Evaluating the Petroleum Contracts of Kurdistan Region in the Surveying and Applying the Deloitte Data (A Comparative Review)

A production sharing contract has been chosen by the Kurdistan Regional Government as supposedly the most appropriate contract model for the oil and gas resources of the Kurdistan Region, among several other forms of contract. In general, in terms of royalty, cost recovery, and sharing the residual sales as negotiated, the Kurdish model is similar to its foreign model, although the proportions are most likely to differ. The model of the Region specified 10 percent for the Royalty: Up to 45 percent for cost recovery, often between 7-9 percent of the company's share of the profit in the agreement. Investigating Deloitte reports and then comparing the 2017 to 2019 data shows the unstable output with a fair boost and stability at the later date as for 2017. A large contribution from the Kirkuk oil fields to the production of the overall region is noted until 16 Oct 2017. Around one-third of the revenues of oil went to the production oil companies, although as agreed for cost recovery, it is still less than 40 percent. The payment of the companies of Oil production could be explained as a collective sum between 9% of the profit oil and 25-28% of the sales oil's gross values! The cost recovery payment could not have been funded in the contract, which explains the region's claim about the debts of the companies, in its agreed manner

From Bidirectional Associative Memory to a noise-tolerant, robust Protein Processor Associative Memory

AbstractProtein Processor Associative Memory (PPAM) is a novel architecture for learning associations incrementally and online and performing fast, reliable, scalable hetero-associative recall. This paper presents a comparison of the PPAM with the Bidirectional Associative Memory (BAM), both with Kosko's original training algorithm and also with the more popular Pseudo-Relaxation Learning Algorithm for BAM (PRLAB). It also compares the PPAM with a more recent associative memory architecture called SOIAM. Results of training for object-avoidance are presented from simulations using player/stage and are verified by actual implementations on the E-Puck mobile robot. Finally, we show how the PPAM is capable of achieving an increase in performance without using the typical weighted-sum arithmetic operations or indeed any arithmetic operations

Control Rate of Diabetic and Hypertensive Adult Patients in Association with Demographic and Healthy Behaviour Factors in Garmian- Kurdistan Region

Hypertension   and   diabetes   mellitus   (DM)   are the      two       major      inter-correlated      risk       factors      of cardiovascular   diseases,    which    considered    as    the    major causes  of  morbidity  and  mortality.  This  study  is  set  up  to determine   control   rate,   and   the   social   demographic   and health   related   behaviours   risk   factors   in   association   with control   rate   in   hypertensive   and/or   diabetes   patients   who are  under  treatment.  Cross  sectional  study  was  carried  out in  this  study.  Data  have  been  collected  by  well-trained paramedics through direct interviews using structured questionnaire     with     the     participants.     A     conventional sampling  which  is  one  of  the  main  types  of  non-probability method  was  used  for  collecting  data.  SPSS  version  16  was used   for   analysing   data.   338   patients   were   recruited   into the   study,   150(44.1%)   of   participants   with   hypertension,88(25.9%) with diabetes and the rest 100(29.4%) with both diseases.   Patients   who   diagnosed   with   hypertension   weremore  under  control  83  (55.3%)  in  comparison  with  diabetic23(26.1%)   and   patients   who   were   diagnosed   both conditions 18(18.0%). High control rate was observed in hypertension  patients  compared  to  diabetes  and  those diagnosed   both   conditions.   Cor   morbidity   was   the   main cause of uncontrolled rate

Patient’s Satisfaction with Health Care Services in Erbil City/Iraq

Background and objective: Patient satisfaction is one of the most important factors to determine the success of a health care facility. It is a relative phenomenon, which evaluates the patients’ perceived needs, their expectations from a health system, and the experience of health care. Patient satisfaction is the main goal today for most health care organizations, from hospitals to physician practices and other health care agencies. This study aimed to compare patient satisfaction with the health care services provided by public and private hospitals in Erbil City. Methods: A cross-sectional study was conducted using a non-probability purposive sample of 450 patients (225 from public and 225 from private hospitals) who were seeking health care in hospitals in Erbil City. The data were collected between the 7th of January and 15th of November 2016 by direct interviews and filling of the standardized questionnaires (Patient Satisfaction Questionnaire-18). Results and Discussion: Most of the patients in public hospitals expressed a neutral level of satisfaction with received health services (80.9%) while 10.7% were dissatisfied and only 8.4% were satisfied with the provided health care. On the contrary, most of the patients in private hospitals (80%) were satisfied with their care, with only 20% expressing a neutral level of satisfaction with private health care services. These findings show that there is a very high statistical difference between patient satisfaction in the governmental and private hospitals in Erbil City (Mean ± Standard Deviation 45.35 ± 3.520), (56.42 ± 5.696) (p-value= <0.001). Conclusion: Most of the patients were satisfied with private health care services but not with public hospitals health services in selected hospitals in Erbil City in Iraq

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

The global burden of cancer attributable to risk factors, 2010–19: a systematic analysis for the Global Burden of Disease Study 2019

BACKGROUND: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. METHODS: The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk–outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. FINDINGS: Globally, in 2019, the risk factors included in this analysis accounted for 4·45 million (95% uncertainty interval 4·01–4·94) deaths and 105 million (95·0–116) DALYs for both sexes combined, representing 44·4% (41·3–48·4) of all cancer deaths and 42·0% (39·1–45·6) of all DALYs. There were 2·88 million (2·60–3·18) risk-attributable cancer deaths in males (50·6% [47·8–54·1] of all male cancer deaths) and 1·58 million (1·36–1·84) risk-attributable cancer deaths in females (36·3% [32·5–41·3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20·4% (12·6–28·4) and DALYs by 16·8% (8·8–25·0), with the greatest percentage increase in metabolic risks (34·7% [27·9–42·8] and 33·3% [25·8–42·0]). INTERPRETATION: The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone