| 1. |
- Ademuyiwa, Adesoji O., et al.
(author)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Journal article (peer-reviewed)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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| 7. |
- Bakhit, Yousuf, et al.
(author)
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Intrafamilial and interfamilial heterogeneity of PINK1-associated Parkinson's disease in Sudan
- 2023
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In: Parkinsonism & Related Disorders. - : Elsevier. - 1353-8020 .- 1873-5126. ; 111
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Journal article (peer-reviewed)abstract
- PINK1 is the second most predominant gene associated with autosomal recessive Parkinson's disease. Homo-zygous mutations in this gene are associated with an early onset of symptoms. Bradykinesia, tremors, and rigidity are common features, while dystonia, motor fluctuation, and non-motor symptoms occur in a lower percentage of cases and usually respond well to levodopa. We investigated 14 individuals with parkinsonism and eleven symptom-free siblings from three consanguineous Sudanese families, two of them multigenerational, using a custom gene panel screening 34 genes, 27 risk variants, and 8 candidate genes associated with parkinsonism. We found a known pathogenic nonsense PINK1 variant (NM_032409.3:c.1366C>T; p.(Gln456*)), a novel pathogenic single base duplication (NM_032409.3:c.1597dup; p.(Gln533Profs*29)), and another novel pathogenic insertion (NM_032409.3:c.1448_1449ins[1429_1443; TTGAG]; p.(Arg483Serfs*7)). All variants were homozygous and co -segregated in all affected family members. We also identified intrafamilial and interfamilial phenotypic het-erogeneity associated with PINK1 mutations in these Sudanese cases, possibly reflecting the nature of the Sudanese population that has a large effective population size, which suggests a higher possibility of novel findings in monogenic and polygenic diseases in Sudan.
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| 8. |
- Elsayed, Mohamed Hammad, et al.
(author)
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Overcoming small-bandgap charge recombination in visible and NIR-light-driven hydrogen evolution by engineering the polymer photocatalyst structure
- 2024
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In: Nature Communications. - 2041-1723. ; 15:1
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Journal article (peer-reviewed)abstract
- Designing an organic polymer photocatalyst for efficient hydrogen evolution with visible and near-infrared (NIR) light activity is still a major challenge. Unlike the common behavior of gradually increasing the charge recombination while shrinking the bandgap, we present here a series of polymer nanoparticles (Pdots) based on ITIC and BTIC units with different π-linkers between the acceptor-donor-acceptor (A-D-A) repeated moieties of the polymer. These polymers act as an efficient single polymer photocatalyst for H2 evolution under both visible and NIR light, without combining or hybridizing with other materials. Importantly, the difluorothiophene (ThF) π-linker facilitates the charge transfer between acceptors of different repeated moieties (A-D-A-(π-Linker)-A-D-A), leading to the enhancement of charge separation between D and A. As a result, the PITIC-ThF Pdots exhibit superior hydrogen evolution rates of 279 µmol/h and 20.5 µmol/h with visible (>420 nm) and NIR (>780 nm) light irradiation, respectively. Furthermore, PITIC-ThF Pdots exhibit a promising apparent quantum yield (AQY) at 700 nm (4.76%).
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| 9. |
- Girgis, Adel S., et al.
(author)
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Synthesis and DFT studies of an antitumor active spiro-oxindole
- 2015
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In: New Journal of Chemistry. - : Royal Society of Chemistry (RSC). - 1144-0546 .- 1369-9261. ; 39:10, s. 8017-8027
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Journal article (peer-reviewed)abstract
- An anti-oncological active spiro-oxindole 7 was synthesized regioselectively via a [3+2]-cycloaddition reaction of azomethine ylide to exocyclic olefinic linkage of 4-piperidone 6, exhibiting properties against diverse tumor cell lines including leukemia, melanoma and cancers of the lung, colon, brain, ovary, breast, prostate, and kidney. Compound 7 crystallizes in the monoclinic system and P21/c space group with four molecules in the unit cell. The structure was also studied by AM1, PM3 and DFT techniques. DFT studies support the stereochemical selectivity of the reaction and determine the molecular electrostatic potential and frontier molecular orbitals.
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| 10. |
- Swed, Sarya, et al.
(author)
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Parents' acceptance to vaccinate children against COVID-19 : A Syrian online survey
- 2022
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In: Frontiers In Public Health. - : Frontiers Media SA. - 2296-2565. ; 10
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Journal article (peer-reviewed)abstract
- After the widespread of COVID-19 virus worldwide, vaccination targeted reducing spread of cases and mortality rates. However, vaccination hesitancy was observed among the communities worldwide. Vaccination hesitancy involved parents regarding the decision of vaccinating their children- After obtaining ethical approval, an online cross-sectional study was conducted from 1 March to 22 April 2021 to evaluate the parents' acceptance of vaccinating their children against the COVID-19 virus in Syria. Data were analyzed using descriptive and multivariate logistic regression analysis in IBM, SPSS V. 28.0 package program (IBM Corporation, Armonk, NY, USA). Among 283 participants, 105 participants agreed to vaccinate their children, and 178 were not. A significant correlation between age and vaccine willingness was found (P-value < 0.0001*), especially in the age group between 18 and 30 years old (45.2%). Parents who accepted vaccinating themselves were more willing to vaccinate their children (34.6%). According to our results, there is a greater need to enhance awareness and knowledge programs about the vaccine's effectiveness and encourage parents to accept giving the vaccine to their children.
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| 11. |
- Abduljaleel, Yasir, et al.
(author)
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Assessment of Subsurface Drainage Strategies Using DRAINMOD Model for Sustainable Agriculture: A Review
- 2023
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In: Sustainability. - : MDPI. - 2071-1050. ; 15:2
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Research review (peer-reviewed)abstract
- Practicing agricultural drainage strategies is necessary to manage excess water in poorly drained irrigated agricultural lands to protect them from induced waterlogging and salinity problems. This paper provides an overview of subsurface drainage strategies and the modeling of their performance using the DRAINMOD model. Given that the DRAINMOD model considers a fixed value of the surface depression capacity (SDC) for the whole simulation period, which does not suit many agricultural practices, the paper then assesses the model’s performance under time-variable SDC. It was revealed that adopting a fixed value of SDC for the whole simulation period in the DRAINMOD model causes it to produce improper predictions of the water balance in farmlands characterized by time-variable SDC. Such a model drawback will also adversely impact its predictions of the nitrogen and phosphorus fate in farmlands, which represent major inputs when managing both the agricultural process and agricultural water quality. Researchers should pay attention when applying the DRAINMOD model to farmlands characterized by time-variable SDC. Moreover, it is recommended that the DRAINMOD input module be improved by considering changes in SDC during the simulation period to ensure better management of the agricultural process and agricultural water.
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| 12. |
- Ahmed, Hesham, et al.
(author)
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Alternative Reducing Agents for Sustainable Blast Furnace Ironmaking
- 2017
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In: ESTAD 2017.
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Conference paper (peer-reviewed)abstract
- Lowering of CO2 emission from the integrated steel industry as well as minimizing theneed for landfill are important challenges in the focus for the integrated steel industry. With thisaim collaborative research projects have been conducted and are on-going on the possible useof renewable reducing agents or such with high content of H2 as well as for enabling recyclingof 1in-plant fines so far not possible to use. Due to contents of undesired impurities the blastfurnace (BF) sludge has to be pre-treated in an appropriate way before carbon and iron oxidecan be valorized. In order to understand the impact of alternative reducing agents as injectedthrough the tuyeres or part of top charged agglomerates containing iron oxide, samples oftorrefied biomass, plastic and in-plant fines have been analyzed by means of thermogravimetricanalyzer coupled with a mass spectrometer (TGA-MS).The results proved that effective utilization of carbon bearing BF dust and sludge as analternate reducing agent could be realized and can be implemented into BF after adequateupgrading. Plastic materials and biomass based reductants decomposition is associated with therelease of volatiles. The main contents of these volatiles are CO, H2 and hydrocarbon which areall known for their reduction potential. Moreover, injection of such materials is expected toimprove process efficiency and sustain the gas permeability along the BF cohesive zone. Onthe other hand, top charging of these materials would improve the energy and materialefficiency in the BF due to their higher reactivity compared to conventional carbon.
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| 13. |
- Akay, Alpaslan, 1975, et al.
(author)
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Everybody’s a Victim? Global Terror, Well-Being and Political Attitudes
- 2018
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Reports (other academic/artistic)abstract
- Terror has become a global issue. Terror acts perpetuated by religious, nationalist or political groups around the globe can propagate distress rapidly through different channels and possibly change political attitudes. This paper suggests the first evaluation of the impact of global terror on human welfare. We combine panel datasets for Australia, Germany, Russia, Switzerland, the UK and the US. Individual well-being information for 750,000 individual x year observations, recorded on precise dates, is matched with daily information on the 70,000 terror events that took place worldwide during 1994-2013. High-frequency data and quasi-random terror shocks of varying intensity provide the conditions for robust inference, while external validity is guaranteed by the use of large representative samples. We find a significantly negative effect of global terror on well-being, with a money-metric cost of around 6% - 17% of national income. Among diffusion channels, stock markets and economic anticipations play a minimal role, while traditional media filter the most salient events. The effect is greatly modulated by the physical, genetic or cultural proximity to the terror regions/victims. For a subset of countries, we also show that global terror has significantly increased the intention to vote for conservative parties. Heterogeneity analyses point to the mediating effect of risk perception: individuals who exhibit stronger emotional responses to terror impossibly more exposed to potential threats - are also more likely to experience a conservative shift.
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| 14. |
- Andersson, Anton, et al.
(author)
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The Potential of Recycling the High-Zinc Fraction of Upgraded BF Sludge to the Desulfurization Plant and Basic Oxygen Furnace
- 2018
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In: Metals. - : MDPI. - 2075-4701. ; 8:12
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Journal article (peer-reviewed)abstract
- In ore-based steelmaking, blast furnace (BF) dust is generally recycled to the BF via the sinter or cold-bonded briquettes and injection. In order to recycle the BF sludge to the BF, the sludge has to be upgraded, removing zinc. The literature reports cases of recycling the low-zinc fraction of upgraded BF sludge to the BF. However, research towards recycling of the high-zinc fraction of BF sludge within the ore-based steel plant is limited. In the present paper, the high-zinc fraction of tornado-treated BF sludge was incorporated in self-reducing cold-bonded briquettes and pellets. Each type of agglomerate was individually subjected to technical-scale smelting reduction experiments aiming to study the feasibility of recycling in-plant residues to the hot metal (HM) desulfurization (deS) plant. The endothermic reactions within the briquettes decreased the heating and reduction rate leaving the briquettes unreduced and unmelted. The pellets were completely reduced within eight minutes of contact with HM but still showed melt-in problems. Cold-bonded briquettes, without BF sludge, were charged in industrial-scale trials to study the recycling potential to the HM deS plant and basic oxygen furnace (BOF). The trials illustrated a potential for the complete recycling of the high-zinc fraction of BF sludge. However, further studies were identified to be required to verify these results.
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| 15. |
- Bakhiet, Salaheldin Fararh, et al.
(author)
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Sex and national differences in internet addiction in Egypt and Saudi Arabia
- 2023
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In: Acta Psychologica. - : Elsevier. - 0001-6918 .- 1873-6297. ; 240
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Journal article (peer-reviewed)abstract
- Background: Understanding individual differences in psychology, and how they relate to specific addictions, may allow society to better identify those at most risk and even enact policies to ameliorate them. Internet addiction is a growing health concern, a research focus of which is to understand individual differences and the psychology of those most susceptible to developing it. Western countries are strongly overrepresented in this regard.Method: Here, sex and national differences in internet addiction are measured, using Young's ‘Internet Addiction Test,’ in two non-Western countries, Egypt and Saudi Arabia. >800 students aged 18 and 35 years (M = 20.65, SD = 1.48) completed a multidimensional internet addiction instrument. The instrument measures traits such as Withdrawal and Social Problems, Time Management and Performance and Reality Substitute.Results: Analyses revealed that males scored higher than females and Saudis higher than Egyptians on nearly all scales, including the total score. Factor analysis of the 20-item instrument revealed three factors, all exhibiting sex and culture differences.Conclusions: These findings add to the body of evidence that males are higher than females in problematic internet use, as they are in addictive behaviors in general. Our findings may also imply that restrictions on male-female interaction, which are more pronounced in Saudi Arabia, may elevate the prevalence of internet addiction. The internet is also easier and cheaper to access in Saudi Arabia than in Egypt.
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| 16. |
- Bandiera, Oriana, et al.
(author)
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Young Adults and Labor Markets in Africa
- 2022
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In: Journal of Economic Perspectives. - : American Economic Association. - 1944-7965 .- 0895-3309. ; 36:1, s. 81-100
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Journal article (peer-reviewed)abstract
- Every year, millions of young adults join the labor market in Africa. This paper harmonizes surveys and censuses from 68 low- and middle-income countries to compare their job prospects to those of their counterparts in other low-income regions. We show that employment rates are similar at similar levels of development but that young adults in Africa are less likely to have a salaried job, especially when the size of their cohort is large. Building on existing evidence on the impacts of interventions targeting both the demand and supply sides of the labor market, we discuss policy priorities for boosting the growth of salaried job creation in the region.
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| 17. |
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Data and Code for : Youths, Jobs and the Development of Africa
- 2022
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Other publication (other academic/artistic)abstract
- Today, one in five youths who enter the labor market is born in Africa. By 2050, it will be one in three. The record figure of young Africans seeking employment is the outcome of different fertility trends across the world: fertility has been falling everywhere, but much more slowly in Africa. This paper present evidence on the labor market consequences of these differences for the young labor market entrants in Africa, compared to older generations and to their counterparts in other low- and middle-income regions of the world. We study how job opportunities depend on the demographic structure and which policies can be implemented to counteract the demographic pressure.
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| 18. |
- Ellabban, Mohamed A., et al.
(author)
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Virtual planning of the anterolateral thigh free flap for heel reconstruction
- 2022
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In: Microsurgery. - : WILEY. - 0738-1085 .- 1098-2752. ; 42:5, s. 460-469
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Journal article (peer-reviewed)abstract
- Purpose three dimensional (3-D) virtual planning is an example of computer assisted surgery that improved management of composite tissue defects. However, converting the 3-D construct into two dimensional format is challenging. The purpose of this study was to assess 3-D virtual planning of complex heel defects for better optimized reconstruction. Patients and methods a prospective analysis of 10 patients [9 male and 1 female; mean age = 27.9 years] with post-traumatic heel defects was performed. Heel defects comprised types II (three patients) or III (seven patients) according to Hidalgo and Shaw and were managed using anterolateral thigh (ALT) free flap adopting 3-D virtual planning of the actual defect which was converted into a silicone two dimensional mold. The mean definitive size of the defects was 63.4 cm(3). Functional, aesthetic, and sensory evaluations of both donor and recipient sites were performed 1 year after surgery. Results Six patients received thinned ALT (mean size = 139 cm(3)) while four patients received musculofasciocutaneous ALT flap (mean size = 199 cm(3)). One flap exhibited partial skin flap necrosis. Another flap was salvaged after re-exploration secondary to venous congestion. The mean follow-up was 20.2 months. The Maryland foot score showed 4 excellent, 5 good, and 1 fair cases. The mean American Orthopedic Foot and Ankle hind foot scoring was 76.3 (range: 69-86). All patients regained their walking capability. Conclusions 3-D virtual planning of complex heel defects facilitates covering non-elliptical defects while harvesting a conventional elliptical flap with providing satisfactory functional outcomes and near-normal contour, volume, and sensibility.
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| 19. |
- Elsadek, Mohamed, et al.
(author)
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Green approach to ironmaking: Briquetting and hydrogen reduction of mill scale using novel binders
- 2024
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In: International journal of hydrogen energy. - : Elsevier Ltd. - 0360-3199 .- 1879-3487. ; 62, s. 732-738
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Journal article (peer-reviewed)abstract
- The most prominent solutions are the establishment of a circular economy by recirculating the iron-rich residues from steelworks and the adoption of hydrogen as a clean reducing agent to mitigate fossil CO2 emission. One such residue is mill scale, which is generated during steelmaking, casting, and rolling processes. However, the fine particles and easy reoxidation of the mill scale make it difficult to be used directly in iron and steel production without proper compaction. This paper aims to demonstrate the feasibility of mill scale briquetting using organic binders to meet the requirements of hydrogen-based direct reduction. The study will investigate the influence of binder type, binder dosage, moisture content, and compaction pressure on the briquetting process and the briquettes quality. Moreover, the reducibility of optimized briquettes will be examined by hydrogen at 900 °C using a thermogravimetric analyzer coupled with a quadrupole mass spectroscopy (TGA-QMS). The optimal combination for achieving the best mechanical strength and reducibility was a briquette produced with 1% Alcotac® CB6, 1% KemPel, and 2.5% moisture content, compressed at a pressure of 125 kN.
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| 20. |
- Elsayed, Ahmed H., et al.
(author)
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Multilayer information spillover networks between oil shocks and banking sectors: Evidence from oil-rich countries
- 2023
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In: International Review of Financial Analysis. - : ELSEVIER SCIENCE INC. - 1057-5219 .- 1873-8079. ; 87
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Journal article (peer-reviewed)abstract
- There is no doubt that oil price shocks significantly affect oil-producing countries macroeconomic fundamentals and financial stability, mainly in crisis times. The recent oil price shocks, coupled with the COVID-19 pandemic, motivated us to investigate the connectedness and risk transmission among oil shocks and banking sectors in the Gulf Cooperation Council (GCC) economies from June 30, 2006, to September 9, 2021. Thus, we construct multilayer information spillover networks between oil price shocks and GCC banking sectors. The empirical results show that the Bahrain banking sector depicts the highest connectedness and risk transmission with oil price shocks on the extreme risk spillover layer. In addition, Kuwait and the United Arab Emirates are highly connected to oil demand shocks. Furthermore, we find a substantial increase in extreme risk spillover and volatility spillover layers during the COVID-19 period. The results of this paper have some important implica-tions for regional portfolio risk management, alleviating systemic risk, and developing hedging and investment strategies.
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| 21. |
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| 22. |
- Elsayed, Mohamed Hammad, et al.
(author)
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Hydrophobic and Hydrophilic Conjugated Polymer Dots as Binary Photocatalysts for Enhanced Visible-Light-Driven Hydrogen Evolution through Forster Resonance Energy Transfer
- 2021
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In: ACS Applied Materials and Interfaces. - : American Chemical Society (ACS). - 1944-8244 .- 1944-8252. ; 13:47, s. 56554-56565
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Journal article (peer-reviewed)abstract
- Organic semiconducting polymers exhibited promising photocatalytic behavior for hydrogen (H-2) evolution, especially when prepared in the form of polymer dots (Pdots). However, the Pdot structures were formed using common nonconjugated amphiphilic polymers, which have a negative effect on charge transfer between photocatalysts and reactants and are unable to participate in the photocatalytic reaction. This study presents a new strategy for constructing binary Pdot photocatalysts by replacing the nonconjugated amphiphilic polymer typically employed in the preparation of polymer nanoparticles (Pdots) with a low-molecular-weight conjugated polyelectrolyte. The as-prepared polyelectrolyte/hydrophobic polymer-based binary Pdots truly enhance the electron transfer between the Pt cocatalyst and the polymer photocatalyst with good water dispersibility. Moreover, unlike the nonconjugated amphiphilic polymer, the photophysics and mechanism of this photocatalytic system through time-correlated single-photon counting (TCSPC) and transient absorption (TA) measurements confirmed the Forster resonance energy transfer (FRET) between the polyelectrolyte as a donor and the hydrophobic polymer as an acceptor. As a result, the designated binary Pdot photocatalysts significantly enhanced the hydrogen evolution rate (HER) of 43 900 mu mol g(-1) h(-1) (63.5 mu mol h(-1), at 420 nm) for PTTPA/PFTBTA Pdots under visible-light irradiation.
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| 23. |
- Elsayed, Mohamed Hammad, et al.
(author)
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Visible-light-driven hydrogen evolution using nitrogen-doped carbon quantum dot-implanted polymer dots as metal-free photocatalysts
- 2021
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In: Applied Catalysis B: Environmental. - : Elsevier BV. - 0926-3373. ; 283
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Journal article (peer-reviewed)abstract
- Given the photocatalytic properties of semiconducting polymers and carbon quantum dots (CQDs), we report a new structure for a metal-free photocatalytic system with a promising efficiency for hydrogen production through the combination of an organic semiconducting polymer (PFTBTA) and N-doped carbon quantum dots (NCQDs) covered by PS-PEGCOOH to produce heterostructured photocatalysts in the form of polymer dots (Pdots). This design could provide strong interactions between the two materials owing to the space confinement effect in nanometer-sized Pdots. Small particle size NCQDs are easy to insert inside the Pdot, which leads to an increase in the stability of the Pdot structure and enhances the hydrogen evolution rate by approximately 5-fold over that of pure PFTBTA Pdots. The photophysics and the mechanism behind the catalytic activity of our design are investigated by transient absorption measurement, demonstrating the role of NCQDs to enhance the charge separation and the photocatalytic efficiency of the PFTBTA Pdot.
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| 24. |
- Gabr, Mohamed Elsayed, et al.
(author)
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Proposing a Wetland-Based Economic Approach for Wastewater Treatment in Arid Regions as an Alternative Irrigation Water Source
- 2023
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In: Hydrology. - : MDPI. - 2306-5338. ; 10:1
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Journal article (peer-reviewed)abstract
- Point and nonpoint wastewater sources have a detrimental, negative effect on agriculture, soil, surface, and groundwater supplies. In this research, a wastewater treatment system made up of a sedimentation tank, a horizontal subsurface flow constructed wetland (HSSF-CW), a vertical subsurface flow constructed wetland (VF-CW), and a storage tank was proposed, designed, and cost estimated. Small populations in underdeveloped nations with dry and semi-arid climates can use the treatment system as an affordable construction, maintenance, and operational solution for wastewater treatment. The system will protect agricultural lands and groundwater from pollution. The system can service 6000 capita and has a wastewater discharge of 780 m3/d in the developing arid region in El-Moghra Oasis western desert of Egypt, where the 1.5 million acres used for the land reclamation project based on groundwater irrigation. The relaxed tanks in a series model based on the areal loading rates and background pollutants concentrations (P-K-C*) was utilized to size the HSSF and VF-CWs. The results indicated that the HSSF-CW design treatment surface area was 2375 m2, and the hydraulic surface loading (q) and hydraulic retention time (RT) were 0.33 m/d and 0.55 d, respectively, and utilizing Phragmites australis and Papyrus for the biological treatment. The expected overall cumulative removal efficiencies were 96.7, 70, and 100% for the biological oxygen demand (BOD), total phosphors (TP), and fecal coliforms (FC), respectively. The VF-CW indicates that there was a 2193 m2 design treatment surface area, q = 0.36 m/d, and RT of 0.63 d. The expected BOD, TP, and FC removal efficiencies were 75, 33.3, and 92.7%, respectively. In order to simplify the design stages and the cost estimation, design and investment cost curves were established for a population range from 500 to 9000. The total monthly water loss due to evapotranspiration for the HSSF and VF-CWs indicates a range from 3.7 to 8.5%, respectively. The total investment cost analysis for the proposed system corresponding to 780 m3/d wastewater discharge of indicates a total investment cost of EUR 146,804 and EUR 24.46/per-capita equivalent (P.E). This approach can be used by decision makers in the Mediterranean region and Middle Eastern countries to improve the water quality using social and economic criteria, leading to the effective implementation of ecological restoration projects as a low-cost treatment system and adding a nonconventional water source that can be used in irrigation.
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| 25. |
- Karaye, Kamilu M., et al.
(author)
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Clinical Profiles and Outcomes of Heart Failure in Five African Countries : Results from INTER-CHF Study
- 2021
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In: GLOBAL HEALTH. - : Ubiquity Press. - 2211-8160 .- 2308-4553 .- 2211-8179. ; 16:1
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Journal article (peer-reviewed)abstract
- Background: A wide knowledge gap exists on the clinical profiles and outcomes of heart failure (HF) in sub-Saharan Africa.Objectives: To determine the clinical profiles and outcomes of HF patients from five African countries.Methods: The INTERnational Congestive Heart Failure Study (INTER-CHF) is a prospective, multicenter cohort study. A total of 1,294 HF patients were consecutively recruited from Nigeria (383 patients), South Africa (169 patients), Sudan (501 patients), Uganda (151patients), and Mozambique (90 patients). HF was defined according to the Boston criteria for diagnosis. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) score.Results: Of the 1294 patients, 51.4% were recruited as out-patients, 53.7% had HF with reduced ejection fraction (EF), 30.1% had HF with mid-range EF and 16.2% had HF with preserved EF (16.2%). The commonest etiologies of HF were hypertensive heart disease (35%) and ischemic heart disease (20%). The mean MoCA score was highest in Uganda (24.3 +/- 1.1) and lowest in Sudan (13.6 +/- 0.3). Prescriptions for guideline-recommended HF therapies were poor; only 1.2% of South African patients received an Implantable Cardioverter Defibrillator, and none of the patients received Cardiac Resynchronised Therapy. The composite outcome of death or HF hospitalization at one year among the patients was highest in Sudan (59.7%) and lowest in Mozambique (21.1%). Six variables were associated with higher mortality risk, while digoxin use (adjusted hazard ratio [aHR]: 0.69; 95% confidence interval [CI]: 0.49-0.97; p = 0.034) and 10mmHg unit increase in systolic blood pressure (aHR 0.86; 95%CI 0.81-0.93; p < 0.001) were associated with lower risk for mortality.Conclusions: This is the largest HF study in Africa that included in- and out-patients from the West, East, North, Central and South African sub-regions. Clinically relevant differences, including cognitive functional impairment, were found between the involved countries.
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