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Background: Prediction scores could help to timely identify patients at risk. More intense care monitoring outside the pediatric intensive care unit (PICU) could improve outcomes. These concepts of critical care without borders could be implemented shortly with local resources and improve patient safety. Predict more, do less in PICUs, and more in the ward. The aim of this work was to evaluate the impact of prediction scores for identification of postoperative high risk surgical patients and their need for pediatric intensive care unit admission. Methods: This prospective study was carried out on 40 pediatric patients. The studied patients were divided into three groups. LR Group: 14 cases with ASA = 1, 2 PEWS ≤ 2, pSOFA ≤ 7, LqSOFA < 2. IR Group: 10 cases with PEWS = 3, 4 pSOFA = 8 -11 HiR Group: 16 cases with ASA = 3 -5, PEWS ≥ 5, pSOFA ≥ 12, LqSOFA ≥ 2. American Society of Anaesthesiologists (ASA) scoring was obtained from each patient preop. The Pediatric Early Warning (PEWS) Scoring was obtained from each patient immediately postop. The Pediatric Sequential Organ Failure Assessment (pSOFA) Scoring was obtained from patients admitted to PICU on day 1 and day 7. Liverpool quick Sequential Organ Failure Assessment (LqSOFA) scoring was obtained from all patients on admission. Results: Regarding prognostic performance of different scores to predict mortality. For ASA score: it was statistically significant with AUC = .882, cut off values > 3, sensitivity = 75%, specificity = 88.89%, PPV = 42.9% and NPV = 97%. -For PEW score: it was statistically significant with AUC = .892, cut off values > 5, sensitivity = 79%, specificity = 80.56%, PPV =30% and NPV = 96.7%. -For pSOFA score: it was statistically significant with AUC = .931, cut off values > 14, sensitivity = 85%, specificity = 86.11%, PPV =37.5%, and NPV = 96.9%. All ASA, PEW, and pSOFA were statistically significant as univariate but none was significant as multivariate. Conclusions: ASA score, pSOFA score and PEWS score were significant predictor to length of stay (>21 days). ASA score, PEW score and pSOFA score were significant as predictor to mortality. ASA score and PEWS score were highly significant as to predict PICU Admission postop. PEWS score was highly significant as to predict PICU Admission postop. ASA, PEWs, and pSOFA were predictors for LOS for more than 21 days, predictors of mortality and predictors for PICU admission Postop. Decreased platelets and increased WBCs, urea, creatinine, AST, and RBG were significant with HiR. LqSOFA is a simple variable bedside tool for identifying septic patients at high risk for poor outcomes.

This Investigation was carried out at Nubaria Agricultural Research Station (30° 54´ N, 29° 57´ E, and 15m above sea level), Agricultural Research Centre (ARC), Ministry of Agriculture and Land Reclamation (MALR), El-Behiera Governorate, Egypt, during 2016-2018 period to study the effects of application liquid humic acid on alfalfa forage yield and quality under irrigation water regime. Three irrigation water regime treatments were100%, 80% and 60% of ETp and three humic acid rates 0, 3 and 6 L/ha humic acid were tested in a strip-plot design. As water requirements decreased forage yield significantly decreased, in the 4 seasons for each year. No significant differences were found between the fresh or dry forage yields or leaf/stem ratio under 100% water requirement without humic acid and 80% water requirement with 6 L/ha humic acid. No significant differences were found between protein content under the interaction between irrigation water requirements and humic acid rate. Irrigation water use efficiency increased under water stress as an application of humic acid rate increased. The previous results indicate that, under experimental conditions, it is possible to save 20% of the amount of added water when adding 6 L/ha humic acid with an insignificant increases in yield amount to 11.421 t /ha.

The aim of this research paper is to discuss market failure of Thomas Cook and analyse the reasons behind the market failure of Thomas Cook Group and how outdated technology, having high debts, and did Brexit lead to its collapse. Further on analysis of the reasons for failure supported by literature review across different economic schools has been elaborated. The paper provides clarification to the characteristics of the airlines and their entry barriers taking into consideration the tour operator. Further, it is described how Thomas Cook collapse affected Africa and Europe. Lastly, the conclusion is about the losses occurred in Thomas Cook Company, how other firms can avoid failure and the direct negative impact of the BREXIT on the company.

This paper aims to analyse the adaptation of the airline industry after the hit of the coronavirus pandemic. This virus is affecting the global economy by targeting the most profitable industries and making them collapse. By making a qualitative analysis of the topic this research paper examines how the airline industry faces such a challenge. Also, it analyses how several airline companies shut down through the huge debt that they faced and how tourism declined sharply in all countries. This paper also examines the slow comeback which was experienced by the airline industry. Finally, the paper proposes a set of policies to overcome the current crisis and future setbacks.

The present investigation was carried out in the farm of Nubaria Agricultural Research. Station during the two winter seasons 2016/2017 and 2017/2018 to study the effect of three surface irrigation treatments (I1=100%, I2= 80%, I3= 60% of ETp) and four potassium levels (control 0, 57.12, 114.24 and 171.36 K2O/ha) on fodder beet growth, physiological characters, productivity and forage quality under calcareous soil conductions. The main results were as follows: 1- Increasing irrigation levels up to 100% ETp led to significant increase in crop growth rate at the two periods (90-120) and (120-150 DAS), root diameter, leaf area per plant, root dry matter/ plant, root fresh weight/plant, total yield, crude protein percentage, digestive crude protein percentage, shoot K%, crude fiber percent and carbohydrate percent. There was insignificant difference between 100% and 80% ETp in leaves dry matter /plant, foliage fresh weight /plant, foliage yield (ton/ha) and K% in root. Whereas the total digestible nutrient percent and root length were significantly increased by increasing water stress. Medium treatment at 80% of ETp give the maximum values of water use efficiency (WUE). 2- Increasing potassium fertilization levels up to 171.36 kg K2O/ha significantly increased CGR at (90-120 and 120-150 DAS), root length, root diameter, leaf area, root dry matter /plant, leaves dry matter /plant, CP%, DCP%, CF% and carbohydrate % In root. Adding 171.36 or 114.24 kg K2O/ha had insignificant differences in the first CGR period (90-120) DAS, root fresh weight (kg/plant), foliage fresh weight (g/plant), K% in shoot and root. TDN (%) decreased by increasing potassium fertilization levels. Maximum water use efficiency (WUE) was obtained when plants received 171.36 kg K2O/ha. 3- The interaction effect between water regime and potassium fertilization was found to be significant for CGR at the two periods, root length, leaf area/plant, leaves dry matter/plant, root and leaves fresh weight / plant, total yield, root yield, CP%, DCP%, K% in shoot and carbohydrate% in the combined analysis. The maximum value of WUE was obtained when plants were watered by 80% from ETp and received 171.36 kg K2O/ha.

A field experiment was conducted at Nubaria Agricultural Research Station during 2016/2017 and 2017/2018 to study the effect of irrigation regimes under saline calcareous soil on fresh and dry yields, quality, water requirements and productivity. Four irrigation regimes with amount of water equals potential evapotranspiration were used as irrigation with amount of water equal potential evapotranspiration (ETp) plus 10%, 20%, 30% and/or 40% as leaching requirements (LR). Average of calcareous soil salinity treatments were S1 equal 2 dSm-1, S2 equal 6 dSm-1 and S3 equal 10 dSm-1. Results indicated that there were significant effects among irrigation and soil salinity treatments on fresh and dry alfalfa yields through the combination of two years. The highest values of fresh and dry yields were 217.736 and 49.861 ton/ha, respectively that was obtained by I1S1 interaction, while the lowest values were 140.0 and 35.91 ton/ha was obtained by I4S2 interaction. Fresh and dry yields were decreased by 28.4 and 18.13% at I1S2 and by 14.6 and 13.19% at I1S3, respectively compared with that obtained by I1S1. Results of I3S3 and I4S3 were given the highest values of N and CP percentages. The water requirements values for alfalfa were 126.0, 135.2, 144.3 and 153.9 cm in the first year, while in the second year they were 128.8, 140.2, 152.0 and 163.8 cm for irrigation treatments, respectively. Also, the highest values of the productivity of irrigation water (PIW) were 8.93 and 8.17 kg/m3 water in 1st and 2nd years, which was I1S1.

Identification of alfalfa genotypes, with high yield potential and good forage quality along with the least seasonal fluctuation over a wide range of environments, is important for crop improvement programs. Trials were conducted to evaluate seven alfalfa (Medicago sativa, L) genotypes over three years at the Nubaria Agricultural Research Station Site. Field experiments were carried out in 2014, 2015 and 2016 seasons to evaluate fresh and dry forage yield, protein and fiber percentages and their stability employing parametric and non-parametric measures for the seven genotypes across environments. Results indicated that the local cultivar Ismailia-1 was superior to the introduced genotypes regarding its fresh and dry forage yield in addition to recording the least fiber percentage; however, MI reya produced higher protein percentage. When stability measures for the four traits was considered, Isamilia-1 was considered the most stable for fiber percentage based on four different measures tested. MI reya was most stable for protein percentage and more stable than Ismailia-1 for fresh and dry forage yield based on estimates from larger number of the tested stability measures, suggesting that MI reya is the most promising genotype among the introduced genotypes under study.

The study aims at measuring the impact of the policies of polarization for leadership positions and their impact on administrative performance and being applied to the employees of the Republic Company for Medical Supplies, through a field study to identify the adequacy, possibilities and requirements of its application to the Republic Company for Medical Supplies. In order to achieve the objectives of the study, a questionnaire form has been designed, which includes a set of statements measuring the sample's attitudes towards the variables of the study. In this study, the researcher relies on a combination of the inductive method and the deductive method, using the approach of the theoretical study and field study. The researcher has analyzed the data using the Kruskal-Wallis Test for each of the survey list questions to test the hypotheses using the study sample using the 100-items as the study sample "the number of valid forms recovered". The researcher has reached a set of results and recommendations that can be applied to under-study facility (Republic Company for Medical Supplies). The study concludes that: Considering the development and setting of policies and procedures that will practice and promote the work of polarization. Working on the establishment of clear evident determinants in the process of polarization commensurate with the requirements of the vacancy. The need to follow the policy of placing the right person in the right place, especially in the circle of polarization of administrative positions.

The Lower Cretaceous aquifer is one of the most important water bearing formations not only in Sinai but also in the Middle East because of its high hydraulic parameters and good water quality. This aquifer is dominated by a thick sequence of well sorted and permeable sandstones The Lower Cretaceous aquifer is generally crossed by two main E–W trending, down to the north normal right-lateral oblique-slip faults; the Ragabet El-Naam Fault (RANF) to the south and Minsherih-Abu Kandu Shear Zone (MAKZ) further north. In Central Sinai, the water flow pattern and hydrochemistry of the Lower Cretaceous aquifer are controlled by the fault-fold patterns. Across the RANF the water flow is retarded behind the fault zone and deviates toward its central segment where the groundwater spills-out northward at Nekhel City. In contrast, the MAKZ defines a barrier for the northward flowing groundwater where the Lower Cretaceous aquifer south of the fault is blocked by the Upper Cretaceous to Eocene limestone and shale to the north. The water type changes across the fault zones from meteoric water to water of marine origin at the RANF and north of MAKZ respectively with sporadic occurrences of old marine water types limited to NW-trending structural lows. Generally the northward flow pattern of the Lower Cretaceous aquifer shows an eastward deviation to Gulf of Aqaba-Dead Sea rift and southwestward deviation to Gulf of Suez rift. Such deviations are controlled by the fault patterns characterizing north and west Sinai provinces.

In a thermal development of a highly fractured carbonate the surface facilities are above the reservoir, and are sensitive to surface deformation. A coupled reservoir-geomechanical model has been history matched to synthetic-aperture radar satellite measurements of the surface uplift that occurred during the pilot, and this will be history matched to the strain measured in a vertical well observing the cap rock during the development. This geomechanical model will be used to generate forecasts of movements that could affect well or facility integrity. The observation well providing data to history match this geomechanical model needs a formation strain measurement insensitive to the steam-induced increasing temperature in the cap rock. As an alternative to dual sensor gamma ray wireline logging of the distance between pairs of radioactive tagged bullets, the permanent installation of optic fibres offers both temperature and strain without intervention, with real-time data. This technique is used to monitor geo-hazards and landslides via the strain of a shallow buried optical sensor cable to monitor onshore pipelines. This is the first time optic fibres are used to acquire measurements of formation strain across an open hole section within an observation well. Laser interrogation of the Brillouin frequency of optic fibre bonded with resin to the inside of a control line demonstrated in the laboratory that the dynamic range of measurable strain is greater than the maximum expected formation deformation. The glass fibre reflected the strain up to the elastic limit of the metallic control line. In the observation well a pre-stressed control line containing resin-bonded optic fibre is stretched across the open hole. This pre-stressing is necessary to provide sensitivity to both negative and positive strain, to measure subsidence as well as thermal expansion. The control line strain will mimic the formation strain, and via the resin glue will pass this strain to the optic fibre that measures strain and temperature. A second free hanging fibre measures the temperature. The Brillouin frequency of optic fibre is sensitive to both strain and temperature, so an independent temperature measurement is required to remove the temperature shift on the strain measurement. These two fibres are deployed inside a specially designed completion. The cap rock is completed open hole, with tubing containing an expansion joint secured to the top and bottom of the cap rock between a packer set at the casing shoe above the cap rock and an open hole swell packer at total depth. A retrievable configuration of several bundled control lines is installed inside this tubing containing the optic fibres and a pair of hydraulically operated tubing anchors. These anchors are spaced out to correspond to the distance between the pair of packers. In a field trial of an in-situ formation strain measurement of a thermal project the completion was run as planned. It is expected that it will be several years before the system measures significant strain.

W UMa türü bir örten çift yıldız olan HV Aqr, 2006 gözlem sezonunda Ankara Üniversitesi Gözlemevi’nde 30 cm çaplı Maksutov-Cassegrain teleskobuyla B ve V bandlarında 4 gece gözlenmiş vesistemin ışık ve renk eğrileri elde edilmiştir. HV Aqr’nin her iki ışık eğrisi, güncel tayfsal kütle oranıdikkate alınarak Wilson-Devinney analiz programıyla modellenmiştir. Analiz sonuçları HV Aqr’nındüşük kütle oranına sahip tipik bir A-türü W UMa örten çift yıldızı olduğunu göstermektedir

We systematically reviewed evidence-based determinants of health-related quality of life (QOL) in adults undergoing epilepsy surgery and assessed the effect of study methods. Medline, Embase, and the Cochrane library (1950–2008) were searched systematically. Two authors independently performed every step of the review. We obtained the proportion of studies reporting statistically significant positive or negative impact on QOL. Of 39 eligible studies, 32 assessed the impact of surgery on QOL and 29 (90.6%) found a significant positive effect. The most prevalent preoperative determinant was psychological function. Seizure freedom was the most prevalent postoperative determinant (80% of studies), followed by antiepileptic drug adverse events, employment status, and psychological function. Psychosocial (95%), physical (91%), and overall QOL (90%) domains improved most frequently, whereas role limitation (63%) and cognition (78%) improved least frequently. Methods, choice of instrument, and time of measurement influenced QOL outcomes and should be carefully chosen in future studies.

Background Diffuse microvascular bleeding remains a common problem after myocardial revascularization with cardiopulmonary bypass. Objectives The efficacy of locally administered tranexamic acid (topical application) was compared with systemically administered tranexamic acid to reduce postoperative bleeding after cardiopulmonary bypass in elective nonredo coronary artery bypass grafting (CABG). Methods The study included 60 patients of both sexes, aged between 35 and 65 years, and scheduled for elective CABG; patients were randomly assigned to two groups: group I (the intravenous tranexamic acid group; 30 patients) and group II (the topical tranexamic acid group; 30 patients). For each patient in each group, postoperative blood loss, number of units of packed red blood cells (RBCs) and fresh frozen plasma (FFP) transfused, frequency of resternotomy, duration of hospital and ICU stay, and mortality were recorded. Results There were statistically significant differences between the two groups with regard to total postoperative blood loss and need for packed RBCs and FFP transfusion, being much greater in group I than in group II. There was no mortality in either group. Frequency of resternotomy was higher in group I than in group II, although the difference was statistically nonsignificant. The duration of hospital and ICU stay revealed no statistically significant differences between the two groups. Conclusion Intraoperative topical administration of tanexamic acid into the pericardial cavity before sternal closure during CABG surgery has reduced the incidence of postoperative blood loss and the need for postoperative packed RBCs and FFP transfusion.