Geochemical characterization of recent Nile Delta inner shelf sediments: Tracing natural and human-induced alterations into a deltaic system

Abstract The present study deals with the geochemical changes observed along Nile Delta inner shelf sediments over a period of 20 years (1995–2015). Major, minor, and trace constituents as well as rare earth elements (REE) were investigated in the surface sediments collected from seven transects along the inner shelf on five years intervals. Geochemical composition of sediments in Nile Delta inner shelf exhibits continuous changes over time due to the depositional and sediment transport processes. The sediments are generally enriched with Fe and Ti oxides, as well as Ta, Nb, Y in comparison to the Upper Continental Crust (UCC). These alterations signify the impact of processes such as erosion and sediment transport, as well as the impact of anthropogenic interferences such as damming the Nile River Flow. The reduction of the sediment input from the Nile River has somehow altered the geochemical signature of the inner shelf sediments. The REE patterns indicate weathering in areas subjected to erosion, while trace elements and major oxides spatial and temporal distributions concentrate eastwards under the influence of the easterly sediment transport pattern. Nile Delta inner shelf presented a typical case for understanding the link between geochemistry and sedimentary processes in nearshore and deltaic systems

Quality of milk fat obtained from cows and buffaloes fed a diet supplemented with flaxseed or soybean oils

The experiment was carried out to evaluate the quality of anhydrous milk fat (AMF) of cows and buffaloes supplemented with flaxseed oil (FO), soybean oil (SO), or their mixture (FSO). Lactating crossbred cows and buffaloes were fed with control diet or with one of three supplements: 2% FO, 2% SO, and 2% FSO according to a double 4 x 4 Latin Square Design. The diets with FO, SO, or FSO reduced saturated FA, mainly C4:0, C14:0 and C16:0, while increased the unsaturated FA C18:1 and C18:2 in milk from cows and buffaloes. Cholesterol content decreased in cow's AMF while increased in buffalo's AMF when a diet supplemented with FO, SO, or FSO. The diet with SO or FSO increased the content of vitamin E in AMF obtained from cows (25.06 and 17.89 mg 100 g-1) and buffaloes (28.48 and 30.32 mg 100 g-1) compared with the control diet (11.02 and 15.68 mg 100 g-1), respectively, which correlated positively with scavenging activity for DPPH• (r2 = 0.66) and ABTS• (r2 = 0.67) radicals. Solid fat content (SFC) was high for cow’s AMF, with 58.12-60.37% at 5°C compared to that of buffalo's AMF, with 52.37-56.98%, but was low for cow's AMF at >15°C. Finally, supplementing a diet with vegetable oils, particularly SO, improves the quality of AMF; increases USFA/SFA ratio, vitamin E content, and antioxidant activitie

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

The Short versus Long Antibiotic Course for Pleural Infection Management (SLIM) randomised controlled open-label trial

Introduction Based on expert opinion, the length of antibiotic treatment for pleural infection in adults is typically recommended to be a minimum of 4 weeks. This clinical trial aimed to assess whether shorter antibiotic courses lead to more treatment failures than standard longer courses. Methods In an open-label randomised controlled trial, adult patients with pleural infection who were medically treated and stabilised within 14 days of admission were randomised to either a short antibiotic course (total course 14–21 days) or a long antibiotic course (total course 28–42 days). Patients were excluded if their baseline RAPID score was >4 (high-risk category). The primary outcome was the incidence of treatment failure by 6 weeks post-admission. Secondary outcomes were total length of antibiotic treatment, proportion of patients who resumed normal activity levels within 6 weeks post-admission, time from discharge to resuming normal activity levels and incidence of antibiotic-related adverse reactions. Results Between September 2020 and October 2021, 50 patients (mean±sd age 46±13.7 years; 35 (70%) males) were recruited to the trial and randomly assigned to the short course group (n=25) or the long course group (n=25), with outcome data available for 24 patients in each study group. Treatment failure occurred in four (16.7%) patients in the short course group and three (12.5%) patients in the long course group. In the intention-to-treat analysis the OR for treatment failure in the long course group was 0.714 (95% CI 0.142–3.600; p=0.683). The median (interquartile range) duration of antibiotic treatment in the short course group was 20.5 (18–22.5) days compared with 34.5 (32–38) days in the long course group (p<0.001). There were no statistically significant differences in the other outcomes. Conclusions In medically treated adult patients with pleural infection a long course of antimicrobial therapy did not lead to fewer treatment failures compared with a shorter course. These findings need to be confirmed in a larger multicentre trial