Despite global efforts to promote healthy and sustainable diets, the nutrition transition witnessed among adolescents worldwide poses serious threats to health and environmental sustainability. The present study aimed to assess the change in environmental footprints (EFPs) associated with dietary intakes of adolescents in Lebanon between 1997 and 2009. Data of Lebanese adolescents (10–19 years old) were drawn from national food consumption surveys during two time periods (1997, n = 451; 2009, n = 527). Dietary assessments were conducted using 24-h dietary recalls. EFP metrics, including water, energy and greenhouse gas emissions (GHG), were derived using review of existing life-cycle analyses. All EFPs increased significantly between 1997 and 2009; meat and sugar-sweetened beverages were the top contributors to the increase in these EFPs. The changes in EFPs between the two years remained significant even after adjustment for energy and other correlates: water (β = 267.7, CI: 123.5; 411.9); energy (β = 4.3, CI: 2.09; 6.52) and GHG (β = 0.44, CI: 0.11; 0.76). Findings show significant dietary shifts among adolescents that can threaten the environmental sustainability of Lebanese diets. Interventions across the food system are needed to promote adherence to healthy and sustainable diets among adolescents.

Menisci are crucial for knee joint functions and meniscal tears are common injuries, especially in sports activities. Platelet-rich plasma (PRP), which enhances healing, has emerged as a promising additive treatment for meniscus injuries, utilizing the regenerative properties of platelets and growth factors for improved clinical outcomes. In studies with a follow-up period of less than one year, the use of platelet-rich plasma (PRP) therapy for meniscus injuries showed significant improvements in knee symptoms and daily activity. Patients experienced enhanced outcomes in terms of pain reduction and increased sports activity, with MRI scans indicating stable meniscus conditions after six months. Studies with a follow-up of more than one year, however, did not find significant differences between groups treated with PRP and groups not treated with PRP in terms of various outcome measures, including pain and knee function. The vascularization of the menisci is vital for their proper function, and insufficient blood supply can affect healing of meniscal injuries. PRP therapy is used to enhance meniscal healing by introducing growth factors and anti-inflammatory agents. PRP therapy may enable athletes with meniscal tears to return to sports more quickly and has less rehabilitation duration. While PRP seems promising as an alternative to failed treatment or as an adjunct to treatment in the short term, its long-term effectiveness remains inconclusive. Patient preferences, commitment to therapy rehabilitation, and cost should all be considered on an individual basis.

Rotator cuff tears are prevalent, affecting 20% of the general population, with massive tears accounting for 40% of these cases. Massive tears, those larger than 5 cm or involving several tendons, pose substantial clinical problems, including poorer surgical outcomes and increased recurrence rates. Multiple classification systems offer varied definitions, complicating treatment strategies. The irreparability of these tears, exacerbated by conditions such as tendon atrophy and advanced imaging abnormalities, can further complicate management. Surgical options include superior capsular reconstruction (SCR) and tendon transfers. SCR, which involves attaching a graft to the superior glenoid and greater tuberosity, has shown promise in individuals with intact subscapularis tendons and minimal arthritis. Graft alternatives include fascia lata (FL) autografts, human dermal allografts, and long head of the biceps tendon (LHBT) autografts. Each graft type has distinct advantages and disadvantages, with FL autografts providing greater results despite donor site morbidity. Tendon transfers, such as latissimus dorsi and lower trapezius transfers, offer alternative treatments, especially for younger, more active individuals. This review thoroughly reviews different therapeutic options, emphasizing the most recent evidence and clinical outcomes to help guide the best management of massive posterosuperior irreparable rotator cuff injuries.

» Closed reduction and physical therapy are the primary approaches for most acute anterior sternoclavicular joint (SCJ) dislocations, with acceptable outcomes for low-demand patients. However, these treatments have a high rate of recurrent instability, albeit with minimal functional impact. » Persistently symptomatic recurrent dislocations typically warrant surgical intervention. The choice of technique—ranging from nonabsorbable sutures to tendon autografts and plating—is based on individualized care by considering patient-specific factors such as activity level, bone quality, and health. » High-demand patients, such as athletes, benefit from robust techniques like suture repair with an internal brace or hamstring tendon autografts. These methods provide durable stability and reduce recurrence risks. » Patients with poor bone quality, such as those with osteoporosis, may require plating techniques (e.g., locking plates or SCJ-specific plates) to ensure rigid fixation, albeit with potential hardware-related complications. » Owing to the rarity of the condition and limited studies, no standardized treatment protocol exists. Tailored approaches based on clinical and functional needs yield optimal outcomes, and further research is needed to identify the best practices.

Background: Data on outcomes of transcatheter aortic valve replacement (TAVR) in the Middle East, particularly in the United Arab Emirates (UAE), are limited. Whether centres with a low volume of patients requiring the procedure can achieve similar outcomes as those reported in pivotal clinical trials remains unclear. This study evaluates procedural outcomes of patients undergoing TAVR in a newly established programme in the UAE. Methods: Procedural outcomes of consecutive patients who underwent transfemoral TAVR at a single centre in the UAE between January 2016 and November 2021 were compared with those at centres in the lowest quartile (Q1) of procedural volume in the Transcatheter Valve Therapy Registry, which covers centres in the US. Results: Among the 183 patients included in the study, the median age was 76 years (interquartile range [IQR] 71–82), and 42.1% of patients were women, with a median Society of Thoracic Surgeons predicted risk of mortality score of 4.6 (IQR 2.9–7.5). Most of the patients (93.3%) received a balloon expandable valve. All-cause death within 30 days, stroke and major vascular complications occurred in 0.6%, 0.6% and 2.2% of patients, respectively, compared with 3.1%, 2.2% and 4% in patients treated at Q1 hospitals. Conclusion: Patients undergoing transfemoral TAVR at an emerging centre in the Middle East had favourable outcomes compared with those performed at Q1 hospitals in the US. These findings suggest that careful patient selection for TAVR is critical and may help optimise patient outcomes, especially when procedural volumes are low.