Harmony of Retaining Systems to Various Local Subsoil Conditions – A Case Study

A case study for the utilization of various retaining systems for different subsoil and groundwater conditions encountered within a given site is presented in this paper. The project is known as “BJK Fulya Complex”, covering approximately 160,000 m2 floor area. It is located at a very prestigious district of the city, therefore maximum underground space gain were desired. As a result nearly 20 m of excavation is planned to be performed partly under groundwater. Due to unique topography and geology of the site, subsoil and groundwater conditions at various faces of the excavation differ considerably. Because of the complicated geology, budget constraints of the project and the high seismicity, it was compulsory to employ various retaining structures such as flexible and rigid retaining systems at various locations within the site including permanent and temporary soil nailing, permanent tie-back cast in-situ reinforced concrete wall and temporary tied-back diaphragm wall consist of soldier cast in-situ piles with jet grout columns in between. Performances of various systems are monitored closely by means of inclinometers. Displacement data and experience obtained from this case study serves an excellent source of data and example for future applications in similar conditions within the city

Liquefied Natural Gas Ship Route Planning Model Considering Market Trend Change

We consider a new biannual liquefi ed natural gas (LNG) ship routing and scheduling problem and a stochastic extension under boil-off gas (BOG) uncertainty while serving geographically dispersed multiple customers using a fl eet of heterogeneous vessels. We are motivated not only by contract trend changes to shorter ones but also by technological advances in LNG vessel design. The mutual coincidence of both transitions enables developing a new LNG shipping strategy to keep up with emerging market trend. We fi rst propose a deterministic LNG scheduling model formulated as a multiple vehicle routing problem (VRP). The model is then extended to consider BOG using a two-stage stochastic modeling approach in which BOG is a random variable. Since the VRP is typically a combinatorial optimization problem, its stochastic extension is much harder to solve. In order to overcome this computational burden, a Monte Carlo sampling optimization is used to reduce the number of scenarios in the stochastic model while ensuring good quality of solutions. The solutions are evaluated using expected value of perfect information (EVPI) and value of stochastic solution (VSS). The result shows that our proposed model yields more stable solutions than the deterministic model. The study was made possible by the NPRP award [NPRP 4-1249-2-492] from the Qatar National Research Fund (a member of the Qatar Foundation)

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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Inventory and scheduling problems in supply chain management

This dissertation deals with real life inventory and supply chain management problems. Three chapters are dedicated to di fferent problems, two of them dealing with vessel scheduling and container management, where as the last one deal with inventory management of critical supplies at hospitals, during time of surging demand. We propose heuristics and exact approaches for these problems that are both e fficient in terms of time, and accurate enough to our needs. Even though inventory and supply chain management fi eld is a popular fi eld of research, these problems have not been addressed yet, and known results cannot be directly applied to any of them.Ph. D.Includes bibliographical referencesby Selim Bor

Reversal learning in patients with obsessive-compulsive disorder (OCD) and their unaffected relatives: Is orbitofrontal dysfunction an endophenotype of OCD?

It has been suggested that reversal learning deficits might be an endophenotype of OCD. To investigate this hypothesis, we administered a probabilistic reversal learning task (ProbRev) to OCD patients, their unaffected first-degree relatives, and healthy controls. Although the relatives had a performance in between OCDs and controls at the early phase of the ProbRev, their performance was similar to controls and was significantly better than OCD patients at the later stages of the test. Our findings imply that reversal learning impairment might be partly a trait-related feature of OCD but state-related factors can also contribute to observed deficits. © 2017 Elsevier Ireland Lt

Accidental death due to intentionally usage of organophosphate: Report of two cases

Abstract The use of organophosphates (OP

Are the sinonasal outcome test and nasal obstruction symptom evaluation scale questionnaires suitable for assessing the quality of life after septorhinoplasty? A prospective case-control study

In the evaluation after septorhinoplasty (SRP), the surgeon&apos;s plan and the patient&apos;s expectations may not always be realised. Therefore, in our prospective case-control study, we aimed to investigate whether the Sinonasal Outcome Test (SNOT-22) and Nasal Obstruction Symptom Evaluation Scales (NOSE), which have been validated in different patient populations in Turkish, are appropriate for evaluating SRP cases and their relationship with each other. Preoperative and postoperative data of NOSE and SNOT-22 questionnaires of 125 cases diagnosed with traumatic septum deviation and external nasal deformity and decided to be operated were analyzed. It was calculated that the SNOT-22 score of those with high/low preoperative NOSE scores was also high/low with a 53.6% probability and that the SNOT-22 score of those with high/low postoperative NOSE scores was also high/low with a 69.9% probability, indicating a positive and high-level relationship between postoperative NOSE and SNOT-22 measurements. When the answers given to all questions in SNOT-22 were evaluated separately, it was observed that the most disturbing symptoms of the cases were nasal obstruction at 78.4% and the need to blow the nose at 46.4% in the preoperative period, and nasal obstruction with 64.8% and the need to blow nose with 37.6% in the postoperative period. The most dramatic changes in the answers to SNOT-22 questions were observed in the patient&apos;s feelings of frustrated/restless/irritable, sadness, and embrassed. SNOT-22 and NOSE questionnaires can be used interchangeably to evaluate the functional status of patients undergoing SRP surgery. [Med-Science 2023; 12(3.000): 710-5