Towards more pedestrian-friendly streets in Cairo

This research explores the factors that make the streets of Cairo better places for walking, more inviting, and adaptable to be used by pedestrians. In order to closely examine how far Cairo streets are pedestrian-friendly, walkable environments, the research investigates one street in Cairo as a case study. The case study uses qualitative research to investigate the street characteristics through participants’ observation technique, while the local pedestrians’ needs and perceptions towards the street’s walkability are explored through interviews. In addition, an in-depth interview is conducted with an expert in order to have deeper insights into the issue of pedestrian-friendly streets from a professional perspective. The existing models reviewed through the literature have contributed to the development of the proposed conceptual framework. The study’s empirical findings have shown that safety and cleanliness of streets are the main factors that influence people’s walking experience. Besides, pavement and sidewalks conditions, street furniture and lighting, along with other street user’s behavior, such as car drivers and shopkeepers, are other factors that implicitly and/or explicitly affect street walkability. The analysis of the findings contributes to the limited qualitative research on walkable streets and pedestrians’ walking experience specifically in Cairo. Thus, this study offers a set of recommendations for policy makers and city managers in terms of conducting further research that covers other geographic areas in Cairo, adopting a participatory planning approach, enforcing laws and regulations on street occupancy, applying people-oriented planning paradigms, and raising public awareness on walkability

Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study.

Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice. Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value < 0.05 was considered to be statistically significant. Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, and 52 (46.4%) were residents. 39 (34.8%) had regular journal club sessions at their hospital, 100 (89.3%) did not have access to cadaver dissection labs, and 62 (55.4%) had never attended a WFNS-endorsed conference. 67.0% of respondents reported limited research opportunities and 58.9% reported limited education opportunities. Lack of mentorship (P = 0.023, Phi = 0.26), lack of access to journals (P = 0.002, Phi = 0.332), and limited access to conferences (P = 0.019, Phi = 0.369) were associated with the country income category. Conclusion: This survey identified barriers to education, research, and practice among African trainees and young neurosurgeons. The findings of this study should inform future initiatives aimed at reducing the barriers faced by this group

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children &lt;18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p&lt;0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p&lt;0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p&lt;0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week. Interpretation Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.Peer reviewe

Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. METHODS: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. FINDINGS: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5–3·0) of age-standardised female deaths and 6·8% (5·8–8·0) of age-standardised male deaths. Among the population aged 15–49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2–4·3) of female deaths and 12·2% (10·8–13·6) of male deaths attributable to alcohol use. For the population aged 15–49 years, female attributable DALYs were 2·3% (95% UI 2·0–2·6) and male attributable DALYs were 8·9% (7·8–9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0–1·7] of total deaths), road injuries (1·2% [0·7–1·9]), and self-harm (1·1% [0·6–1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week. INTERPRETATION: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption. FUNDING: Bill & Melinda Gates Foundation

A Full 3D Railroad System Model to Investigate Train-Substructure Interaction Under Dynamic Load

Since the first day the railroad have been invented, it has become one of the most important methods of transportation for both passengers and goods. Millions of miles of railroads tracks are crossing the land all over the world to facilitate the transportation of passengers and different products. The importance of the railroad raised the interest of many researchers and engineers to try to understand and improve the performance of the rails. The finite element method (FEM) has been used widely, as a very powerful numerical method, in the literature to model and investigate the performance of the different components of the railroad system. A lot of scientists used the FEM to study different issues associated with the railroad system, such as stresses in the wheel or the rail web, degradation of the ballast, soil settlement, and many other problems. Beside the FEM, the multi-body systems dynamics (MBS) have been used by many researchers as well as the FEM in the same field. It is very useful tool especially when it comes to the dynamic analysis and investigating the vehicle performance or issues related to the wheel/rail contact. In this work, a detailed model that couples both FEM and MBS in one model is created. This model consists of a full 3D FE model that includes the different components of the railroad system (rails, sleepers, ballast, subballast, subgrade, and fasteners) using beam, solid and spring elements. The FE model is then coupled with the MBS code to extract the output of the dynamic analysis. The model was verified with the results in the literature and showed great performance. The good results of the coupled model provided a strong motivation to move forward with another problem, which is the bridge approach problem in this work. A new coupled model was created to investigate the bridge approach problem that arises from the variation of the stiffness below the rail due to the stiff foundation on the bridge and the softer substructure before and after the bridge. To solve the stiffness variation problem, a concrete slab was implemented under the ballast before the bridge with one end resting on the abutment. Two designs of the slab were studied in this work, namely rectangular and inclined slab. The performance of both slabs was compared with the no slab case, and the results showed great improvement in the vertical displacement, the contact force, and the substructure stresses for both slabs, while the inclined slab showed better performance than the rectangular one as it provides a gradual change in the stiffness in the approach zone. The results of this work show the effectiveness of the presented coupling technique between the FEM and MBS in one model and the usefulness of the presented models. The bridge model analysis showed the effectiveness of the inclined slab as a recommended solution for the approach zone problem and its impact on the reduction of the vertical displacement, the contact forces, and the stresses

Multipath Activity Based Routing Protocol for Mobile ‎Cognitive Radio Ad Hoc Networks

Cognitive radio networks improve spectrum utilization by ‎sharing licensed spectrum with cognitive radio devices. In ‎cognitive radio ad hoc networks the routing protocol is one ‎of the most challenging tasks due to the changes in ‎frequency spectrum and the interrupted connectivity ‎caused by the primary user activity. In this paper, a multi‎path activity based routing protocol for cognitive radio ‎network (MACNRP) is proposed. The protocol utilizes ‎channel availability and creates multiple node-disjoint ‎routes between the source and destination nodes. The ‎proposed protocol is compared with D2CARP and FTCRP ‎protocols. The performance evaluation is conducted ‎through mathematical analysis and using OPNET ‎simulation. The performance of the proposed protocol ‎achieves an increase in network throughput; besides it ‎decreases the probability of route failure due to node ‎mobility and primary user activity. We have found that the ‎MACNRP scheme results in 50% to 75% reduction in ‎blocking probability and 33% to 78% improvement in ‎network throughput, with a reasonable additional routing ‎overhead and average packet delay. Due to the successful ‎reduction of collision between primary users and ‎cognitive users, the MACNRP scheme results in decreasing ‎the path failure rate by 50% to 87%.

Outcome of aneurismal subarachnoid hemorrhage: How far is vasospasm involved? – Retrospective study

AbstractPurposeTo evaluate vasospasm and/or other possible mechanisms as a contributor to poor outcome following aneurismal subarachnoid hemorrhage (SAH).Materials and methodsSixty patients with aneurismal SAH, and severe cerebral vasospasm warranting endovascular angioplasty were included. Data included age, sex, bleeding severity, number and territory of spastic arteries, angioplasty result, development of new infarcts and their location relative to spastic territory. Final outcome was reported.ResultsThere was strong correlation between outcome and both grade of hemorrhage and age. Angioplasty was either successful (80%), equivocal (10%), failed (8.3%), or could not be done (1.7%).New Infarcts were found in 44/60 patients (73.3%). In 7 of which (16%) they were out of spastic territory. The remaining 37 (84.1%) had infarcts anatomically related to spasm, of these, 28 had successful angioplasty (75%).No new infarcts were found in the remaining 16 patients (26.7%). There was no significant correlation between new infarcts and either successful angioplasty or outcome. However, when outcome was correlated to infarcts within the spastic territory, it turned strongly significant (p=0.008).ConclusionVasospasm and new infarcts have different pathophysiology. Only the coexistence of both in the same territory significantly correlates with poor outcome. Both are related to severity of SAH