GEOCHEMISTRY, URANIUM, THORIUM AND RARE EARTH ELEMENTS OF TRACHYTE DYKES OF UMM SALATIT MOUNTAIN AREA, CENTRAL EASTERN DESERT, EGYPT

Umm Salatit Mountain area is a part of the Central Eastern Desert of Egypt. It is composed of ophiolitic mélange, older granitoids, biotite granites, muscovite granites and post granitic dykes and veins. Purpose of the work. The present work deals with the detailed investigations of the geology, petrography, geochemistry and spectrometric prospecting of the studied trachyte dykes as a possible source of uranium mineralization. Research methods. This work involves both field work (Construction of geological map with the structural features, scale 1 : 50,000, Spectrometric measurements of the different rock units using a portable gamma-ray spectrometer RS-230) and laboratory work (preparation of thin sections for petrographic studies by polarizing microscope), Atomic Emission Spectroscopy (AES), and Mass-Spectrometer with Inductively Coupled Plasma (ICPMS). Results. Petrographically, trachyte dykes consist mainly of K-feldspar with relatively minor amount of plagioclase, iron oxides, quartz and biotite. Secondary minerals are represented by sericite, muscovite, chlorite, carbonates and epidote. Accessory minerals are represented by opaque minerals. Trachytic textures are the main characteristic feature in trachyte. Geochemically, the investigated trachyte dykes were originated from an alkali magmarich in total alkalis, and the tectonic setting is continental basalt. Trachyte dykes have steep LREEs, nearly flat HREEs and a negative Eu anomaly. The negative Eu anomaly is either due to the partitioning of Eu into feldspar during fractionation, which is an important process in developing alkalinity, or the presence of residual feldspar in the source. Another alternative explanation for the negative Eu anomaly is based on the high oxygen fugacity in the melt due to volatile saturation. In general, all trachyte samples show moderate enrichment of most large ion lithophile elements (LILE) and high field strength elements (HFSE) and depletion of P, Ti and K. The depletion of Ti and p is ascribed to fractionation of titanomagnetite and apatite. The determination of equivalent uranium, thorium (ppm), potassium % and dose rate (m Sv/y) radiometrically by using portable RS-230 indicates that the dose rate in the trachyte dykes ranges from 0.5 to 1.5 with an average of 1.2 (m Sv/y). The radiometric data of the radioelements for them show a wide variation in eU and eTh contents. The eU content ranges from 2 to 14 ppm with an average of 6.6 ppm and the eTh content ranges from 4 to 37 ppm with an average of 18.03 ppm. Both U and Th correlate similarly with other major and trace elements, reflecting their geochemical coherence during the crystallization of the magma

Mineral composition, textures and gold habit of the Hamama mineralizations (Central Eastern Desert of Egypt)

Mineralization in the Hamama area exists mainly as quartz-carbonate veins, extending along the contact between the footwall volcanics (basalt, dacite, and rhyolite) and the hanging wall volcaniclastics (laminated, massive and lapilli tuffs with minor breccia). Also, mineralization was recorded as low mineralized cavity filling dolomitic veins occupying NW-SE faults in the basalt. The principal mineralization is represented by a mineral association - quartz + dolomite + calcite + pyrite + chalcopyrite + sphalerite with varying amounts of barite, cinnabar, and galena. It is suggested that these carbonates are post-tectonic low-temperature hydrothermal solution (exhalations) filling fault zones. The injected mineralized carbonate solution dissolved the silicate minerals along contacts. This fault system was caused by the group of porphyritic rhyolite dykes extending NE-SW. The carbonates then were subjected to digenetic processes after their formation resulted in the formation of some secondary sedimentary textures (for example spherulitic, colloform and cockade textures) and dolomitization. The mineralized carbonates are rich in Zn, Cu, and occasionally Pb and Sb. The cavity filling dolomitic veins within basalt show low concentration of ore minerals. The pyrite was crystallized in four phases; the first phase is well-developed pyrite that was formed from the primary hydrothermal solution. The role of bacterial action is obvious in the formation of a second phase framboidal pyrite. The third phase represented by atoll structures formed by diagenetic reworking of the framboidal pyrite. The last phase of pyrite crystallization appears as fine skeletal grains mostly attached to sericite alteration of altered volcanics. The gold and silver are concentrated mainly in the upper iron cap. Secondary supergene enrichment of gold in the oxidation zone, especially in Hamama western zone, is indicated by the reprecipitation of gold as thin filaments or rounded nano-grains along cracks of the oxidized pyrite or at the periphery of the pyrite relicts

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

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

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Towards better delineation of hydrothermal alterations via multi-sensor remote sensing and airborne geophysical data

Abstract Integrating various tools in targeting mineral deposits increases the chance of adequate detection and characterization of mineralization zones. Selecting a convenient dataset is a key for a precise geological and hydrothermal alteration mapping. Remote sensing and airborne geophysical data have proven their efficiency as tools for reliable mineral exploration. Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), Advanced land imager (ALI), Landsat 8 (L8), and Sentinel 2 data are widely-used data among various types of remote sensing images in resolving lithological and hydrothermal alteration mapping over the last two decades. ASTER is a well-established satellite in geological remote sensing with detailed Short-wave infrared (SWIR) range compared to visible and near-infrared region (VNIR) that controls iron-associated alteration detection. On contrary, ALI has excellent coverage of the VNIR area (6 bands), but does not possess the potentiality of ASTER for the SWIR and thermal regions. Landsat 8 is widely used and highly recommended for lithological and hydrothermal alteration mapping. The higher spatial (up to 10 m) resolution of Sentinel 2 MSI has preserved its role in producing accurate geological mapping. Notwithstanding the foregoing, implementing the four datasets in a single study is time-consuming. Thus, an important question when commencing an exploration project for hydrothermal alterations-related mineralization (orogenic mineral deposits in the current research) is: which dataset should be adopted to fulfill proper and adequate outputs? Here the four widely recommended datasets (ASTER, ALI, L8, and sentinel 2) have been tested by applying the widely-accepted techniques (false color combinations, band ratios, directed principal component analysis, and constrained energy minimization) for geological and hydrothermal alteration mapping of Gabal El Rukham-Gabal Mueilha district, Egypt. The study area is covered mainly by Neoproterozoic heterogeneous collection of ophiolitic components, island arc assemblage, intruded by enormous granitic rocks. Additionally, airborne magnetic and radiometric data were applied and compared with the remote sensing investigations for deciphering the structural and hydrothermal alteration patterns within the study area. The results demonstrated a different extent from one sensor to another, highlighting their varied efficacy in detecting hydrothermal alterations (mainly hydroxyl-bearing alterations and iron oxides). Moreover, the analysis of airborne magnetic and radiometric data showed hydrothermal alteration zones that are consistent with the detected alteration pattern. The coincidence between high magnetic anomalies, high values of the K/eTh ratio, and the resultant alterations confirm the real alteration anomalies. Over and above that, the remote sensing results and airborne geophysical indications were verified with fieldwork and petrographic investigations, and strongly recommend combining ASTER and Sentinel 2 results in further investigations. Based on the outputs of the current research, we expect better hydrothermal alteration delineation by adopting the current findings as they sharply narrow the zones to be further investigated via costly geophysical and geochemical methods in mineral exploration projects