Synoptic, thermodynamic and agroeconomic aspects of severe hail events in Cyprus

Hail is a hazardous weather element often accompanying a thunderstorm, as a result of either thermal instability or instability associated with baroclinic synoptic-scale systems (i.e. frontal depressions). Nevertheless, instability of any kind and thunderstorm activity does not always lead to the formation of hail of adequate size to reach the ground. The broader the knowledge concerning hail events the better the understanding of the underlying thermodynamic and dynamic mechanisms, as well as the physical processes associated with its formation. <br><br> In the present study, the severe hail events that were recorded in Cyprus during the ten-year period from 1996 until 2005 were examined, first by grouping them into two clusters, namely, the "thermal instability cluster" and the "frontal depression cluster". Subsequently, the spatial and temporal evolution of the synoptic, dynamic and thermodynamic characteristics of these hail events was studied in depth. Also, the impact of hailstorms on the local economy of the island is presented in terms of the compensations paid by the Agricultural Insurance Organization of the country

The effect of pre-deposited titanium-based PVD metallic thin films on the nitrogen diffusion efficiency and wear behaviour of nitrided Ti alloys

Low-temperature Triode Plasma Nitriding (TPN) has been reported to increase the load-bearing capacity of titanium alloys without compromising either core strength or fatigue resistance. It is known also that the effective adhesion between PVD hard coatings and titanium alloy substrates can be improved significantly following substrate diffusion pre-treatment. In TPN treatment the diffusion of the nitrogen can be achieved more efficiently (than conventional nitriding techniques) at a comparatively low substrate temperature - and after relatively short treatment times. Moreover, there is evidence to suggest that the effectiveness of the triode-plasma diffusion treatment can be further increased by depositing a suitable thin PVD metallic layer on to the titanium alloy substrate before plasma nitriding treatment, to beneficially modify the diffusion kinetics. In this paper, both hcp-α and bcc-β titanium coatings (the latter stabilised by the addition of Nb) are applied to (α + β) Ti-6Al-4 V and (β) Ti-4Al-10 V-22Mo substrate materials; the effects of α Ti and β TiNb PVD pre-coating on the diffusion treatment efficiency (and nitride phase development) and the wear behaviour of each of the Ti alloy substrates after TPN treatment at 700 °C is evaluated

Paclitaxel, vinorelbine and 5-fluorouracil in breast cancer patients pretreated with adjuvant anthracyclines

We investigated the activity and toxicity of a combination of vinorelbine (VNB), paclitaxel (PTX) and 5-fluorouracil (5-FU) continuous infusion administered as first-line chemotherapy in metastatic breast cancer patients pretreated with adjuvant anthracyclines. A total of 61 patients received a regimen consisting of VNB 25 mg m−2 on days 1 and 15, PTX 60 mg m−2 on days 1, 8 and 15 and continuous infusion of 5-FU at 200 mg m−2 every day. Cycles were repeated every 28 days. Disease response was evaluated by both RECIST and World Health Organization (WHO) criteria. Objective responses were recorded in 39 of 61 patients (64.0%) assessed by WHO and in 36 of 50 patients (72.0%) assessable by RECIST criteria. Complete remission occurred in 15 (24.6%) and 14 patients (28.0%), respectively. The median time to progression and overall survival of entire population was 10.6 and 27.3 months, respectively, and median duration of complete response was 14.8 months. The dose-limiting toxicity was myelosuppression (leucopenia grade 3/4 in 52.5% of patients). Grade 3/4 nonhaematologic toxicities included mucositis/diarrhoea in 13.1%, skin in 3.3% and cardiac in 1.6% of patients. Grade 2/3 neurotoxicity was observed in five patients (7.2%). The VNB, PTX and 5-FU continuous infusion combination regimen was active and manageable. Complete responses were frequent and durable

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

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Load Balanced Priority Queues on Distributed Memory Machines (Extended Abstract)

) Ajay K. Gupta ? Andreas G. Photiou Western Michigan University Lake States Insurance Company Kalamazoo, MI 49008, USA Traverse City, MI 49685, USA Abstract. We consider efficient algorithms for priority queues on distributed memory multiprocessors, such as nCUBE, iPSc, MPP and looselycoupled systems consisting of networked workstations. For a p-processor distributed memory multicomputer P and n data items in the priority queue, n ? p, we investigate two priority queues; horizontally sliced and vertically sliced. Both of these achieve load balance, i.e. at most \Theta(n=p) data items are stored at every processor of P . Horizontally sliced priority queue allows deletions and insertions of \Theta(p) items in time O( p bw øc + øpp log n) on hypercubic networks where øc is the communication time between a pair of processors, øp is the unit processing time and bw is the width of the communication channel between a pair of processors. Vertically sliced priority queue allows deletio..

Association between education and self-assessment of the neighborhood environment

DEpICT is an ongoing observational, cross-sectional study in community-dwellers in Limassol, Cyprus aiming to combine individual-level and community-level risk factors to decode their effect on arterial health (stiffness) as measured with pulse wave velocity (PWV)