Mineralogy and Geochemistry of Sandstones from the Tanjero Formation, Bekhme Gorge Northeastern Iraq: Implications for Paleoweathering and Provenance

The Tanjero Formation is exposed on the Northern flank of the Perat anticline near the Northern entrance to the Bakhme gorge through which the waters of the Upper Zab flow. As for tectonics, it is located within the High Folded Zone of the Unstable Shelf. The Tanjero Formation is about 80 m. thick, it is bounded from the bottom by the Shiranish Formation. The formation consists of gray sandstone that contains gravel at the bottom followed by beds of marl, hard sandstone, and black claystone containing cushioning structures and small-scale cross-bedding are present. According to the Williams classification, theTanjero sandstones drop at the lithic wacke field. The provenance of these sandstones was investigated based on their minerals and geochemical composition. The geochemical analyses showed low silica, a negative correlation of silica with the most major oxides due to recycling sedimentary sources or weathering of silicates. The index of compositional variability indicates that the sandstones of the Tanjero Formation are immature clastic sediments and the high index of compositional variability values confirm that the clastic sediments occurred in the tectonically-active-settings area. Moderate chemical weathering has dominated in the studied area, which was inferred from the chemical index of alteration, the chemical index of weathering and the plagioclase index of alteration. Based on the tectonic discrimination diagrams, the Tanjero sandstones are quartzose sedimentary provenance, felsic igneous rocks source, transitional arc–lithic recycled setting, and located in the collision zone between the passive Arab margin and the effective Iranian-Turkish margin that formed the orogeny belt along the collision zone

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Comparison Between the Classical Classification and Digital Classification for Selected Samples of Igneous and Carbonate Rocks

As igneous rocks have widely chemical and mineralogical compositions, there are many ways to classify these rocks. These ways are classical approved methods to give a reliable classification and nomenclature of rocks. Some igneous rocks may be classified by digital image processing to assist in classical methods. Five igneous samples were cut, prepared of thin sections, and polished to classify them by classical methods and digital image processing by ENVI software. Moreover, part of these samples crushed an analysis of major oxides. The current igneous samples have referred to the basic and mesocratic rocks based on the classical methods and this has corresponded to ENVI software. The igneous samples have reflected the leucogabbros when classify them by classical and ENVI classifications, except the G5 sample, which has been referred to as gabbro by ENVI. There is a clear similarity between the classical and ENVI classifications. ENVI classification is a reliable classification to assist the classical methods in the nomenclature of igneous rocks, especially, plutonic rocks, it can be also applied to thin sections of volcanic rocks to classify and nomenclature classification by ENVI has been applied on fifty thin sections of limestones to identify microfacies which are classified beforehand by classical (optical) classification. According to optical classification, microfacies have classified as mudstone, wackestone, packstone, and grainstone. When the digital classification is applied to them, there is no grainstone texture found in these them. Digital thin sections, where the true name of these microfacies is packstone. Therefore, the positive sides of the digital image processing by ENVI software appeared and contrasted to the optical classification which contained some mistakes when applied to the nomenclature of these microfacies.</jats:p

The impact of Human Resources Management (development and training, motivation, performance evaluation) on achieving entrepreneurship for Public Hospital administrations in the Najran region of Saudi Arabia

The study aimed to learn about the role of human resource management (development, training, motivation, performance evaluation) and to achieve the management of the work of the hospitals in the Najarn region of Saudi Arabia. The study relied on the analytical descriptive approach that helps describe the heterologies and axes of the study on the ground and to show the relationships in it, and to link the results of the analysis used to detect interactions between the hetero study in a logical scientific method. The study community included administrative staff in public hospitals in the Najarn region in the Kingdom of Saudi Arabia, numbering about 3,500 employees, where a random sample of the Al-Arsa community consisted of (325) employees was selected, and the data was collected from them using a questionnaire and then analyzed using (SPSS) to reach the results. The study reached several results, the most important of which is the presence of a high degree of appreciation for human resources management in public hospitals in the Najarn region in the Kingdom of Saudi Arabia, in order to the efficiency of its dimensions (development and training, motivation, performance evaluation). The results of the study also indicated a statistical impact of human resource management on the investigation of the work of the management of the hospitals in the Najarn region. In light of the results, the study recommends strengthening the management of human resources in the common hospitals in the Najarn region in Saudi Arabia

Psychological impact of COVID-19 pandemic on medical students in Sudan, 2020

Abstract Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging infection causing a widely spread pandemic of Coronavirus disease 2019 (COVID-19). The current COVID-2019 pandemic is prompting fear of falling sick, dying, helplessness and stigma so urgent and timely understanding of mental health status is needed to help the community. The aim of our study is to assess the psychological impact of COVID19 pandemic on medical students in Sudan. Methods and Materials: A cross-sectional descriptive research was done among medical student in Sudan during COVID 19 pandemic in August 2020. DASS-21 scales were used to determine the level of depression, anxiety and stress among medical students through an online questionnaire, their responses were taken relatable to 21 items of DASS scale. The data was analyzed by means of SPPS version 25.0. Results: The mean (SD) age of our study participants was 21.8 (2.4) with female to male ratio of 2.1. Most of the participants were residing during the time the of the study in middle stats of Sudan (50.8%) and 83% were staying with their families. Interestingly, more than 40.5% of the study participants were free of depression while more than 13% had extremely severe depression. On the other hand, only 4.4% had extremely severe stress. However, anxiety ranked the higher numbers with 23% had extremely severe anxiety. Adjusted linear regression model revealed that lower levels in the medical school and open colleges during the lock down period were associated with more anxiety (p value 0.01,0.006 respectively), while having a family member working in the medical field is associated with less stress (p value 0.02). Conclusion : Our study provides good idea about the magnitude of the psychological burden upon medical students during the COVID- 19 pandemic and showed many factors that can influence mental health so as to emphasize the need to adopt new strategies to improve psychological services. In addition, it's important to support high-risk groups especially those with preexisting mental illness to offer advanced psychological interventions. So our study can be used to construct and formulate a psychological intervention and implement mental health strategies directed toward vulnerable groups during the COVID-19 epidemic.</jats:p