Bridging the information gap: A webGIS tool for rural electrification in data-scarce regions

Rural electrification in developing countries is often hampered by major information gaps between local communities and urban centers, where technical expertise and funding are concentrated. The tool presented in this paper addresses these gaps to support the implementation of off-grid micro hydropower infrastructure. Specifically, we present a method to site, size and evaluate the potential for micro hydropower based on remote sensing data. The method improves on previous approaches by (i) incorporating the effect of hillslope topography on the optimal layout of the infrastructure, and (ii) accounting for the constraints imposed by streamflow variability and local electricity demand on the optimal size of the plants. An assessment of the method's performance against 148 existing schemes indicates that it correctly identifies the most promising locations for hydropower in Nepal, but does not generally reproduce the specific design features of constructed plants, which are affected by site-specific constraints. We develop a proof-of-concept computer tool to explore the potential of webGIS technology to account for these constraints by collecting site-specific information from local users

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P &lt; 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P &lt; 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Prioritization of soil conservation measures using erodibility indices as criteria in Sikkim (India)

Erodibility indices are important parameter that can be used to describe the intensity of the soil erosion problems causing environmental concerns. These indices are convenient to estimate the susceptibility to erosion where physical measurement is very difficult. Sikkim is one such state in India where measuring erosion is a tedious process due to its difficult and inaccessible terrain conditions. In the present study, spatial variation of susceptibility of erosion in East district of Sikkim was estimated by using indices such as clay ratio, dispersion ratio, mod clay ratio and critical level of soil organic matter. The result indicates soils in East district are mostly dominated by sand particles (40.5-81.06%) in majority of soil samples. The dispersion ratio values in most of the soils were > 15% indicating very high vulnerability to erosion. The values of clay ratio (3.44-9), modified clay ratio (mean value of 6.9) and critical level of soil organic matter content (< 5%) indicated high susceptibility to erosion. The trends of indices were generated by IDW interpolation method to understand the spatial variation of the susceptibility to erosion. The interpolated maps were overlaid on subwatershed maps to prioritize the subwatershed for planning treatment measures

Anatomical Variations of Branching Pattern of the Arch of Aorta: A Cadaveric Cross-sectional Study

Introduction: The arch of the aorta normally gives off three major branches from its convex surface. Variations in the branching pattern of the Aortic Arch (AA) are not uncommon. Knowledge of these variations is crucial during aortic instrumentation and thoracic or neck surgeries. Aim: This study aimed to investigate the anatomical variations in the branching pattern of the AA in perinatal and adult cadavers. Materials and Methods: A cross-sectional cadaveric study was conducted in the Department of Anatomy, at Assam Medical College and Hospital, Dibrugarh, from August 2018 to July 2021. The study included cadavers of various ages and both genders (N=46). Perinatal cadavers received from the Obstetrics and Gynecology department were also included. The thoracic cavity was opened by cutting through the costochondral junctions and reflecting the sternum. Fibrofatty tissue was removed to expose the branches of the AA, which were then examined and classified. Variations were observed, and the results were expressed in terms of frequency and percentages. Results: A classical branching pattern (Type-A) was observed in 89.1% of cadavers. Five cadavers (10.9%), comprising four males and one female, exhibited branching patterns different from the classical pattern. Among them, Type-C variation was noted in 4 (8.7%) cadavers, and Type-D variation was found in 1 (2.2%) male cadaver. Conclusion: Having a good understanding of the variations in the branching pattern of the arch of the aorta can be beneficial for surgeons performing complex vascular surgery

Assessment of hydropower potential using GIS and hydrological modeling technique in Kopili River basin in Assam (India)

A hilly watershed in Kopili River basin in Assam (India) was considered for assessment of hydropower potential using spatial tool (GIS) and hydrological model (SWAT2000). The available data related to topography, soil, land use, weather and discharge pertaining to the study watershed were used to characterize the watershed. The characterization was required for water resources hence hydropower assessment. The hydrology of the study watershed was simulated through the model. The prediction accuracy of the model was confirmed through three well known efficiency criteria viz., coefficient of determination (R2 = 0.70), Nash-Sutcliffe efficiency (E = 0.64) and Index of agreement (d = 0.91). A total of 107 sites on 9 streams could be identified as potential location for hydropower generation in the study watershed using the model outputs. Distributed power availability through micro units (Hydrological modeling Soil and water assessment tool Hydropower

Islamic financing and its role in Dubai's economic development

Throughout the years, Islamic Financing has been growing at a fast pace. Whether it is due to the increasing number of Muslims in the world, or due to the uniqueness and benefits of the system, no one can deny that Islamic Finance has a place in this world. A prime example of where we can see the growth and development of Islamic Finance is in the Middle East, particularly Dubai and the United Arab Emirates. The Middle East has always been an area predominantly occupied by Muslims. Thus, it is here where we can find Islamic Finance to be practiced more predominantly.Master of Business Administratio