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Abstract Introduction The Lebanese government estimates the number of Syrian refugees to be 1.5 million, representing 25% of the population. Refugee healthcare services have been integrated into the existing Lebanese health system. This study aims to describe the integration of Syrian refugee health services into the Lebanese national health system from 2011 to 2022, amid an ongoing economic crisis since 2019 and the COVID-19 pandemic. Methods This paper employs a mixed-methods approach drawing upon different data sources including: 1- document review (policies, legislation, laws, etc.); 2- semi-structured interviews with policymakers, stakeholders, and health workers; 3- focus group discussions with patients from both host and refugee populations; and 4- health systems and care seeking indicators. Results Although the demand for primary health care increased due to the Syrian refugee crisis, the provision of primary health care services was maintained. The infusion of international funding over time allowed primary health care centers to expand their resources to accommodate increased demand. The oversupply of physicians in Lebanon allowed the system to maintain a relatively high density of physicians even after the massive influx of refugees. The highly privatized, fragmented and expensive healthcare system has impeded Syrian refugees’ access to secondary and tertiary healthcare services. The economic crisis further exacerbated limits on access for both the host and refugee populations and caused tension between the two populations. Our findings showed that the funds are not channeled through the government, fragmentation across multiple financing sources and reliance on international funding. Common medications and vaccines were available in the public system for both refugee and host communities and were reported to be affordable. The economic crisis hindered both communities’ access to medications due to shortages and dramatic price increases. Conclusion Integrating refugees in national health systems is essential to achieve sustainable development goals, in particular universal health coverage. Although it can strengthen the capacity of national health systems, the integration of refugees in low-resource settings can be challenging due to existing health system arrangements (e.g., heavily privatized care, curative-oriented, high out-of-pocket, fragmentation across multiple financing sources, and system vulnerability to economic shocks).

Large-scale models are the backbone of Computer Vision and Natural Language Processing, and their generalizability allows for transfer learning and deployment in different scenarios. However, their large size means that reducing their computational and memory demands remains a challenge. Recent research proposes to achieve “layer collapse”, a condition where multiple layers can be combined due to the collapse of non-linearities to linear operators. While this is an important discovery, most studies remain theoretical, often replacing non-linearities with simple identity functions and not providing a real implementation of the more compact architecture. Our contribution is LayerFold, a library that studies and implements the merging of collapsed layers. We address typical cases, from fully connected to convolutional layers, discussing constraints and prospective challenges. Our tests on edge devices reveal that merely reducing network depth does not always result in faster computation, even when GPU-equipped. This work raises important warnings and opens the door to further advances in efficient model deployment.

BackgroundAnastomotic leaks (ALs) are a significant and feared postoperative complication, with incidence of up to 30% despite advances in surgical techniques. With implications such as additional interventions, prolonged hospital stays, and hospital readmission, ALs have important impacts at the level of individual patients and healthcare providers, as well as healthcare systems as a whole. Challenges in developing unified definitions and grading systems for leaks have proved problematic, despite acknowledgement that colorectal AL is a critical issue in intestinal surgery with serious consequences. The aim of this study was to construct a narrative review of literature surrounding definitions and grading systems for ALs, and consequences of this postoperative complication.MethodsA literature review was conducted by examining databases including PubMed, Web of Science, OVID Embase, Google Scholar, and Cochrane library databases. Searches were performed with the following keywords: anastomosis, anastomotic leak, colorectal, surgery, grading system, complications, risk factors, and consequences. Publications that were retrieved underwent further assessment to ensure other relevant publications were identified and included.ResultsA universally accepted definition and grading system for ALs continues to be lacking, leading to variability in reported incidence in the literature. Additional factors add to variability in estimates, including differences in the anastomotic site and institutional/individual differences in operative technique. Various groups have worked to publish guidelines for defining and grading AL, with the International Study Group of Rectal Cancer (ISGRC/ISREC) definition the current most recommended universal definition for colorectal AL. The burden of AL on patients, healthcare providers, and hospitals is well documented in evidence from leak consequences, such as increased morbidity and mortality, higher reoperation rates, and increased readmission rates, among others.ConclusionsColorectal AL remains a significant challenge in intestinal surgery, despite medical advancements. Understanding the progress made in defining and grading leaks, as well as the range of negative outcomes that arise from AL, is crucial in improving patient care, reduce surgical mortality, and drive further advancements in earlier detection and treatment of AL.

Abstract Background Knowledge management (KM) emerged as a strategy to promote evidence-informed decision-making. This scoping review aims to map existing KM tools and mechanisms used to promote evidence-informed health decision-making in the WHO European Region and identify knowledge gaps. Methods Following the Joanna Briggs Institute (JBI) guidance for conducting scoping reviews, we searched Medline, PubMed, EMBASE, the Cochrane library, and Open Grey. We conducted a descriptive analysis of the general characteristics of the included papers and conducted narrative analysis of the included studies and categorized studies according to KM type and phase. Results Out of 9541 citations identified, we included 141 studies. The KM tools mostly assessed are evidence networks, surveillance tools, observatories, data platforms and registries, with most examining KM tools in high-income countries of the WHO European region. Findings suggest that KM tools can identify health problems, inform health planning and resource allocation, increase the use of evidence by policymakers and stimulate policy discussion. Conclusion Policymakers and funding agencies are called to support capacity-building activities, and future studies to strengthen KM in the WHO European region particularly in Eastern Europe and Central Asia. An updated over-arching strategy to coordinate KM activities in the WHO European region will be useful in these efforts.

Background: Typing and grading of endometrial carcinomas (ECs) on small biopsy specimens is crucial to determine the need for full surgical staging. Histological subtype and grade are key factors available for risk stratification before surgery. However, this can be diagnostically challenging on small biopsy specimens, especially when morphologic features are subtle or overlapping. Aims: The aims of this audit were to assess concordance of endometrial carcinomas on biopsy specimens with hysterectomy specimens and to determine if the immunohistochemistry (IHC) panel being used in our practice was adequately subtyping ECs. Settings and Design: The audit was approved by the Clinical Effectiveness Team of the Royal College of Pathologists (UK) as meeting all the criteria and standards set out by the College. Materials and Methods: Biopsies from 67 cases of EC were compared for histological subtype and grade of endometrioid carcinoma with resection specimens. A re-audit was carried out on 59 cases after implementation of changes recommended by the initial audit. Results: Two of 35 (6%) tumours defined as G1 on biopsy were upgraded (to G2) on final pathology, as was one of 7 (14%) G2 tumours (to G3). One of these cases had solid areas just amounting to more than 6% on resection. In the second case, a comment was made that assessment had been difficult as the specimen was suboptimally fixed, but nuclei appeared atypical. Of seven G2 biopsies, one case was upgraded to grade 3 on final pathology based on proportion of solid areas. Our data show lower rates of discordance as compared to previous studies and on re-audit, the concordance between endometrioid and nonendometrioid serous carcinoma improved with the addition of immunohistochemistry (IHC) for Phosphatase and tensin homolog (PTEN) to biopsies. Conclusions: PTEN IHC can complement other stains and aid in the distinction of grade 3 endometrioid carcinoma from serous carcinoma on endometrial biopsies.

Over the past few decades, the world has witnessed considerable progress in women's, children's and adolescents' health (WCAH) and the Sustainable Development Goals (SDGs). Yet deep inequities remain between and within countries. This scoping review aims to map financing interventions and measures to improve equity in WCAH in low- and middle-income countries (LMICs). This scoping review was conducted following Joanna Briggs Institute (JBI) guidance for conducting such reviews as well as the PRISMA Extension for Scoping Reviews (PRISMA-ScR) for reporting scoping reviews. We searched Medline, PubMed, EMBASE and the World Health Organization's (WHO) Global Index Medicus, and relevant websites. The selection process was conducted in duplicate and independently. Out of 26 355 citations identified from electronic databases, relevant website searches and stakeholders' consultations, 413 studies were included in the final review. Conditional cash transfers (CCTs) (22.3%), health insurance (21.4%), user fee exemptions (18.1%) and vouchers (16.9%) were the most reported financial interventions and measures. The majority were targeted at women (57%) and children (21%) with others targeting adolescents (2.7%) and newborns (0.7%). The findings highlighted that CCTs, voucher programs and various insurance schemes can improve the utilization of maternal and child health services for the poor and the disadvantaged, and improve mortality and morbidity rates. However, multiple implementation challenges impact the effectiveness of these programmes. Some studies suggested that financial interventions alone would not be sufficient to achieve equity in health coverage among those of a lower income and those residing in remote regions. This review provides evidence on financing interventions to address the health needs of the most vulnerable communities. It can be used to inform the design of equitable health financing policies and health system reform efforts that are essential to moving towards universal health coverage (UHC). By also unveiling the knowledge gaps, it can be used to inform future research on financing interventions and measures to improve equity when addressing WCAH in LMICs.

Anastomotic leaks (AL) and staple line leaks are a serious post-operative complication that can develop following bariatric surgery. The delay in the onset of symptoms following a leak usually results in reactive diagnostics and treatment, leading to increased patient morbidity and mortality, and a clinical and economic burden on both the patient and the hospital. Despite support in literature for pH as a biomarker for early detection of AL, the current methods of pH detection require significant clinician involvement and resources. Presented here is a polyaniline (PANI)-based pH sensor that can be connected inline to surgical drains to continuously monitor peritoneal secretion in real time for homeostatic changes in pH. During this study, the baseline peritoneal fluid pH was measured in two pigs using the PANI sensor and verified using a benchtop pH probe. The PANI sensor was then utilized to continuously monitor the changes in the pH of peritoneal effluent, as a gastric leak was simulated. The inline sensors were able to detect the resulting local changes in drainage pH within 10 min of leak induction. The successful implementation of this sensor in clinical practice can both enable high efficiency continuous monitoring of patient status and drastically decrease the time required to detect AL, thus potentially decreasing the clinical and economic burden incurred by gastric leaks.

This study aims to conduct a comprehensive needs analysis on french language for tourism and hospitality programs by looking closely at three points of view, i.e., 120 students of tourism and hospitality program, 7 french lecturers, and 5 hospitality professionals. This research applied a mixed-methods approach to collecting the data. This means that this study deployed a set of qualitative and quantitative measures to attain deep answers. Furthermore, the data in this study were collected through multiple instruments, including interviews and questionnaires. The result of the analysis of the data revealed that the French language was one of the significant foreign languages, besides English, that needed to be learned by the students to have a good carrier in the hospitality and tourism industry in the future. Along with that fact, speaking was considered as the most important language skill, among the other skills, which have to be developed by the students. Moreover, the ideal teaching materials urgently needed to be developed within this context were those equal to the intermediate level. The findings of this study were expected to have a further contribution to the development of comprehensive teaching syllabuses, materials, as well as lesson plans for French-language classrooms in the tourism and hospitality program.

Abstract Background There is increased interest in using narratives or storytelling to influence health policies. We aimed to systematically review the evidence on the use of narratives to impact the health policy-making process. Methods Eligible study designs included randomised studies, non-randomised studies, process evaluation studies, economic studies, qualitative studies, stakeholder analyses, policy analyses, and case studies. The MEDLINE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO Global Health Library, Communication and Mass Media Complete, and Google Scholar databases were searched. We followed standard systematic review methodology for study selection, data abstraction and risk of bias assessment. We synthesised the findings narratively and presented the results stratified according to the following stages of the policy cycle: (1) agenda-setting, (2) policy formulation, (3) policy adoption, (4) policy implementation and (5) policy evaluation. Additionally, we presented the knowledge gaps relevant to using narrative to impact health policy-making. Results Eighteen studies met the eligibility criteria, and included case studies (n = 15), participatory action research (n = 1), documentary analysis (n = 1) and biographical method (n = 1). The majority were of very low methodological quality. In addition, none of the studies formally evaluated the effectiveness of the narrative-based interventions. Findings suggest that narratives may have a positive influence when used as inspiration and empowerment tools to stimulate policy inquiries, as educational and awareness tools to initiate policy discussions and gain public support, and as advocacy and lobbying tools to formulate, adopt or implement policy. There is also evidence of undesirable effects of using narratives. In one case study, narrative use led to widespread insurance reimbursement of a therapy for breast cancer that was later proven to be ineffective. Another case study described how the use of narrative inappropriately exaggerated the perceived risk of a procedure, which led to limiting its use and preventing a large number of patients from its benefits. A third case study described how optimistic ‘cure’ or ‘hope’ stories of children with cancer were selectively used to raise money for cancer research that ignored the negative realities. The majority of included studies did not provide information on the definition or content of narratives, the theoretical framework underlying the narrative intervention or the possible predictors of the success of narrative interventions. Conclusion The existing evidence base precludes any robust inferences about the impact of narrative interventions on health policy-making. We discuss the implications of the findings for research and policy. Trial registration The review protocol is registered in PROSPERO International prospective register of systematic reviews (ID = CRD42018085011).

Abstract Background Community-based health insurance (CBHI) has evolved as an alternative health financing mechanism to out of pocket payments in low- and middle-income countries (LMICs), particularly in areas where government or employer-based health insurance is minimal. This systematic review aimed to assess the barriers and facilitators to implementation, uptake and sustainability of CHBI schemes in LMICs. Methods We searched six electronic databases and grey literature. We included both quantitative and qualitative studies written in English language and published after year 1992. Two reviewers worked in duplicate and independently to complete study selection, data abstraction, and assessment of methodological features. We synthesized the findings based on thematic analysis and categorized according to the ecological model into individual, interpersonal, community and systems levels. Results Of 15,510 citations, 51 met the eligibility criteria. Individual factors included awareness and understanding of the concept of CBHI, trust in scheme and scheme managers, perceived service quality, and demographic characteristics, which influenced enrollment and sustainability. Interpersonal factors such as household dynamics, other family members enrolled in the scheme, and social solidarity influenced enrollment and renewal of membership. Community-level factors such as culture and community involvement in scheme development influenced enrollment and sustainability of scheme. Systems-level factors encompassed governance, financial and delivery arrangement. Government involvement, accountability of scheme management, and strong policymaker-implementer relation facilitated implementation and sustainability of scheme. Packages that covered outpatient and inpatient care and those tailored to community needs contributed to increased enrollment. Amount and timing of premium collection was reported to negatively influence enrollment while factors reported as threats to sustainability included facility bankruptcy, operating on small budgets, rising healthcare costs, small risk pool, irregular contributions, and overutilization of services. At the delivery level, accessibility of facilities, facility environment, and health personnel influenced enrollment, service utilization and dropout rates. Conclusion There are a multitude of interrelated factors at the individual, interpersonal, community and systems levels that drive the implementation, uptake and sustainability of CBHI schemes. We discuss the implications of the findings at the policy and research level. Trial registration The review protocol is registered in PROSPERO International prospective register of systematic reviews (ID = CRD42015019812).

Abstract Introduction Media interventions can potentially play a major role in influencing health policies. This integrative systematic review aimed to assess the effects of planned media interventions—including social media—on the health policy-making process. Methods Eligible study designs included randomized and non-randomized designs, economic studies, process evaluation studies, stakeholder analyses, qualitative methods, and case studies. We electronically searched Medline, EMBASE, Communication and Mass Media Complete, Cochrane Central Register of Controlled Trials, and the WHO Global Health Library. We followed standard systematic review methodology for study selection, data abstraction, and risk of bias assessment. Results Twenty-one studies met our eligibility criteria: 10 evaluation studies using either quantitative (n = 7) or qualitative (n = 3) designs and 11 case studies. None of the evaluation studies were on social media. The findings of the evaluation studies suggest that media interventions may have a positive impact when used as accountability tools leading to prioritizing and initiating policy discussions, as tools to increase policymakers’ awareness, as tools to influence policy formulation, as awareness tools leading to policy adoption, and as awareness tools to improve compliance with laws and regulations. In one study, media-generated attention had a negative effect on policy advocacy as it mobilized opponents who defeated the passage of the bills that the media intervention advocated for. We judged the confidence in the available evidence as limited due to the risk of bias in the included studies and the indirectness of the evidence. Conclusion There is currently a lack of reliable evidence to guide decisions on the use of media interventions to influence health policy-making. Additional and better-designed, conducted, and reported primary research is needed to better understand the effects of media interventions, particularly social media, on health policy-making processes, and the circumstances under which media interventions are successful. Trial registration PROSPERO 2015: CRD42015020243

Sharm El-Sheikh, located at the southern entrance of the Gulf of Aqaba, is a key tourist destination known for its mild climate and commitment to environmental initiatives, notably hosting COP27 in 2022. This study evaluates heavy metal contamination in beach sediments to assess environmental and human risks. Sampling was conducted at Sharm Port and El-Maya Bay, both popular tourist areas. Sediment samples revealed varying concentrations of Fe, Mn, Zn, Pb, Cu, and Co, all within safe levels. Non-carcinogenic and carcinogenic risks were evaluated through chronic daily intake and hazard indices, revealing that ingestion poses the highest risk among exposure pathways. However, the beach sediments of the study area are generally safe for recreational use by both adults and children according to international standards. Statistical analyses identified low-level natural and anthropogenic sources of contamination, underscoring the need for ongoing environmental monitoring to preserve environmental quality in this vital tourist area and to ensure public health and safety by implementing sustainable waste management practices, regulating tourism activities, and protecting marine ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

This environmental assessment focuses on the coastal sediments of the Al-Khafji area in the Saudi Arabian Gulf, with an analysis of the human health risks posed by lead (Pb) and cadmium (Cd) contamination. Single and integrated indices were used to detect contamination and evaluate these metals' non-carcinogenic and carcinogenic impacts on adults and children through ingestion, dermal contact, and inhalation pathways. Sediment quality guidelines and contamination indices indicated the absence of significant contamination levels. The moderate contamination observed in scattered samples did not imply adverse biological effects due to the presence of these two metals in Al-Khafji sediments. The average values of the chronic daily intake (CDI) for both Pb and Cd were higher in children than adults across all three pathways, with ratios of 9.4, 4.7, and 4.7 folds, respectively. The hazard index (HI) values for Pb and Cd were below 1, confirming that the sediments of Al-Khafji are considered acceptable and safe in terms of these potentially toxic elements (PTEs). The average lifetime cancer risk (LCR) values for Pb and Cd were higher in children compared to adults, with ratios of 9.3 and 9.4 folds, respectively. However, all detected LCR levels do not represent a potential carcinogenic health hazard. Nevertheless, a regular monitoring program aimed at detecting early signals of environmental health depletion is recommended., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Water, as an indispensable constituent of life, serves as the primary source of sustenance for all living things on Earth. The contamination of surface water with heavy metals poses a significant global health risk to humans, animals, and plants. Sharkiya Governorate, situated in the East Nile Delta region of Egypt, is particularly susceptible to surface water pollution due to various industrial, agricultural, and urban activities. The Bahr Mouse Stream, crucial for providing potable water and supporting irrigation activities in Sharkiya Governorate, caters to a population of approximately 7.7 million inhabitants. Unfortunately, this vital water source is exposed to many illegal encroachments that may cause pollution and deteriorate the water resource quality. In a comprehensive study conducted over two consecutive seasons (2019-2020), a total of 38 surface water samples were taken to assess the quantity of heavy metals in surface water destined for human consumption and other applications, supported by indices and statistics. The assessment utilized flame atomic absorption spectrophotometry to determine the concentration of key heavy metals including iron (Fe), manganese (Mn), cadmium (Cd), copper (Cu), lead (Pb), zinc (Zn), nickel (Ni), cobalt (Co), and chromium (Cr). The calculated mean value of the Water Quality Index (WQI) was found to be 39.1 during the winter season and 28.05 during the summer season. This value suggests that the surface water maintains good quality and is suitable for drinking purposes. Furthermore, the analysis indicated that the concentrations of heavy metals in the study area were below the recommended limits set by the World Health Organization and fell within the safe threshold prescribed by Egyptian legislation. Despite the identification of localized instances of illegal activities in certain areas, such as unauthorized discharges, the findings affirm that the Bahr Mouse stream is devoid of heavy metal pollution. This underscores the importance of continued vigilance and regulatory enforcement to preserve the integrity of these vital water resources., (© 2024. The Author(s).)

Throughout the year, people flock to the Red Sea's shoreline for tourism and fishing. The current study aims to document heavy metal contamination and human health assessment in 30 surface sediment samples collected along the Hurghada shoreline in Egypt. To estimate sediment contamination, the pollution index (PI), pollution load index (PLI), degree of contamination (Cdeg), and Nemerow integrated pollution index (NIPI) were calculated, while the chronic daily intake (CDI), hazard index (HI), cancer risk (CR), and total lifetime cancer risk (LCR) were determined on both adults and children via ingestion, dermal, and inhalation pathways. The HM averages (μg/g dry weight) were in the following order: Fe (345.70) > Mn (49.36) > Pb (41.98) > Zn (7.47) > Ni (1.73) > Cu (1.23) > Co (1.09) > Cd (0.14). Pollution indices found that Hurghada coastal sediments were moderately polluted with Pb but not with the other HMs. The average CDI values were in the descending order of ingestion > dermal > inhalation pathways, and the average CDI values on children were higher than those on adults. The hazard index (HI) for adults and children was Pb > Ni > Cd > Fe > Mn > Co > Cu > Zn, and all values were <1.0, showing that these HMs had no substantial non-carcinogenic impacts on the human body. LCR results show that children have greater values than adults. LCR values in adults were lower than 1 × 10 -6 , indicating no substantial health concerns, while in children they ranged from 1 × 10 -6 to 1 × 10 -4 , indicating no significant risk to human health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Due to the significance of mangroves for the diversity of marine and terrestrial life along the Red Sea coast, the present work aimed to evaluate the environmental and health risk of heavy metals in Wadi el-Gemal sediments. The findings of single and integrated indices demonstrated no significant pollution with Fe, Cu, Zn, Ni, Co, and Cd, while the sediments showed severe and minor enrichment with Mn and Cd, respectively, which might be attributed to the presence of some mining activities in the mountains near the study area. The possible carcinogenic and non-carcinogenic risks due to their dermal absorption from the sediments were analyzed and the findings demonstrated that the non-carcinogenic health hazards were within tolerable and safe limits. Moreover, the evaluation of chronic daily intake and the overall cancer risk (LCR) for adults and children for Pb and Cd both ruled out any current potential carcinogenic health risks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Surface sediment samples from twenty-nine stations in south Al-Khobar coastline, Arabian Gulf, have been examined to assess the heavy metal contamination and impact on human health through dermal contact. The content in Cu, Zn, Cd, Pb, Fe, Mn, Co, Hg and Ni, was evaluated. Pollution index, modified degree of contamination, and pollution load index agreed to exclude heavy metal pollution. Differently, soil pollution index and Nemerow integrated pollution index pointed out moderate and heavy pollution grade for Hg and Cu, respectively. The human health assessment, according to the low values of the hazard index ˂ 1.0 for both adults and children, excluded any significant impact on the human body. The chronic daily intake and the total lifetime cancer risk also were consistent in excluding any risk to human health. Similarly, the carcinogenic risks for Pb and Cd, and the total cancer risk ˂1 × 10 -6 , did not imply significant health hazards., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The contamination and health risks by arsenic and chromium in the Al-Khobar coastal area, Arabian Gulf, have been assessed by examining 29 samples of surface sediment. Several single and complex indices were accounted to assess contamination, while the chronic daily intake (CDI), the hazard index (HI) and the total lifetime cancer risk (LCR) were applied to assess human health. The studied sediments showed absence or low level of As and Cr contamination. Results of CDI suggested a greater intake of As and Cr in children than in adults, mainly by ingestion pathway, reaching >99.5 % from the total for both adults and children. The recorded values of HI indicated not significant non-carcinogenic effects on the human body. LCR was higher in children than in adults. However, the recorded values suggested that the present carcinogenic risk for As and Cr can be considered acceptable or tolerable., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

The Egyptian beaches on the Red Sea and the Gulf of Aqaba in Sinai are a destination for international tourism throughout the year. Therefore, assessing the concentration levels of heavy metal pollutants and identifying the extent of their impact on human health is important. Single and integrated pollutants indices have been used to assess the risks of these elements. The results of single indices proved that the study area contain Fe and Zn came mostly from natural source while Cu, Pb, Cd and Hg originated from anthropogenic sources. However, the integrated pollutants indices revealed that this area is not polluted with heavy metals. On the other hand, the hazard index, and the carcinogenic risk over the lifetime coefficients proved that the beach sand of the study area is completely safe and does not have additional health risks to children or adults, where LCR < 10 -6 ., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

To assess the contamination and ecological risk assessment of the Shalateen coastal sediments, Red Sea, Egypt, 35 samples were collected to analyze Cu, Sr, Zn, Cd, Pb, Fe, Co, Ni, Mn, and total organic matter with an atomic absorption spectrophotometer. Several indices were calculated to estimate the contamination levels. The results indicated the following order of metal concentrations: Fe > Sr > Mn > Zn > Ni > Pb > Cu > Co > Cd, and revealed that the investigated sediments are highly enriched and contaminated with Sr, Cd, Pb and Zn. Statistical analyses subdivided the elements into Fe and Mn from natural sources, Sr, Cd, Pb and Zn from anthropogenic sources, and Ni, Cu and Co from combined natural and anthropogenic sources. The average Pb and Cd concentrations are considerably higher compared to the Caspian Sea, Indian Ocean, northern Red Sea, background shale, and continental crust. Possible sources of pollutants are fishing operations, antifouling paints, runoff, desalination plants, industries and dissolution of carbonate sediments., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Thirty bottom sediment samples were collected from northern Hurghada coast, Red Sea, Egypt to evaluate the level of anthropogenic pollutants, using enrichment factor (EF), potential ecological risk index (PERI), soil pollution index (SPI), potential contamination index (Cp) and multivariate statistical analysis (correlation analysis, principal component analysis, and hierarchical cluster analysis). Fe, Mn, Zn, Pb, Ni, Cu, Co and Cd were analyzed by Atomic Absorption Spectrophotometer. Results indicated that the average values of Pb and Cd were greater than the ones recorded from many other worldwide coastal areas. The studied sediments are extremely severe enrichment with Pb and Cd (EF > 50), severe enrichment with Zn (EF = 10-25), very high risk with Cd (PERI ≥ 320), high risk with Pb (160 ≤ PERI ˂ 320), highly contaminated with Pb (SPI > 3), a severe contamination with Pb (Cp > 3). The accumulation of pollutants is associated with the muddy and fine sediment; especially the studied area is a semi-closed bay, characterized by long time of water retention. Possible sources of metals pollution in the studied area are shipment operations and anticorrosive and antifouling paints, dredging and land filling, municipal wastewater from tourist centers and fishermen cargo boats., (Copyright © 2018 Elsevier Ltd. All rights reserved.)