DEBRIS FLOW MODELLING: THE CASE OF MANDRA

Σκοπός της παρούσας εργασίας είναι η παρουσίαση και η περιγραφή των φαινομένων ροών κορημάτων κατά τη διάρκεια μιας ξαφνικής πλημμύρας. Στις 15 Νοεμβρίου 2017 η πόλη της Μάνδρας και η ευρύτερη περιοχή αναπάντεχα δέχτηκαν μεγάλη πλημμύρα. Οι ανάντη λεκάνες απορροής, οι οποίες δέχθηκαν τεράστια ποσότητα βροχόπτωσης σχεδόν 300mm σε λιγότερο από 8 ώρες, υπέστησαν πολλές σημαντικές ζημιές, απώλειες ανθρώπων αλλά και σημαντικές γεωμορφολογικές επιπτώσεις. Η κατανομή των ροών κορημάτων στο ρέμα της Αγίας Αικατερίνης παρουσιάζει ιδιαίτερο ενδιαφέρον έχοντας μεγάλη σημασία για την μελέτη των διεργασιών που συνέβησαν. Τα πρώτα δεδομένα που χρειάστηκαν για την προσομοίωση των ροών κορημάτων ήταν οι ήδη προυπάρχοντες χάρτες που απεικονίζουν που συνέβησαν οι ροές κορημάτων. Με βάση αυτά πραγματοποιήθηκε η προσομοίωση με σκοπό την αξιοπιστία του λογισμικού. Το Rapid Mass Movements Simulation ( RAMMS:: DEBRIS FLOW) είναι καλό λογισμικό που χρησιμοποιείται για τη προσομοίωση των ροών κορημάτων, έχοντας πολλά εργαλεία και τη δυνατότητα να παρουσιάζονται τα αποτελέσματά του με μεγάλη ευκρίνεια. Τα ακόλουθα κεφάλαια αναφέρουν την έννοια των κατολισθήσεων και τον τρόπο αντιμετώπισης των προβλημάτων που προκαλούν, τους παράγοντες που επηρεάζουν την εμφάνιση και την έναρξη των ροών κορημάτων, την ταξινόμησή τους, την εναπόθεση και τη μορφολογία τους, την ανάλυση, την ευστάθεια και τα χαρακτηριστικά της αστοχίας , τέλος, τις απαραίτητες πληροφορίες για την περιοχή μελέτης.The purpose of this thesis is to present and describe debris flow phenomena during a flash flood. On November 15, the city of Mandra and the surrounding countryside were flooded unexpectedly. The upstream watersheds, which received massive amounts of rainfall with a cumulative rainfall of nearly 300mm in less than 8 hours, suffered considerable damage, many human casualties, and significant geomorphological consequences. The distribution of debris flows in the Agia Aikaterini stream is of great importance for the research of their processes. The pre-existing maps that depict the points where there were debris flows were the first data needed for the simulation. The simulation was run based on these to ensure the program's reliability. The Rapid Mass Movements Simulation(RAMMS:: DEBRIS FLOW) is a surprisingly great software for simulating flow streams, with several useful tools and the ability to present them as editable graphics pretty quickly. The following chapters discuss the concept of landslides and how to deal with the problems they cause, the factors that influence the appearance and onset of debris flows, the classification of debris flows, their deposition and morphology, failure analysis and stability, the characteristics and failure mechanisms of debris flows, the elimination of weak layers, and finally the study area and the simulation results

Diagnostic Clinical and Laboratory Findings in Response to Predetermining Bacterial Pathogen: Data from the Meningitis Registry

BACKGROUND: Childhood meningitis continues to be an important cause of mortality in many countries. The search for rapid diagnosis of acute bacterial meningitis has lead to the further exploration of prognostic factors. This study was scheduled in an attempt to analyze various clinical symptoms as well as rapid laboratory results and provide an algorithm for the prediction of specific bacterial aetiology of childhood bacterial meningitis. METHODOLOGY AND PRINCIPAL FINDINGS: During the 32 year period, 2477 cases of probable bacterial meningitis (BM) were collected from the Meningitis Registry (MR). Analysis was performed on a total of 1331 confirmed bacterial meningitis cases of patients aged 1 month to 14 years. Data was analysed using EPI INFO (version 3.4.3-CDC-Atlanta) and SPSS (version 15.0-Chicago) software. Statistically significant (p<0.05) variables were included in a conditional backward logistic regression model. A total of 838 (63.0%) attributed to Neisseria meningitidis, 252 (18.9%) to Haemophilus influenzae, 186 (14.0%) to Streptococcus pneumoniae and 55 (4.1%) due to other bacteria. For the diagnosis of Meningococcal Meningitis, the most significant group of diagnostic criteria identified included haemorrhagic rash (OR 22.36), absence of seizures (OR 2.51), headache (OR 1.83) and negative gram stain result (OR 1.55) with a Positive Predictive Value (PPV) of 96.4% (95%CI 87.7-99.6). For the diagnosis of Streptococcus pneumoniae, the most significant group of diagnostic criteria identified included absence of haemorrhagic rash (OR 13.62), positive gram stain (OR 2.10), coma (OR 3.11), seizures (OR 3.81) and peripheral WBC > or = 15000/microL (OR 2.19) with a PPV of 77.8% (95%CI 40.0-97.2). For the diagnosis of Haemophilus influenzae, the most significant group of diagnostic criteria included, absence of haemorrhagic rash (OR 13.61), age > or = 1 year (OR 2.04), absence of headache (OR 3.01), CSF Glu < 40 mg/dL (OR 3.62) and peripheral WBC < 15,000/microL (OR 1.74) with a PPV of 58.5% (95%CI 42.1-73.7). CONCLUSIONS: The use of clinical and laboratory predictors for the assessment of the causative bacterial pathogen rather than just for predicting outcome of mortality seems to be a useful tool in the clinical management and specific treatment of BM. These findings should be further explored and studied

Meningitis registry of hospitalized cases in children: epidemiological patterns of acute bacterial meningitis throughout a 32-year period

<p>Abstract</p> <p>Background</p> <p>Bacterial meningitis remains a source of substantial morbidity and mortality in childhood. During the last decades gradual changes have been observed in the epidemiology of bacterial meningitis, related to the introduction of new polysaccharide and conjugate vaccines. The study presents an overview of the epidemiological patterns of acute bacterial meningitis in a tertiary children 's hospital during a 32-year period, using information from a disease registry. Moreover, it discusses the contribution of communicable disease registries in the study of acute infectious diseases.</p> <p>Methods</p> <p>In the early 1970s a Meningitis Registry (MR) was created for patients admitted with meningitis in Aghia Sofia Children's Hospital in Athens. The MR includes demographic, clinical and laboratory data as well as treatment, complications and outcome of the patients. In 2000 a database was created and the collected data were entered, analyzed and presented in three chronological periods: A (1974–1984), B (1985–1994) and C (1995–2005).</p> <p>Results</p> <p>Of the 2,477 cases of bacterial meningitis registered in total, 1,146 cases (46.3%) were classified as "probable" and 1,331 (53.7%) as "confirmed" bacterial meningitis. The estimated mean annual Incidence Rate (IR) was 16.9/100,000 for bacterial meningitis, 8.9/100,000 for <it>Neisseria meningitidis</it>, 1.3/100,000 for <it>Streptococcus pneumoniae</it>, 2.5/100,000 for <it>Haemophilus influenzae </it>type b (Hib) before vaccination and 0.4/100,000 for Hib after vaccination. <it>Neisseria meningitis </it>constituted the leading cause of childhood bacterial meningitis for all periods and in all age groups. Hib was the second most common cause of bacterial meningitis before the introduction of Hib conjugate vaccine, in periods A and B. The incidence of bacterial meningitis due to <it>Streptococcus pneumoniae </it>was stable. The long-term epidemiological pattern of <it>Neisseria meningitidis </it>appears in cycles of approximately 10 years, confirmed by a significant rise of IR in period C. The Case Fatality Rate (CFR) from all causes was 3.8%, while higher CFR were estimated for <it>Streptococcus pneumoniae </it>(7.5%, RR=2.1, 95% CI 1.2–3.7) and <it>Neisseria meningitidis </it>(4.8%, RR=1.7, 95% CI 1.1–2.5) compared to other pathogens. Moreover, overall CFR varied significantly among the three time periods (p = 0.0015), and was estimated to be higher in period C.</p> <p>Conclusion</p> <p>By using the MR we were able to delineate long-term changes in the epidemiology of bacterial meningitis. Thus the MR proved to be a useful tool in the study and the prevention of communicable diseases in correlation with prevention strategies, such as vaccinations.</p

Prognostic factors related to sequelae in childhood bacterial meningitis: Data from a Greek meningitis registry

<p>Abstract</p> <p>Background</p> <p>Bacterial meningitis (BM) is a life-threatening disease, often related with serious complications and sequelae. Infants and children who survive bacterial meningitis often suffer neurological and other sequelae.</p> <p>Methods</p> <p>A total of 2,477 patients aged 1 month to 14 years old hospitalized in a Children's Hospital in Greece diagnosed with acute bacterial meningitis were collected through a Meningitis Registry, from 1974 to 2005. Clinical, laboratory and other parameters (sex, age, pathogen, duration of symptoms before and after admission) were evaluated through univariate and multivariate analysis with regard to sequelae. Analysis of acute complications were also studied but not included in the final model.</p> <p>Results</p> <p>The rate of acute complications (arthritis and/or subdural effusion) was estimated at 6.8% (152 out of 2,251 patients, 95%CI 5.8-7.9) while the rate of sequelae (severe hearing loss, ventriculitis, hydrocephalus or seizure disorder) among survivors was estimated at 3.3% (73 out of 2,207 patients, 95%CI 2.6-4.2). Risk factors on admission associated with sequelae included seizures, absence of hemorrhagic rash, low CSF glucose, high CSF protein and the etiology of meningitis. A combination of significant prognostic factors including presence of seizures, low CSF glucose, high CSF protein, positive blood culture and absence of petechiae on admission presented an absolute risk of sequelae of 41.7% (95%CI 15.2-72.3).</p> <p>Conclusions</p> <p>A combination of prognostic factors of sequelae in childhood BM may be of value in selecting patients for more intensive therapy and in identifying possible candidates for new treatment strategies.</p

Συγκριτική μελέτη παιδιών που εισήχθησαν με εισαγγελική εντολή στο Γ.Ν Παίδων Παν. &amp; Αγλαΐας Κυριακού, προ και κατά τη διάρκεια της οικονομικής κρίσης

Η οικονομική κρίση, διαμόρφωσε ένα περιβάλλον αυστηρών δημοσιονομικών προσαρμογών και περιορισμών, οδηγώντας πολλά κράτη σε οικονομικό μαρασμό. Η οικογένεια, βίωσε τις συνέπειες της οικονομικής κρίσης με αντίκτυπο στη πορεία της, τη δομή, τις προοπτικές, ακόμη και την ύπαρξή της. Τα χρόνια της οικονομικής κρίσης, το φαινόμενο εισαγωγής ανηλίκων κατόπιν εισαγγελικής εντολής σε Παιδιατρικά Νοσοκομεία, για την προστασία, την διασφάλιση των δικαιωμάτων τους με γνώμονα το βέλτιστο συμφέρον τους, φαίνεται να έχει ενταθεί. Ο σκοπός της παρούσας έρευνας είναι, κατά πρώτον να εξετάσει την ύπαρξη ή μη, αυξητικής τάσης στις εισαγωγές ανήλικων με εισαγγελική εντολή στο Γ. Ν. Παίδων «Παν. &amp; Αγλαΐας Κυριακού», και την πιθανή σχέση με την κλιμακούμενη πορεία της οικονομικής κρίσης. Κατά δεύτερον, η καταγραφή και διερεύνηση πιθανής μεταβολής των ποιοτικών και ποσοτικών χαρακτηριστικών τόσο των ανηλίκων όσο και των οικογενειών αυτών, συγκριτικά, μεταξύ των χρονικών διετιών 2004-2005, 2011-2012, 2018-2019, που αντιπροσωπεύουν διαφορετικές φάσεις τις ελληνικής οικονομίας. Συμπεράσματα: Η πορεία και η εξέλιξη της οικονομικής κρίσης συμπίπτει με την αυξητική τάση στις εισαγωγές ανηλίκων με εισαγγελική εντολή στο υπό μελέτη Νοσοκομείο, που μπορεί να αποδεικνύει μια αιτιώδη σύνδεση, επιβεβαιώνοντας την υπόθεση εργασίας. Από τα επιμέρους αποτελέσματα της παρούσας έρευνας φαίνεται, ότι η οικονομική κρίση επηρέασε, επιδείνωσε, και ενέτεινε τα δημογραφικά, τα κοινωνικο-οικονομικά χαρακτηριστικά του υπό μελέτη δείγματος, και των γονέων καθώς και, την οικογενειακή κατάσταση, τον τρόπο συντήρησης της οικογένειας, το καθεστώς στέγασης, εν μέρει, ή και στο σύνολο.The financial crisis has created an environment of severe fiscal adjustments and constraints, leading many countries to economic decline. The family has experienced the consequences of the economic crisis, which has had an impact on its course, its structure, its prospects and even its existence. During the years of the economic crisis, the phenomenon of admission of minors on the basis of a prosecutor&apos;s order to Pediatric Hospitals, for the protection and safeguarding of their rights in their best interest, seems to have intensified. The purpose of the present study is, firstly, to examine the existence or not of an increasing trend in the admission of minors with a public prosecutor&apos;s order to the Children&apos;s Hospital &quot;Pan. &amp; Aglaia Kyriakou&quot;, and the possible connection with the escalating course of the economic crisis. Secondly, the recording and investigation of possible changes in the qualitative and quantitative characteristics of both minors and their families, comparatively, between the time periods 2004-2005, 2011-2012 and 2018-2019, representing different phases of the Greek economy. Conclusions: the course and evolution of the economic crisis coincides with the increasing trend in the admissions of juveniles with prosecution orders in the hospital under study, which may prove a causal link, confirming the working hypothesis. From the individual results of the present research it appears that the economic crisis has affected, worsened and intensified the demographic, socio-economic characteristics of the sample under study, and of the parents, as well as the family situation, the way of maintaining the family, the housing status, partly or in total

Bacterial meningitis in infants and children (1974-2005): changes in epidemiology, clinical presentation, diagnosis, outcome and study of risk factors

Current study presents findings on the epidemiology of childhood bacterial meningitis from 1974 to 2005 through a Meningitis registry in “Aghia Sophia Children’s Hospital” in Athens, Greece. Neisseria meningitidis was found to be the leading cause of meningitis in all age groups during all study periods. Changes in the incidence of meningococcal meningitis were observed during the 32-years of the study, which were attributed to the natural fluctuation of meningococcal infections. Haemophilus influenzae type b was found to be an important cause of morbidity from bacterial meningitis before the introduction of Hib conjugate vaccines. Streptococcus pneumoniae was the leading cause of mortality from bacterial meningitis overal.Moreover, a case-control study was performed in order to investigate possible risk factors for meningococcal disease. Parental smoking, recent acute viral infection of the upper respiratory tract and a recent change in life setting or accomodation were found to be independent risk factors for meningococcal disease, while having a stable pediatrician was found to play a protective role. Nevertheless, biological factors such as MBL and other constitutional factors were not found to be related with meningococcal disease in our series. Above findings highlight the importance of simple modifiable factors, which could positively influence children’s quality of life.Στην παρούσα διατριβή μελετήθηκαν οι διαχρονικές μεταβολές στην επιδημιολογία της μικροβιακής μηνιγγίτιδας στα παιδιά μέσω του Αρχείου Καταγραφής Μηνιγγίτιδας του Νοσοκομείου Παίδων «Η Αγία Σοφία». Ο μηνιγγιτιδόκοκκος αποτελούσε την κύρια αιτία μικροβιακής μηνιγγίτιδας σε όλες τις ηλικιακές ομάδες και στα 32 έτη που διήρκησε η μελέτη. Παρατηρήθηκαν μεταβολές στην επίπτωση της μηνιγγιτιδοκοκκικής μηνιγγίτιδας στην πορεία του χρόνου, στα πλαίσια των φυσικών κύκλων που χαρακτηρίζουν την επιδημιολογία των μηνιγγιτιδοκόκκων. Ο πνευμονιόκοκκος ήταν το πιο θανατηφόρο από τα παθογόνα που εμπλέκονται στην μικροβιακή μηνιγγίτιδα. Ο Hib αποτέλεσε σημαντική αιτία νοσηρότητας πριν την καθολική εφαρμογή του συζευγμένου εμβολίου, ενώ μειώθηκε σημαντικά μετά την κυκλοφορία του εμβολίου. Ο πνευμονιόκοκκος συνδέεται με τα υψηλότερα ποσοστά θνητότητας μεταξύ των τριών κύριων παθογόνων που συμμετέχουν στη μικροβιακή μηνιγγίτιδα.Επιπλέον μέσω μελέτης πασχόντων και μαρτύρων διερευνήθηκαν πιθανοί παράγοντες κινδύνου για τη μηνιγγιτιδοκοκκική νόσο. Σύμφωνα με τα ευρήματα της μελέτης οι παράγοντες που σχετίζονται με αυξημένο κίνδυνο για μηνιγγιτιδοκοκκική νόσο περιλαμβάνουν το κάπνισμα του πατέρα, πρόσφατη ιογενής λοίμωξη του αναπνευστικού και πρόσφατη αλλαγή του τρόπου ζωής. Προστατευτική επίδραση βρέθηκε ότι επιφέρει η παρακολούθηση της υγείας του παιδιού από σταθερό παιδίατρο. Τα παραπάνω ευρήματα είναι σημαντικά καθώς αφορούν τροποποιήσιμους παράγοντες που μπορεί να επιφέρουν σημαντικές αλλαγές στην ποιότητα ζωής των παιδιών. Αντίθετα βιολογικοί παράγοντες (όπως η MBL) και άλλοι ιδιοσυστασιακοί παράγοντες δε βρέθηκε να επηρεάζουν σημαντικά τον κίνδυνο για διεισδυτική μηνιγγιτιδοκοκκική νόσο

A Case-Control Study on the Risk Factors for Meningococcal Disease among Children in Greece.

The aim of this study was to identify environmental or genetic risk factors that are associated with invasive meningococcal disease (IMD) in children in Greece.A case-control study was performed in 133 children (44 cases and 89 controls) aged between 0-14 years, who were hospitalized in a children's hospital in Athens. Demographics and possible risk factors were collected by the use of a structured questionnaire. To investigate the association of mannose binding lectin (MBL) with IMD, a frequency analysis of the haplotypes of the MBL2 gene and quantitative measurement of MBL serum protein levels were performed using Nanogen NanoChipR 400 technology and immuno-enzyme techniques, respectively.The multivariate analysis revealed that changes in a child's life setting (relocation or vacation, OR = 7.16), paternal smoking (OR = 4.51), upper respiratory tract infection within the previous month (OR = 3.04) and the density of people in the house/100m2 (OR = 3.16), were independent risk factors associated with IMD. Overall 18.8% of patients had a MBL2 genotype with low functionality compared to 10.1% of healthy controls, but this was not statistically significant (p = 0.189).Prevention strategies aimed at reducing parental smoking and other risk factors identified in this study could decrease the risk of IMD among children in Greece

Multivariate analysis of diagnostic factors for the diagnosis of <i>Neisseria meningitidis</i>.

<p>Multivariate analysis of diagnostic factors for the diagnosis of <i>Neisseria meningitidis</i>.</p

Multivariate analysis of groups of diagnostic factors for the diagnosis of ‘other pathogens’.

<p>Multivariate analysis of groups of diagnostic factors for the diagnosis of ‘other pathogens’.</p