Impact of primary percutaneous coronary intervention on ST-segment elevation myocardial infarction patients:A comprehensive analysis

BACKGROUND Myocardial infarction,particularly ST-segment elevation myocardial infarction(STEMI),is a key global mortality cause.Our study investigated predictors of mortality in 96 STEMI patients undergoing primary percutaneous coronary intervention at Erbil Cardiac Center.Multiple factors were identified influencing in-hospital mortality.Significantly,time from symptom onset to hospital arrival emerged as a decisive factor.Consequently,our study hypothesis is:"Reducing time from symptom onset to hospital arrival significantly improves STEMI prognosis."AIM To determine the key factors influencing mortality rates in STEMI patients.METHODS We studied 96 consecutive STEMI patients undergoing primary percutaneous coronary intervention(PPCI)at the Erbil Cardiac Center.Their clinical histories were compiled,and coronary evaluations were performed via angiography on admission.Data included comorbid conditions,onset of cardiogenic shock,complications during PPCI,and more.Post-discharge,one-month follow-up assessments were completed.Statistical significance was set at P<0.05.RESULTS Our results unearthed several significant findings.The in-hospital and 30-d mortality rates among the 96 STEMI patients were 11.2%and 2.3%respectively.On the investigation of independent predictors of in-hospital mortality,we identified atypical presentation,onset of cardiogenic shock,presence of chronic kidney disease,Thrombolysis In Myocardial Infarction grades 0/1/2,triple vessel disease,ventricular tachycardia/ventricular fibrillation,coronary dissection,and the no-reflow phenomenon.Specifically,the recorded average time from symptom onset to hospital arrival amongst patients who did not survive was significantly longer(6.92±3.86 h)compared to those who survived(3.61±1.67 h),P<0.001.These findings underscore the critical role of timely intervention in improving the survival outcomes of STEMI patients.CONCLUSION Our results affirm that early hospital arrival after symptom onset significantly improves survival rates in STEMI patients,highlighting the critical need for prompt intervention.

The Three Gorges Project and Its Environmetal Impact

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Assessment of impact of water diversion projects on ecological water uses in arid region

In arid regions, large-scale water diversion from rivers leads to significant changes in river flow regimes, which may have large impacts on ecological water uses of river-dependent ecosystems, such as river, lake, wetland, and riparian ecosystems. To assess the integrated impact of water diversion on ecological water uses, we proposed a hierarchy evaluation model composed of four layers representing the evaluation goal, sub-areas of the influenced region, evaluation criteria, and water diversion schemes, respectively. The evaluation criteria for different types of ecological water uses were proposed, and the analytical hierarchy process was used for the integrated assessment. For a river ecosystem, the percentage of mean annual flow was used to define the grade of environmental flow. For a lake ecosystem, water recharge to the lake to compensate the lake water losses was used to assess the ecological water use of a lake. The flooding level of the wetland and the groundwater level in the riparian plain were used to assess the wetland and riparian ecological water uses, respectively. The proposed model was applied to a basin in northern Xinjiang in northwest China, where both water diversion and inter-basin water transfer projects were planned to be carried out. Based on assessment results for the whole study area and two sub-areas, an appropriate scheme was recommended from four planning schemes. With the recommended scheme, ecological water uses of the influenced ecosystems can be maintained at an acceptable level. Meanwhile, economical water requirements can be met to a great extent.

Impact on Mountainous Agricultural Development in the Three Gorges Reservoir Area forced by Migrants of the Three Gorges Project

The Three Gorges Project attracts worldwide attention because of the Three Gorges migrants, and the agriculture of the Three Gorges Reservoir Area is a foundation for the development of the Three Gorges migrants. The Three Gorges Reservoir Area is situated at the mountainous area with bad agricultural development conditions and relatively low levels of development. As a result, the large-scale migration fias special influence on its agricultural development, which has attracted much attention. The paper analyzes influence that the migrants have forced on its agricultural development based on the scientific data, and makes some explorations on the models that are suitable for the development of mountainous agriculture in the Three Gorges Reservoir Area.

Reduced projection augmented Lagrange bi-conjugate gradient method for contact and impact problems

Based on the numerical governing formulation and non-linear complementary conditions of contact and impact problems, a reduced projection augmented Lagrange bi- conjugate gradient method is proposed for contact and impact problems by translating non-linear complementary conditions into equivalent formulation of non-linear program- ming. For contact-impact problems, a larger time-step can be adopted arriving at numer- ical convergence compared with penalty method. By establishment of the impact-contact formulations which are equivalent with original non-linear complementary conditions, a reduced projection augmented Lagrange bi-conjugate gradient method is deduced to im- prove precision and efficiency of numerical solutions. A numerical example shows that the algorithm we suggested is valid and exact.

Health Providers’ Points of View on the Impact of the Project to Strengthen the Expanded Program of Routine Vaccination from 2014 to 2018 in the Barumbu Health Zone in Kinshasa, Democratic Republic of Congo

According to the World Health Organization, approximately 3 million deaths are prevented each year in the world thanks to vaccination and then, in addition, each year, it makes it possible to avoid nearly 750,000 children suffering from serious physical, mental or neurological handicaps and 1.5 million other deaths could be avoided if the vaccination coverage is improved. However, vaccination coverage is often not achieved due to various difficulties encountered by health providers in the expanded program on vaccination activities. Yet, it is important to strengthen the program. This research paper aimed to assess health providers’ points of view on the impact of the project to strengthen the routine expanded program on vaccination in the Barumbu health zone in Kinshasa, Democratic Republic of Congo (RDC). To do so, we surveyed a convenience sample of 234 health providers involved in the implementation of the project, including 210 community relays, 9 permanent nurses, 9 health committee chairpersons and 6 health authorities. A questionnaire related to the objective of the research was submitted to them. After analyzing the data, we found that the points of view of health providers are negative. The performance of the vaccination program was not great. Several reasons were given for this, including the non-involvement of the political and administrative authorities, the failure to respect the funds disbursement circuit and the non-effective financing of vaccination activities in the Barumbu health zone in Kinshasa, DRC.

Community Evaluation and Impact Assessment of Revitalization Project: A Case Study in Hong Kong

With the aim of promoting sustainable conservation and development of historic buildings in Hong Kong, the Hong Kong government introduced the Revitalizing Historic Buildings Through Partnership Scheme in 2007 to conserve and revitalize government-owned historic buildings. Since the announcement of the Revitalization Scheme, many people have criticized that the revitalization projects ended up not for the benefit of the local communities. Based on a completed revitalization project (the former North Kowloon Magistracy building) and situated within the literature of revitalization practices, community involvement, community evaluation, and impact assessment, this paper explored how community involvement with the revitalization project might influence the community’s evaluation of the project’s outcomes. The research found that community connections or involvement with the revitalization project significantly affected the community’s evaluation of the project’s various impacts.

Substituted plan analysis in the environmental impact assessment of Yongchuan wastewater treatment project

Substituted plan in the environmental impact assessment (EIA) mainly means the treatment technology and the substituted site of plant, and it also includes the many kinds of environment protection measures. This paper will make detailed analysis on the treatment technology, the substituted site of plant, the purpose of discharged water and the dispose of sludge in the Yongchuan wastewater treatment project.

A multi-level evaluation model for the recognition and assessment of impact factors associated with intercontinental power interconnection projects

The construction of intercontinental power grid interconnection projects is key to realizing the vision of Global Energy Interconnection,which is to solve global energy problems in a clean and sustainable manner.These projects may be influenced by a few factors that are neither technological nor economic,such as political,social,and international factors.This paper thus presents a multi-level model for recognizing which factor from a compiled list of 14 would impact a particular intercontinental interconnection project and for assessing the degree of the factor’s influence.In the first part of the model,the Analytic Hierarchy Process(AHP)method is used to recognize the project’s most significant impact factors.Using the recognition results,the second part of the model can assess the degree of the factor’s influence on the project based on ratings provided by experts.A comprehensive evaluation can thus be provided.As a case study,the proposed Saudi Arabia-Ethiopia power grid interconnection project connecting Asia and Africa was analyzed.Derived from a combination of multiple opinions from experts,evaluations from the model will be of direct benefit to decision-makers,investors,project implementers,and engineers,providing them with a deeper insight into the project.

Impact of Risk on Performance of Design and Build Projects in Lagos State, Nigeria

＂Design and Build＂ procurement method has been in use in Nigeria and this method has been latent with a lot of risks. This study intends to identify the risk inherent in ＂Design and Build＂ and also to evaluate the impact of the identified risks on project performance. A descriptive research survey is undertaken for this study. Snowballing sampling technique was used via the use of questionnaires. Population of the study includes contracting organizations, consultants and clients＇ organizations that are recently involved in ＂Design and Build＂ projects. A total of 39 questionnaires were distributed and 27 were returned and used for the analysis. Statistical Package for Social Sciences was used for analyzing the data collected. Descriptive statistical tool of mean item score was employed for the analysis. The results show that the most prominent risk is change in quantity/scope of work in terms of cost related risk while in terms of time related risks the most prominent risk is design changes. Errors and omissions during construction are the risks prominent in terms of quality. In conclusion, ＂Design and Build＂ procurement has a lot of inherent, unresolved and undefined cost, time and quality related factors that can trigger off risks that will affect performance of DB project. Implications of this study to practitioners in the construction is such that the findings of this study can create awareness for stakeholders and construction practitioners of the prominent risks that affect DB projects and this can help in better management of future DB projects in Nigeria and other developing countries. Design and Build procurement in spite of these plethora of risks is still strongly recommended for clients, stakeholders and other practitioners in the construction industry for use in their future projects. This procurement method delivers project faster, within cost and offers good quality of workmanship and product to users of this method.

Application of 3D Projection Profilometry in the High Speed Impaction Surface Deformation Measurement Research

In order to study the strength of the composite material plate problems, need to adopt a nondestructive testing method to obtain the specimen surface under the effect of high-speed impact regularity of shape. The projection profilometry was used to measure the surface profile or the full field deformation. Furtherly, by using the Fourier transform algorithm, there is only one frame of captured image which is needed in the measurement, so that it can be introduced into the high speed impaction procedure measurement. An experimental system, which was contained with an impact setup and the projection profilometry measurement part, was constructed for the impaction action characteristic research. The metallic impact object can be launched by a gas gun or a spin fan, respectively. The detected object is manufactured by composite materials. In order to increase the surface deformation measurement accuracy, the calibration method and the error was discussed with different calibration specimen. And then, the proposed profilometry measurement method is proved by the gas gun and spin fan projectile test. The surface deformation of the manufactured composite plates and fan case are measured in the impaction procedure. So that the impact action details can be described much more clearly than the traditional video monitoring method.

Socioeconomic Impact of Small Water Impounding Projects in Quirino Province, Philippines

The study was conducted to determine the socioeconomic impact two (2) Small Water Impounding Projects (SWIPs) namely Burgos SWIP in Cabarroguis and Divisoria Norte SWIP in Maddela, both in the Province of Quirino, Philippines. The study made use of structured questionnaire to gather the socio-demographic profile and determined the socioeconomic impact of the SWIPs to the farmer-beneficiaries. Most of the farmer-beneficiaries of Burgos and Divisoria Norte SWIPs are male, 40 - 59 years old, married, have below four household members, Roman Catholic, high school graduates and some are members of cooperatives. They are rice farmers, and have attended one to two training courses related to farming and own a 1.00 to 1.99 hectares farm. “Utilization of water in the reservoir for other purposes like wallowing pool for carabaos” and “integration of fish production and livestock raising” were the identified benefits at the farmer’s level while “introduction of new techniques in farming by the Local Government Units,” “availability of cheap fish and additional income as a result of integration of fish production” and “construction of better roads” were the identified benefits at the community level. The SWIPs have positive impact as confirmed by the increase in the annual mean yield and in the annual gross income of the farmer-beneficiaries. It contributed a significant increase of 2.14 tons/year in the mean yield generating an additional income of PhP 32,113.64 for Burgos SWIP. On the other hand, it contributed a significant increase of 2.08 tons/year giving an additional income of PhP 31,313.60 for Divisoria Norte farmer-beneficiaries. The result of this study will provide strategic information to policy makers of agricultural and irrigation agencies on the existing weaknesses of irrigation systems in the country and determine in a more quantifiable terms level of potential improvement and investment targets.

Traffic Impact on Incentive Contracting Project Time Performance during Highway Construction

The volume of highway traffic in the United States continues to increase. In the face of this there is a concomitant need to improve and repair transportation infrastructure. Construction frequently requires a reduction in capacity during construction activity; consequently road users as well as adjacent businesses must endure the delays and inconveniences associated with transportation construction. Recognizing the problems that construction can produce, state highway agencies （SHAs） have continually sought ways to minimize the negative impact from their construction operations. Incentive contracting has played an important role in this effort to improve project performance. The Florida Department of Transportation （FDOT） is one of the leading SHAs using such innovative contracting methods as Incentive/Disincentive （I/D）, A＋B （cost plus time bidding） combined with I/D, No Excuse Bonus, and Liquidated Savings. This paper analyzes the traffic impact on incentive project time performance using highway construction projects recently completed in Florida. Project data obtained from FDOT were evaluated using time performance indices. A survey of traffic impact on project work types was performed in Florida in order to evaluate the relationship between construction project types and road traffic influence during construction. Based on the survey results, the 38 most frequently used work types in Florida during the study period were categorized into three traffic impact levels： （1） high traffic impact, （2） medium traffic impact, and （3） low traffic impact. Statistical analysis was performed. The results show that there are significant differences on project time performance between low and high impact levels as well as low and medium impact levels.

Landscape Visual Environment Impact Analysis of Wind Power Project in Plain Region--Case in One Wind Power Farm Project of Zhanjiang

The construction of wind power project is conducive to saving energy,reducing emissions and regulating energy structure. But it inevitably causes some impacts on the environment in the construction process. Because that the height of wind power generator generally exceeds 100 m,and visual range in plain region is farther,it is necessary to scientifically and rationally evaluate and analyze landscape visual environment impact of wind power generator in plain region. One wind power farm project of Zhanjiang is located in typical plain region of Guangdong coast. Referring to traditional analytic method of landscape visual impact and comparing with actual situation for the same kind of project in the region,results show that it is ＂ extremely sensitive＂ area at 0- 2. 5 km from wind power generator, ＂ very sensitive＂ area at 2. 5- 5. 0 km, ＂ sensitive＂ area at 5- 10 km, ＂generally sensitive＂ area at 10- 20 km,and non-sensitive area outside 20 km.

Assessment of Impacts of Public Health Interventions on the SARS Epidemic in Beijing in Terms of the Intervals Between Its Symptom Onset, Hospital Admission, and Notification

Objectives To assess the impacts of public health interventions on the outbreak of SARS in Beijing by analyzing the intervals between symptom onset, hospital admission and notification of its cases. Methods Data of SARS cases reported from the Beijing Municipal Centers for Disease Prevention and Control (BCDC) were collected and analyzed by descriptive epidemiology. Results In the early epidemic period, the intervals between the disease onset and the hospital admission seemed irregular, so was the intervals between the hospital admission and the notification. After the middle ten days of April, the intervals turned out to be more regular, and the disordered situation in terms of the hospital admission and the case notification was gradually brought under control. Conclusions Public health interventions against SARS has revealed positive impacts on SARS control program in Beijing. The timing and sensitivity of epidemic information reporting systems has been greatly improved in Beijing as a result of successful fight against this disease.

Impacts and risks of“realistic”global warming projections for the 21st century

The IPCC AR6 assessment of the impacts and risks associated with projected climate changes for the 21st century is both alarming and ambiguous.According to computer projections,global surface temperature may warm from 1.3℃to 8.0℃by 2100,depending on the global climate model(GCM)and the shared socioeconomic pathway(SSP)scenario used for the simulations.Actual climate-change hazards are estimated to be high and very high if the global surface temperature rises,respectively,more than 2.0℃and 3.0℃above pre-industrial levels.Recent studies,however,showed that a substantial number of CMIP6 GCMs run“too hot”because they appear to be too sensitive to radiative forcing,and that the high/extreme emission scenarios SSP3-7.0 and SSP5-8.5 are to be rejected because judged to be unlikely and highly unlikely,respectively.Yet,the IPCC AR6 mostly focused on such alarmistic scenarios for risk assessments.This paper examines the impacts and risks of“realistic”climate change projections for the 21st century generated by assessing the theoretical models and integrating them with the existing empirical knowledge on global warming and the various natural cycles of climate change that have been recorded by a variety of scientists and historians.This is achieved by combining the SSP2-4.5 scenario(which is the most likely SSP according to the current policies reported by the International Energy Agency)and empirically optimized climate modeling.According to recent research,the GCM macro-ensemble that best hindcast the global surface warming observed from 1980 to 1990 to 2012–2022 should be made up of models that are characterized by a low equilibrium climate sensitivity(ECS)(1.5℃<ECS≤3.0℃),in contrast to the IPCC AR6 likely and very likely ECS ranges at 2.5–4.0℃and 2.0–5.0℃,respectively.I show that the low-ECS macro-GCM with the SSP2-4.5 scenario projects a global surface temperature warming of 1.68–3.09℃by 2080–2100 instead of 1.98–3.82℃obtained with the GCMs with ECS in the 2.5–4.0℃range.However,if the global surface temperature records are affected by significant non-climatic warm biases—as suggested by satellite-based lower troposphere temperature records and current studies on urban heat island effects—the same climate simulations should be scaled down by about 30%,resulting in a warming of about 1.18–2.16℃by 2080–2100.Furthermore,similar moderate warming estimates(1.15–2.52℃)are also projected by alternative empirically derived models that aim to recreate the decadal-to-millennial natural climatic oscillations,which the GCMs do not reproduce.The proposed methodologies aim to simulate hypothetical models supposed to optimally hindcast the actual available data.The obtained climate projections show that the expected global surface warming for the 21st-century will likely be mild,that is,no more than 2.5–3.0℃and,on average,likely below the 2.0℃threshold.This should allow for the mitigation and management of the most dangerous climate-change related hazards through appropriate low-cost adaptation policies.In conclusion,enforcing expensive decarbonization and net-zero emission scenarios,such as SSP1-2.6,is not required because the Paris Agreement temperature target of keeping global warming<2℃throughout the 21st century should be compatible also with moderate and pragmatic shared socioeconomic pathways such as the SSP2-4.5.

The Comfortable Housing Project and Its Impact on Housing Reform

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Coping and Constructing: A Narrative Perspective on Project Dynamics

Recent studies on collaborative practices in large infrastructural projects address the importance of discursive strategies and power relations in dynamic project arenas [1]-[3]. This paper focuses on the coping narratives developed by contract team members during the building phase of a large-scale infrastructural project. Coping narratives relate to the management based grand narrative of the project and are produced and shaped in the process of sense making. By analyzing this interaction and the developments in a specific sub-team of a project, which is faced with multiple identity claims, this paper aims to contribute to the knowledge on how policies, views and decisions on an organizational level work out in project teams. The empirical material relates to a recent Dutch Mega-Project regarding the construction of a new sea defense and boulevard in Scheveningen. This paper shows that developments, discourses and decisions on an organizational level are of importance for the commencing coping narratives in project teams.