulating the PSSF, the number of fishers and vessels, the size of the catch and the species caught, etc. Through regular meetings and constant exchange of information between project partners, this report documents all the available and relevant material on the PSSF in Lebanon, including the species caught, the geographical areas covered by the case study, the socio-economic profile of the fishery and the current institutional arrangements for its management. [ABSTRACT FROM AUTHOR]

Summary: Our study aimed at constructing and validating the Lebanese Osteoporosis Knowledge Scale adapted for use among Lebanese women and to assess factors associated with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. This scale showed adequate psychometric properties; higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions. Introduction: The primary objective of this study was to describe the construction of the Lebanese Osteoporosis Knowledge Scale (LOKS) and assess its psychometric properties in a representative sample of Lebanese women aged 40 years and above. Secondary objectives were to explore factors associated with this knowledge score. Methods: A cross-sectional study carried out between March and June 2018, enrolled 560 women over the age of 40 years living in the community. This proportionate sample was randomly selected from all Lebanese governorates to cover the entire Lebanese area. A survey was developed and adapted to the Lebanese population based on preexisting scales. Personal interviews were conducted to collect data. Results: The items of the LOKS were distributed across seven factors with an Eigenvalue over 1 solution, outlining an overall value of 55.89% of the variance. A high Cronbach's alpha was found for the full scale (0.725). Individuals having a university level of education (beta = 1.62; compared to illiteracy), having heard of osteoporosis (beta = 2.62), taking supplements of calcium and vitamin D compared to none (beta = 0.77), and having had Crohn's disease (beta = 1.71) had significantly higher knowledge scores of osteoporosis; oppositely, having diabetes (beta = − 1.17), currently taking chemotherapy (beta = − 2.25), and ever having had a fracture (beta = − 0.74) were significantly correlated with lower awareness of osteoporosis. Conclusions: Our findings suggest that the LOKS-19 can be used to measure knowledge of osteoporosis and help assess osteoporosis-related interventions. A better knowledge seems to be associated with more preventive measures and less risk of fracture. [ABSTRACT FROM AUTHOR]

Coastal vegetation includes unique species with adaptations to the specific conditions of this environment, and in the Mediterranean region urban development of coastal areas has severely affected coastal ecosystems. Astragalus berytheus Boiss. & Blanche is a narrow endemic plant of the eastern Mediterranean coast, occurring in Lebanon and Palestine/Israel; its Red List status has not been previously assessed. As a result of the effects of urban sprawl in coastal areas A. berytheus is one of the most threatened plant taxa in Lebanon. We assess the conservation status of this taxon and propose conservation measures. Only one population of A. berytheus is extant in Lebanon, in the Tyre Coast Nature Reserve. We recommend that A. berytheus should be categorized as Endangered globally and as Critically Endangered at the national level in Lebanon. Unless adequate conservation measures are implemented A. berytheus is likely to go extinct in Lebanon in the near future. [ABSTRACT FROM AUTHOR]

This study aims to describe the molecular mechanisms of carbapenem and colistin resistance in Klebsiella pneumoniae strains isolated from hospitalized patients in Lebanon. We report in this study the first description of NDM-5 producing carbapenem-resistant K. pneumoniae ST383, as well as the presence of two out of five isolates resistant to colistin due to mutations in the amino acid sequences of proteins (PmrB, PhoQ, and MgrB). Therefore, screening of such isolates may be effective in limiting the spread of these resistant microorganisms in hospitalized patients and within the community. [ABSTRACT FROM AUTHOR]

Background: Although new guidelines developed by the American Society of Anesthesiologists (ASA) recommend a liberalized preoperative nutrition, authorized clinical practice guidelines or recommendations have not yet been proposed by the Lebanese Society of Anesthesia (LSA). Objective: The purpose of this study was to examine Lebanese anesthesiologists' preoperative fasting routines and determine their knowledge and acceptance of the ASA recommendations, their attitude toward liberalized fasting, and the factors favoring their nonadherence to the new recommendations. Materials and Methods: This study was conducted in university hospitals, affiliated hospitals, and nonuniversity hospitals located in different regions of Lebanon. The survey was approved by the local ethics committee. A written questionnaire was emailed to all anesthesiologist members of the LSA which was completed anonymously. Results: Out of the 294 anesthesiologists registered in the LSA and who read the email, 118 (40.1%) completed the questionnaire. Of respondents, 90% are aware of the latest ASA practice guidelines for preoperative fasting, and 78.7% claim to apply them in their practices; however, 75% of respondents still require adult patients to stop eating after midnight, and only 45% allow them to drink clear fluids up to 2 h preoperatively. One of the main reasons for not complying with the ASA guidelines was "to allow flexibility for changes in the operating schedule." Conclusion: A long preoperative fasting period is still the common practice for Lebanese anesthesiologists. National guideline for preoperative fasting as liberal as that recommended by the ASA should be considered. [ABSTRACT FROM AUTHOR]

Summary: Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures in order to identify categories that should be targeted in future campaigns and educational programs. Higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, osteoporosis awareness campaigns and educational programs are mostly needed in populations with lower educational levels. Introduction: Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. Methods: A cross-sectional study, conducted between March and June 2018, enrolled 560 community dwelling women aged 40 years and above. A questionnaire was used to collect data. A proportionate random sample from all Lebanese Mohafazat was used. Data collection was performed through personal interviews. The median was used as a cutoff point for both the Knowledge and Health Belief scales. Results: The study results showed that 47.3% of participants had a poor knowledge score. Women who received no education, compared to a higher education and have not previously heard about the disease, had lower knowledge scores. In addition, women not taking calcium and vitamin D supplements and not exercising or exercising less than 20 min per day compared to those having these characteristics had lower osteoporosis knowledge levels. A lower knowledge score was associated with less recognized benefits of adequate calcium intake and regular physical activity, more perceived barriers towards their practice, and a less important health motivation. A lower level of education correlated to the same results. Conclusion: Lower knowledge scores were reached in women who have never heard of osteoporosis and had a lower level of education. As a result, osteoporosis awareness campaigns and educational programs need to target population categories with lower educational levels. [ABSTRACT FROM AUTHOR]

Background: Acinetobacter baumannii is an opportunistic pathogen causing various nosocomial infections. The spread of multidrug-resistant A. baumannii is a major public health problem. The aim of this study was to investigate the molecular epidemiology and the genetic support of multidrug-resistant A. baumannii isolates collected from Saint-Georges Hospital in Lebanon. Methods: Between January and August 2016, 31 A. baumannii isolates were collected from sputum samples of patients infected with ventilator-associated pneumonia (VAP) and treated with colistin-carbapenem combination therapy. Antibiotic susceptibility testing was performed using the disk diffusion method. Carbapenemases, extended spectrum β-lactamases encoding genes and mcr-1/2 genes were investigated by RT-PCR and standard PCR. The epidemiological relatedness of the strains was studied using MLST analysis. Results: Most of the isolates exhibited multidrug-resistant phenotypes. All the isolates were carbapenem-resistant and among them, 30 carried the class D carbapenemase blaoxa-23 gene while one isolate carried blaoxa-72 gene. MLST results revealed three sequence types, namely ST2, ST699, and ST627. Isolates having ST2 were the most prevalent clone (29/31, 93.5%). Conclusions: This study shows a nosocomial spread of multidrug-resistant A. baumannii ST2 having blaOXA-23 gene in Saint-George in Lebanon. Monitoring and control measures need to be adopted to avoid the spread of A. baumannii to patients. [ABSTRACT FROM AUTHOR]

The emergence of carbapenem resistant Escherichia coli represents a serious public health concern. This study investigated the resistome, virulence, plasmids content and clonality of 27 carbapenem resistant E. coli isolated from 27 hospitalized patients at the American University of Beirut Medical Center (AUBMC) in Lebanon between 2012 and 2016. Whole-genome sequencing (WGS) data were used to identify resistance determinants. Multilocus sequence typing (MLST), pulsed field gel electrophoresis (PFGE), phylogenetic grouping and PCR-based replicon typing (PBRT) were also performed. The 27 isolates were distributed into 15 STs, of which ST405 (14.8%; n = 4) was the most prevalent. All of the 27 isolates were carbapenem resistant and 20 (74%) were extended-spectrum β-lactamase (ESBL) gene carriers. The predominant detected carbapenemases were blaOXA-48 (48.1%; n = 13) and blaOXA-181 (7.4%; n = 2), for the ESBLs it was blaCTX-M-15 (55.6%; n = 15) and blaCTX-M-24 (18.5%; n = 5), and for the AmpC-type β–lactamases, blaCMY-42 (40.7%; n = 11) and blaCMY-2 (3.7%; n = 1). Thirteen replicons were identified among the 27 E. coli isolates including: IncL/M, IncFIA, IncFIB, IncFII, IncI1, and IncX3. PFGE revealed a high genetic diversity with the 27 isolates being grouped in 21 different pulsotypes. SNPs analysis and PFGE showed a possible clonal dissemination of ST405, ST1284, ST354 and ST410 and the dominance of certain STs, monitoring of which could help in elucidating routes of transmission. This study represents the first WGS-based in depth analysis of the resistomes and mobilomes of carbapenem resistant E. coli in Lebanon. [ABSTRACT FROM AUTHOR]

Considered as a hotspot for biodiversity in the Mediterranean Basin, Lebanon is currently witnessing anarchic urbanization and unprecedented destruction of its natural habitats. Unregulated urbanization is also compounded by the surge in Lebanon’s population due to the unabated influx of Syrian refugees since 2012. This work aims to define Important Plant Areas (IPAs) with exceptional botanical richness. These IPAs should constitute the priority zones for conservation, contributing to the fulfillment of national targets in the framework of the Aichi Biodiversity Targets. A customised methodology was developed to suit to the Lebanese geomorphological characteristics, using an approach that combined three indicators: species richness; species conservation value including endemism and rarity; and, the habitat conservation value. Out of the characterized 1250 cells of 3 km × 3 km covering Lebanon, 11 were ranked as IPAs of very high importance and 20 as IPAs of high importance. These 31 top ranked cells covered 3% of Lebanon’s area. These IPAs contained diverse habitat mosaics, including forests, mountain screes, cliffs and grasslands and host a total of 2386 species amounting to 79% of the flora of Lebanon and 80% of the species endemic to Lebanon. Seven of these top ranked cells contained species strictly endemic to Lebanon. Only 26% of these IPAs were already designated as protected areas and hosted 45% of Lebanon’s plant species. This map of IPAs provides important information for stakeholders, practitioners and politicians involved in conservation in Lebanon to protect endangered zones and develop rational strategies for their conservation. [ABSTRACT FROM AUTHOR]

Purpose. Evaluate infection control knowledge, attitude, and practice in Lebanese private dental clinics. Materials and Methods. A survey including 46 questions related to routine safety procedures was sent to 1150 Lebanese dentists between July 1st and 2nd, 2015. The study sample was selected from the database of registered dentists based on a proportional random sampling ensuring equitable representation of the 5 geographic regions of Lebanon. A subset of 29 questions was used to generate an overall score of compliance (excellent, good, fair, and poor). Comparisons according to gender, type, region, and years of practice were performed. Results. 417 dentists returned the completed questionnaires. 96% expressed concern about infection transmission, 90.6% were vaccinated against Hepatitis B, and 61.8% asked routinely about patients medical history. Only 43% used protective eyewear. Although most dentists (65%) used autoclaves, dry heat was still used. Significant correlations were found between gender and use of personal protective equipment. Less compliance was shown by clinicians with fewer years of experience. In the overall compliance questionnaire, the mean percentage of correct answers was roughly 54% with <5% of the practitioners scoring “excellent.” Conclusions. The study found inadequacy of compliance in private Lebanese dental clinics necessitating improved educational training and sustained monitoring by regulatory bodies. [ABSTRACT FROM AUTHOR]

Despite being an important target of conservation concern and horticultural interest, Lebanese irises yet have a confusing taxonomic history and species’ delimitation is often considered problematic, more especially among royal irises (Iris section Oncocyclus). Indeed, these irises of exceptionally large and spectacular flowers have radiated across Caucasus and eastern Mediterranean giving rise to a number of strict endemic taxa, many of them being considered under threat. Whilst efforts have mostly focused on clarifying the evolutionary relationships in the group based on morphological and molecular data, karyological and cytogenetic characters have been comparatively overlooked. In this study, we established for the first time the physical mapping of 35S rDNA loci and heterochromatin, and obtained karyo-morphological data for ten Lebanese Iris species belonging to four sections (Iris, Limniris, Oncocyclus and Scorpiris). Our results evidenced distinctive genomic profiles for each one of the sections, where Oncocyclus irises, while having the lowest chromosome numbers, exhibit both the highest number of 35S loci and CMA3+ sites. The continental radiation of royal irises has been accompanied by a relative karyological and cytogenetic stasis, even though some changes were observed regarding karyotype formula and asymmetry indexes. In addition to that, our results enabled taxonomic differentiation between I. germanica and I. mesopotamica–two taxa currently considered as synonyms–and highlighted the need for further studies on populations of I. persica and I. wallasiae in the Eastern Mediterranean Region. [ABSTRACT FROM AUTHOR]

During the last few years, the induction of toxicological mechanisms by atmospheric ultrafine particles (UFP) has become one of the most studied topics in toxicology and a subject of huge debates. Fine particles (FP) and UFP collected at urban and rural sites in Lebanon were studied for their chemical composition and toxicological effects. UFP were found more enriched in trace elements, secondary inorganic ions, total carbon and organic compounds than FP. For toxicological analysis, BEAS-2B cells were exposed for 24, 48 and 72 h to increasing concentrations of FP, water-UFP suspension (UFP w ) and UFP organic extract (UFP org ). Our findings showed that UFP caused earlier alterations of mitochondrial metabolism and membrane integrity from the lowest concentrations. Moreover, a significant induction of CYP1A1, CYP1B1 and AhRR genes expression was showed after cells exposure to UFP org and to a lesser extent to UFP w and FP samples. [ABSTRACT FROM AUTHOR]

Background: Most studies on sepsis were conducted in developed countries. The aim of this study is to report on a series of patients with sepsis in a tertiary hospital in a developing country. Methods: Patients admitted through the emergency department of a single university-based institution between January 2008 and June 2012, with a final diagnosis of sepsis, bacteremia, or septic shock, were retrieved. A sample of 97 patients was selected. Vital signs at presentation, number of SIRS criteria, use of vasopressors and steroids, and in-hospital mortality were recorded. Results: The mean age was 70.09 ± 16.82, ranging from 19 to 96 years; 48.5 % were females and 51.5 % were males; 42.3 % of the patients were found to be bacteremic. IV fluid requirement during the first 6 h was 1.75 ± 1.96 l. The time for antibiotic initiation was 3.43 ± 4.48 h, with 87.6 % of the antibiotics initiated in the emergency department. Norepinephrine was the most commonly used vasopressor (38.1 %) followed by dopamine (8.2 %), and the inotrope dobutamine (4.1 %); 45.3 % of the patients were admitted to the intensive care unit (ICU), and the remaining 54.7 % were managed on the general practice unit (GPU). A total of 30 (30.9 %) septic patients died. The 28-day mortality was 20.6 %. Deceased patients had greater vasopressor use, a longer stay in the ICU (p = 0.001), and a longer time to norepinephrine use (p = 0.004). Conclusions: This is the first study providing an in-depth analysis of sepsis patients in a developing country, looking at in-hospital mortality, SIRS criteria utility, and at the overall sepsis management. [ABSTRACT FROM AUTHOR]

Abstract: This study investigates the dynamic linkages between oil prices and stock markets, also known as the oil price–stock price nexus. Within the framework of a VAR (vector autoregression) we examine dynamic interactions between daily Brent spot prices and several Lebanese stock prices. As expected, we find evidence of oil prices Granger causing stock prices, but no evidence of the opposite relationship. To better understand how shocks in the oil market are transmitted to the stock market, the orthogonalized impulse response function is examined. The behavior of all stocks examined is very similar; they all respond positively to a shock in crude oil prices on the same day and the day after the shock, with the impact of the shock disappearing thereafter. As for the variance decomposition analysis, it shows that the forecast errors of the stocks are largely attributable to their own innovations and the percentages do not change much with time. Only around 1% is attributable to oil shocks, increasing to around 3% after a few days and remaining at that level. Thus, our main conclusion is that the estimated level of the impact of an oil price shock on the Lebanese stock market is positive but marginal. [Copyright &y& Elsevier]

The geographic position of Lebanon in the Mediterranean basin at the transition of two major landmasses, Eurasia and Africa, has contributed to its high plant diversity and makes its flora particularly interesting to study. This paper contributes to the plant DNA C-value database of native Lebanese taxa. These data should reinforce biodiversity evaluation, systematic and evolution studies involving processes of speciation such as polyploidisation. C-values have been estimated by flow cytometry using propidium iodide as intercalary fluorochrome stain. Each sample comprised at least five individuals. Where possible, several populations were measured for each species. This study presents C-values for 225 taxa belonging to 55 families and 141 genera. C-values are novel for 193 taxa including 126 plants endemic to the Eastern Mediterranean region. These are the first values for 50 genera. In this panel, genome size ranged from 1C = 0.28 pg inHypericum thymifoliumto 54.69 pg inFritillaria alfredae.The life growth form and life cycle type are analysed according to the genome size class. Cases of polyploidy are reported for some species usually considered as only diploid. Examination of C-value variation through flow cytometry constitutes a powerful tool to screen taxonomic heterogeneity, opening further investigations. [ABSTRACT FROM PUBLISHER]

Objective This study explores the views of Lebanese hospitals on the worthiness of accreditation vis-à-vis its associated expenses in addition to examining the type and source of financial investments incurred during the accreditation process. Design Observational cross-sectional design. Participants All private short-stay hospitals registered with the Syndicate of Private Hospitals in Lebanon (110 hospitals). Main Outcome Measure Hospital's views on the worthiness of accreditation in lieu of its associated expenses. Other measures explored included areas of expenditure increase and sources of expenses coverage for accreditation. Results Three-fifths of responding hospitals (63% response rate) considered accreditation as a worthy investment. Favorable views on accreditation were mostly related to its effect on enhanced quality and safety culture. Unfavorable views regarding the worthiness of accreditation investment were justified by absence of link with enhanced tariffs from payers (25.7%). All hospitals incurred increased expenses due to accreditation. Areas of highest increase included training of staff (95.7%), consultants' costs (80.0%) and infrastructure maintenance (77.1%). Most of the hospitals covered expenses through internal absorption (52%) or bank loans (45.7%). Conclusions The financial burden of accreditation on hospitals has to be factored in the decision of its adoption at a national level, especially in developing countries. [ABSTRACT FROM PUBLISHER]

Lebanon lacks updated information related to the status of mammalian species, their richness and distribution. This study aimed at developing a rapid assessment methodology combining three non-invasive techniques based on the transect-quadrat survey scheme to measure mammalian richness at the Horsh Ehden Nature Reserve. The achieved results showed that the combination of the three techniques, droppings, footprints and photo-trapping for the rapid assessment of mammalian richness supported by Geographical Information System applications is highly effective. Twenty visits covering twenty quadrats out of 49 over a period of nine months allowed the detection of 12 of the 14 targeted species with droppings providing the majority of evidence while footprints and photo-trapping being of equal efficiency. The method can be easily replicated in any region to rapidly assess mammalian richness and the area of activity of the detected species and therefore directing conservation and management activities towards species of interest. [ABSTRACT FROM AUTHOR]

Abstract: This paper is concerned with modeling possible future paths for Lebanon’s electricity future and evaluating them. The baseline scenario (BS) reflects the business-as-usual state of affairs and thus describes the most likely evolution of the power sector in the absence of any climate change-related or other policies. Two alternative scenarios are examined in contrast to the BS; the renewable energy scenario (RES) and the natural gas scenario (NGS). Using the Long range Energy Alternatives Planning System (LEAP) software we conduct a full-fledged scenario analysis and examine the technical, economic, and environmental implications of all scenarios. From an economic standpoint as well as from an environmental perspective both alternative scenarios are superior to the baseline. Hence, the results of the simulation show that the alternative scenarios are more environmentally and economically attractive than the BS. They would help Lebanon meet its social, environmental, and economic development goals, while at the same time providing other unquantifiable benefits that are discussed further in the paper. Anticipated barriers to the shift in energy mix from conventional sources to renewable energy sources are also presented and discussed [Copyright &y& Elsevier]

Carbapenem and colistin-resistant bacteria represent a global public health problem. Refugees carrying these bacteria and living in inadequate shelters can spread these microorganisms. The aim of this study was to investigate the intestinal carriage of these bacteria in Syrian refugees in Lebanon. Between June and July 2019, 250 rectal swabs were collected from two refugee camps in North Lebanon. Swabs were cultured on different selective media. Antibiotic susceptibility testing was performed using the disk diffusion method. Carbapenemase-encoding genes and mcr genes were investigated using real-time polymerase chain reaction (RT-PCR) and standard polymerase chain reaction (PCR). Epidemiological relatedness was studied using multilocus sequence typing (MLST). From 250 rectal swabs, 16 carbapenem-resistant, 5 colistin-resistant, and 4 colistin and carbapenem-resistant Enterobacteriaceae were isolated. The isolates exhibited multidrug-resistant phenotypes. Seven Klebsiella pneumoniae isolates harboured the blaOXA-48 gene, and in addition four K. pneumoniae had mutations in the two component systems pmrA/pmrB, phoP/phoQ and co-harboured the blaNDM-1 gene. Moreover, the blaNDM-1 gene was detected in six Escherichia coli and three Enterobacter cloacae isolates. The remaining five E. coli isolates harboured the mcr-1 gene. MLST results showed several sequence types, with a remarkable clonal dissemination. An urgent strategy needs to be adopted in order to avoid the spread of such resistance in highly crowded underserved communities. [ABSTRACT FROM AUTHOR]

This article provides questions and answers regarding the artistic practices of Beirut, Lebanon, including the current challenges of curating in Lebanon, what the Lebanese video art distribution sources are, and the issue of freedom in Lebanese art.

Three different calcareous soil samples from Lebanon were analyzed for total DDT pesticide residue using GC and ELISA methods. Two experiments were conducted on three different calcareous soil samples. In each experiment, triplicates of 5 gm soil samples were each fortified with standard solutions of DDE to reach concentrations of 0, 5, 25, 50, 100 and 200 ng g[SUP-11 and allowed to equilibrate at room temperature for 6 hours. Each sample was then extracted with 25 mL of 90% methanol by shaking in glass bottles on a mechanical shaker for 16 hours. The bottles were allowed to stand for 30 minutes and aliquots were taken from the clear supernatant for analyses without further cleanup. The total DDT in the extract was measured in triplicate by GC and ELISA. The results indicated that the two methods were highly correlated (R = 0.955-0.994). Differences in soil properties did not affect the accuracy of the detection limits of ELISA. Immunoassay technique can be used for rapid and accurate measurement of total DDT residues in mineral calcareous soils in Lebanon. [ABSTRACT FROM AUTHOR]

Abstract. Little is known about Lebanese college students' oral hygiene and the factors associated with how often they brush their teeth. The authors used a structured questionnaire to investigate these issues in a sample of 954 new students at the American University of Beirut in fall 1998. The results indicated poor flossing habits and unfavorable dietary habits among the group. Moreover, using logistic regression analysis, they found that variables such as gender, father's education, exercise, and dietary habits, were significantly correlated with the how frequently the students brushed their teeth. Appropriate promotional activities to improve flossing and dietary habits associated with better oral hygiene are recommended. In addition, the authors call for further research to elaborate on the deficiencies in oral health practices and explore a wider variety of lifestyle behaviors and their correlation. [ABSTRACT FROM AUTHOR]

The use of contaminated water has been associated with severe disease outbreaks. Due to widespread pollution with untreated sewage, concerns have been raised over water quality in Lebanon, a country with well-documented challenges in infrastructure. Here, we evaluated the water quality of major rivers in Lebanon by quantifying the densities of fecal indicator bacteria (fecal coliforms and Escherichia coli). Additionally, we assessed the dissemination of antibiotic-resistant E. coli in river water. Composite water samples (n = 132) were collected from fourteen rivers, and 378 E. coli were isolated and analyzed. Fecal coliforms and E. coli were detected in 96.29% and 95.5% of the samples, respectively. Additionally, 73.48–61.3% and 31.81% of the samples exceeded the microbiological acceptability standards for irrigation and the fecal coliform limit for recreational activities, respectively. The E. coli exhibited resistance to ampicillin (40% of isolates), amoxicillin + clavulanic acid (42%), cefepime (4%), cefotaxime (14%), cefalexin (46%), cefixime (17%), doripenem (0.3%), imipenem (0.5%), gentamicin (6%), kanamycin (9%), streptomycin (35%), tetracycline (35%), ciprofloxacin (10%), norfloxacin (7%), trimethoprim-sulfamethoxazole (32%), and chloramphenicol (13%). Notably, 45.8% of the isolates were classified as multidrug resistant (MDR). Our results highlight the need to urgently address fecal pollution and the dissemination of antibiotic resistance in Lebanese rivers. [ABSTRACT FROM AUTHOR]

Milk samples were collected from 32 nursing mothers living in the Beirut area, Lebanon. Dietary intakes of participating mothers were obtained from data of their diet histories, 24h dietary recalls and food frequency questionnaires. Milk samples were screened for the presence of organochlorine pesticide residues and DDE levels were estimated using gas chromatographic techniques. The relationship between consumption of various food groups and DDE content of milk was investigated. A positive correlation was found between the consumption of either/or high fat meat, tuna fish and DDE levels in milk. Consumption of poultry products showed a weak correlation with DDE content of milk, whereas consumption of vegetable oils showed a negative correlation. [ABSTRACT FROM AUTHOR]

Explores how some university biology majors in Beirut, Lebanon accommodate the theory of biological evolution with their existing religious beliefs. Number of respondents to open-ended questions; Students' understanding of the theory of evolution; Students' perception of conflict between this theory and religion.

Insights into genome size dynamics and its evolutionary impact remain limited by the lack of data for many plant groups. One of these is the genus Iris, of which only 53 out of c. 260 species have available genome sizes. In this study, we estimated the C-values for 41 species and subspecies of Iris mainly from the Eastern Mediterranean region. We constructed a phylogenetic framework to shed light on the distribution of genome sizes across subgenera and sections of Iris. Finally, we tested evolutionary models to explore the mode and tempo of genome size evolution during the radiation of section Oncocyclus. Iris as a whole displayed a great variety of C-values; however, they were unequally distributed across the subgenera and sections, suggesting that lineage-specific patterns of genome size diversification have taken place within the genus. The evolutionary model that best fitted our data was the speciational model, as changes in genome size appeared to be mainly associated with speciation events. These results suggest that genome size dynamics may have contributed to the radiation of Oncocyclus irises. In addition, our phylogenetic analysis provided evidence that supports the segregation of the Lebanese population currently attributed to Iris persica as a distinct species. [ABSTRACT FROM AUTHOR]

Background: Unique pathogenic mutations in BRCA1 and 2 genes have been reported in different populations of patients originating from the Middle East region. Limited data are available for the Iraqi population. For many reasons a large number of Iraqi patients present to Lebanon for medical care. This is the first report of BRCA full gene sequencing conducted in a cohort of high-risk patients originating from Iraq. Methods: This is a retrospective review of Iraqi patients diagnosed with breast or ovarian cancer referred for BRCA mutation testing at the American University of Beirut from January 2012 to October 2018. Results: Of the 42 Iraqi women who underwent genetic testing at our institution, 3 BRCA pathogenic variants were found. Two mutations in BRCA1 c.224_227delAAAG and c.5431C > T and one mutation in BRCA2 c.5576_5579delTTAA were identified. Three other patients had sequence changes considered as variants of undetermined significance. Conclusion: In this cohort of high-risk patients, one out of the three pathogenic BRCA variants detected has not previously been reported in the Middle Eastern population. Further studies are required to delineate the spectrum of BRCA mutations in the Iraqi population. [ABSTRACT FROM AUTHOR]

Assessing land degradation is essentially needed for decision-makers to monitor and mitigate degradation and implement sustainable land management practices. More specifically, monitoring land degradation on a regular basis enables decision-makers to analyze impact of degradation and effects of sustainable land management practices. This requires adopting a precise methodology for assessing land degradation. With information form assessments, decision-makers can establish achievable management goals to attain land degradation neutrality as addressed by the Sustainable Development Goal 15 (i.e., SDG 15). Accordingly, this work aimed at developing a systematic approach for assessing land degradation at the subnational level with the combined use of geo-spatial information and field data. The specific objectives were to (1) assess trends in land degradation and the impact of historical land uses on the current landscape characters, (2) investigate and characterize principal criteria of land degradation, and (3) identify sustainable land management practices. Multi-source and multi-resolution spatial data were employed for assessing the three indicators of land degradation neutrality (i.e., changes in vegetation cover, land productivity, and soil organic carbon). Prioritizing lands prone to degradation was investigated using a set of spatial attributes of different weights. Field data collection involved the use of pre-defined set of questions for assessing the principal criteria of land degradation including type, extent, rate, degree, and causes of land degradation. Sustainable land management practices were identified and categorized accordingly. This assessment provided a means for prioritization of interventions (i.e., prevention, mitigation, and/or rehabilitation) in an area characterized by a climate varying from semi-arid to moist subhumid. [ABSTRACT FROM AUTHOR]

The present study aimed to describe the emergence of carbapenem-resistant Pseudomonas aeruginosa isolated from clinical Lebanese patients. The resistance of these isolates is due to the presence of the plasmid-encoded bla VIM-2 gene. We provide its first description in Lebanon, as well as a description of disruption of the oprD gene by mutations. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested that the prevalence of BRCA1 and 2 mutations in the Lebanese population is low despite the observation that the median age of breast cancer diagnosis is significantly lower than European and North American populations. We aimed at reviewing the rates and patterns of BRCA1/2 mutations found in individuals referred to the medical genetics unit at the American University of Beirut. We also evaluated the performance of clinical prediction tools. Methods: We retrospectively reviewed the cases of all individuals undergoing BRCA mutation testing from April 2011 to May 2016. To put our findings in to context, we conducted a literature review of the most recently published data from the region. Results: Two-hundred eighty one individuals were referred for testing. The prevalence of mutated BRCA1 or 2 genes were 6 and 1.4% respectively. Three mutations accounted for 54% of the pathogenic mutations found. The BRCA1 c.131G > T mutation was found among 5/17 (29%) unrelated subjects with BRCA1 mutation and is unique to the Lebanese and Palestinian populations. For patients tested between 2014 and 2016, all patients positive for mutations fit the NCCN guidelines for BRCA mutation screening. The Manchester Score failed to predict pathogenic mutations. Conclusion: The BRCA1 c.131G > T mutation can be considered a founder mutation in the Lebanese population detected among 5/17 (29%) of individuals diagnosed with a mutation in BRCA1 and among 7/269 families in this cohort. On review of recently published data regarding the landscape of BRCA mutations in the Middle East and North Africa, each region appears to have a unique spectrum of mutations. [ABSTRACT FROM AUTHOR]

Background: Emergency Department (ED) visits for suicide attempts have been described worldwide; however, the populations studied were predominantly Western European, North American, or East Asian. This study aims to describe the epidemiology of ED patients presenting post-suicide attempt to an academic medical center in Lebanon and to report on factors that affect ED disposition. Methods: A retrospective cohort study was conducted between 2009 and 2015. Patients of any age group were included if they had presented to the ED after a suicide attempt. Patients with unintentional self-harm were excluded. Descriptive analysis was performed on the demographics and characteristics of suicide attempts of the study population. A bivariate analysis to compare the two groups (hospitalized or discharged) was conducted using Student's t test and Pearson Chi-square where appropriate. A multivariate analysis was then conducted to determine the predictors of hospital admission. Results: One hundred and eight patients were included in the final analysis. Most patients were females (71.4%) and between 22 and 49 years of age. A considerable number of patients were unemployed (43%), unmarried (61.1%), and living with family (86.9%). Most suicide attempts were performed at home (93.5%) and on a weekday (71.3%). The most common mechanisms of injury were overdose with prescription medications (61.3%), overdose with over-the-counter drugs (27.9%), and self-inflicted lacerations (10.1%). The classes of medication most commonly abused were benzodiazepines (39.3%) followed by acetaminophen (27.3%). A large portion of our patients were admitted (70.3%), with the majority going to the psychiatric ward (71.1%). Of note, a quarter (27.5%) of our patients left the ED against medical advice, with 23.5% of admitted patients leaving the hospital before completion of treatment. The main predictors of admission were found to be overdose on prescription medications OR 9.25 (2.12–40.42 CI95%). Conclusions: The characteristics of our suicide attempters mirror those of international and regional suicide attempters. Further work is required to quantify the effect of voluntary refusal of hospital treatment, the repercussions of family, and financial barriers to healthcare and suicide as a whole in our society. [ABSTRACT FROM AUTHOR]

Located on the eastern side of the Mediterranean Basin at the intersection of air masses circulating between three continents, the agglomeration of Beirut, capital of Lebanon is an important investigating area for air pollution and more studies are needed to elucidate the composition of the smallest particles classified as carcinogenic to humans. PM 2.5–0.3 and PM 0.3 samples were collected during the spring-summer period in an urban background site of Beirut, after a dust storm episode occurred, and their chemical composition was determined. Our findings showed that components formed by gas to particle conversion (SO 4 2 − and NH 4 + ) and related to combustion processes are mainly found in the PM 0.3 fraction. Typical crustal (Ca 2+ , Fe, Ti, Mg 2+ ), sea-salt (Na + , Cl − , Mg 2+ , Sr) species, and NO 3 − are mainly associated with the PM 2.5–0.3 fraction. We have also evidenced that the dust episode which occurred in Lebanon in May 2011 originated from the Iraqian and Syrian deserts, which are the least studied, and had a direct influence on the composition of PM 2.5–0.3 during the beginning of the first sampling period, and then an indirect and persistent influence by the re-suspension of deposited dust particles. Moreover, PAHs concentrations were much higher in PM 0.3 than in PM 2.5–0.3 and their composition appeared influenced by diesel (buses, trucks and generator sets) and gasoline (private cars) emissions. [ABSTRACT FROM AUTHOR]