Land transformation assessment using the integration of remote sensing and GIS techniques: a case study of Al-Anbar Province, Iraq

Human activities and climate changes significantly affect our environment, altering hydrologic cycles. Several environmental, social, political, and economical factors contribute to land transformation as well as environmental changes. This study first identified the most critical factors that affect the environment in Al-Anbar city including population growth, urbanization expansion, bare land expansion, and reduction in vegetation cover. The combination of remote sensing data and fuzzy analytic hierarch process (Fuzzy AHP) enabled exploration of land transformations and environmental changes in the study area during 2001 to 2013 in terms of long and short-term changes. Results of land transformation showed that the major changes in water bodies increased radically (94 %) from the long-term change in 2001 to 2013 because of water policies. In addition, the urban class expanded in two short-term periods (2001–2007 and 2007–2013), representing net changes of 46 and 60 %, respectively. Finally, barren land showed 25 % reduction in the first period because of the huge expansion of water in the lake; a small percentage of growth gain was observed in the second period. Based on the land transformation results, the environmental degradation assessment showed that the study area generally had high level of environmental degradation. The degradation was mostly in the center and the north part of the study area. This study suggested for further studies to include other factors that also responsible for environmental degradation such as water quality and desertification threatening

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Improvement of road safety using passive and active intelligent vehicle safety systems

Following the measures foreseen in the Transport White Paper 2001, situation of road safety has improved. Road fatalities have declined by more than 17 % since 2001 in the EU. However, with around 41 600 deaths and more than 1.7 million injured in 2005, road remains the least safe mode of transport and objectives to halve the number of fatalities on road by 2010 is most likely not feasible to achieve. Therefore a need for the intelligent vehicle safety systems, that enable to raise the level of road safety, is much higher than ever before. The Intelligent Vehicle Safety Systems ensure a superior safety on road would it be vehicle-based or infrastructure-related systems. These can be divided into passive and active safety applications where the former help people stay alive and uninjured in a crash, while the latter help drivers to avoid accidents. Some of the most promising (e-call) and the most used (ABS, ESP) systems are analised more specifi cally in the paper. Possible solutions to deploying intelligent transport systems in Lithuania are also introduced

The impact of transport on the competitiveness of national economy

Transport has always been and remained one of the main driving forces in the economical development of any country including Lithuania. The paper assesses a positive impact of transport on Lithuanian economy in the light of the analysis of the main indicators measuring the success of the transport sector: the share of transport and warehousing sectors to national GDP (%) and the share of the export of transport services in GDP (%). It is also widely acknowledged that transport is going to play a crucial role in economic development in the future, especially in transit-related transport like the Baltic States. On the other hand, the growth of transport, particularly in road transport, has had a significant impact on congestion, safety and pollution. Therefore, the task of transport decision makers is to find the key for sustainable transport development and reduction of a negative transport impact to sustain the transport sector as the engine of economy. The paper analyses both the positive and negative impacts of transport on economy and evaluates the possible ways developing the sustainable transport system