Reforming land and real estate markets

Land and real estate reforms have not been effective at achieving their objectives, in part because of how they have been designed and implemented. To be successful, reforms must become comprehensive in design, argue the authors, although implementation may be phased over time and take local conditions into account. Reform must include three elements: 1) Institutional reforms that better define property rights, reduce information asymmetry, and improve contract enforcement. 2) Capital market reforms that make mortgage finance available at reasonable rates, especially for the poor. 3) Market reforms that reduce or eliminate the main distortions in the prices of goods and services produced by land and real estate assets. In their review of land and real estate reforms supported by the World Bank, the authors find that such reforms receive less attention at the conceptual stage than they should, considering their great impact on poverty, growth, and stability. They base their conclusion on the limited coverage of land and real estate issues in country assistance strategies, the main vehicle for identifying priority areas for reform. Most Bank-supported projects do not address all three elements critical for reform. And most provide no justification for excluding them, and no plan for follow-up. The Bank's Operations Evaluation Department rates Bank-supported land and real estate projects relatively well on outcome and sustainability but not on institutional development. But land and real estate reform is institutional by nature. The authors urge the Bank and policymakers to change course. After a comprehensive assessment of the status of real estate institutions and markets, all actors in this sector should be pulled together to develop a comprehensive approach to land and real estate reform.Banks&Banking Reform,Environmental Economics&Policies,Land and Real Estate Development,Municipal Housing and Land,Real Estate Development,Environmental Economics&Policies,Banks&Banking Reform,Municipal Housing and Land,Land and Real Estate Development,Real Estate Development

Change of size and type of patent ductus arteriosus in a one year old infant during routine echocardiographic study

There are only very few publications which document reactivity of patent ductus arteriosus. This report documentes the reactivity of a patent arterial duct in a one year old infant, 6.5 kg weight during a routine echocardiographic color Doppler study. Echocardiographic images were obtained during conscious sedation.peer-reviewe

Producing and Applying Runtime Adjustments to Semantic Textures

Semantic textures are labels associated with objects or regions in a scene, map, or video, and they enable the accurate interpretation of geospatial content. Auto-generated semantic textures frequently include mislabeled regions, e.g., water labeled as ground (and vice-versa). This disclosure describes techniques to enable the touching-up (correcting of semantic labels) of two- or three-dimensional maps, scenes, or videos such that the touch-ups precisely correspond to real-world locations. Touch-up edits can be executed by painting over existing semantic textures using lat-long-centered, touch-up texture tiles as paint brushes within a photo-editing software. The parameters of the touch-up tile, e.g., its resolution, its semantic label (e.g., water, ground, etc.), etc., can be set such that the user has a granular control over the refinement of semantic textures. The mislabeling of ground as water (and vice-versa), an error often found in auto-generated semantic textures, can be corrected or eliminated

Monitoring histological changes in oral mucosa using AgNORs as biomarkers for oxygenic stress in smokers and COPD patients

Background: It is well known that tobacco smoke causes cellular proliferation and chronic obstructive pulmonary disease (COPD), but changes in buccal mucosa cells in smokers and COPD patients remains unknown. Aims: The aim of this study is twofold: (i) to assess the effect of smoking on cellular proliferative activity of buccal mucosa in healthy smokers and in smoking COPD patients (ii) to detect early cellular proliferative activity in buccal mucosa. Our hypothesis is that tobacco smoking induces changes in buccal mucosa cells that we can detect using AgNOR analysis. Methods: 879 male subjects; non-smokers (controls), smokers and COPD patients were studied. Cytogenic damage was defined using the argyrophilic nucleolar organiser regions (AgNOR). Buccal mucosa cells were obtained from swabs and brushing. The respiratory symptoms were assessed by St. George’s questionnaire and lung function tests were measured by Vitalograph spirometer. Statistical analysis using ANOVA and discriminant analysis (classification)was used to determine differences between the three groups, regression models were built on the lung function data. Results: The AgNOR count, nuclear area, nuclear volume, and percentage of cells with 5 or more AgNORs, were significantly higher in smokers than non–smokers (5.20 vs 3.27, 74.66 vs 55.65, 462.67 vs 304.01, 73.93% vs 14.75%, respectively). For COPD patients, the values were 6.77, 110.42, 813.26, 96.97%, respectively.Respiratory symptoms were higher in smokers and COPD patients than non- smokers. There was significant relationship between respiratory symptoms and AgNORs count (P≤ 0.001). There was positive association between cigarette smoking and enhanced cellular activity in oral mucosa. Pack years of smoking is significantly associated with cellular abnormality in smokers and COPD patients. Conclusions: Strong correlations were found between AgNORs parameters and respiratory symptoms, pulmonary function tests and pack years. Keywords: COPD, buccal mucosa, AgNOR staining, discriminant analysis

Predictors of Angio access failure in end stage renal disease patients in Southern Egypt

Background: Hemodialysis (HD) seems to be the most often used Renal Replacement Therapy (RRT) modality worldwide, and it is the primary modality in the majority of instances with extended RRT. The ability to provide our patients with high-quality HD treatment while also increasing their chances of survival is heavily reliant on the functionality of the vascular access (VA). Despite the fact that it is a very necessary component of all clinical practise standards, it is the most expensive individual component of RRT.Objectives: This study was aimed at comparing between the group with Angio access failure and group without Angio access failure and predicting Angio access failure among end stage renal failure patients in Southern Egypt.Subjects and Methods: a prospective cohort study among 125 patients with end stage renal failure at Aswan University. The research comprised patients who had NCVA placement [intra-atrial catheter (IAC) and trans-lumbar catheter (TLC)] between January 1, 2020, and December 31, 2020.Results: The duration of previous RRT was significantly higher among the Angio access failure than the group without Angio access failure. In multivariate analysis using logistic regression, the age, duration of previous RRT, diabetes, IHD (ischemic heart disease), PVD (peripheral vascular disease) and CVD (cardiac vascular disease) were significantly direct predictors of the Angio access failure in the first one year.Conclusion: In conclusion the failure of Angio access was positively associated with age, previous RRT and other comorbidities

63. Pulmonary atresia with intact ventricular septum, associated with intracranial calcifications and left parietal hemangioma (Sturge–Weber Syndrome)

Case reportNeurocutaneous disorders are characterized by skin lesions (port wine stain, hypopigmented patches) associated with intracranial features (ipsilateral leptomeningeal angiomas, intracranial calcifications and subsequent seizures). Some of these patients will also have opthalmological findings.These disorders are occasionally accompanied by congenital heart disease. Example: PHACE syndrome which is associated with aortic coarctation. On the contrary, Sturge–Weber syndrome, apart from one single case report, is usually not described with congenital heart disease. In the mentioned case report, 13year old female had along with this syndrome, pulmonary atresia with ventricular septal defect. As the author of this case report questioned whether this might be a new association, we would like to report our patient.This is a 14months old boy with pulmonary atresia/intact ventricular septum along with intracranial calcification, seizures along with strabismus and tunnel vision. Clinical findings were similar to Sturge–Weber syndrome, though cutaneous features were not present. Brain CT angio with contrast was diagnostic for Sturge–Weber and showed calcifications as well as left parietal hemangioma.As far as we know, this specific association has never been reported before and might be a new constellation as suggested by Huseyin Tan et al. (2003)

FACTORS ASSOCIATED WITH HYPERTENSION PREVALENCE AND CONTROL AMONG LEBANESE TYPE 2 DIABETIC PATIENTS

Objective: The objectives of this study were to assess the prevalence of hypertension and the level of blood pressure (BP) control among a cohort of diabetic Lebanese patients on antihypertensive medications, as well as to identify factors associated with hypertension prevalence and uncontrolled BP.Methods: This cross-sectional retrospective study was conducted in a tertiary health care clinic that is specialized in the management and follow-up of diabetic outpatients.Results: Among the 700 type 2 diabetes mellitus patient files that were screened529 (75%) were found to have hypertension. Hypertension was more prevalent in women, patients aged ≥65-year-old, and those having a body mass index (BMI) of ≥30 (kg/m2) (p-value<0.05). Among the hypertensive cohort, 465 T2DM were on antihypertensive medications and were included in the hypertension control analysis. Ninety-three patients (20%) attained BP control (SBP<140 and DBP<90 mmHg). Multivariate analyses revealed three factors that were significantly associated with uncontrolled BP control: Age being ≥65 y (adjusted OR = 1.96 (95% CI: 1.07–3.61, p-value<0.05), male gender (adjusted OR = 2.57, 95% CI: 1.41–4.66, p-value<0.05) and uncontrolled HDL (adjusted OR = 1.58, 95% CI: 1.33–2.01, p-value = 0.05). Conclusion: Hypertension is prevalent among the study patients. However, attainment of BP control was poor among these patients. Therefore, there is a need for studies that determine reasons behind this low BP control rate in order to design interventions aiming at improving the standard of care for these patients

Five- to nine-year follow-up results of balloon angioplasty of native aortic coarctation in infants and children

AbstractObjectives. To evaluate the usefulness of balloon angioplasty for relief of native aortic coarctation, we reviewed our experience with this procedure, with special emphasis on follow-up results.Background. Controversy exists with regard to the role of balloon angioplasty in the treatment of native aortic coarctation.Methods. During an 8.7-year period ending September 1993, 67 neonates, infants and children underwent balloon angioplasty for native aortic coarctation. A retrospective review of this experience with emphasis on long-term follow-up forms the basis of this study.Results. Balloon angioplasty produced a reduction in the peak-to-peak coarctation gradient from 46 ± 17 (mean ± SD) to 11 ± 9 mm Hg (p < 0.001). No patient required immediate surgical intervention. At intermediate-term follow-up (14 ± 11 months), catheterization (58 patients) and blood pressure (2 patients) data revealed a residual gradient of 16 ± 15 mm Hg (p > 0.1). When individual results were scrutinized, 15 (25%) of 60 had recoarctation, defined as peak gradient >20 mm Hg. Recoarctation was higher (p < 0.01) in neonates (5 [83%] of 6) and infants (7 [39%] of 18) than in children (3 [8%] of 36), respectively. Two infants in our early experience had surgical resection with excellent results. Three patients had no discrete narrowing but had normal arm blood pressure and had no intervention. The remaining 10 patients had repeat balloon angioplasty with reduction in peak gradient from 52 ± 13 to 9 ± 8 mm Hg (p < 0.001). Reexamination 31 ± 18 months after repeat angioplasty revealed a residual gradient of 3 to 19 mm Hg (mean 11 ± 6). Three (5%) of 58 patients who underwent follow-up angiography developed an aneurysm. Detailed evaluation of the femoral artery performed in 51 (88%) of 58 patients at follow-up catheterization revealed patency of the femoral artery in 44 (86%) of 51 patients. Femoral artery occlusion, complete in three (6%) and partial in four (8%), was observed, but all had excellent collateral flow. Blood pressure, echocardiography-Doppler ultrasound and repeat angiographic or magnetic resonance imaging data 5 to 9 years after angioplasty revealed no new aneurysms and minimal (2%) late recoarctation.Conclusions. On the basis of these data, it is concluded that balloon angioplasty is safe and effective in the treatment of native aortic coarctation; significant incidence of recoarctation is seen in neonates and infants; repeat balloon angioplasty for recoarctation is feasible and effective; and the time has come to consider balloon angioplasty as a therapeutic procedure of choice for the treatment of native aortic coarctation

Endovenous Laser Ablation, Radiofrequency Ablation and Flebogrif versus Conventional Surgery in Treatment of Primary Varicose Vein of the Lower Limb: Prospective Randomized Controlled Study

Background: Endovenous laser ablation (EVLA), radiofrequency ablation (RFA) and mechanochemical ablation (MOCA) of primary varicose vein are thought to minimise postoperative morbidity and reduce work loss compared with the conventional surgical procedure. Objective: To determine, whether endovenous ablation methods (radiofrequency, laser and mechanochemical) have any advantages or disadvantages in comparison with conventional surgery, in the treatment of primary varicose vein. Patients and Methods: This was a prospective randomized study, conducted on forty patients presented at Vascular Outpatient Clinic for management of chronic venous insufficiency. All patients underwent clinical examination and duplex ultrasonography. Ten (10) patients were treated with ligation and stripping of the great saphenous vein (GSV). Ten (10) patients were treated with radiofrequency ablation. Ten (10) patients were treated with endovenous laser ablation. Ten (10) patients were treated with Flebogrif. Results: Compared with conventional surgery, endovenous ablation methods reduced postoperative discomfort and pain, with a lower complication rate after treatment for avoidance of a groin incision and dissection at the saphenofemoral confluence. Cosmetic demands were also better satisfied. Non-controlled clinical trials have shown that the ablation rate of GSV after EVLA is over 90%. However, risks of EVLA, RFA and Flebogrif remain in terms of recanalization and neoreflux via junctional tributaries. Conclusion: RFA, EVLA, and Flebogrif are minimally invasive procedures. Their potential early benefits, by avoiding groin dissection and GSV stripping, have been confirmed by the findings from this trial. Current evidence based on randomized trials consistently demonstrates significant early benefits after RFA, EVLA and Flebogrif in suitable patients with varicose veins

Influence of Thermomechanical Treatment on the Mechanical Behavior of Protaper Gold versus Protaper Universal (A Finite Element Study)

AIM: To compare and evaluate the influence of thermomechanical treatment of Protaper Gold file versus Protaper Universal file during testing of bending and torsion using ï¬nite-element analysis. METHODS: Two nickel-titanium NiTi rotary ï¬les (ProTaper Gold and ProTaper Universal) were used in this study. The files were imaged using stereomicroscope to produce 3D models. The behaviour of the instrument during bending and torsion was numerically analysed in CAD/CAM software package. RESULTS: Under bending, ProTaper, Gold showed higher flexibility and flexural resistance than ProTaper Universal. The highest stress was related at the cutting edge of both files. While during testing of torsion, the maximum amount of stresses was related to the base of the flutes in both files. ProTaper Gold showed higher torsional resistance than the ProTaper Universal file. CONCLUSION: Thermomechanical treatment improved the mechanical response (bending and torsional resistance) of NiTi files