Experimental Evaluation of Geocell and EPS Geofoam as Means of Protecting Pipes at the Bottom of Repeatedly Loaded Trenches

© 2020 American Society of Civil Engineers. With growing populations and continuing urban development, embedding pipes in the ground that are then overrun by traffic is inevitable. This paper describes full-scale prototype tests on high-density polyethylene (HDPE) flexible pipes (of 250 mm diameter), buried at shallow depth, under simulated traffic loading. The paper studies the effect of surface load diameter (0.6×, 0.8×, and 1× pipe diameter) and the amplitude of repeated load (400 or 800 kPa) on pipe behavior. The effects of expanded polystyrene (EPS) geofoam blocks of various densities and also of geocells as a three-dimensional (3D) reinforcement in reducing the pressure transferred to the pipe, the deformation of the pipe, and the surface settlement of the backfill were investigated. The results show that, with an increase in loading surface diameter, the pipe's vertical diametral strain, the pressure transferred to the pipe, and the surface settlement grow significantly, irrespective of applied pressure. Using an EPS block over the pipe increases the soil settlement but reduces transferred pressure onto the pipe and, consequentially, results in lower pipe deformations. The increase in density of an EPS block helps improve response but was still found to be insufficient to prevent increase in surface deflections. The use of geocell reinforcement beneath the loading surface not only reduces the pressure transferred to the pipe and decreases its deformation but also significantly negates the tendency of the EPS block to increase the soil surface settlement. Thus, a geocell reinforcement layer placed over two EPS geofoam blocks (with total thickness 0.3× and width 1.5× the pipe diameter) all above a pipe buried at a depth of twice the pipe diameter, was found to deliver an acceptable, stable response. By these means, the vertical pipe strain, transferred pressure over the pipe, and soil surface settlement were reduced, respectively, by 0.45, 0.37, and 0.53× those obtained for the comparable unmodified buried pipe installation and are within allowable limits

Comparing efficacy of montelukast versus doxycycline in treatment of moderate acne

Background: Treatment of acne is an important issue for reducing the cosmetic and psychological burden of disease. Regarding the inflammatory effect of LT-B4 in acne lesions and action mechanism of Montelukast, this study was performed to determine the efficacy of Montelukastin acne treatment comparison with doxycycline. Materials and Methods: In a randomized clinical trial that was performed in Dermatology Clinic in a Training Tertiary Health Care Center in Tehran, Iran since January 2012 to May 2014, 52 patients with moderate acne were evaluated. The included patients were randomly assigned to receive doxycycline 100 mg/day plus 1 Clindamycin solution (Group 1) or Montelukast 5 mg daily plus 1 clindamycin solution (Group 2). The acne severity index was measured and compared between two groups at baseline (on admission), 1-month and 3 months later. Independent-Sample-T, Chi-Square, and Repeated-Measure ANOVA tests were used and were considered statistically significant at P < 0.05. Results: The mean age was 26.8 ± 7.1 in Group 1 and25 ± 4.8 in Group 2 (P = 0.1). 73 women and 26.7 4 men in Group 1 and 86.7 women, and 13.3 men in Group 2 (P = 0.01). The mean acne severity index at baseline was 18.2 ± 6.1 and 19 ± 4.2 in Montelukast and doxycycline group, respectively (P = 0.679). The mean acne severity index after 1-month was 10.5 ± 6.2 and 12.9 ± 3.3 in Montelukast and doxycycline group, respectively (P = 0). Finally, the mean acne severity index after 3 months follow-up was 8.6 ± 4.8 and 8.2 ± 1.2 in Montelukast and doxycycline group, respectively (P = 0.01). There was no significant difference between two groups regarding the amount of decrease in acne severity index across the study (P = 0.186). However, each groups showed a significant reduction in the acne severity index, separately (P = 0.001). Conclusion: It may be concluded that Montelukast is an effective and safe medication for moderate-level acne treatment. © 2015, Isfahan University of Medical Sciences(IUMS). All rights reserved

Sinteza, antitumorsko i citostatsko djelovanje derivata 6H-indolo[2,3-b]kinoksalina

Various 6-aralkyl-9-substituted-6H-indolo[2,3-b]quinoxalines were synthesized by reaction of 1,5-disubstituted 2,3-dioxo-2,3-dihydroindole with orthophenylene diamine. Appreciable anticancer activity of compounds 5b, 5d, 5g and 5l at various cell lines among 59 human tumor cell panels was observed. All the synthesized compounds were evaluated for cytostatic activity against human Molt 4/C8 and CEM T-lymphocytes as well as for murine L1210 leukemia cells. Compound 5h exhibited an IC50 of 71 μmol mL1 against Molt 4/C8 and 117 μmol mL1 against CEM compared to melphalan 3.2 μmol mL1 and 2.5 μmol mL1, respectively. The IC50 for compound 7i against L1210 was 7.2 μmol mL1 compared to melphalan 2.1 μmol mL1.Reakcijom 1,5-disupstituiranih 2,3-diokso-2,3-dihidroindola s ortofenilen diaminom sintetizirani su različiti 6-aralkil-9-supstituirani-6H-indolo[2,3-b]kinoksalini. Spojevi 5b, 5d, 5g i 5l pokazali su značajno antitumorsko djelovanje na 59 humanih tumorskih stanica. Svi sintetizirani spojevi ispitani su na citostatsko djelovanje na stanične linije Molt 4/C8 i CEM T-limfocite, te na murin L1210 stanice leukemije. IC50 za spoj 5h je 71 μmol mL1 na staničnu liniju Molt 4/C8 i 117 μmol mL1 na CEM, dok su vrijednosti za melfalan 3,2, odnosno 2,5 μmol mL1. IC50 spoja 7i na stanice L1210 je 7,2 μmol mL1, dok je za melfalan 2,1 μmol mL1

ЛЕЧЕНИЕ БОЛЬНЫХ С МЕСТНОРАСПРОСТРАНЕННЫМИ РЕЦИДИВАМИ РАКА КОЖИ ЛИЦА КРИО-ЛУЧЕВЫМ МЕТОДОМ

The aim of the study was to improve the treatment outcomes for patients with locally advanced recurrent basal cell and squamous cell skin carcinomas of the face. Material and methods. A total of 26 patients with locally advanced recurrent basal cell (n=21) and squamous cell (n=5) skin carcinomas of the skin were treated with radiotherapy (2–2.5 Gy daily fractions to a total dose of 60–70 Gy, 5 days a week) in combination with local freezing of the tumor. Local cooling of the tumor to the temperature of tissue freezing was performed 10–15 minutes before each session of radiation therapy using liquid nitrogen cryo-preservation equipment. Patients with recurrent skin cancer who had received previously radiation therapy were not eligible for cryoradiotherapy. Results. Complete response was achieved in 23 (88.5 %) patients, residual tumors were removed by conventional surgery (n=2) and cryosurgery (n=1). At 2 to 14-year follow up, recurrences of skin cancer occurred in 3 (11.5 %) cases. Good aesthetic and functional results were observed. Conclusion. Cryo-radiotherapy was shown to be effective, providing long-term aesthetic and functional results. Целью работы явилось улучшение результатов лечения больных с местнораспространенными рецидивами базальноклеточного и плоскоклеточного рака кожи лица. Материал и методы. Для лечения больных с местнораспространенными рецидивами рака кожи лица применён крио-лучевой метод, включающий проведение лучевой терапии РОД 2–2,5 Гр 5 дней в нед до СОД 60–70 Гр в сочетании с локальным охлаждением новообразования. Локальное охлаждение до температуры замораживания тканей производится с помощью криогенного аппарата жидким азотом по разработанной методике за 10–15 мин перед каждым сеансом облучения. Метод был применён по показаниям у 26 больных с местнораспространенными рецидивами базальноклеточного (n=21) и плоскоклеточного (n=5) рака кожи лица. Крио-лучевой метод не показан, если рецидив рака кожи возник после ранее проведенного лучевого лечения. Результаты. Полная регрессия опухоли достигнута у 23 (88,5 %) больных, остаточные опухоли были удалены хирургическим (n=2) и криохирургическим (n=1) методами. При последующем наблюдении в сроки от 2 до 14 лет рецидивы возникли у 3 (11,5 %) больных. Отмечены хорошие эстетические и функциональные результаты лечения. Заключение. Показана высокая эффективность крио-лучевого метода, получены хорошие эстетические, функциональные и отдалённые результаты.

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods: We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings: In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation: Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. Funding: Bill & Melinda Gates Foundation

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Evaluation of sesamum gum as an excipient in matrix tablets

In developing countries modern medicines are often beyond the affordability of the majority of the population. This is due to the reliance on expensive imported raw materials despite the abundance of natural resources which could provide an equivalent or even an improved function. The aim of this study was to investigate the potential of sesamum gum (SG) extracted from the leaves of Sesamum radiatum (readily cultivated in sub-Saharan Africa) as a matrix former. Directly compressed matrix tablets were prepared from the extract and compared with similar matrices of HPMC (K4M) using theophylline as a model water soluble drug. The compaction, swelling, erosion and drug release from the matrices were studied in deionized water, 0.1 N HCl (pH 1.2) and phosphate buffer (pH 6.8) using USP apparatus II. The data from the swelling, erosion and drug release studies were also fitted into the respective mathematical models. Results showed that the matrices underwent a combination of swelling and erosion, with the swelling action being controlled by the rate of hydration in the medium. SG also controlled the release of theophylline similar to the HPMC and therefore may have use as an alternative excipient in regions where Sesamum radiatum can be easily cultivated