92 research outputs found

    Dynamic political contexts and power asymmetries: the cases of the Blue Nile and the Yarmouk Rivers

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    This paper explores the evolving patterns of hydropolitical relations in the dynamic contexts of Yarmouk and Blue Nile Rivers in comparison. The analysis aims at shedding light over the complex implications that recent political and social changes have aroused for the water disputes between Jordan and Syria on the one hand, and Ethiopia and Egypt on the other. In both basins, cooperative efforts toward the integrated management of transboundary waters have been only partially effective and largely undermined by the perpetuation of unilateral actions by riparian states. In the case studies, the lack of a basin-wide vision over the control and use of shared waters has resulted in disputes among the basin states and ultimately in an unsustainable, unfair, and unwise utilization of the resources. This paper argues that a substantive and effective integration of national water policies is unlikely to occur, unless power asymmetries are properly addressed in order to overcome the likelihood of hegemonic regimes

    Long-term outcome of COVID-19 patients treated with helmet noninvasive ventilation vs. high-flow nasal oxygen: a randomized trial

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    Background: Long-term outcomes of patients treated with helmet noninvasive ventilation (NIV) are unknown: safety concerns regarding the risk of patient self-inflicted lung injury and delayed intubation exist when NIV is applied in hypoxemic patients. We assessed the 6-month outcome of patients who received helmet NIV or high-flow nasal oxygen for COVID-19 hypoxemic respiratory failure. Methods: In this prespecified analysis of a randomized trial of helmet NIV versus high-flow nasal oxygen (HENIVOT), clinical status, physical performance (6-min-walking-test and 30-s chair stand test), respiratory function and quality of life (EuroQoL five dimensions five levels questionnaire, EuroQoL VAS, SF36 and Post-Traumatic Stress Disorder Checklist for the DSM) were evaluated 6 months after the enrollment. Results: Among 80 patients who were alive, 71 (89%) completed the follow-up: 35 had received helmet NIV, 36 high-flow oxygen. There was no inter-group difference in any item concerning vital signs (N = 4), physical performance (N = 18), respiratory function (N = 27), quality of life (N = 21) and laboratory tests (N = 15). Arthralgia was significantly lower in the helmet group (16% vs. 55%, p = 0.002). Fifty-two percent of patients in helmet group vs. 63% of patients in high-flow group had diffusing capacity of the lungs for carbon monoxide < 80% of predicted (p = 0.44); 13% vs. 22% had forced vital capacity < 80% of predicted (p = 0.51). Both groups reported similar degree of pain (p = 0.81) and anxiety (p = 0.81) at the EQ-5D-5L test; the EQ-VAS score was similar in the two groups (p = 0.27). Compared to patients who successfully avoided invasive mechanical ventilation (54/71, 76%), intubated patients (17/71, 24%) had significantly worse pulmonary function (median diffusing capacity of the lungs for carbon monoxide 66% [Interquartile range: 47–77] of predicted vs. 80% [71–88], p = 0.005) and decreased quality of life (EQ-VAS: 70 [53–70] vs. 80 [70–83], p = 0.01). Conclusions: In patients with COVID-19 hypoxemic respiratory failure, treatment with helmet NIV or high-flow oxygen yielded similar quality of life and functional outcome at 6 months. The need for invasive mechanical ventilation was associated with worse outcomes. These data indicate that helmet NIV, as applied in the HENIVOT trial, can be safely used in hypoxemic patients. Trial registration Registered on clinicaltrials.gov NCT04502576 on August 6, 202

    Analysis for water conflict transformation

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    This article proposes and fleshes out an analytical method designed to support efforts to transform inequitable and unsustainable transboundary water arrangements. Such ‘transformative analysis’ leverages socio-ecological thinking to critically evaluate the processes that have established and maintain an arrangement, including hydro-diplomacy itself. Transformative analysis facilitates the interpretation of strategies to deflect transformation, identification of destructive forms of cooperation, and strategic classification of opportunities for transformation. The assertions are premised on an understanding of the particularities of water conflict, and followed by a discussion of ways researchers may overcome the challenges inherent in the method

    The synergetic effects of surface texturing and MoDDP additive applied to ball-on-disk friction subject to both flooded and starved lubrication conditions

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    This paper reports a novel work on the synergetic effects of microscale surface texturing and lubricant friction modifier additive of molybdenum dialkyldithiophosphate (MoDDP) subject to both flooded and starved lubrication conditions. The experiments were performed on reciprocating ball-on-disk friction in GTL8 base oil with and without MoDDP. In the flooded lubrication condition, the test results demonstrated that the presence of the MoDDP additive contributed to lower friction coefficients, and also more pronounced effect of surface textures on friction than in the case of the bare base oil. In the starved lubrication experiments, textured and texture-free surfaces in the oils with and without MoDDP additive were tested until an abrupt rising of friction coefficient was detected. The results showed that the magnitude of friction coefficient before terminating each test was the almost same for various tests, while the endurance time in different test conditions was significantly different. The textured surface exhibited longer endurance time than the texture-free surface, especially when the MoDDP additive was used. The mechanism of the synergetic effects of surface textures and MoDDP additive has been discussed based on the experimental observations in the following sections. This study provides a new idea for the application of surface texture in boundary lubrication when lubricant additive is contained in the lubricating oils
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