INFLUENCE OF WELL LOCATION ON DRAWDOWN IN AREA SURROUNDED BY VERTICAL CUTOFF WALLS

Dewatering systems with vertical partially penetrating cutoff walls are usually used in the case of deep excavation for side support system and further increases the efficiency of the groundwater control system. In this study a parametric analysis was carried out using the finite difference software VISUAL MODFLOW4.2® to study the effect of placing a deep well at different locations inside the excavated area surrounded by impervious wall on drawdown results. The dewatering system under consideration consists of a single partially penetrating deep well having a penetration depth (lw) and well yield (Q). The well is located at variable distances from the corner (the origin of X and Y axes) inside the excavated area surrounded by an impervious wall. The vertical impervious wall has a depth (lc), and the excavated area (A) surrounded with impervious wall is square and having a width (W). The aquifer is unconfined with a depth (H) and is underlain by an impervious layer. The aquifer consists of an extended layer of fine to medium sand having permeability (k). The soil is assumed to be homogenous and isotropic

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

Preventive Agents for Migraine: Focus on the Antiepileptic Drugs

Migraine is among the 10 most disabling disorders worldwide. It is characterized by episodes of moderate or severe headaches with various degree of disability, resulting in a considerable health burden upon the sufferers and their family. The objective of this article is to review the use of prophylaxis with antiepileptic drugs. Particular focus is given to their mechanism of action, metabolism, pharmacokinetics, safety profile, efficacy and to provide a summary of the most relevant clinical studies and patient preference

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in an Israeli family

Radi Shahien1, Silvia Bianchi2, Abdalla Bowirrat11Department of Neurology, Ziv Medical Center, Safed, Israel; 2Department of Neurological and Behavioral Sciences, University of Siena, Viale Bracci, Siena, ItalyAbstract: Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common monogenic form of hereditary cerebral microangiopathy, and is caused by over 170 different mutations in the NOTCH3 gene at locus 19p13.1–13.26. We report the first study of familial CADASIL in a 39-year-old Jewish woman and her mother who had died previously. The patient's investigations revealed a normal hemogram with no vascular risk factors or chronic disease. Lumbar puncture was normal. Cranial computed tomography scan revealed bilateral diffuse hypodensities in the subcortical white matter. Cranial magnetic resonance imaging showed hyperintense lesions in the cerebral white matter on T2-weighted images. On electron microscopy, a characteristic granular osmiophilic material was seen in the basement membrane surrounding the pericytes and smooth muscle cells in small-sized and medium-sized vessels. Molecular analysis of the NOTCH3 gene was performed with automatic sequencing of exon 3 and 4 (and intron-exon boundaries) showing a nucleotide c.268C > T substitution, leading to a pathogenic amino acid substitution of p.Arg90Cys, confirming a diagnosis of CADASIL. This mutation was also found in the patient's mother. Although the exact prevalence of CADASIL is not known, this disorder has been reported worldwide, and now including Jews, with a genotype and clinical phenotype similar to that in other ethnic groups.Keywords: CADASIL, autosomal-dominant inheritance, genetic diagnostics, NOTCH3, arteriopath

Photocatalytic degradation and photo-Fenton oxidation of Congo red dye pollutants in water using natural chromite—response surface optimization

Abstract Refined natural Fe-chromite was characterized by XRD, FT-IR, reflected polarized microscope, XRF and UV spectrophotometer. Photocatalytic degradation and photo-Fenton oxidation of Congo red dye by Fe-chromite was investigated using 1 mL H2O2. The degradation of dye was studied as a function of illumination time, chromite mass, initial dye concentration, and pH. Fe-chromite acts as binary oxide system from chromium oxide and ferrous oxide. Thus, it exhibits photocatalytic properties under UV illumination and photo-Fenton oxidation after addition of H2O2. The degradation in the presence of H2O2 reached the equilibrium stage after 8 h (59.4%) but in the absence of H2O2 continued to 12 h (54.6%). Photocatalytic degradation results fitted well with zero, first order and second order kinetic model but it represented by second order rather than by the other models. While the photo-Fenton oxidation show medium fitting with the second order kinetic model only. The values of kinetic rate constants for the photo-Fenton oxidation were greater than those for the photocatalytic degradation. Thus, degradation of Congo red dye using chromite as catalyst is more efficient by photo-Fenton oxidation. Based on the response surface analysis, the predicted optimal conditions for maximum removal of Congo red dye by photocatalytic degradation (100%) were 12 mg/l, 0.14 g, 3, and 11 h for dye concentration, chromite mass, pH, and illumination time, respectively. Moreover, the optimum condition for photo-Fenton oxidation of dye (100%) is 13.5 mg/l, 0.10 g, 4, and 10 h, respectively