Evaluating Existing and Proposing New Seismic Design Provisions for Rigid Wall - Flexible Diaphragm Buildings

Buildings with heavy concrete on masonry walls supported by flexible wood or steel deck roof diaphragms are ubiquitour across the United States and the rest of North America. The current seismic design approach is based on the equivalent lateral force (ELF) method whose underlying assumptions significantly differ from the actual dynamic response of these buildings. The seismic behavior of rigid wall-flexible rood diaphragm (RWFD) Buildings is dominated by the diaphragm\u27s response instead of the wall\u27 in-plane response. Furthermore, the diaphragm\u27s ductility and overstrength capacity is unique to its own construction. Yet the current design methodology employed by practitioners directly ties the diaphragm shears and overstrength to the characteristics of the seismic force0resisting system\u27s (SFRS) vertical elements. Past problems in these buildings have been the repeated failures of the walls\u27 anchorage to the diaphragm, and through a series of trial and error iterations, the current design provisions have evolved. current wall anchorage forces for RWFD buildings are believed to now be near maximum expected force levels with litter necessary reliance on connector ductility; however, solving the wall anchorage issue may result in new failures within the diaphragm itself. Using a dedicated numerical modeling framework coupled with a FEMA P-695 collapse capacity evaluation process, a research study was conducted t evaluate performance for a variety of RWFD archetypes conforming to ASCE/SEI 7-10, as well as redesigned archetypes conforming to a new design methodology. Furthermore, a review of the predicted wall anchorage forces in FWFD buildings was also compared with existing design provisions. A new RWFD design methodology is proposed providing a rational approach to improve performance in these unique buildings

A cluster of four cases of cutaneous leishmaniasis by Leishmania donovani in Cyprus: a case series

Introduction: Leishmaniasis is endemic in more than 95 countries and is the only tropical/subtropical vector-borne disease that has been endemic in Southern Europe for decades. To the best of our knowledge, this is the first case of cutaneous leishmaniasis by Leishmania donovani in a child and the first cluster with adult cases reported in Europe. Case presentation: We describe a familial cluster of four cutaneous leishmaniasis cases among Greek Cypriots caused by L. donovani in a Paphos village, in Cyprus. A 6-year-old boy (Case number 1) had a persistent lesion in the left angle of his upper lip, a 60-year-old woman (Case number 2) presented with a 2cm-diameter glabella lesion on her forehead, a 60-year-old man (Case number 3) developed a lesion on his moustache area and a 40-year-old woman (Case number 4) had a lesion on her neck. In Case number 3 the lesion was self-cured; the other cases recovered after surgical resection followed by liposomal amphotericin B (Case numbers 1 and 4) or thermotherapy and liposomal amphotericin B (Case number 2). Conclusions: This familial cluster of cutaneous leishmaniasis, due to the anthroponotic L. donovani, shows that the sand fly species responsible for transmitting this parasite species is found in the area around the three neighbouring houses involved. The factors favourable for the survival, spread and contact of the vector with people could be assessed in this area for the establishment of preventative measures to safeguard public health

Η εφαρμογή των εγγυήσεων του Συντάγματος και της ΕΣΔΑ για τις ποινικές κυρώσεις στις φορολογικές κυρώσεις

Η παρούσα διπλωματική εργασία πραγματεύεται τη σημερινή διάκριση των φορολογικών κυρώσεων, όπως αυτή έχει διαμορφωθεί έπειτα από πληθώρα νομοθετικών επεμβάσεων, που έλαβαν χώρα ακόμη και μετά την πρόβλεψη του Κώδικα Φορολογικής Διαδικασίας (Ν. 4174/2013) και των σημείων συμπλοκής των κυρώσεων που επιβάλλονται από το Φορολογικό Δίκαιο με τις καθαρά ποινικές κυρώσεις ως προς την προστασία που διαλαμβάνουν οι τελευταίες από το Σύνταγμα, μέσω του άρθρου 7, την προστασία της αρχής της αναδρομικής εφαρμογής της ευνοϊκότερης φορολογικής κύρωσης, αλλά και των εγγυήσεων των διεθνών συμβάσεων, όπως των διατάξεων του άρθρου 6 της ΕΣΔΑ και του άρθρου 4 του 7ου ΠΠ της ΕΣΔΑ που θεμελιώνει και προστατεύει την αρχή “ne bis in idem”. Εξετάστηκε ενδελεχώς πως αντιμετωπίζονταν οι φορολογικές κυρώσεις σε θεωρητικό και νομολογιακό επίπεδο, αφού κάποιες φορές γινόταν δεκτό ότι αφίστανται της έννοιας της κύρωσης του Ποινικού Δικαίου και ενίοτε ότι δεν αποτελούν καν κυρωτικά μεγέθη, με αποτέλεσμα οι αρχές που εφαρμόζονται στις ποινικές κυρώσεις να είναι αλλότριες στο πεδίο των φορολογικών κυρώσεων. Κρίνεται, λοιπόν, καθοριστική η συμβολή των Ευρωπαϊκών Δικαστηρίων στην μεταστροφή της ελληνικής νομολογίας, η οποία παρέμενε προσκολλημένη σε τυπολατρικά κριτήρια χαρακτηρισμού των φορολογικών κυρώσεων ως διοικητικές ή ποινικές, έχοντας ως άλλοθι την προστασία της αρχής της ασφάλειας δικαίου και των άρθρων 94 και 96 Σ. Χαράχθηκε ένας μακρύς δρόμος μέχρι την αποδοχή των εγγυήσεων τους για την προστασία των φορολογουμένων σε σχέση με την επιβολή φορολογικών βαρών και κυρώσεων. Πλέον, το Ανώτατο Διοικητικό Δικαστήριο, ως κοινός δικαστής της ΕΣΔΑ, εγγυάται αποτελεσματικά ένα υψηλότερο επίπεδο προστασίας των δικαιωμάτων των φορολογουμένων στο πλαίσιο διαφορών από τη διαπίστωση φορολογικών παραβάσεων και την επιβολή φορολογικών κυρώσεων. Δεν θα ήταν καθόλου παράλογο, όμως, να δεχτούμε την ανάγκη αντιμετώπισης τόσο των διοικητικών όσο και των ποινικών κυρώσεων στο φορολογικό δίκαιο στο πλαίσιο μιας κοινής διαδικασίας και δικαιοδοσίας, προκειμένου να επιτευχθεί μια ταχεία απονομή δικαιοσύνης και επίλυσης των σχετικών διαφορών, διασφαλίζοντας τα συμφέροντα του κράτους για την είσπραξη των φόρων και την αποκατάσταση της μη συμμόρφωσης των διοικουμένων στις φορολογικές τους υποχρεώσεις.This thesis deals with the current distinction of tax sanctions, as it has been formed after numerous legislative interventions, which took place even after the provision of the Tax Procedure Code (N. 4174/2013) and the points of conflict between the sanctions imposed by tax law and the purely criminal sanctions regarding the protection provided by the Constitution, through Article 7, the protection of the principle of retroactive application of the most favorable tax penalty, but also the guarantees of international conventions, such as the provisions of Article 6 of the ECHR and Article 4 of FP7 of the ECHR that establishes and protects the principle “ne bis in idem”. It was examined in detail how tax sanctions were treated in theoretical and judicial level, since sometimes it was accepted that they depart from the concept of sanction of Criminal Law and sometimes that they do not even constitute punitive magnitudes, with the result that the principles applied to criminal sanctions are unknown in the field of tax sanctions. Therefore, the contribution of the European courts to the conversion of greek jurisprudence, which remained attached to formal criteria for the classification of tax sanctions as administrative or criminal, having as an alibi the protection of the principle of legal certainty and articles 94 and 96 P. A long road has been drawn to the acceptance of their guarantees to protect taxpayers in relation to the imposition of tax burdens and penalties. Now, the Supreme Administrative Court effectively guarantees a higher level of protection of taxpayers ' rights in disputes from the finding of tax violations and the imposition of tax penalties. It would not be unreasonable at all, however, to accept the need to address both administrative and criminal penalties in tax law within the framework of a common procedure and jurisdiction, in order to achieve a speedy administration of justice and resolution of the relevant disputes, safeguarding the interests of the state in collecting taxes and remedying the non-compliance of the governed with their tax obligations

Acute hepatitis and myositis associated with Erythema infectiosum by Parvovirus B19 in an adolescent

Background: Erythema infectiosum is the most common clinical manifestation of Parvovirus B19 infection although it has also been associated with rheumatologic diseases and various types of systemic vasculitides. Acute hepatitis and benign myositis however are rarely reported in association with Parvovirus B19 infection. Case presentation: Here we report a 14-year old male, who developed acute hepatitis and benign myositis associated with erythema infectiosum following Parvovirus B19 infection. Conclusion: Parvovirus B19 infection has rarely been associated with acute hepatitis and exceptionally rarely with benign myositis. Parvovirus B19 should be considered in the differential diagnosis of acute non-A to E hepatitis and in the case of acute benign myositis presenting with a rash especially in children

Epidemiology and risk factors for resistance to treatment of Kawasaki disease in Cyprus

Kawasaki disease (KD) is one of the most common vasculitides of early childhood. There are no previous studies on KD in Cyprus. The aim of this study was to evaluate the epidemiology of KD in Cyprus, risk factors for resistance to treatment and the development of cardiac complications. This is a retrospective multicenter study of pediatric patients with KD hospitalized between January 2000 and-December 2019. The data were collected from medical records. A total of 136 patients with KD were included in the study. 83% of patients were < 5 years of age and 10% were < 6 months. Thirty patients (22%) developed coronary artery lesions. Serum sodium ≤ 133 mmol/L, albumin ≤ 3.2 g/dl, ALT ≥ 80 U/L and neutrophils percentage ≥ 80% at diagnosis, were identified as risk factors for resistance to IVIG. Clinical and epidemiological characteristics of KD in Cyprus population were similar to those reported in the literature. Although the majority of cases received appropriate treatment in time, cardiac complications still occurred

Exploring the factors associated with the mental health of frontline healthcare workers during the COVID-19 pandemic in Cyprus

Introduction: The spread of COVID-19 into a global pandemic has negatively affected the mental health of frontline healthcare-workers. This study is a multi-centre, cross-sectional epidemiological study that uses nationwide data to assess the prevalence of stress, anxiety, depression and burnout among health care workers managing COVID-19 patients in Cyprus. The study also investigates the mechanism behind the manifestation of these pathologies, as to allow for the design of more effective protective measures. Methods: Data on the mental health status of the healthcare workers were collected from healthcare professionals from all over the nation, who worked directly with Covid patients. This was done via the use of 64-item, self-administered questionnaire, which was comprised of the DASS21 questionnaire, the Maslach Burnout Inventory and a number of original questions. Multivariable logistic regression models were used to investigate factors associated with each of the mental health measures. Results: The sample population was comprised of 381 healthcare professionals, out of which 72.7% were nursing staff, 12.9% were medical doctors and 14.4% belonged to other occupations. The prevalence of anxiety, stress and depression among the sample population were 28.6%, 18.11% and 15% respectively. The prevalence of burnout was 12.3%. This was in parallel with several changes in the lives of the healthcare professionals, including; working longer hours, spending time in isolation and being separated from family. Discussion: This study indicates that the mental health of a significant portion of the nation’s workforce is compromised and, therefore, highlights the need for an urgent intervention particularly since many countries, including Cyprus, are suffering a second wave of the pandemic. The identified risk factors should offer guidance for employers aiming to protect their frontline healthcare workers from the negative effects of the COVID-19 pandemic

Trends in HIV surveillance data in the EU/EEA, 2005 to 2014: New HIV diagnoses still increasing in men who have sex with men

Human immunodeficiency virus (HIV) transmission remains significant in Europe. Rates of acquired immunodeficiency syndrome (AIDS) have declined, but not in all countries. New HIV diagnoses have increased among native and foreign-born men who have sex with men. Median CD4+T-cell count at diagnosis has increased, but not in all groups, and late diagnosis remains common. HIV infection and AIDS can be eliminated in Europe with resolute prevention measures, early diagnosis and access to effective treatment

Climate change and human health in the Eastern Mediterranean and middle east: Literature review, research priorities and policy suggestions

Human health is linked to climatic factors in complex ways, and climate change can have profound direct and indirect impacts on the health status of any given region. Susceptibility to climate change is modulated by biological, ecological and socio-political factors such as age, gender, geographic location, socio-economic status, occupation, health status and housing conditions, among other. In the Eastern Mediterranean and Middle East (EMME), climatic factors known to affect human health include extreme heat, water shortages and air pollution. Furthermore, the epidemiology of vector-borne diseases (VBDs) and the health consequences of population displacement are also influenced by climate change in this region. To inform future policies for adaptation and mitigation measures, and based on an extensive review of the available knowledge, we recommend several research priorities for the region. These include the generation of more empirical evidence on exposure-response functions involving climate change and specific health outcomes, the development of appropriate methodologies to evaluate the physical and psychological effects of climate change on vulnerable populations, determining how climate change alters the ecological determinants of human health, improving our understanding of the effects of long-term exposure to heat stress and air pollution, and evaluating the interactions between adaptation and mitigation strategies. Because national boundaries do not limit most climate-related factors expected to impact human health, we propose that adaptation/mitigation policies must have a regional scope, and therefore require collaborative efforts among EMME nations. Policy suggestions include a decisive region-wide decarbonisation, the integration of environmentally driven morbidity and mortality data throughout the region, advancing the development and widespread use of affordable technologies for the production and management of drinking water by non-traditional means, the development of comprehensive strategies to improve the health status of displaced populations, and fostering regional networks for monitoring and controlling the spread of infectious diseases and disease vectors.This project received funding from the Cyprus Institute's Core funds and from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 856612 and the Cyprus Government. All authors are members of the Task Force on Health of the Eastern Mediterranean and Middle East Climate Change Initiative (EMME-CCI).Peer reviewe