Petrophysical characterization and durability aspects of tufa rocks at Kurkur Oasis, Western Desert, Egypt

Various kinds of rocks can be used as building stones based on their durability, appearance, and availability. During many periods of times, particularly the Hellenistic, tufa rocks were used as building stones because of their appropriateness for construction. In this research, tufa rocks exposed at Kurkur Oasis are evaluated based on various geological, petrophysical, and geomechanical investigations on 47 rock samples collected from four sites in the study area. Mineralogically, the studied tufa consists essentially of calcite with slight amounts of other minerals such as quartz, dolomite, gypsum, halite, and clay minerals. The tufa rocks are characterized by heterogeneous petrophysical and elastic properties. Porosity, density, and the geomechanical properties vary widely based on different facies and diagenetic processes. Major geomechanical differences between the studied rocks give constraints on the use of these rocks as bedrock foundation, or as construction and building stones. The obtained results and correlations between the different parameters help to predict the geomechanical properties from the more easily measured elastic and petrophysical parameters. Although the uses of tufa as an ornamental stones may be productive to the national economy, however, it is suggested that processing the tufa into polished, ornamental stone, cladding, tiles, and face slabs will be of more economical value both to the investors and the national economy especially at this time of economic stagnation. © 2021, Springer-Verlag GmbH Germany, part of Springer Nature

Effects of porosity and composition on seismic wave velocities and elastic moduli of lower cretaceous rocks, central Lebanon

We collected 40 rock samples from the Cretaceous strata exposed at central Lebanon in order to study the effects of porosity and rock composition on their seismic wave velocities and elastic moduli. Several sedimentological and mineralogical studies were conducted to evaluate the rock composition, provenance, depositional conditions, and the diagenetic history of the studied rocks. Porosity, bulk and grain densities and seismic wave velocities were measured for 35 drilled core samples at ambient conditions in the laboratory. Velocity measurements were conducted on the dry core samples utilizing the pulse transmission technique. Petrographically, four lithofacies have been identified under the polarizing microscope. From oldest to youngest, these comprise arenitic sandstone, lithic limestone, oolitic limestone, and micritic limestone. Investigations of representative rock samples under the SEM revealed that a number of diagenetic processes have impacted the studied rocks, and thereby affected their petrophysical properties. The XRD analysis, on the other hand, revealed that quartz and calcite are the dominant minerals in the sandstones of the Chouf Formation and the limestones of the Abeih and Mdairej Formations, respectively. The measured porosity, bulk density, and compressional and shear wave velocities of the investigated rocks vary, respectively, between 2.14–10.05%, 2.41–2.67 g/cm3, 3885–6385 m/s and 2246–3607 m/s. The grain density was calculated from the measured porosity and bulk density data and varies narrowly between 2.64 and 2.78 g/cm3. We further calculated the Poisson’s ratio and the moduli of shear, bulk, and Young from the measured bulk density and seismic wave velocities. Calculated values of these parameters vary between 0.18–0.28, 1.23–3.43 × 1010 Pa, 2.03–6.18 × 1010 Pa and 3.06–8.69 × 1010 Pa, respectively. The generalized mixture rule is used to provide a unified description of the physical properties of the studied rocks regarding their component properties, volume fractions, and microstructures. We constructed a number of relationships between the measured petrophysical and elastic properties to evaluate the mutual interdependence of these parameters and assess the effects of porosity and rock type on these important rock characteristics. © 2018, Institute of Geophysics, Polish Academy of Sciences & Polish Academy of Sciences

Geophysical and borehole investigations of subsurface hazardous karsts in Ar-Riyadh city, Kingdom of Saudi Arabia

Geophysical and borehole investigations were carried out to explore the sites of subsurface buried cavities and related subsidence in Ar-Riyadh city, Kingdom of Saudi Arabia (KSA). Traditional ground probing practices were not adequately conducted in the city due to various reasons including lack of technology at a time, economic factors, the ambient general culture, and time constraints. Consequently, locations of near-surface buried hazardous cavities for proposed development projects in the studied area are essentially unknown. The geophysical studies are represented by the interpretation of ground penetrating radar (GPR) images, while the borehole investigations were done through five drilled boreholes (BHs). A good match between the results of the two methods has been found indicating the usefulness of radar techniques to identify the ground conditions prior to major engineering projects in karstic regions such as Ar-Riyadh. In addition to locating major cavities in a city underlain by limestone bedrock, crucial recommendations have been proposed to be implemented before and/or during the design and construction of major foundations in the area. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Systematic Review of Potential Health Risks Posed by Pharmaceutical, Occupational and Consumer Exposures to Metallic and Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide and Its Soluble Salts

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007). Challenges encountered in carrying out the present review reflected the experimental use of different physical and chemical Al forms, different routes of administration, and different target organs in relation to the magnitude, frequency, and duration of exposure. Wide variations in diet can result in Al intakes that are often higher than the World Health Organization provisional tolerable weekly intake (PTWI), which is based on studies with Al citrate. Comparing daily dietary Al exposures on the basis of “total Al”assumes that gastrointestinal bioavailability for all dietary Al forms is equivalent to that for Al citrate, an approach that requires validation. Current occupational exposure limits (OELs) for identical Al substances vary as much as 15-fold. The toxicity of different Al forms depends in large measure on their physical behavior and relative solubility in water. The toxicity of soluble Al forms depends upon the delivered dose of Al+ 3 to target tissues. Trivalent Al reacts with water to produce bidentate superoxide coordination spheres [Al(O2)(H2O4)+ 2 and Al(H2O)6 + 3] that after complexation with O2•−, generate Al superoxides [Al(O2•)](H2O5)]+ 2. Semireduced AlO2• radicals deplete mitochondrial Fe and promote generation of H2O2, O2 • − and OH•. Thus, it is the Al+ 3-induced formation of oxygen radicals that accounts for the oxidative damage that leads to intrinsic apoptosis. In contrast, the toxicity of the insoluble Al oxides depends primarily on their behavior as particulates. Aluminum has been held responsible for human morbidity and mortality, but there is no consistent and convincing evidence to associate the Al found in food and drinking water at the doses and chemical forms presently consumed by people living in North America and Western Europe with increased risk for Alzheimer\u27s disease (AD). Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of AD or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic. Aluminum exposures during neonatal and pediatric parenteral nutrition (PN) can impair bone mineralization and delay neurological development. Adverse effects to vaccines with Al adjuvants have occurred; however, recent controlled trials found that the immunologic response to certain vaccines with Al adjuvants was no greater, and in some cases less than, that after identical vaccination without Al adjuvants. The scientific literature on the adverse health effects of Al is extensive. Health risk assessments for Al must take into account individual co-factors (e.g., age, renal function, diet, gastric pH). Conclusions from the current review point to the need for refinement of the PTWI, reduction of Al contamination in PN solutions, justification for routine addition of Al to vaccines, and harmonization of OELs for Al substances

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)