Flash Flood Risk Estimation of Wadi Qena Watershed, Egypt Using GIS Based Morphometric Analysis

Flash flooding is one of the periodic geohazards in the eastern desert of Egypt where many parts of Upper Egypt, Sinai, and Red Sea areas were hit by severe flash floods, for example in 1976, 1982, 1996 and January 2010. The hazard degree for each sub-basin was determined using the approach developed by El-Shamy for assessing susceptibility of sub-basins to flash flooding risk. To identify at-risk sub-basins, two different methods were applied. The first method is based on the relationship between the drainage density and bifurcation ratio, and the second one uses the relationship between drainage frequency and bifurcation ratio. The three morphometric parameters (the bifurcation ratio, drainage density, and stream frequency) were extracted and calculated for each sub-basin of the watershed. Based on the final hazard degree resulting from the two methods, a detailed hazard degree map was extracted for all sub-basins. The results illustrate that there are no sub-basins with low risk of flooding. The sub-basins with the highest hazard degree are concentrated in the middle of the watershed although they have smaller areas compared with the surrounding sub-basins. The sub-basins located at the boundary of the watershed have an intermediate risk of flooding and moderate potential for groundwater recharge. This constructed map can be used as a basic data for assessment of flood mitigation and planning

Flood Hazard Mapping and Assessment of Precipitation Monitoring System Using GIS-Based Morphometric Analysis and TRMM Data: A Case Study of the Wadi Qena Watershed, Egypt

Wadi Qena is one of the Nile Valley areas particularly at risk of severe flash flooding, located in Egypt. The study aims to verify TRMM rainfall data (TRMM 3B42), using eight stations across Egypt as well as relies on morphometric analysis to generate a flood risk map based on the ranking method. Three process could be recognized through the study, calibration, correction and verification processes. The results discuss the match daily rainfall trends of TRMM and observed data, producing a correction equation for TRMM data with root mean square error (RMSE) value of 0.837 mm d-1 and R2= 0.238 (calibration process). On the other hand, a verification process, using the developed correction equation, obtain RMSE value of 1.701 mm d-1 and R2= 0.601. The morphometric analysis shows 32 sub-basins with a hazard degree from moderate to high, amounting to 50.3% of the watershed area. Conclusively, this study confirms that the current monitoring system is not enough to cover the whole area, especially the high-risk sub-basins, and TRMM data could provide key information for water-related applications in Egypt

Photocatalytic degradation of trimethoprim using S-TiO2 and Ru/WO3/ZrO2 immobilized on reusable fixed plates

In this study, photocatalytic degradation of trimethoprim by synthesized S-TiO2 and Ru/WO3/ZrO2 catalysts was investigated. Both photocatalysts have been immobilized on circular aluminum plates by polysiloxane to investigate their reusability performance. The morphology and structure of the catalysts were studied by high-resolution transmission electron microscopy, X-ray diffraction, and energy-dispersive X-ray spectroscopy. The photocatalytic experiments were carried out using suspended and attached catalysts using a metal halide lamp as a light source. The degradation efficiencies of trimethoprim were 100% and 98.2% at catalyst dose of 0.5 g/L, pH of 7.0 and irradiation time of 240 min using suspended Ru/WO3/ZrO2 and S-TiO2, respectively. After immobilization of the catalysts on the aluminum plates, the removal efficiencies in five repetitive cycles were 98%, 96.9%, 96.8%, 93.2% and 83.4% using Ru/WO3/ZrO2, while they were 88.6%, 86%, 84%, 78% and 75.9% in case of S-TiO2. The irradiation time of each cycle was 240 min, and the initial trimethoprim concentration was 10 mg/L. The degradation rates of trimethoprim were estimated in the case of suspended and immobilized S-TiO2 and Ru/WO3/ZrO2. The radical trapping experiments using various scavengers revealed that superoxide radicals, holes and hydroxyl radicals all participated in the photo-degradation process. Furthermore, the transformation products generated during the trimethoprim oxidation process were detected by liquid chromatography/mass spectroscopy to identify the possible degradation pathways

Prevalence and Causes of Intrahepatic and Extrahepatic Bile Duct Obstruction among the Jaundiced Patients at Riyadh Hospitals Diagnosed by Ultrasound

The aim of this study was to assess the prevalence and causes of bile duct obstruction among patients with jaundice at the ultrasound departments in Riyadh hospitals. Methods and Results: The study included 525 records of jaundiced patients above 18 years old that were referred to the ultrasound department. Data were collected from PACS (Picture Archiving and Communication System) at three different hospitals in Riyadh. Of 525 adult jaundiced patients, 69 had biliary obstruction, a 13% prevalence. In our study, 38(55.1%) cases of obstruction were caused by stones, 14(20.3%) by tumors, 9(13.0%) by inflammation, 5(7.2%) by a nonfunctioning stent, and 3(4.3%) by pnemobilia. Obstructive jaundice occurred significantly more frequently with increasing age. The study revealed no significant difference between gender and the presence of obstruction. More studies with a larger sample size of obstructive jaundice patients are suggested

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations