NAKED EYE ESTIMATES OF MORNING PRAYER AT TUBRUQ OF LIBYA

Naked eye observations at Tubruq sky (φ = 32° 05´, λ = 23° 59´) in Libya at the Mediterranean coast (see-desert background) during the two years (2008 – 2009) of morning twilight have been recorded.  These observations led us to get some estimates about morning twilight, as it is necessary to determine the time of the True Dawn (Al-Fajr Prayer Time).  this research aims to determine the correct time of Al-Fajr Prayer by finding the accurate angle of the sun vertical depression below the horizon that is associated with legitimate mark. The Methode used in this research was field research while the observations have been recorded by monitoring the first white thread on the eastern horizon (True Dawn) that announces the time of the Morning Prayer (Al-Fajr Prayer).  The azimuthally range of observation about the solar vertical extends from 0° up to ±20°, while the phenomenon was followed from 0° up to 20° along the altitudinal range.  This research gives a result that a beginning of the morning twilight is estimated to be around 13.5° depression of the sun below the horizon.  This value can reach a minimum depression around 11.5° at low visibility and a maximum around 13.5° at a very god visibility

NAKED EYE ESTIMATES OF MORNING PRAYER AT TUBRUQ OF LIBYA

Naked eye observations at Tubruq sky (φ = 32° 05´, λ = 23° 59´) in Libya at the Mediterranean coast (see-desert background) during the two years (2008 – 2009) of morning twilight have been recorded.  These observations led us to get some estimates about morning twilight, as it is necessary to determine the time of the True Dawn (Al-Fajr Prayer Time).  this research aims to determine the correct time of Al-Fajr Prayer by finding the accurate angle of the sun vertical depression below the horizon that is associated with legitimate mark. The Methode used in this research was field research while the observations have been recorded by monitoring the first white thread on the eastern horizon (True Dawn) that announces the time of the Morning Prayer (Al-Fajr Prayer).  The azimuthally range of observation about the solar vertical extends from 0° up to ±20°, while the phenomenon was followed from 0° up to 20° along the altitudinal range.  This research gives a result that a beginning of the morning twilight is estimated to be around 13.5° depression of the sun below the horizon.  This value can reach a minimum depression around 11.5° at low visibility and a maximum around 13.5° at a very god visibility

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

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

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Simulation model of a new solar pumped laser system of Fresnel lens in Helwan of Egypt

A simulation model of a new solar pumped laser system is tested to be run in Helwan in Egypt as an example of an industrial polluted area. The system is based on concentrating the solar radiation using a Fresnel lens on a laser head fixed on a mount tracking the sun during the day and powered by a DC battery. The model is fed by real solar radiation data in the various seasons in order to know the laser power got from such a system in those conditions. The results showed that the output laser power obtained from this system can be up to 6.2 W in spring, 6.8 W in summer, 2.2 W in autumn and 0.4 W in winter

Simulation model of a new solar laser system of Fresnel lens according to real observed solar radiation data in

A new simulation model of a new solar pumped laser system was tested to be run in Helwan in Egypt (latitude φ = 29°52′N, longitude λ = 31°21′E and elevation = 141 m) as an example of an industrial polluted area. The system is based on concentrating the solar radiation using a Fresnel lens on a laser head fixed on a mount tracking the sun during the day and powered by a DC battery. Two cases of this model are tested; the first one is the model consisting of a Fresnel lens and a two-dimensional Compound Parabolic Concentrator (CPC), while the other is the model consisting of a Fresnel lens and a three-dimensional Compound Parabolic Concentrator (CPC). The model is fed by real actual solar radiation data taken in Helwan Solar Radiation Station at NRIAG in the various seasons in order to know the laser power got from such a system in those conditions. For the system of Fresnel lens and 2D-CPC, an average laser output power of 1.27 W in Winter, 2 W in Spring, 5 W in Summer and 4.68 W in Autumn respectively can be obtained. Accordingly, the annual average output power for this system is 3.24 W. For the system of Fresnel lens and 3D-CPC, an average laser output power of 3.28 W in Winter, 3.55 W in Spring, 7.56 W in Summer and 7.13 W in Autumn respectively can be obtained. Accordingly, the annual average output power for this system is 5.38 W

On the Orientation of Ancient Egyptian Temples: (5) Testing the Theory in Middle Egypt and Sudan

30 pages.[EN]The article examines the orientation with respect to the sky of ancient temples in Middle Egypt and Sudan. A previous paper compiled facts concerning the location of temples, and from these facts postulated a theory that connected temple siting to celestial phenomena. The current paper describes two separate efforts based on temples in Middle Egypt and Sudan to either refute or confirm this theory. The authors' presentation presents strong evidence of the impact sky-watching had on ancient culture, religion, and architecture.This work is partially financed in the framework of the projects P310793 "Arqueoastronomía" of the Instituto -de Astrofísica de Canarias, and AYA200 "Orientaio ad Sidera II" of the Spanish Ministry of Science and InnovationPeer reviewe

Naked eye observations for morning twilight at different sites in Egypt

Twilight observations were carried out in the period between 1984 and 1987 in different seasons at different sites of Egypt (Baharia, Matrouh, Kottamia and Aswan) through a cooperation project between Dar El-Iftaa’ and the Egyptian Academy of Scientific Research and Technology. Naked eye observations of the first light of the dawn were done in parallel to the photoelectric measurements of the twilight phenomena. The depression of the sun below the horizon corresponding to the first light was calculated from the time of observations. Our estimates show that the normal eye can just discriminate the dawn (the first white light thread) at a depression of 14.7° with a maximum value of 15.08° and a minimum value of 12.01°. This result agrees with result obtained by our previous photoelectric measurements