Beyond ethnic entrenchment and amelioration: an analysis of non-sectarian social movements and Lebanon’s consociationalism

Research on consociational power-sharing divides on whether it provides a successful model for peacebuilding or instead exacerbates antagonistic ethnic divisions. In these debates, non-sectarian movements are either invisible or rendered as actors marginalized, co-opted, stripped of agency and disempowered by power-sharing. This article moves the focus away from “either” “or” analyses of consociationalism measuring its capacity to entrench or weaken ethnic divisions. Alternatively, it examines the different ways power-sharing effects a range of issues and groups and the varying modes of engagement generated by non-ethnic social movements in response. Power-sharing creates various dynamics that can result in either hegemonic compliance, constructive engagement, or active resistance by social movement actors that cross-cut ethnic cleavages. Using Lebanon as a case study, the paper examines movements that deal with sexuality, privatization, and public goods, issues that are shaped by consociational institutions but rarely incorporated in power-sharing research.     

To share or divide power? Minorities in autonomous regions,the case of the autonomous region in Muslim Mindanao

Abstract

Autonomy granted to minority groups as a form of power-sharing may not necessarily address the representation and welfare needs of the smaller minorities within the autonomous government. Although numerically insignificant, the smaller minorities' disempowerment and discrimination can lead to these groups' further marginalization and weaken the democratic viability and legitimacy of the autonomy project. What institutional mechanisms would work best for minorities-within-minorities in an autonomous region? Should similar power-sharing or consociational arrangements be replicated within the region? Or, are power-dividing measures and the integrative approach more appropriate for regional stability and democratic governance? Analyzing the institutional design of and practices in the Philippines' Autonomous Region in Muslim Mindanao, this paper concludes that a combination of power-sharing and power-dividing measures are needed to address the gaps in representation and protection of welfare of all ethnic groups for both the short- and long-term viability of regional autonomy.     

The prediction of civil violence to the year 2001

Abstract

Annual predictions of global deaths from civil war to the year 2001 have been made based on an earlier two‐stage cyclical model. In stage one three cycles (8.6, 17.4, and 34 yr) predict to changes in the global political system, while four cycles (5.6, 9.4, 20.5, and 54 yr) predict to changes in the global economic system. In stage two, changes in the political and economic systems predict to changes in the level of civil violence. Fifteen regression equations, four tables, and six diagrams are included with the text     

Prevalence and Risk Factors for Intestinal Protozoan Infections with Cryptosporidium,Giardia, Blastocystis and Dientamoeba among Schoolchildren in Tripoli,Lebanon

BackgroundIntestinal protozoan infections are confirmed as major causes of diarrhea, particularly in children, and represent a significant, but often neglected, threat to public health. No recent data were available in Lebanon concerning the molecular epidemiology of protozoan infections in children, a vulnerable population at high risk of infection.ConclusionsThis is the first study performed in Lebanon reporting the prevalence and the clinical and molecular epidemiological data associated with intestinal protozoan infections among schoolchildren in Tripoli. A high prevalence of protozoan parasites was found, with Blastocystis spp. being the most predominant protozoans. Although only 50% of children reported digestive symptoms, asymptomatic infection was observed, and these children may act as unidentified carriers. This survey provides necessary information for designing prevention and control strategies to reduce the burden of these protozoan infections, especially in children.     

Post-combat syndromes from the Boer war to the Gulf war: a cluster analysis of their nature and attribution

ObjectivesTo discover whether post-combat syndromes have existed after modern wars and what relation they bear to each other.DesignReview of medical and military records of servicemen and cluster analysis of symptoms.ResultsThree varieties of post-combat disorder were identified—a debility syndrome (associated with the 19th and early 20th centuries), somatic syndrome (related primarily to the first world war), and a neuropsychiatric syndrome (associated with the second world war and the Gulf conflict). The era in which the war occurred was overwhelmingly the best predictor of cluster membership.ConclusionsAll modern wars have been associated with a syndrome characterised by unexplained medical symptoms. The form that these assume, the terms used to describe them, and the explanations offered by servicemen and doctors seem to be influenced by advances in medical science, changes in the nature of warfare, and underlying cultural forces.

What is already known on this topic

Service in the Gulf war is associated with an increased rate of reported symptoms and worsening subjective healthPost-combat syndromes have been described after most modern conflicts from the US civil war onwards

What this study adds

There seems to be no single post-combat syndrome but a number of variations on a themeThe ever changing form of post-combat syndromes seems to be related to advances in medical understanding, the developing nature of warfare, and cultural undercurrentsBecause reported symptoms are subject to bias and changing emphasis related to advances in medical science or the discovery of new diseases, the characterisation of individual syndromes has to be treated with cautionAttributions by servicemen are generally consistent with symptom characteristics, though there seems to be a growing reluctance to consider the stress of military service as a cause     

Health sector response to security threats during the civil war in E1 Salvador.

During the recent civil war in E1 Salvador, as in other modern wars, human rights abuses adversely affected health workers, patients, and medical facilities. The abuses themselves have been described in reports of human rights advocacy organisations but health sector adaptations to a hostile wartime environment have not. Agencies engaged in health work during the civil war adapted parties such as training of community based lay health workers, use of simple technology, concealment of patients and medical supplies, denunciation of human rights abuses, and multilevel negotiations in order to continue providing services. The Salvadorean experience may serve as a helpful case study for medical personnel working in wars elsewhere.     

The earliest fossil schizopterid bug (Insecta: Heteroptera) in the Lower Cretaceous amber of Lebanon

The schizopterid bug Libanohypselosoma popovi n. gen., n. sp. belonging to the subfamily Hypselosomatinae is described from the Lower Cretaceous amber of Lebanon. This fossil is the earliest record of the Schizopteridae. The species is distinguished from its related taxa, a discussion is given.     

Development of a quantitative prediction model for peripheral blood stem cell collection yield in the plerixafor era

Background aimsPredicting autologous peripheral blood stem cell (PBSC) collection yield before leukapheresis is important for optimizing PBSC mobilization and autologous stem cell transplantation (ASCT) for treating hematological malignancies. Although guidelines for plerixafor usage based on peripheral blood CD34⁺ (PB-CD34⁺) cell count are available, their predictive performance in the real world remains unclear.MethodsThis study retrospectively analyzed 55 mobilization procedures for patients with non-Hodgkin lymphoma or multiple myeloma and developed a novel quantitative prediction model for CD34⁺ cell collection yield that incorporated four clinical parameters available the day before leukapheresis; namely, PB-CD34⁺ cell count the day before apheresis (day ?1 PB-CD34⁺), number of prior chemotherapy regimens, disease status at apheresis and mobilization protocol.ResultsThe effects of PB-CD34⁺ cell counts on CD34⁺ cell collection yield varied widely per patient characteristics, and plerixafor usage was recommended in patients with poorly controlled disease or those with a history of heavy pre-treatments even with abundant day ?1 PB-CD34⁺ cell count. This model suggested a more proactive use of plerixafor than that recommended by the guidelines for patients with poor pre-collection condition or those with a higher target number of CD34⁺ cells. Further, the authors analyzed the clinical outcomes of ASCT and found that plerixafor use for stem cell mobilization did not affect short- or long-term outcomes after ASCT.ConclusionsAlthough external validations are necessary, the results can be beneficial for establishing more effective and safer mobilization strategies.     

星形胶质细胞糖原动员改善大脑缺血再灌注损伤的研究

摘要 目的：探讨星形胶质细胞糖原动员是否对大脑缺血再灌注损伤有神经保护作用。方法：研究构建了星形胶质细胞特异性糖原分解代谢关键酶糖原磷酸化酶（Glycogen phosphorylase, GP）过表达转基因小鼠（GFAP-GP）,并通过免疫荧光染色对GP的含量进行验证。在小鼠大脑中动脉梗死/再通模型中,利用GFAP-GP小鼠促进再灌注后累积糖原的分解（糖原动员）,通过三苯基氯化四氮唑（Triphenyl tetrazolium chloride, TTC）染色分析再灌注后GFAP-GP小鼠的脑梗死面积,Corner test和Grid-walking test检测再灌注后GFAP-GP小鼠的神经行为学功能。结果：GFAP-GP小鼠中GP的含量发生了明显的增加,再灌注后GFAP-GP小鼠与野生型小鼠相比,脑糖原含量明显降低,梗死明显减少,肢体感觉与运动功能明显改善。结论：星形胶质细胞糖原动员可改善大脑缺血再灌注损伤。     

Civil war: is it all about disease and xenophobia? A comment on Letendre,Fincher & Thornhill

Letendre, Fincher & Thornhill (2010) argue that pathogen intensity provides the ultimate explanation for why some countries are more prone to civil war than others. They argue that the economic and political factors highlighted in previous research on civil war are largely caused by underlying differences in pathogen intensity, and contend that disease proneness increases the risk of civil war through its effects on resource competition and xenophobia. They present empirical evidence that they interpret as consistent with their argument: a statistically significant correlation between pathogen intensity and civil war onset. In this comment, we raise concerns over their interpretation of the empirical evidence and their proposed causal mechanisms. We find that the data provide stronger evidence for the reverse causal relationship, namely that civil war causes disease to become more prevalent. This finding is consistent with the literatures on the public health effects of civil war as well as research on state capacity and public health.     

Predictive factors for poor peripheral blood stem cell mobilization and peak CD34(+) cell count to guide pre-emptive or immediate rescue mobilization

Background aimsFailure in mobilization of peripheral blood (PB) stem cells is a frequent reason for not performing hematopoietic stem cell transplantation (HSCT). Early identification of poor mobilizers could avoid repeated attempts at mobilization, with the administration of pre-emptive rescue mobilizationMethodsData from the first mobilization schedule of 397 patients referred consecutively for autologous HSCT between 2000 and 2010 were collected. Poor mobilization was defined as the collection of < 2 × 10⁶ CD34⁺cells/kg body weight (BW).ResultsThe median age was 53 years (range 4–70) and 228 (57%) were males. Diagnoses were multiple myeloma in 133 cases, non-Hodgkin's lymphoma in 114, acute myeloid leukemia or myelodysplastic syndrome in 81, Hodgkin's lymphoma in 42, solid tumors in 17 and acute lymphoblastic leukemia in 10. The mobilization regimen consisted of recombinant human granulocyte–colony-stimulating factor (G-CSF) in 346 patients (87%) and chemotherapy followed by G-CSF (C + G-CSF) in 51 (13%). Poor mobilization occurred in 105 patients (29%), without differences according to mobilization schedule. Diagnosis, previous therapy with purine analogs and three or more previous chemotherapy lines were predictive factors for poor mobilization. A CD34⁺cell count in PB > 13.8/μL was enough to ensure ≥ 2 × 10⁶ CD34⁺cells/kg, with high sensitivity (90%) and specificity (91%).ConclusionsThe prevalence of poor mobilization was high, being associated with disease type, therapy with purine analogs and multiple chemotherapy regimens. The threshold of CD34⁺ cell count in PB identified poor mobilizers, in whom the administration of immediate or pre-emptive plerixafor could be useful to avoid a second mobilization.     

Pharmacoeconomic impact of up-front use of plerixafor for autologous stem cell mobilization in patients with multiple myeloma

Background aimsStem cell collection can be a major component of overall cost of autologous stem cell transplantation (ASCT). Plerixafor is an effective agent for mobilization; however, it is often reserved for salvage therapy because of its high cost. We present data on the pharmacoeconomic impact of the use of plerixafor as an up-front mobilization in patients with multiple myeloma (MM).MethodsPatients with MM who underwent ASCT between January 2008 and April 2011 at the Mount Sinai Medical Center were reviewed retrospectively. In April 2010, practice changes were instituted for patients with MM to delay initiation of granulocyte-colony-stimulating factor (G-CSF) support from day 0 to day +5 and to add plerixafor to G-CSF as an up-front autologous mobilization. Targets of collection were 5–10 × 10⁶ CD34⁺ cells/kg.ResultsOf 50 adults with MM who underwent ASCT, 25 received plerixafor/filgrastim and 25 received G-CSF alone as an up-front mobilization. Compared with the control, plerixafor mobilization yielded higher CD34⁺ cell content (16.1 versus 8.4 × 10⁶ CD34⁺ cells/kg; P = 0.0007) and required fewer sessions of apheresis (1.9 versus 3.1; P = 0.0001). In the plerixafor group, the mean number of plerixafor doses required per patient was 1.8. Although the overall cost of medications was higher in the plerixafor group, the cost for blood products and overall cost of hospitalization were similar between the two groups.ConclusionsUp-front use of plerixafor is an effective mobilization strategy in patients with MM and does not have a substantial pharmacoeconomic impact in overall cost of hospitalization combined with the apheresis procedure.     

Paramesopsocidae,a new Mesozoic psocid family (Insecta: Psocodea “Psocoptera”: Psocomorpha)

Paramesopsocus lu n. gen., n. sp. and Paramesopsocus adibi n. sp. are respectively described from the Early Cretaceous amber of Lebanon and from the Late Jurassic limestone of Karatau (Kazakhstan). They are placed within the suborder Psocomorpha, and in the Mesozoic extinct family Paramesopsocidae n. fam. A cladistic phylogeny for Psocomorpha is given including our fossil taxa. The discovery of these new taxa demonstrates the necessity of a deep cladistic redefinition of the currently admitted major subdivisions of this suborder.     

Clinical findings for the first 1000 Gulf war veterans in the Ministry of Defence’s medical assessment programme

ObjectiveTo review the clinical findings in the first 1000 veterans seen in the Ministry of Defence’s Gulf war medical assessment programme to examine whether there was a particular illness related to service in the Gulf.DesignCase series of 1000 veterans who presented to the programme between 11 October 1993 and 24 February 1997.SubjectsGulf war veterans.Results588 (59%) veterans had more than one diagnosed condition, 387 (39%) had at least one condition for which no firm somatic or psychological diagnosis could be given, and in 90 (9%) veterans no other main diagnosis was made. Conditions characterised by fatigue were found in 239 (24%) of patients. At least 190 (19%) patients had a psychiatric condition, which in over half was due to post-traumatic stress disorder. Musculoskeletal disorders and respiratory conditions were also found to be relatively common (in 182 (18%) and 155 (16%) patients respectively).ConclusionMany Gulf war veterans had a wide variety of symptoms. This initial review shows no evidence of a single illness, psychological or physical, to explain the pattern of symptoms seen in veterans in the assessment programme. As the veterans assessed by the programme were all self selected, the prevalence of illness in Gulf war veterans cannot be determined from this study. Furthermore, it is not known whether the veterans in this study were representative of sick veterans as a group.

Key messages

• Many Gulf war veterans present with a wide variety of symptoms
• No single cause has been found to explain these symptoms
• From a clinical standpoint the variety and multiplicity of symptoms makes it unlikely that any single cause will be found to underlie Gulf war illness
• Some of the illnesses may be an example of a postwar syndrome

     

Reproducibility of kinematic motion coupling parameters during manual upper cervical axial rotation mobilization: A 3-dimensional in vitro study of the atlanto-axial joint

IntroductionThe reproducibility of the 3-dimensional (3D) kinematic aspects of motion coupling patterns of segmental manual mobilizing techniques is not yet known. This study analyzes the segmental 3D aspects of manual mobilization of the atlanto-axial joint in vitro.Methods and materialsTwenty fresh human cervical specimens were studied in a test–retest situation with two examiners. The specimens were manually mobilized using three different techniques: a regional mobilization technique, a segmental mobilization technique on the atlas with manual fixation of the axis and a segmental mobilization applying a locking technique. Segmental kinematics were registered with a Zebris CMS20 ultrasound-based tracking system. The 3D aspects of motion coupling between main axial rotation and coupled lateral bending were analyzed by six parameters: the range of motion the three motion components, the cross-correlation, the ratio and the shift.ResultsThe results indicate stronger intra- than inter-examiner reproducibility. The range of motion of the axial rotation component shows a substantial level of intra- and inter-examiner reproducibility (ICC’s 0.67–0.76). The parameters describing the coupling patterns show only moderate to substantial intra-examiner reproducibility for the more experienced of the two examiners (ICC’s 0.55–0.68). All other correlations were not significant and no differences could be observed between regional versus segmental techniques.ConclusionReproducibility of segmental 3D-aspects of manual mobilization of the atlanto-axial joint in an in vitro situation can differ between examiners. The results of the present study may indicate a possible tendency to higher reproducibility if mobilizations are performed by an examiner with high expertise and experience in applying the specific techniques. Continued investigation including more examiners with different levels of experience and different techniques is necessary to confirm these observations.     

New biting midges from the Cretaceous amber of Lebanon (Diptera: Ceratopogonidae)

New Ceratopogonidae from the Early Cretaceous amber of Hammana (Central Lebanon) are studied. Five new species (Lebanoculicoides daheri sp. nov., Protoculicoides krzeminskii sp. nov., Archiaustroconops annae sp. nov., Archiaustroconops hammanensis sp. nov., and Archiaustroconops dominiakae sp. nov.) are characterized, described, illustrated, and compared with other Cretaceous taxa. New keys for species of the three genera Lebanoculioides, Protoculicoides, and Archiaustroconops, but also for all genera of Lebanese fossil biting midges, are proposed.     

When the state is (n)ever present: on cynicism and political mobilization in Lebanon

This article looks at the way cynical reasoning consumes political action in Lebanon. Through ethnographic observations with political activists and former militia fighters, specifically during the final days of the 2009 Lebanese parliamentary elections, I show how cynicism is present in political mobilization. I argue that political mobilization moves between modes of cynicism and resistance, calling on us to see these two postures as discursively related. This work has broader implications for understanding political reactions and mobilizations in the aftermath of the 2011 Arab revolts.     

Colorectal cancer and country of birth in New South Wales,Australia: All-of-population data for prioritising health service delivery and research

IntroductionCancer care and outcomes differ across cultural groups in Australia. Quantifying these differences facilitates prioritisation and targeting of services and research. All-of-population data are needed by health agencies to understand and fulfil their cancer-control responsibilities. Compiling these data can be challenging while maintaining privacy. We have used data linkage to gain population-wide colorectal cancer data on stage (degree of spread), treatment, and survival in New South Wales (NSW), Australia, by country of birth (COB), and consider service implications.MethodsWe studied colon and rectal cancers diagnosed in 2003–2016 and recorded on the NSW Cancer Registry (n = 41,575), plus linked hospital data and data from Australian Medical and Pharmaceutical Benefits payments, other treatment data and death records. Outcomes for 12 COB categories were analysed using multiple logistic and proportional hazards regression, with Australia as the reference category.ResultsCompared with Australian born, the adjusted odds ratio for distant spread of colon cancer was higher for people born in Lebanon and the United Kingdom. Treatment was less common for people born in China (surgery), Germany (systemic), Italy (surgery), New Zealand (any treatment) and Vietnam (all treatments), while treatment for rectal cancer was more common for people born in Italy (surgery), United Kingdom (radiotherapy, systemic therapy), and Vietnam (surgery), and less frequent for people born in China (radiotherapy). Adjusted 5-year survival was higher for people born in China, Italy, Vietnam, Greece (colon), Lebanon (colon) and other non-English speaking countries. More advanced stage was negatively related to having surgery and survival.ConclusionsThis study illustrates how linked data can enable comparisons of multiple outcomes for colorectal cancer by country of birth across an entire population. Results disclose “big picture” variations in population characteristics, stage, treatment and survival. This will enable better targeting and prioritisation of services and inform research priorities to address disparities.     

The image of loss: Jalal Toufic's filmic Beirut

Jalal Toufic's cinematic and literary pieces form a unique corpus within contemporary Arab filmmaking. His esthetic vision—built around a sublime understanding of image as loss—not only connects with the current ruins of the Lebanon he films, but also resonates with the classical tradition of the nasib in Arabic poetry.     

Profile of cancer in the Eastern Mediterranean region: The need for action

BackgroundMany countries in the Eastern Mediterranean region (EMR) are undergoing marked demographic and socioeconomic transitions that are increasing the cancer burden in region. We sought to examine the national cancer incidence and mortality profiles as a support to regional cancer control planning in the EMR.MethodsGLOBOCAN 2012 data were used to estimate cancer incidence and mortality by country, cancer type, sex and age in 22 EMR countries. We calculated age-standardized incidence and mortality rates (per 100,000) using direct method of standardization.ResultsThe cancer incidence and mortality rates vary considerably between countries in the EMR. Incidence rates were highest in Lebanon (204 and 193 per 100,000 in males and females, respectively). Mortality rates were highest in Lebanon (119) and Egypt (121) among males and in Somalia (117) among females. The profile of common cancers differs substantially by sex. For females, breast cancer is the most common cancer in all 22 countries, followed by cervical cancer, which ranks high only in the lower-income countries in the region. For males, lung, prostate, and colorectal cancer in combination represent almost 30% of the cancer burden in countries that have attained very high levels of human development.ConclusionsThe most common cancers are largely amenable to preventive strategies by primary and/or secondary prevention, hence a need for effective interventions tackling lifestyle risk factors and infections. The high mortality observed from breast and cervical cancer highlights the need to break the stigmas and improve awareness surrounding these cancers.