Search results for: emergency period

Authors: Rajashree Bothale, Venkateswara Rao

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Indian Himalayas also known as third pole with 0.9 Million SQ km area, contain the largest reserve of ice and snow outside poles and affect global climate and water availability in the perennial rivers. The variations in the extent of snow are indicative of climate change. The snow melt is sensitive to climate change (warming) and also an influencing factor to the climate change. A study of the spatio-temporal dynamics of snow cover and melt/freeze conditions is carried out using space based observations in visible and microwave bands. An analysis period of 2003 to 2015 is selected to identify and map the changes and trend in snow cover using Indian Remote Sensing (IRS) Advanced Wide Field Sensor (AWiFS) and Moderate Resolution Imaging Spectroradiometer(MODIS) data. For mapping of wet snow, microwave data is used, which is sensitive to the presence of liquid water in the snow. The present study uses Ku-band scatterometer data from QuikSCAT and Oceansat satellites. The enhanced resolution images at 2.25 km from the 13.6GHz sensor are used to analyze the backscatter response to dry and wet snow for the period of 2000-2013 using threshold method. The study area is divided into three major river basins namely Brahmaputra, Ganges and Indus which also represent the diversification in Himalayas as the Eastern Himalayas, Central Himalayas and Western Himalayas. Topographic variations across different zones show that a majority of the study area lies in 4000–5500 m elevation range and the maximum percent of high elevated areas (>5500 m) lies in Western Himalayas. The effect of climate change could be seen in the extent of snow cover and also on the melt/freeze status in different parts of Himalayas. Melt onset day increases from east (March11+11) to west (May12+15) with large variation in number of melt days. Western Himalayas has shorter melt duration (120+15) in comparison to Eastern Himalayas (150+16) providing lesser time for melt. Eastern Himalaya glaciers are prone for enhanced melt due to large melt duration. The extent of snow cover coupled with the status of melt/freeze indicating solar radiation can be used as precursor for monsoon prediction.

Keywords: Indian Himalaya, Scatterometer, Snow Melt/Freeze, AWiFS, Cryosphere

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Authors: Mohamed A. Saleem

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Using mostly seismic data, this study intends to show some examples of igneous intrusions found in some areas of the Sirt Basin and explore the period of their emplacement as well as the interrelationships between these sills. The study area is located in the south of the Zallah Trough, south-west Sirt basin, Libya. It is precisely between the longitudes 18.35ᵒ E and 19.35ᵒ E, and the latitudes 27.8ᵒ N and 28.0ᵒ N. Based on a variety of criteria that are usually used as marks on the igneous intrusions, twelve igneous intrusions (Sills), have been detected and analysed using 3D seismic data. One or more of the following were used as identification criteria: the high amplitude reflectors paired with abrupt reflector terminations, vertical offsets, or what is described as a dike-like connection, the violation, the saucer form, and the roughness. Because of their laying between the hosting layers, the majority of these intrusions are classified as sills. Another distinguishing feature is the intersection geometry link between some of these sills. Every single sill has given a name just to distinguish the sills from each other such as S-1, S-2, and …S-12. To avoid the repetition of description, the common characteristics and some statistics of these sills are shown in summary tables, while the specific characters that are not common and have been noticed for each sill are shown individually. The sills, S-1, S-2, and S-3, are approximately parallel to one other, with the shape of these sills being governed by the syncline structure of their host layers. The faults that dominated the strata (pre-upper Cretaceous strata) have a significant impact on the sills; they caused their discontinuity, while the upper layers have a shape of anticlines. S-1 and S-10 are the group's deepest and highest sills, respectively, with S-1 seated near the basement's top and S-10 extending into the sequence of the upper cretaceous. The dramatic escalation of sill S-4 can be seen in N-S profiles. The majority of the interpreted sills are influenced and impacted by a large number of normal faults that strike in various directions and propagate vertically from the surface to the basement's top. This indicates that the sediment sequences were existed before the sill’s intrusion, were deposited, and that the younger faults occurred more recently. The pre-upper cretaceous unit is the current geological depth for the Sills S-1, S-2 … S-9, while Sills S-10, S-11, and S-12 are hosted by the Cretaceous unit. Over the sills S-1, S-2, and S-3, which are the deepest sills, the pre-upper cretaceous surface has a slightly forced folding, these forced folding is also noticed above the right and left tips of sill S-8 and S-6, respectively, while the absence of these marks on the above sequences of layers supports the idea that the aforementioned sills were emplaced during the early upper cretaceous period.

Keywords: Sirt Basin, Zallah Trough, igneous intrusions, seismic data

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Authors: Amin Osama Amin Mohamed Elbaramawy

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In the last period of time, about ten years ago, wars caused violations of human rights in many places, and despite international condemnations, they did not stop, and the truth is that international law was unable to stop them. The global wars and conflicts that the world has been witnessing for more than ten years have caused the displacement of millions of people in all parts of the earth, causing a violation of the human rights of those people. Despite international condemnations of these conflicts, these conflicts have not stopped and have not been resolved until now. Therefore, I call for international law and international courts to be more effective and not just in words, taking into account the speed in this due to the increase in those wars and conflicts every day and new violations every day.

Keywords: war, freedom, human rights, international law

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Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

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Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

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Authors: Habiba Ben Abdessalem

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The emergence of giant set of textual data was the push that has encouraged researchers to invest in this field. The purpose of textual data analysis methods is to facilitate access to such type of data by providing various graphic visualizations. Applying these methods requires a corpus pretreatment step, whose standards are set according to the objective of the problem studied. This step determines the forms list contained in contingency table by keeping only those information carriers. This step may, however, lead to noisy contingency tables, so the use of wavelet denoising function. The validity of the proposed approach is tested on a text database that offers economic and political events in Tunisia for a well definite period.

Keywords: textual data, wavelet, denoising, contingency table

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Authors: Nouira Mariem, Ennigrou Samir

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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

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Authors: M. Azadi, N. Tahouni, M. H. Panjeshahi

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A techno-economic evaluation for efficient use of energy in a large scale industrial plant of methanol is carried out. This assessment is based on integration of a gas turbine with an existing plant of methanol in which the outlet gas products of exothermic reactor is expanded to power generation. Also, it is decided that methanol production rate is constant through addition of power generation system to the existing methanol plant. Having incorporated a gas turbine with the existing plant, the economic results showed total investment of MUSD 16.9, energy saving of 3.6 MUSD/yr with payback period of approximately 4.7 years.

Keywords: energy saving, methanol, gas turbine, power generation

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Authors: Taisiia Gorshkova

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Since the 1980s, spatial correlation models have been used more often to model regional indicators. An increasingly popular method for studying regional indicators is modeling taking into account spatial relationships between objects that are part of the same economic zone. In 2000s the new class of model – spatial vector autoregressions was developed. The main difference between standard and spatial vector autoregressions is that in the spatial VAR (SpVAR), the values of indicators at time t may depend on the values of explanatory variables at the same time t in neighboring regions and on the values of explanatory variables at time t-k in neighboring regions. Thus, VAR is a special case of SpVAR in the absence of spatial lags, and the spatial panel data model is a special case of spatial VAR in the absence of time lags. Two specifications of SpVAR were applied to Russian regional data for 2000-2017. The values of GRP and regional CPI are used as endogenous variables. The lags of GRP, CPI and the unemployment rate were used as explanatory variables. For comparison purposes, the standard VAR without spatial correlation was used as “naïve” model. In the first specification of SpVAR the unemployment rate and the values of depending variables, GRP and CPI, in neighboring regions at the same moment of time t were included in equations for GRP and CPI respectively. To account for the values of indicators in neighboring regions, the adjacency weight matrix is used, in which regions with a common sea or land border are assigned a value of 1, and the rest - 0. In the second specification the values of depending variables in neighboring regions at the moment of time t were replaced by these values in the previous time moment t-1. According to the results obtained, when inflation and GRP of neighbors are added into the model both inflation and GRP are significantly affected by their previous values, and inflation is also positively affected by an increase in unemployment in the previous period and negatively affected by an increase in GRP in the previous period, which corresponds to economic theory. GRP is not affected by either the inflation lag or the unemployment lag. When the model takes into account lagged values of GRP and inflation in neighboring regions, the results of inflation modeling are practically unchanged: all indicators except the unemployment lag are significant at a 5% significance level. For GRP, in turn, GRP lags in neighboring regions also become significant at a 5% significance level. For both spatial and “naïve” VARs the RMSE were calculated. The minimum RMSE are obtained via SpVAR with lagged explanatory variables. Thus, according to the results of the study, it can be concluded that SpVARs can accurately model both the actual values of macro indicators (particularly CPI and GRP) and the general situation in the regions

Keywords: forecasting, regional data, spatial econometrics, vector autoregression

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Authors: Gultekin Gurcay

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In this paper, effects and responses of stock were analyzed. This analysis was done periodically. The dimensions of the financial crisis impact on the stock market were investigated by GARCH model. In this context, S&P 500 stock market is modeled with DAX, NIKKEI and BIST100. In this way, The effects of the changing in S&P 500 stock market were examined on European and Asian stock markets. Conditional variance coefficient will be calculated through garch model. The scope of the crisis period, the conditional covariance coefficient will be analyzed comparatively.

Keywords: conditional variance coefficient, financial crisis, garch model, stock market

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Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: Taşkın Deniz Yıldız, Mustafa Topaloğlu, Orhan Kural

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The right to operate a fairly long periods of prior periods and after the 3213 Mining Law has been observed to be shortened in Turkey. Permit the realization of business activities (or concession) requested the purchase of the mine operated "found mine" position, as well as the financial and technical capability to have the owner of the right to operate the mines as well as the principle of equality is important in terms of assessing the best way be. In particular, in this context, license fields "negligence" (downsizing) have noted that the current arrangement for all periods. However, in the period after 3213 Mining Act and a permit to operate more effectively within the framework of implementation of negligence is laid down.

Keywords: mining legislation, operation, permit, Turkey

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Authors: Zahra Amirhosseini, Mahtab Nameni

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The aim of this study was to investigate the relationship between growth, beta, and Company's cash. We calculate cash as dependent variable and growth opportunity and beta as independent variables. This study was based on an analysis of panel data. Population of the study is the companies which listed in Tehran Stock exchange and a financial data of 215 companies during the period 2010 to 2015 have been selected as the sample through systematic sampling. The results of the first hypothesis showed there is a significant relationship between growth opportunities cash holdings. Also according to the analysis done in the second hypothesis, we determined that there is an inverse relation between company risk and cash holdings.

Keywords: growth, beta, liquidity, company

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Authors: Ahmad Saleem

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Ethereum is the second largest crypto currency in blockchain ecosystem. Along with standard transactions, it supports smart contracts and NFT’s. Current research trends are focused on analyzing the overall structure of the network its growth and behavior. Ethereum addresses are anonymous and can be created on fly. The nature of Ethereum network and addresses make it hard to predict their behavior. The activity period of an ethereum address is not much analyzed. Using machine learning we can make early prediction about the disposability of the address. In this paper we analyzed the lifetime of the addresses. We also identified and predicted the disposable addresses using machine learning models and compared the results.

Keywords: blockchain, Ethereum, cryptocurrency, prediction

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Authors: Sahar Heidary, Ramin Ghasemi Shayan

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The recent coronavirus disease 2019 (COVID-19) occurrence has carried considerabletrials to the world health system, comprising the training of dental and maxillofacial radiology (DMFR). DMFR will keep avital role in healthcare throughout this disaster. Severe acute breathing disease coronavirus 2 (SARS-CoV-2), the virus producing the current coronavirus disease 2019 (COVID-19) pandemic, is not only extremely contagious but can make solemn consequences in susceptible persons comprising dental patients and dental health care personnel (DHCPs). Reactions to COVID-19 have been available by the Cores for Infection Switch and Inhibition and the American Dental Association, but a more detailed answer is necessary for the harmless preparation of oral and maxillofacial radiology. Our goal is to evaluation the existing information just how the illness threatens patients and DHCPs and how to define which patients are possible to be SARS-CoV-2 infected; study how the usage of private shielding utensils and contamination control measures based on recent top observes, and knowledge can decrease the danger of virus spread in radiologic trials; and scrutinize how intraoral radiography, with its actually superior danger of scattering the infection, might be changed by extraoralradiographic methods for definite diagnostic jobs. In the pandemic, teleradiology has been extensively recycled for diagnostic determinations of COVID-19 patients, for discussions with radiologists in crisis cases, or managing of distance among radiology clinics. Dentists can have the digital radiographic images of their emergency patients through online service area also by electronic message or messaging applications to view in their smart phones, laptops, or other electronic devices.

Keywords: radiology, dental, oral, COVID-19, infection

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Authors: Hamed Hedayatnia, Nathan Van Den Bossche

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Understanding the ways in which climate change accelerates or slows down the process of material deterioration is the first step towards assessing adaptive approaches for the conservation of historical heritage. Analysis of the climate change effects on the degradation risk assessment parameters like freeze-thaw cycles and wind erosion is also a key parameter when considering mitigating actions. Due to the vulnerability of cultural heritage to climate change, the impact of this phenomenon on material degradation criteria with the focus on brick masonry walls in Timurid heritage, located in Iran, was studied. The Timurids were the final great dynasty to emerge from the Central Asian steppe. Through their patronage, the eastern Islamic world in northwestern of Iran, especially in Mashhad and Herat, became a prominent cultural center. Goharshad Mosque is a mosque in Mashhad of the Razavi Khorasan Province, Iran. It was built by order of Empress Goharshad, the wife of Shah Rukh of the Timurid dynasty in 1418 CE. Choosing an appropriate regional climate model was the first step. The outputs of two different climate model: the 'ALARO-0' and 'REMO,' were analyzed to find out which model is more adopted to the area. For validating the quality of the models, a comparison between model data and observations was done in 4 different climate zones in Iran for a period of 30 years. The impacts of the projected climate change were evaluated until 2100. To determine the material specification of Timurid bricks, standard brick samples from a Timurid mosque were studied. Determination of water absorption coefficient, defining the diffusion properties and determination of real density, and total porosity tests were performed to characterize the specifications of brick masonry walls, which is needed for running HAM-simulations. Results from the analysis showed that the threatening factors in each climate zone are almost different, but the most effective factor around Iran is the extreme temperature increase and erosion. In the north-western region of Iran, one of the key factors is wind erosion. In the north, rainfall erosion and mold growth risk are the key factors. In the north-eastern part, in which our case study is located, the important parameter is wind erosion.

Keywords: brick, climate change, degradation criteria, heritage, Timurid period

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Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Worldwide regulators, practitioners and researchers view risk-disclosure as one of the most important steps that will promote corporate accountability and transparency. Recognizing this growing significance of risk disclosures, the paper first develops a risk disclosure index. Covering 69 risk items/themes, this index is developed by employing thematic content analysis and encompasses three attributes of disclosure: namely, nature (qualitative or quantitative), time horizon (backward-looking or forward-looking) and tone (no impact, positive impact or negative impact). As the focus of study is on substantive rather than symbolic disclosure, content analysis has been carried out manually. The study is based on non-financial companies of Nifty500 index and covers a ten year period from April 1, 2005 to March 31, 2015, thus yielding 3,872 annual reports for analysis. The analysis reveals that (on an average) only about 14% of risk items (i.e. about 10 out 69 risk items studied) are being disclosed by Indian companies. Risk items that are frequently disclosed are mostly macroeconomic in nature and their disclosures tend to be qualitative, forward-looking and conveying both positive and negative aspects of the concerned risk. The second objective of the paper is to gauge the factors that affect the level of disclosures in annual reports. Given the panel nature of data, and possible endogeneity amongst variables, Diff-GMM regression has been applied. The results indicate that age and size of firms have a significant positive impact on disclosure quality, whereas growth rate does not have a significant impact. Further, post-recession period (2009-2015) has witnessed significant improvement in quality of disclosures. In terms of corporate governance variables, board size, board independence, CEO duality, presence of CRO and constitution of risk management committee appear to be significant factors in determining the quality of risk disclosures. It is noteworthy that the study contributes to literature by putting forth a variant to existing disclosure indices that not only captures the quantity but also the quality of disclosures (in terms of semantic attributes). Also, the study is a first of its kind attempt in a prominent emerging market i.e. India. Therefore, this study is expected to facilitate regulators in mandating and regulating risk disclosures and companies in their endeavor to reduce information asymmetry.

Keywords: risk disclosure, voluntary disclosures, corporate governance, Diff-GMM

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Authors: Maria Medrano, Cristina Cadenas-Sanchez, Maddi Oses, Lide Arenaza, Maria Amasene, Idoia Labayen

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The COVID-19 outbreak began in December 2019 in China and was rapidly expanded globally. Emergency measures, such as social distance or home confinement, were adopted by many country governments to prevent its transmission. In Spain, one of the most affected countries, the schools were closed, and one of the most severe mandatory home confinement was established for children from 14th March to 26th April 2020. The hypothesis of this study was that the measures adopted during the COVID-19 pandemic may have negatively affected physical activity and screen time of children. However, few studies have examined the effects of COVID-19 pandemic on lifestyle behaviours. Thus, the aim of the current work was to analyse the effects of the COVID-19 confinement on physical activity and screen time in Spanish children. For the current purpose, a total of 113 children and adolescents (12.0 ± 2.6 yr., 51.3% boys, 24.0% with overweight/obesity according to the World Obesity Federation) of the MUGI project were included in the analyses. Physical activity and screen time were longitudinally assessed by 'The Youth Activity Profile' questionnaire (YAP). Differences in physical activity and screen time before and during the confinement were assessed by dependent t-test. Before the confinement, 60% did not meet physical activity recommendations ( ≥ 60/min/day of moderate to vigorous physical activity), and 61% used screens ≥ 2 h/day. During the COVID-19 confinement, children decreased their physical activity levels (-91 ± 55 min/day, p < 0.001) and increased screen time ( ± 2.6 h/day, p < 0.001). The prevalence of children that worsened physical activity and screen time during the COVID-19 confinement were 95.2% and 69.8%, respectively. The current study evidence the negative effects of the COVID-19 confinement on physical activity and screen time in Spanish children. These findings should be taken into account to develop and implement future public health strategies for preserving children's lifestyle behaviours and health during and after the COVID-19 pandemic.

Keywords: COVID-19, lifestyle changes, paediatric, physical activity, screen time

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Authors: Ö. Şenyiğit, A. Çolak

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It is of great importance for an architectural student to know the parameters through which he/she can conduct his/her design and makes his/her design effective in architectural education. Therefore; an empirical application study was carried out through the designing activity using the emulation model to support the design and design approaches of architectural students. During the investigation period, studies were done on the basic design elements and principles of the fall semester, and the emulation model, one of the designing methods that constitute the subject of the study, was fictionalized as three phased “recognition-interpretation-application”. As a result of the study, it was observed that when students were given a key method during the design process, their awareness increased and their aspects improved as well.

Keywords: basic design, design education, design methods, emulation

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Authors: Tali Capua, Karin Hermon, Miguel Glatstein, Oren Tavor, Ayelet Rimon

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Background: Electric bicycles (E-bikes) are one of a wide range of light electric vehicles that provide convenient local transportation and attractive recreational opportunities. Along with their growing use worldwide, the E-bike related injury rate increases. To the best of our knowledge, this study is the first to specifically compare E-bike with classic bicycle related injuries in children. Methods: Data of all pediatric ( < 16 years of age) bicycle related injuries presenting to an urban level I trauma center between 2014 and 2015 were collected and analyzed. The recorded data included age, gender, details of the accident, as well severity of injury, medical diagnosis, and the outcome. Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) were calculated for each patient. Data of E-bike related injuries and classic bicycle were then compared. Results: A total of 124 bicycle related injuries and 97 E-bike related injuries presented to the emergency department. Once pedestrians and bicycle passengers were removed, the groups of riders consisted of 111 bikers and 85 E-bikers. The mean age of bikers was 9.9 years (range 3-16 years) and of E-bikers was 13.7 years (range 7.5-16 years). Injuries to the head and the extremities were common in both groups. Compared to bikers, E-bikers had significantly more injuries to intra-abdominal organs (p = 0.04). Twenty patients (16%) with bicycle related injuries were admitted, and 13 (15%) patients with E-bike related injuries, of the latter group four underwent surgical intervention. ISS scores were low overall, but the injuries of higher severity (ISS > 9) were among the E-bikers. Conclusions: This study provides unique information which suggests that injuries in E-bikers tend to be more severe than in classic bikers. There is a need for regulation regarding the use of E-bikes to enhance the safety of both bikers and other road and pavement users.

Keywords: bicycle, electric bicycle, injury, pediatric, trauma

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Authors: Meskure Pak, Nihal Buyukuslu

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During Ramadan Muslims refrain from eating and drinking from dawn to sunset. Transformation of the eating habits cause profound changes in body composition. This study was performed during Ramadan of June-July 2015 with the regular fasting healthy adults (15 women and 15 men). The participants who were not fasting the whole month, have chronic diseases, pregnant and lactated were excluded. All attendances were informed about study. Written informed consent was taken from the voluntary participants. The work was approved by the Ethics and Research Committee of Istanbul Medipol University, Turkey. A questionnaire was conducted to determine the nutritional status, demographic and anthropometric data at the beginning, in the middle and at the end of Ramadan. Statistical Package for Social Sciences version 18.0 (SPSS, Chicago, IL, USA) was used for analyses. The mean ages of women and men were 34.4±9.45 and 28.9±10.55 years respectively. The BMI values (kg/m2) were slightly increased in men (26.5±3.9 to 26.2±3.7) and decreased in women (22.5±3.5 to 23.3±4.5). However the differences in BMI values between genders were not significant. Waist circumferences (WC) (cm) decreased in both women (80.2±14.6 to 79.4±17.7) and men (98.9±8.4 to 95.2±11.0) through the Ramadan. Fat percentages of women (27.0±71) increased in the middle of Ramadan (28.4±7.8) and decreased at the end of Ramadan (27.8±8.3). The fat percentages of men (21.5±6.3) were not affected in the middle of Ramadan (21.5±6.4) however decreased at the end of Ramadan (20.8±6.2). The total change in fat mass from beginning to end of Ramadan was higher in women than in men. The daily energy intake was higher in men than in women during Ramadan. In the middle of Ramadan energy intake (kcal) was reached to the highest level (2057.8±693.1) and at the end of Ramadan it decreased to the beginning level (1656.7±553.2) for men. However, daily energy intake of women slightly decreased from the beginning (1410.0±359.7) to the end (1409.2±366.7) of Ramadan. The comparison of energy intake between men and women was significant in the middle of Ramadan (p < 0.05). Water consumptions for both groups were increased in Ramadan fasting period. In comparison with the beginning of Ramadan, daily carbohydrate and fat consumptions increased and the consumption of protein decreased for men and for women at the end of Ramadan. The gender comparison resulted in a significant increase for protein and carbohydrate consumption of men in the middle of Ramadan (p < 0.05). In the first two weeks, the daily energy intake, the consumption of carbohydrates and fats seemed to increase for both men and women. However the later days of Ramadan daily fat consumption decreased to the level of beginning consumption levels which may indicate the nutritional adaptation period. In spite of the consumption of protein sources such as meat, poultry and egg increased, the decrease in the total amount of protein consumed in Ramadan may be due to a decrease in the consumption of milk and dairy products. In conclusion, the nutritional habits and preferred foods changed during Ramadan as a result affected the body composition.

Keywords: body composition, fasting, nutritional status, Ramadan

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Authors: Osama Zayed

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Aim of the work: The aim of this study is to assess the predictors of pelvic vascular injuries in patients with pelvic fractures from major blunt trauma. Methods: This study was conducted as a tool-assessment study. Forty six patients with pelvic fractures from major blunt trauma will be recruited to the study arriving to department of emergency, Suez Canal University Hospital. Data were collected from questionnaire including; personal data of the studied patients and full medical history, clinical examinations, outcome measures (The Physiological and Operative Severity Score for enumeration of Mortality and morbidity (POSSUM), laboratory and imaging studies. Patients underwent surgical interventions or further investigations based on the conventional standards for interventions. All patients were followed up during conservative, operative and post-operative periods in the hospital for interpretation the predictive scores of vascular injuries. Results: Significant predictors of vascular injuries according to computed tomography (CT) scan include age, male gender, lower Glasgow coma (GCS) scores, occurrence of hypotension, mortality rate, higher physical POSSUM scores, presence of ultrasound collection, type of management, higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) POSSUM scores, presence of abdominal injuries, and poor outcome. Conclusions: There was higher frequency of males than females in the studied patients. There were high probability of morbidity and low probability of mortality among patients. Our study demonstrates that POSSUM score can be used as a predictor of vascular injury in pelvis fracture patients.

Keywords: predictors, pelvic vascular injuries, pelvic fractures, major blunt trauma, POSSUM

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Authors: Abdullah Al Mamoon, Niels E. Joergensen, Ataur Rahman, Hassan Qasem

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Intergovernmental Panel for Climate Change (IPCC) in its fourth Assessment Report AR4 predicts a more extreme climate towards the end of the century, which is likely to impact the design of engineering infrastructure projects with a long design life. A recent study in 2013 developed new design rainfall for Qatar, which provides an improved design basis of drainage infrastructure for the State of Qatar under the current climate. The current design standards in Qatar do not consider increased rainfall intensity caused by climate change. The focus of this paper is to update recently developed design rainfalls in Qatar under the changing climatic conditions based on IPCC's AR4 allowing a later revision to the proposed design standards, relevant for projects with a longer design life. The future climate has been investigated based on the climate models released by IPCC’s AR4 and A2 story line of emission scenarios (SRES) using a stationary approach. Annual maximum series (AMS) of predicted 24 hours rainfall data for both wet (NCAR-CCSM) scenario and dry (CSIRO-MK3.5) scenario for the Qatari grid points in the climate models have been extracted for three periods, current climate 2010-2039, medium term climate (2040-2069) and end of century climate (2070-2099). A homogeneous region of the Qatari grid points has been formed and L-Moments based regional frequency approach is adopted to derive design rainfalls. The results indicate no significant changes in the design rainfall on the short term 2040-2069, but significant changes are expected towards the end of the century (2070-2099). New design rainfalls have been developed taking into account climate change for 2070-2099 scenario and by averaging results from the two scenarios. IPCC’s AR4 predicts that the rainfall intensity for a 5-year return period rain with duration of 1 to 2 hours will increase by 11% in 2070-2099 compared to current climate. Similarly, the rainfall intensity for more extreme rainfall, with a return period of 100 years and duration of 1 to 2 hours will increase by 71% in 2070-2099 compared to current climate. Infrastructure with a design life exceeding 60 years should add safety factors taking the predicted effects from climate change into due consideration.

Keywords: climate change, design rainfalls, IDF, Qatar

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Authors: Fergus Wade, Jasmine Makker, Matthew Jankinson, Aminah Qamar, Gemma Morrelli, Shayan Shah

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Background: Ambulance offload delays (AODs) affect patient outcomes. At baseline, the average AOD at Princess Royal University Hospital (PRUH) was 41 minutes, in breach of the 15-minute target. Aims: By February 2023, we aimed to reduce: the average AOD to 30 minutes percentage of AOD >30 minutes (PA30) to 25% and >60 minutes (PA60) to 10% Methods: Following a root-cause analysis, we implemented 2 Plan, Do, Study, Act (PDSA) cycles. PDSA-1 ‘Drop-and-run’: ambulances waiting >15 minutes for a handover left the patients in the Emergency Department (ED) and returned to the community. PDSA-2: Booking in the patients before the handover, allowing direct updates to online records, eliminating the need for handwritten notes. Outcome measures: AOD, PA30, and PA60, and process measures: total ambulances and patients in the ED were recorded for 16 weeks. Results: In PDSA-1, all parameters increased slightly despite unvarying ED crowding. In PDSA-2, two shifts in data were seen: initially, a sharp increase in the outcome measures consistent with increased ED crowding, followed by a downward shift when crowding returned to baseline (p<0.01). Within this interval, the AOD reduced to 29.9 minutes, and PA30 and PA60 were 31.2% and 9.2% respectively. Discussion/conclusion: PDSA-1 didn’t result in any significant changes; lack of compliance was a key cause. The initial upward shift in PDSA-2 is likely associated with NHS staff strikes. However, during the second interval, the AOD and the PA60 met our targets of 30 minutes and 10%, respectively, improving patient flow in the ED. This was sustained without further input and if maintained, saves 2 paramedic shifts every 3 days.

Keywords: ambulance offload, district general hospital, handover, quality improvement

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Authors: Amy Darwin, Claire Blacklock

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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.

Keywords: calais, mental health, refugees, the jungle, MHPSS

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Authors: Getalem E. Haylia

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The Ribb dam is one of the irrigation projects in the Upper Blue Nile basin, Ethiopia, to irrigate the Fogera plain. Reservoir sedimentation is a major problem because it reduces the useful reservoir capacity by the accumulation of sediments coming from the watersheds. Estimates of sediment yield are needed for studies of reservoir sedimentation and planning of soil and water conservation measures. The objective of this study was to simulate the Ribb dam catchment sediment yield using SWAT model and to estimate Ribb reservoir effective life according to trap efficiency methods. The Ribb dam catchment is found in North Western part of Ethiopia highlands, and it belongs to the upper Blue Nile and Lake Tana basins. Soil and Water Assessment Tool (SWAT) was selected to simulate flow and sediment yield in the Ribb dam catchment. The model sensitivity, calibration, and validation analysis at Ambo Bahir site were performed with Sequential Uncertainty Fitting (SUFI-2). The flow data at this site was obtained by transforming the Lower Ribb gauge station (2002-2013) flow data using Area Ratio Method. The sediment load was derived based on the sediment concentration yield curve of Ambo site. Stream flow results showed that the Nash-Sutcliffe efficiency coefficient (NSE) was 0.81 and the coefficient of determination (R²) was 0.86 in calibration period (2004-2010) and, 0.74 and 0.77 in validation period (2011-2013), respectively. Using the same periods, the NS and R² for the sediment load calibration were 0.85 and 0.79 and, for the validation, it became 0.83 and 0.78, respectively. The simulated average daily flow rate and sediment yield generated from Ribb dam watershed were 3.38 m³/s and 1772.96 tons/km²/yr, respectively. The effective life of Ribb reservoir was estimated using the developed empirical methods of the Brune (1953), Churchill (1948) and Brown (1958) methods and found to be 30, 38 and 29 years respectively. To conclude, massive sediment comes from the steep slope agricultural areas, and approximately 98-100% of this incoming annual sediment loads have been trapped by the Ribb reservoir. In Ribb catchment, as well as reservoir systematic and thorough consideration of technical, social, environmental, and catchment managements and practices should be made to lengthen the useful life of Ribb reservoir.

Keywords: catchment, reservoir effective life, reservoir sedimentation, Ribb, sediment yield, SWAT model

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Authors: Mimoza Canga, Irene Malagnino, Vergjini Mulo, Alketa Qafmolla, Vito Antonio Malagnino

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Background: Dental caries is the most common dental disease and pregnancy represents a special process of physical, hormonal and metabolic changes in pregnant women, which is accompanied by an imbalance in the oral cavity. Objective: The objective of this study is to evaluate caries reduction after dental visits, the scaling of teeth, fluoridated water, brushing of the teeth and using fluoride toothpaste before and during pregnancy. Materials and methods: This study was conducted in the time period March 2018- September 2021, the age range of the participants was: 18-41 years old. The sample taken under observation was composed of 84 pregnant women. The questionnaire included the demographic characteristics of the sample, such as age, women's education level was primary, secondary, and higher education. Based on women's education level, our analysis found that 25.9% of pregnant women had completed primary education, 35.2% of them had secondary education and 38.9% of pregnant women had higher education. The descriptive and analytical research analysis is formulated as a longitudinal study. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: In the present study, it was observed that there is a strong relationship between dental visits and the scaling of the teeth with the value of P˂ .0001. While the number of teeth with caries before pregnancy and fluoridated water have a P-value=0.002. If we compare the same factor with the number of teeth with dental caries during pregnancy, the correlation is P-value = 0.0001. The number of teeth with caries before pregnancy and carbohydrates consumption has a strong relation with P-value=0.05. According to the present research, the number of teeth with dental caries before pregnancy in relation to brushing the teeth has a P-value ˂ 0.05. Furthermore, in the actual research, it was established that using fluoride toothpaste doesn’t affect the number of teeth with caries before pregnancy with a P-value= .314. Conclusion: According to the results of the present study performed in Albania, it was found out that the periodical dental visits, scaling of the teeth, fluoridated water, brushing of the teeth influenced caries reduction before and during pregnancy. In comparison, the usage of fluoride toothpaste did not have any effect on dental caries reduction in the same time period. The recommendations are as follows: maintaining oral hygiene, using fluoridated water and brushing the teeth regularly. Healthcare providers should inform pregnant women about the importance of oral health and the implementation of measures to manage dental caries.

Keywords: brushing of the teeth, dental visits, dental scaling, fluoridated water, pregnancy

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Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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Authors: Maryam Shayani Rad, Seyed Ahmad Mohajeri, Mohsen Mouhebati, Seyed Danial Mousavi

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High blood pressure is one of the most important and serious health-threatening because of no symptoms in most people, which can lead to sudden heart attack, heart failure, and stroke. Nowadays, herbal medicine is one of the best and safest strategies for treatment that have no adverse effects. Apium graveolens (celery) can be used as an alternative treatment for many health conditions such as hypertension. Natural compounds reduce blood pressure via different mechanisms in which Apium graveolens extract provides potent calcium channel blocking properties. A randomized, double-blind, placebo-controlled, cross-over clinical trial was done to evaluate the efficacy of formulated Apium graveolens extract with a maximum yield of 3-n-butylphthalide to reduce systolic and diastolic blood pressure in patients with hypertension. 54 hypertensive patients in the range of 20-68 years old were randomly assigned to the treatment group (26 cases) and the placebo control group (26 cases) and were crossed over after washout duration. The treatment group received at least 2 grams of formulated powder in hard capsules orally, before each meal, 2 times daily. The control group received 2 grams of placebo in hard capsules orally, exactly as the same as shape, time, and doses of treatment group. Treatment was administrated in 12 weeks with 4 weeks washout period at the middle of the study, meaning 4 weeks drug consumption for the treatment group, 4 weeks washout and 4 weeks placebo consumption, and vice versa for the placebo control group. The clinical assessment was done 4 times, including at the beginning and ending of the drug and placebo consumption period by 24-hour ambulatory blood pressure monitoring (ABPM) holter, which measured blood pressure every 15 minutes continuously. There was a statistically significant decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the end of drug duration compared to baseline. The changes after 4 weeks on average was about 12.34 mm Hg for the SBP (P < 0.005) and 7.83 mm Hg for the DBP (P < 0.005). The results from this clinical trial study showed this Apium graveolens extract formulation in the mentioned dosage had a significant effect on blood pressure-lowering for hypertensive patients.

Keywords: Apium graveolens extract, clinical trial, cross-over, hypertension

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Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

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Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

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Authors: Larisa Liamina, Vasily Lavrushin, Salvatore Inguaggiato

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This study presents and summarizes the results of researching the isotopic signature of helium in the deep fluid eastern part of the Southern slope of the Greater Caucasus and the Lesser Caucasus (Azerbaijan and Armenia) for the period from 2010 to 2016. The results of isotope ratios of 3He/4He in 59 samples of the gas phase of geothermal fluids and mud volcanoes are presented. New data have been obtained not only on the isotopic ratios of helium, but also neon and argon. The R/Ra ratio was analyzed along the Ankara-Sevan ophiolite structure. The patterns of lateral variations of the 3He/4He ratio of different geological structural elements of the studied region are revealed.

Keywords: isotopes helium, deep fluids, tectonic structures, Caucasus

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