Strategija razvoja kontejnerskog terminala u luci Port Saidu

Since 1960 there has been a growing trend for utilizing containers in marine shipping due to the growth of global trade, safety of containers, faster handling in ports and door to door services. This trend led to a development of container ships from 1000 TEU to 12000 TEU capacities. Consequently there is a continuous development in all related parties to container shipping such as port authorities, container terminals, cargo handling equipment manufacturers, management of container terminals and information technology. The system of containerization made a revolution at the entire pattern of trade and ports around the world, gearing up to meet trade growth and its requirements. Although there is a development in most of container terminals globally, our Egyptian container terminals still suffer from low performance which leads to losing the competitive capability. The paper is discussing the problems of public sector container terminals in Egypt and pointing particularly to Port Said Container Terminal, focusing on existing problems and suggested solutions for solving and improving the performance and productivity to compete and face the challenges due to the continuous growth in container shipping market.Od 1960. stalno raste trend rabljenja kontejnera u pomorskom brodarstvu. Taj je rast generiran prije svega zbog rasta globalnog prometa, sigurnosti kontejnera, bržeg rukovanja u lukama i servisom „od vrata – do vrata“. Taj trend doveo je do kontejnerskih brodova kapaciteta od 1000 do 12000 TEU. Sukladno tome, došlo je do razvoja svih ostalih subjekata međusobno povezanih s kontejnerskim brodarstvom, kao što su: lučke vlasti, kontejnerski terminali, proizvođači za opremu pri rukovanju teretom, upravom kontejnerskih terminala i tehnologijom informacija. Sustav prijevoza robe u kontejnerima revolucionarno je djelovao na globalnu strukturu prometa i luka, čvrsto se povezujući da bi se zadovoljio zahtjev porast prometa. Na globalnom planu većina se kontejnerskih terminala razvila. Ali, primjerice, egipatski kontejnerski terminali još uvijek pate od niskog stupnja učinkovitosti, što dovodi do nedostatne konkurentske sposobnosti. U ovom se radu raspravlja o problemima javnog sektora kontejnerskih terminala u Egiptu s posebnim osvrtom na kontejnerski terminal Port Saida, fokusirajući se na postojeće probleme i na elaboriranje prijedloga za rješavanje i usavršavanje rada i produktivnosti kako bi se povećala konkurentnost i suočilo s izazovima neprekidnog rasta na tržištu kontejnerskog brodarstva

THE MOST ECONOMICAL CONFIGURATION OF PUSHED BARGE CONVOY SYSTEM THROUGH CAIRO-ASWAN WATERWAY

In the recent years, as a result of the economical situation in Egypt, fuel price is rapidly increased. Consequently, the cost of cargo transport is also increased. Therefore, the aim of the present paper is to check the feasibility of a pushed barge convoy system working through Cairo-Aswan waterway as an alternative mean of cargo transport in order to encourage the transport companies to transport their cargoes through river Nile which is considered the cheapest transport mode in Egypt. In this paper, the current situation of the river transport and the characteristics of the Egyptian inland waterways network are reviewed and investigated to identify the navigation problems and constraints which affect the navigation through Cairo-Aswan waterway. The basic concept of ship controllability is reviewed to clarify the maneuver characteristics of a pushed barge convoy system in shallow waterways. Also, different configurations for pushed barge convoy system are proposed and the required power of each configuration is calculated using a specially developed computer program. A technical and operational measure called transport efficiency is used as a criterion to get the most economical configuration of the desired pushed barge convoy system. Finally, a comparison between the pushed barge convoy system and the existing river transport means in Egypt is made to clarify the feasibility of using pushed barge convoy system through Cairo-Aswan waterway

Cytomegalovirus Management in Solid Organ Transplant Recipients: A Pre-COVID-19 Survey From the Working Group of the European Society for Organ Transplantation

Infections are leading causes of morbidity/mortality following solid organ transplantation (SOT) and cytomegalovirus (CMV) is among the most frequent pathogens, causing a considerable threat to SOT recipients. A survey was conducted 19 July–31 October 2019 to capture clinical practices about CMV in SOT recipients (e.g., how practices aligned with guidelines, how adequately treatments met patients’ needs, and respondents’ expectations for future developments). Transplant professionals completed a ∼30-minute online questionnaire: 224 responses were included, representing 160 hospitals and 197 SOT programs (41 countries; 167[83%] European programs). Findings revealed a heterogenous approach to CMV diagnosis and management and, sometimes, significant divergence from international guidelines. Valganciclovir prophylaxis (of variable duration) was administered by 201/224 (90%) respondents in D+/R− SOT and by 40% in R+ cases, with pre-emptive strategies generally reserved for R+ cases: DNA thresholds to initiate treatment ranged across 10–10,000 copies/ml. Ganciclovir-resistant CMV strains were still perceived as major challenges, and tailored treatment was one of the most important unmet needs for CMV management. These findings may help to design studies to evaluate safety and efficacy of new strategies to prevent CMV disease in SOT recipients, and target specific educational activities to harmonize CMV management in this challenging population

Safety and efficacy of eculizumab for the prevention of antibody-mediated rejection after deceased-donor kidney transplantation in patients with preformed donor-specific antibodies

Abstract View references (47) The presence of preformed donor-specific antibodies in transplant recipients increases the risk of acute antibody-mediated rejection (AMR). Results of an open-label single-arm trial to evaluate the safety and efficacy of eculizumab in preventing acute AMR in recipients of deceased-donor kidney transplants with preformed donor-specific antibodies are reported. Participants received eculizumab as follows: 1200 mg immediately before reperfusion; 900 mg on posttransplant days 1, 7, 14, 21, and 28; and 1200 mg at weeks 5, 7, and 9. All patients received thymoglobulin induction therapy and standard maintenance immunosuppression including steroids. The primary end point was treatment failure rate, a composite of biopsy-proved grade II/III AMR (Banff 2007 criteria), graft loss, death, or loss to follow-up, within 9 weeks posttransplant. Eighty patients received transplants (48 women); the median age was 52 years (range 24-70 years). Observed treatment failure rate (8.8%) was significantly lower than expected for standard care (40%; P <.001). By 9 weeks, 3 of 80 patients had experienced AMR, and 4 of 80 had experienced graft loss. At 36 months, graft and patient survival rates were 83.4% and 91.5%, respectively. Eculizumab was well tolerated and no new safety concerns were identified. Eculizumab has the potential to provide prophylaxis against injury caused by acute AMR in such patients (EudraCT 2010-019631-35). \ua9 2019 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of The American Society of Transplantation and the American Society of Transplant Surgeon

Patterns of fatigue in adolescents receiving chemotherapy

Abstract: Purpose/Objectives: To describe patterns of fatigue in adolescents and the impact of fatigue during one month of chemotherapy, to explore variables that affect fatigue, and to explore the feasibility of collecting daily selfreport data in this population. Design: Longitudinal, descriptive. Setting: Two pediatric oncology centers in central Virginia. Sample: 20 adolescents with a variety of cancer diagnoses receiving chemotherapy. Methods: Adolescents described daily fatigue for one month using rating scales and qualitative diaries Main Research Variables: Fatigue severity. Finding: Adolescents commonly reported a peak in fatigue in the days immediately following chemotherapy administration. The most common pattern for adolescents who received chemotherapy on a schedule every three to four weeks was a &quot;declining rollercoaster&quot; pattern, with fatigue severity alternating on a daily basis but gradually declining until chemotherapy was scheduled again. Adolescents who received chemotherapy weekly showed more frequent peaks and troughs (the &quot;yo-yo&quot; pattern) that did not diminish in severity over the weeks of the study. Adolescents associated fatigue with other symptoms, particularly sleep-wake disturbances, pain, and nausea, and frequently reported that fatigue interfered with daily activities. Conclusions: Fatigue commonly bothers adolescents receiving chemotherapy, particularly in the days following chemotherapy administration and when other symptoms are present. Although fatigue interfered with the adolescents&apos; abilities to maintain their usual lifestyles, many still participated in the typical activities of adolescence. Implications for Nursing: Fatigue is a complex and dynamic symptom. Oncology clinicians and researchers should frequently assess fatigue in adolescents receiving chemotherapy and apply timely and tailored interventions to match the factors that contribute to fatigue and influence fatigue severity. Management of fatigue during treatment will help adolescents stay involved in age-related activities and meet developmental milestones. Article: Adolescents diagnosed with cancer represent a group of patients with a unique cancer epidemiology, development profile, and research needs. The population&apos;s most common cancers include lymphoma, leukemia, central nervous system cancers, endocrine and germ cell tumors, and sarcomas--a spectrum of cancers different than that seen in adults or in younger childre

First Isolation of Hepatitis E Virus Genotype 4 in Europe through Swine Surveillance in the Netherlands and Belgium

Hepatitis E virus (HEV) genotypes 3 and 4 are a cause of human hepatitis and swine are considered the main reservoir. To study the HEV prevalence and characterize circulating HEV strains, fecal samples from swine in the Netherlands and Belgium were tested by RT-PCR. HEV prevalence in swine was 7–15%. The Dutch strains were characterized as genotype 3, subgroups 3a, 3c and 3f, closely related to sequences found in humans and swine earlier. The HEV strains found in Belgium belonged to genotypes 3f and 4b. The HEV genotype 4 strain was the first ever reported in swine in Europe and an experimental infection in pigs was performed to isolate the virus. The genotype 4 strain readily infected piglets and caused fever and virus shedding. Since HEV4 infections have been reported to run a more severe clinical course in humans this observation may have public health implications

Current preventive strategies and management of Epstein-Barr virus-related post-transplant lymphoproliferative disease in solid organ transplantation in Europe. Results of the ESGICH Questionnaire-based Cross-sectional Survey

There is limited clinical evidence on the utility of the monitoring of Epstein-Barr virus (EBV) DNAemia in the pre-emptive management of post-transplant lymphoproliferative disease (PTLD) in solid organ transplant (SOT) recipients. We investigated current preventive measures against EBV-related PTLD through a web-based questionnaire sent to 669 SOT programmes in 35 European countries. This study was performed on behalf of the ESGICH study group from the European Society of Clinical Microbiology and Infectious Diseases. A total of 71 SOT programmes from 15 European countries participated in the study. EBV serostatus of the recipient is routinely obtained in 69/71 centres (97%) and 64 (90%) have access to EBV DNAemia assays. EBV monitoring is routinely used in 85.9% of the programmes and 77.4% reported performing pre-emptive treatment for patients with significant EBV DNAemia levels. Pre-emptive treatment for EBV DNAemia included reduction of immunosuppression in 50.9%, switch to mammalian target of rapamycin inhibitors in 30.9%, and use of rituximab in 14.5% of programmes. Imaging by whole-body 18-fluoro-deoxyglucose positron emission tomography (FDG-PET) is used in 60.9% of centres to rule out PTLD and complemented computer tomography is used in 50%. In 10.9% of centres, FDG-PET is included in the first-line diagnostic workup in patients with high-risk EBV DNAemia. Despite the lack of definitive evidence, EBV load measurements are frequently used in Europe to guide diagnostic workup and pre-emptive reduction of immunosuppression. We need prospective and controlled studies to define the impact of EBV monitoring in reducing the risk of PTLD in SOT recipients

Cure of Chronic Viral Infection and Virus-Induced Type 1 Diabetes by Neutralizing Antibodies

The use of neutralizing antibodies is one of the most successful methods to interfere with receptor–ligand interactions in vivo. In particular blockade of soluble inflammatory mediators or their corresponding cellular receptors was proven an effective way to regulate inflammation and/or prevent its negative consequences. However, one problem that comes along with an effective neutralization of inflammatory mediators is the general systemic immunomodulatory effect. It is, therefore, important to design a treatment regimen in a way to strike at the right place and at the right time in order to achieve maximal effects with minimal duration of immunosuppression or hyperactivation. In this review, we reflect on two examples of how short time administration of such neutralizing antibodies can block two distinct inflammatory consequences of viral infection. First, we review recent findings that blockade of IL-10/IL-10R interaction can resolve chronic viral infection and second, we reflect on how neutralization of the chemokine CXCL10 can abrogate virus-induced type 1 diabetes