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It has been over three decades since the term “sustainable development” was coined in Brundtland’s report in 1987, and 28 years have passed since the world’s first sustainability assessment method for buildings was founded by the Building Research Establishment in UK in 1990. During these three decades, many sustainability standards, codes, and rating systems were created and used to help in designing, constructing, maintaining, rating, and labeling buildings with attaining the principles of sustainability. Yet by looking at the Arab world at the beginning of 2019, one can argue that, although the Arab countries have dedicated the effort and budget to save energy, water, and natural resources, the region as a whole is still struggling to shift the paradigm of the building industry from conventional to sustainable. This struggle raises some questions; are there any challenges that Arab countries must overcome to leap forward to a prosperous sustainable building design and construction practices? Why are existing green building rating systems such as Estidama in United Arab Emirates, global sustainability assessment system (GSAS) in Qatar, and ARZ in Lebanon lagging behind the trends of green building rating systems in the developed countries? What are the coordinated steps needed to expedite this movement across the region? The current study explores the limits and potentials of the green building industry in the Arab world through analysis of the green building initiatives, academic scholarship activities in architecture and engineering sectors, and feedback from green building professionals across the Arab world. This article introduces a theoretical framework to expedite the green building movement in the Arab region; the framework is shaped by the environmental, social, and economic factors that are crucial to the transformation of the building industry from conventional to sustainable. The study seeks to support a line of research that could help governments in the Arab world catch up with the global green building trends.

To identify the frequency and reasons of operations cancellation in 25 Makkah region hospitals in Saudi Arabia. Retrospective evaluation of the rate of surgery cancellation in 25 hospitals of Makkah region was performed in this study. The data of scheduled surgeries from 15 different surgical specialties was collected from January to December 2013. Frequency and reasons of cancellation of elective surgical cases in different specialty were studied with a view to recommend suggestions for improvement. Data was analyzed on SPSS -16. There are 120 operating rooms (OR) in 25 Makkah region hospitals and during the year 2013, a total of 16,211 surgery cases were listed, and 1,238 (7.6%) cases were canceled. Contribution to total cancellation was highest in orthopedic 33.8% followed by general surgery 27.5%, obstetrics 7.7% and ENT 5.2%. According to category, 42.81% rate of cancellation was patient related, 20.03% facility related, 9.45% due to improper work-up, 1.45% associated with anesthesia, 7.19% related to surgeons, and 18.90% other/and not recorded reasons. Present study found 7.6% cancelation rate in Makkah region hospitals and three most common causes for cancellations were patients related, facility related and improper work-up.

Precision spectroscopy of the electron spectrum of the tritium$$\\upbeta $$β -decay near the kinematic endpoint is a direct method to determine the effective electron antineutrino mass. The KArlsruhe TRItium Neutrino (KATRIN) experiment aims to determine this quantity with a sensitivity of better than$${0.3}{\\hbox { eV}}$$0.3 eV ($$90\\%$$90 %  C.L.). An inhomogeneous electric potential in the tritium source of KATRIN can lead to distortions of the$$\\upbeta $$β -spectrum, which directly impact the neutrino-mass observable. This effect can be quantified through precision spectroscopy of the conversion-electrons of co-circulated metastable$$^{83\\text {m}}\\text {Kr}$$83 m Kr . Therefore, dedicated, several-weeks long measurement campaigns have been performed within the KATRIN data taking schedule. In this work, we infer the tritium source potential observables from these measurements, and present their implications for the neutrino-mass determination.

Precision spectroscopy of the electron spectrum of the tritium β-decay near the kinematic endpoint is a direct method to determine the effective electron antineutrino mass. The KArlsruhe TRItium Neutrino (KATRIN) experiment aims to determine this quantity with a sensitivity of better than 0.3 eV (90% C.L.). An inhomogeneous electric potential in the tritium source of KATRIN can lead to distortions of the β-spectrum, which directly impact the neutrino-mass observable. This effect can be quantified through precision spectroscopy of the conversion-electrons of co-circulated metastable 83mKr. Therefore, dedicated, several-weeks long measurement campaigns have been performed within the KATRIN data taking schedule. In this work, we infer the tritium source potential observables from these measurements, and present their implications for the neutrino-mass determination.

The projected sensitivity of the effective electron neutrino-mass measurement with the KATRIN experiment is below 0.3 eV (90 % CL) after 5 years of data acquisition. The sensitivity is affected by the increased rate of the background electrons from KATRIN’s main spectrometer. A special shifted-analysing-plane (SAP) configuration was developed to reduce this background by a factor of two. The complex layout of electromagnetic fields in the SAP configuration requires a robust method of estimating these fields. We present in this paper a dedicated calibration measurement of the fields using conversion electrons of gaseous 83mKr, which enables the neutrino-mass measurements in the SAP configuration.

Adenosine inhibits the activation of most immune cells and platelets. Selective adenosine A2A receptor (A2AR) agonists such as regadenoson (RA) reduce inflammation in most tissues, including lungs injured by hypoxia, ischemia, transplantation, or sickle cell anemia, principally by suppressing the activation of invariant natural killer T (iNKT) cells. The anti-inflammatory effects of RA are magnified in injured tissues due to induction in immune cells of A2ARs and ecto-enzymes CD39 and CD73 that convert ATP to adenosine in the extracellular space. Here we describe the results of a five patient study designed to evaluate RA safety and to seek evidence of reduced cytokine storm in hospitalized COVID-19 patients. Five COVID-19 patients requiring supplemental oxygen but not intubation (WHO stages 4-5) were infused IV with a loading RA dose of 5 μg/kg/h for 0.5 h followed by a maintenance dose of 1.44 μg/kg/h for 6 hours, Vital signs and arterial oxygen saturation were recorded, and blood samples were collected before, during and after RA infusion for analysis of CRP, D-dimer, circulating iNKT cell activation state and plasma levels of 13 proinflammatory cytokines. RA was devoid of serious side effects, and within 24 hours from the start of infusion was associated with increased oxygen saturation (93.8 ± 0.58 vs 96.6 ± 1.08%, P<0.05), decreased D-dimer (754 ± 17 vs 518 ± 98 ng/ml, P<0.05), and a trend toward decreased CRP (3.80 ± 1.40 vs 1.98 ± 0.74 mg/dL, P = 0.075). Circulating iNKT cells, but not conventional T cells, were highly activated in COVID-19 patients (65% vs 5% CD69+). RA infusion for 30 minutes reduced iNKT cell activation by 50% (P<0.01). RA infusion for 30 minutes did not influence plasma cytokines, but infusion for 4.5 or 24 hours reduced levels of 11 of 13 proinflammatory cytokines. In separate mouse studies, subcutaneous RA infusion from Alzet minipumps at 1.44 μg/kg/h increased 10-day survival of SARS-CoV-2-infected K18-hACE2 mice from 10 to 40% (P<0.001). Infused RA is safe and produces rapid anti-inflammatory effects mediated by A2A adenosine receptors on iNKT cells and possibly in part by A2ARs on other immune cells and platelets. We speculate that iNKT cells are activated by release of injury-induced glycolipid antigens and/or alarmins such as IL-33 derived from virally infected type II epithelial cells which in turn activate iNKT cells and secondarily other immune cells. Adenosine released from hypoxic tissues, or RA infused as an anti-inflammatory agent decrease proinflammatory cytokines and may be useful for treating cytokine storm in patients with Covid-19 or other inflammatory lung diseases or trauma.

In this work we present a keV-scale sterile-neutrino search with a low-tritium-activity data set of the KATRIN experiment, acquired in a commissioning run in 2018. KATRIN performs a spectroscopic measurement of the tritium β-decay spectrum with the main goal of directly determining the effective electron anti-neutrino mass. During this commissioning phase a lower tritium activity facilitated the measurement of a wider part of the tritium spectrum and thus the search for sterile neutrinos with a mass of up to 1.6 keV. We do not find a signal and set an exclusion limit on the sterile-to-active mixing amplitude of $\\text {sin}^{2}\\: \\theta<5\\times 10^{-4}\\: (95\\%\\: $C.L) at a mass of 0.3 keV. This result improves current laboratory-based bounds in the sterile-neutrino mass range between 0.1 and 1.0 keV.

Since the discovery of neutrino oscillations, we know that neutrinos have non-zero mass. However, the absolute neutrino-mass scale remains unknown. Here we report the upper limits on effective electron anti-neutrino mass, $m_ν$, from the second physics run of the Karlsruhe Tritium Neutrino experiment. In this experiment, $m_ν$ is probed via a high-precision measurement of the tritium β-decay spectrum close to its endpoint. This method is independent of any cosmological model and does not rely on assumptions whether the neutrino is a Dirac or Majorana particle. By increasing the source activity and reducing the background with respect to the first physics campaign, we reached a sensitivity on $m_v$ of ${\\text{0.7eV}c^{-2}}$ at a 90% confidence level (CL). The best fit to the spectral data yields $m\\frac{2}{v}=\\text{(0.26 ± 0.34)eV}^2c^{-4}$, resulting in an upper limit of $m_v{\\text{<0.9eV}}c^{-2}$at 90% CL. By combining this result with the first neutrino-mass campaign, we find an upper limit of mν$m_v{\\text{<0.8eV}}c^{-2}$ at 90% CL.

Since the discovery of neutrino oscillations, we know that neutrinos have non-zero mass. However, the absolute neutrino-mass scale remains unknown. Here we report the upper limits on effective electron anti-neutrino mass, mν, from the second physics run of the Karlsruhe Tritium Neutrino experiment. In this experiment, mν is probed via a high-precision measurement of the tritium β-decay spectrum close to its endpoint. This method is independent of any cosmological model and does not rely on assumptions whether the neutrino is a Dirac or Majorana particle. By increasing the source activity and reducing the background with respect to the first physics campaign, we reached a sensitivity on mν