Post Closure Research Articles

Mining as a temporary land use: A global stocktake of post-mining transitions and repurposing

Post-mining land use and associated economies have become a priority issue in mine lifecycle planning amongst many major companies. Ensuring the post-mining landscape is returned to a safe and stable condition is usually the first order priority in mine closure, though achieving this is often a challenge. The drive for industry to do more than rehabilitation is also growing. One of the many drivers for this expectation is the scale of mines, with many mining leases occupying thousands of hectares. Some of this land may be used for other purposes with relatively little intervention. For the mine footprint itself, it is often not possible or feasible to return the landscape to the prior condition, although creative repurposing of mine features and elements of mine infrastructure may be an option. At the same time, these large-scale mines employ hundreds, sometimes thousands of people and consideration of economic transitions for mining workforces, notably local dependant populations, is increasingly expected of industry post closure, as employment is often positioned at the “heart” of development. In this article, we reframe mining as a temporary land use. This approach positions post-mining land use as intrinsic to the mine lifecycle, including the planning and operational phases. We developed a global database of repurposing cases building on the S&P Global Market Intelligence database, relevant literature and other publicly available information. We provide an overview of the findings and the themes to emerge from this global repurposing database of 141 cases. Our findings include: our general observations on the research process; an analysis of the most common repurposing land uses; factors influencing repurposing, including factors internal and external to the company; initial observations about industry approaches to repurposing. Finally, we argue that reconceptualising mine ‘closure’ and the associated mining legacies is an essential operational shift the extractives industry, notably the major companies, will need to make to keep pace with societal and local community expectation.

Groundwater Risk Assessment in the Context of an Underground Coal Mine Closure and an Economic Evaluation of Proposed Treatments: A Case Study

Mining companies are responsible for the impacts that result from their mining activities even after the mining period has ended. At the same time, at the European and international levels, there is a lack of a detailed operational methodology comprising environmental risks during and after closure of underground coal mines. The environmental risk aspects that need to be considered when planning the closure of an underground coal mine and post closure in the broader environmental context are the following: modification of water flow scheme, surface instability, mine gas emission on the surface, and water and soil pollution. In this study, we focus on assessing groundwater risk in the context of an underground coal mine closure and evaluating the selected risk mitigation strategies in terms of performance and cost. The results from this study could be used for developing a final closure groundwater assessment plan by selecting the most feasible treatment alternatives for different environmental impacts, together with the transitional monitoring that could guarantee a hazard level in compliance with land reuse and the use of natural resources. Finally, the cost-efficient monitoring and treatment programs are used to estimate the financial provisions needed to mitigate groundwater risks during underground coal mine closure contexts.

The safety of early versus late ileostomy reversal after low anterior rectal resection: a retrospective study in 47 patients

BackgroundThis study aimed to clarify the safety of early closure in diverting ileostomy with lower anterior rectal-cancer resection.MethodsWe retrospectively reviewed consecutive 47 patients who underwent diverting ileostomy with lower rectal-cancer resection between May 2009 and October 2017. The results of the stoma closure were compared between patients who underwent stoma closure within 90 days (early closure [EC] group) and those who underwent late closure (LC group; closure after 90 days). Because of the small sample size, the frequency of severe complications post closure was analyzed.ResultsAmong 47 patients, 29 were in the EC group. Postoperative complications occurred in 48.3% (14/29) and 27.8% (5/18) of patients in the EC and LC groups, respectively. This difference was due to minor complications (Clavien-Dindo Classification I/II), such as superficial incisional surgical site infections (n=5) in the EC group. The rate of severe complications (Clavien-Dindo Classification ≥ III) was similar between the groups (20.7% vs. 16.7%, p=1, Fisher’s exact test).ConclusionsNo association was observed between the time of closure and development of major complications; however, there was an increased likelihood of minor complications after EC. This study provides a basis on which future treatment guidelines for early stoma closure may be developed without affecting patient quality of life.

New-onset atrial fibrillation following percutaneous closure of patent foramen ovale: a systematic review and meta-analysis.

A patent foramen ovale (PFO), present in up to 25% of adults, is an embryologic remnant which allows for right to left shunting and has been implicated in cryptogenic stroke (Neill and Lin, Methodist Debakey Cardiovasc J. 13(3):152-159, 2017; Bass 2015). The current standard of care for selected patients with PFO and cryptogenic stroke is transcatheter closure, but the risk of post-closure, new-onset atrial fibrillation (AF) is unknown (Vaidya et al., Cardiovasc Diagn Ther. 8(6):739-753, 2018; Kjeld et al., Acta Radiol Open. 7(9):2058460118793922, 2018; Staubach et al., Catheter Cardiovasc Interv. 74(6):889-95, 2009). This systematic review and meta-analysis synthesized evidence on AF development post transcatheter PFO closure and predictors of AF development, and assessed existing knowledge gaps. Randomized controlled trials and observational studies were selected according to the inclusion criteria of adults that underwent a transcatheter PFO closure without a history of AF. Studies were retrieved from electronic databases from inception until February 2019. A Freeman-Tukey arcsine transformation was performed for meta-analysis of AF incidence rate. From 765 studies, 45 were included in quantitative data synthesis. Study sample sizes ranged between 20 and 1887 individuals, and average patient age between 37 to 67years across studies. The overall incidence rate was 0.013 person-years, and 0.014 person-years for the within 6months follow-up subgroup. There was no consistency in reported predictors of AF development. The incidence of AF post-PFO closure was low across studies, with a high level of between-study heterogeneity. Until a concerted effort is made to improve accurate AF diagnosis, it will be difficult to gauge the association between transcatheter PFO closure and incidence of AF.

Validity Of Right Ventricular Strain In Prediction Of Successful Simple Cardiac Shunt Closure

Background: Pulmonary arterial hypertension in congenital heart disease is reversed by early shunt closure, but this potential is lost beyond a certain point of no return. this study was conducted to evaluate the results of simple cardiac shunt closure regarding right ventricular function using speckle tracking and reversibility of pulmonary hypertension, testing its ability to provide information with minimal risk,we detected right ventricular function in simple cardiac shunt patients before closure using longitudinal strain and to investigate its role in predicting reversibility of pulmonary hypertension after closure Methods: a prospective randomized comparative study,simple shunt patients from age 25-48 years presented to Zagazig University hospitals, cardiology department from September 2018 to July 2019 were divided into two groups Group I: ten patients having irreversible pulmonary hypertension. Group II: Twenty patients having reversible pulmonary hypertension. Results: There was statistically significant increase in Group II post closure regarding LVEF, RVFAC,TAPSE,SRV, RVLS (P< 0.05). While PASP showed significant decrease in Group II post closure (P < 0.05). On the other hand, RVLS was negatively correlated with the defect size (r = -0.65; p = <0.001), Qp/Qs (r = -0.53, p = <0.001), PASP (r = -0.8, p = <0.001). And significant positive correlation with SRV(r = 0.37; p = <0.001),RVFAC (r =0.30, p < 0.001),TAPSE(r =0.34, p < 0.001).ROC curve analysis revealed that RVLS value of ≥ -20 could predict reversibility of PASP (P< 0.001). Conclusion: The RVLS value of ≥-20 could predict reversibility of PASP (P< 0.001). RVLS correctly identify simple shunt patients with increased PASP.

Changes in hemodynamics pre and post closure of patent ductus arteriosus due to intervention less than 26 weeks of gestation

Changes in hemodynamics pre and post closure of patent ductus arteriosus due to intervention less than 26 weeks of gestation

CO2 Footprint of the Norwegian Longship Project

An analysis of the CO storage efficiency of the Longship project has been performed using a spreadsheet based LCA tool. Results are presented in terms of the CO2 footprint for each value chain measured in units of “tonnes of CO2 equivalent emissions per tonne of CO2 stored underground”. In other words, the results from the tool show the impact of the implementation and operation of the chain on the CO2 storage efficiency. The work was commissioned by Gassnova, the Norwegian State Enterprise for Carbon Capture and Storage. The work was performed by DNV GL and Carbon Limits The method used is consistent with the principles of ISO 14040 “Life Cycle Analysis – principles and framework” and ISO 14044 “Life Cycle Analysis – requirements and guidelines” and has been designed to calculate CO2 equivalent emissions to atmosphere in a 100-year perspective. The functional unit of the system studied is 1 tonne of CO2 stored, where storage refers to permanent geological storage .as defined in ISO 27914 “Carbon dioxide capture, transportation and geological storage – Geological storage”. The tool is capable of accounting for direct and indirect greenhouse gas emissions of each building block of the Carbon Capture and Storage (CCS) chain for the life cycle of the project. As such, for each building block, all project phases are included (construction, operation, decommissioning for capture and transport – construction, injection, post injection, decommissioning and post closure for storage) and for each phase CO2 emissions from the use of fuel, energy, chemicals, materials and transport are considered. In the Longship project, CO2 is captured from two capture sites, the cement factory of Norcem in Brevik and the waste to energy facility at Klemetsrud in Oslo, transported by ship to a receiving terminal at Naturgassparken near Bergen and further transported in a subsea pipeline to the Aurora CO2 storage license area near the Troll field in the North Sea for final geological storage. Three main value chains have been investigated corresponding to each of the two capture sites individually and one combining the two capture sites all with the same sort of transport and storage. Calculation results are then presented as total CO2 footprint measured in tonnes of CO2 equivalent per tonne CO2 stored for the value chain of each capture site separately and for both capture sites combined. In other words, the results from the tool show the impact of the implementation and operation of the chain on the CO2 storage efficiency. In addition, all three alternatives above are estimated when utilizing the full capacity of the storage infrastructure, 1.5Mt/y by introducing CO2 from other sources. The capture from these other sources are not included in the footprint calculations presented. Generally, the Longship project shows very low CO2 footprint compared to projects studied elsewhere. The 3 main reasons for the low CO2 footprint are 1) waste heat or internal steam is utilized for the CO2 capture processes,,2) the Norwegian electricity mix have a very low CO2 footprint and 3) the project has had high focus on using low footprint energy and fuel alternatives wherever possible. Since both capture sites have an element of biologically based raw materials the impact of BioCCS is also discussed as Longship can lead to net negative emissions.

A case study of management and disposal of TENORMs: radiological risk estimation by TSD Dose and RESRAD-ONSITE

&lt;abstract&gt; &lt;p&gt;Naturally Occurring Radioactive Materials (NORMs) and Technologically Enhanced NORMs (TENORMs) are among the principal sources of radiation exposure for humans and for the environment. Therefore, the assessment of the impact of NORMs and TENORMs waste on human health is a key issue for their management and for acceptance of disposal sites. The radiological doses to workers and public due to TENORMs disposal depend on the waste inventory, on the usage of the site during operational activities and post closure phase and on the presence of dwelling areas in the vicinity of the disposal site. In the present study it is presented a methodology to preliminary assess the feasibility of a disposal of TENORMs, mainly constituted by phosphate sludges, originated from phosphoric acid industry activities. The hypothetical case study here presented is inspired by a real case study. Different possible scenarios have been considered. The potential doses to workers and to the public on-site have been estimated by the use of the TSD Dose and the RESRAD on-site codes both during the production life cycle of the site and once it ended. Sensitivity analyses were conducted to evaluate the impact of some key parameters, such the coverage thickness and wind velocity, on potential risk for workers and public.&lt;/p&gt; &lt;/abstract&gt;

Preliminary impact of the COVID-19 pandemic on smoking and vaping in college students

We examined tobacco use changes in young adult college students in the context of the COVID-19 pandemic, focusing on smoking and vaping. First, we evaluated changes in tobacco use from pre to post campus closure focusing on smoking and electronic nicotine vaping frequency (days) and quantity (cigarettes/cartridges per day). Also, given the potential protective effects of pausing (temporarily or permanently discontinuing) smoking or vaping, we evaluated its predictors. We hypothesized that generalized anxiety and moving home would increase the odds of pausing. We also explored effects of COVID-related news exposure and seeking on tobacco use. We re-contacted young adults two years after they completed a study on alcohol and marijuana co-use. A subset (N = 83; 26.6% of the 312 respondents) were enrolled in college and reported use of cigarettes (n = 35) and/or e-cigarettes (n = 69) in the week prior to their campus closing (PC). Paired sample t-tests compared smoking and vaping frequency and quantity PC to past-week use since closing (SC). Multivariate logistic regression models were fit to examine predictors of pausing. Both smoking and vaping frequency decreased from PC to SC; however, decreased frequency did not correspond to reduced quantity. Twenty-four participants (28.9%) paused past-week use SC. Higher anxiety and moving home (versus living independently) were related to increased odds of pausing, whereas COVID-19 related news exposure and seeking were related to decreased odds of pausing. Characterizing COVID-19 related tobacco use change provides insights into how college students respond to novel health threats and informs potential interventions.

Gastroschisis: five cases after primary closure at Sanglah General Hospital, Bali, Indonesia

Background: Gastroschisis is a congenital anterior abdominal wall defect characterized by intra-abdominal organs evisceration without covering the membrane. Several risk factors affect the outcome of a gastroschisis patient. Considering these risk factors might also increase the chance of better prognosis and survival. We report five neonates with gastroschisis after primary closure in Sanglah General Hospital, Denpasar, Bali, in 2017. This case series aims to describe the clinical characteristics and outcome of different babies with gastroschisis managed by primary closure surgery.Case Presentation: Four of our cases were detected during pregnancy with fetal gastroschisis at the age of 32, 19, 23, 25 weeks of gestation, respectively. We reserve cesarean delivery for the patient who did antenatal care in our hospital, but one of our patients was born by spontaneous labor due to lack of antenatal care. Four cases had the primary closure of less than 2 hours and one of them after 10 hours. Good outcome was found in three cases that started enteral feeding on the 7th day after post closure. Other cases started oral feeding on the 3rd day and 12th day—both of them shown poor outcomes. Three cases survive, but two others died because of sepsis.Conclusion: We found poor outcomes in both cases, which neonatal sepsis as a significant cause. One of our cases with poor outcome was referred from another hospital without antenatal care and had a long duration of entering the operating room. Diagnosing these babies in their early prenatal period and transferring them to an experienced medical centre containing multidisciplinary working facilities will contribute to both the mother and the baby's health.

Cystic duct patch closure of remnant bile duct in living donor hepatectomy when primary closure is difficult: An easy solution.

Backgrounds/AimsIn living donor hepatectomy, hepatic duct division is a crucial step and often a technical challenge, with the aim of obtaining a good hepatic duct for anastomosis in the recipient and an adequate stump in the donor for closure. Very rarely, after duct division, the remaining stump may not be adequate for primary closure. In such a difficult situation, the options would be either to close stump transversely or a Roux-en-Y Hepaticojejunostomy.MethodsWe describe a novel surgical technique of “Cystic duct patch repair”, utilizing the available local tissues for closure of bile duct wall.ResultsTwo year follow up of this technique showed satisfactory results with no evidence of stricture and normal liver functions.ConclusionsIn living donor hepatectomy, “Cystic duct patch closure” may be used if the post closure cholangiogram is not satisfactory. Although the best method is prevention by ensuring a stump for closure, very rarely this error can occur and can be sorted by cystic duct patch repair.

Does Intraoperative Diuretic Therapy Affect the Thoracic Fluid Content and Clinical Outcome in Patients Undergoing Mitral Valve Surgery?

AbstractPulmonary congestion is inevitable in valvular heart disease. The condition worsens when a patient undergoes cardiopulmonary bypass (CPB). Thoracic fluid content (TFC) is an indicator of total volume status of lung in health and disease. We hypothesize that intraoperative diuretic therapy can improve the hemodynamic and clinical outcome in patients undergoing mitral valve surgery by decreasing TFC as measured by impedance cardiography (ICG).Sixty adult patients with critical mitral stenosis scheduled for mitral valve surgery divided into diuretic (Gr D, n = 30) and control (Gr C, n = 30) group. One mg/kg of furosemide was administered before CPB to Gr D and similar volume of normal saline to Gr C. Hemodynamic and TFC measurements were done by index of contractility (ICON), NICOM monitor at baseline, before anesthesia induction (T1), post skin closure (T2), postoperatively at 6th hour (T3), 24th hour (T4), and 48th hour (T5). The duration of mechanical ventilation (hour), intensive care unit stay (day) and inotropic score was significantly higher in Gr C (5.29 ± 1.4 vs. 2.15 ± 1.1; p = 0.001; 2.11 ± 0.64 vs. 1.67 ± 0.57, p = 0.002; 9 ± 5.4 vs. 5.8 ± 3.2, p = 0.05), respectively. Three patients in Gr C developed respiratory complication during their course of hospital stay. The baseline TFC value was comparable (p = 0.08). In Gr C. it gradually increased over time and never reached the baseline value, whereas in Gr D, there was slight increase in TFC till 6th postoperative hour and it came below the baseline value at 48th hour. A significantly higher TFC value in Gr C in comparison with Gr D from 6th to 48th postoperative hour (p = 0.005, 0.000, and 0.005, respectively) was observed.The ICON had a gradual improvement from 12th over 48th postoperative hour in Gr D in comparison to Gr C. The systemic vascular resistance index was decreased over time in Gr C, whereas in Gr D there was a mild fall at the end of surgery and it came back to near the baseline value at 48th postoperative hour. A continuous decrease in DO2 I except at 6th postoperative hour was seen in Gr C, whereas it remained near the baseline value in Gr D.Linear regression analysis showed significant direct correlation of TFC with intraoperative fluid balance (r = 0.524, p = 0.001), cumulative fluid balance (r = 0.680, p = 0.000) and both peak and mean airway pressure (r = 0.436, p = 0.001 and r = 0.548, p = 0.001, respectively).We concluded that TFC is clearly influenced by intraoperative diuretic therapy. A decrease in TFC has an association with better hemodynamic parameters that could find interesting clinical applications in the decision, whether or not to include a diuretic as a routine therapy during intraoperative management in valve surgery patients.

Comparative Study of Microscope Assisted Tympanoplasty and Endoscope Assisted Tympanoplasty

Aim: Endomeatal endoscopic tympanoplasty (ET) is a relatively new technique. We wanted to study the feasibility of performing this technique, its outcome using tragal perichondrium (TP) and its cosmetic benefits over the conventional microscopic tympanoplasty (MT) using temporalis fascia (TF).Patients and Methods: Study consisted of 81 patients in total between the age group 7 years to 70 years who fulfilled the inclusion criteria. Of these patients, 41 underwent MT using TP, while the remaining 40 underwent ET using TP as graft material.Results: For the graft uptake and hearing gain, ET and MT had similar outcomes, but time taken for surgery for ET was significantly less than the time taken for MT. In addition to this, satisfaction of clarity of view, depth perception, round window reflex, and ossicular chain visualization were all comparable in both groups but the visualization of the entire tympanic membrane was better in ET group. Cosmetic satisfaction of ET were significantly better than the MT group.Conclusion: Endoscope has a better visualization of the entire tympanic membrane without the need to manipulate the patients head. ET was an equally effective technique and TP was an efficient graft material. Conventional MT required a long post auricular incision, dissection and closure which lead to change in normal orientation of the pinna leading to poor cosmetic satisfaction. The dissection and closure also extended the duration of surgery which was not required in endoscopic technique which lead to significant reduction of duration of surgery and better cosmesis.

Editorial Comment on: Volumetric and acetabular changes in the bony pelvis associated with primary closure of classic bladder exstrophy

This manuscript examines a small subset of bladder exstrophy patients and describes pelvic bony anatomy. 18 patients underwent an MRI after closure, between 2 and 188 days after surgery, and 1/3 of these patients had osteotomies. All patients who were included had a successful closure, but there are no selection criteria provided. Fourteen patients had a pre and post closure MRI, and found that pelvic volumes increased, however, the authors admitted that this is likely due to normal patient somatic growth. Both pre and post closure pelvic volumes were different from controls. However, the authors demonstrate that acetabular angles more closely resembled controls after closure than pre-operatively. Volumetric and acetabular changes in the bony pelvis associated with primary closure of classic bladder exstrophyJournal of Pediatric UrologyVol. 16Issue 6PreviewRepair of classic bladder exstrophy (CBE) is known to alter dimensions of the bony pelvic ring. Pelvic volume and acetabular configuration are additional metrics which merit analysis in the reconstruction process. Advances in magnetic resonance imaging (MRI) allow for precise elucidation of such anatomy in pediatric patients, providing enhanced knowledge of how primary reconstruction may impact factors in pelvic health. Full-Text PDF

Evolution of blood biomarker levels following percutaneous atrial septal defect closure in adults.

We sought to assess the effects of percutaneous atrial septal defect (ASD) closure on blood biomarker levels that possibly reflect reverse cardiac remodeling. Therefore, this study investigated temporal changes in six blood biomarkers following percutaneous ASD closure in adults. In this prospective observational cohort study, adults with ASD type II scheduled for percutaneous closure were included (2012-2016). NT-proBNP, high-sensitive troponin-T (hs-TnT), high-sensitive C-reactive protein (hs-CRP), red blood cell distribution width (RDW), growth differentiation factor-15 (GDF-15) and galectin-3 were measured one day prior to ASD closure and one day, three months and one year post ASD closure, and changes were evaluated using paired T-tests. Echocardiographic measurements were obtained. Fifty patients were included (median age 50years, 62% women, 32% NYHA II). At baseline, biomarker levels were elevated in a substantial number of patients; NT-proBNP n=22 (45%), hs-TnT n=6 (13%) hs-CRP n=19 (40%), galectin-3 n=5 (11%) and GDF n=10 (23%). One day after ASD closure, significant increases of hs-TnT (median change (Δ)=12ng/L), hs-CRP (Δ=1.9mg/L), GDF-15(Δ=129pg/mL) and RDW (Δ=0.1%) were observed, and a decrease in galectin-3 (Δ=-1.0ng/mL). Consequently, 92% had at least one abnormal biomarker directly after closure. At three months biomarker levels returned to baseline, and while echocardiographic measures 1year post closure were indicative of reverse cardiac remodeling, biomarker levels did not further decrease. Percutaneous ASD closure in adults leads to a direct increase in most blood biomarkers, in particular hs-CRP and hs-TnT. After three months, biomarkers returned to baseline levels and remained stable up to one year.

Percutaneous secundum atrial septal defect closure for the treatment of atrial arrhythmia in the adult: A meta-analysis

BackgroundAtrial arrhythmias are common in patients with atrial septal defects (ASD) but the effects of percutaneous closure on atrial arrhythmia prevalence is unclear. We investigated the effects of ASD device closure and the impact of age at time of closure on prevalent atrial arrythmia. MethodsMeta-analysis of studies reporting atrial arrhythmia prevalence in adult patients before and after percutaneous closure was performed. Primary outcomes were prevalence of ‘all atrial arrhythmia’ and atrial fibrillation alone post closure. Sub-group analysis examined the effects of closure according to age in patients; <40 years, ≥40 and ≥ 60 years. 25 studies were included. ResultsMeta-analysis of all studies demonstrated no reduction in all atrial arrhythmia or atrial fibrillation prevalence post-closure (OR 0.855, 95% CI 0.672 to 1.087, P = .201 and OR 0.818, 95% CI 0.645 to 1.038, P = .099, respectively). A weak reduction in all atrial arrhythmia and atrial fibrillation was seen in patients ≥40 years (OR 0.77, 95% CI 0.616 to 0.979, P = .032 and OR 0.760, 95% CI 0.6 to 0.964, P = .024, respectively) but not ≥60 years (OR 0.822, 95% CI 0.593 to 1.141, P = .242 and OR 0.83, 95% CI 0.598 to 1.152, P = .266, respectively). No data were available in patients <40 years. This, and other limitations, prevents conclusive assessment of the effect of age on arrhythmia prevalence. ConclusionsOverall, percutaneous ASD closure is not associated with a reduction in atrial arrhythmia prevalence in this meta-analysis. A weak benefit is seen in patients ≥40 years of age, not present in patients ≥60 years.

Growth and mortality of planted interior Douglas-fir and western larch seedlings during the establishment phase in Idaho, USA

Planting for reforestation is increasingly important for the establishment of forests for future timber production and enhanced carbon sequestration. Planting also requires significant investment to ensure successful seedling establishment. However, initial seedling growth and survival is a common missing link in forest growth and yield models as they are predominantly designed to project established trees often post canopy closure. The multitude of both biotic and abiotic factors that influence growth and mortality of planted seedlings during the establishment phase is less examined. This is likely due to the high variability and complexity of this type of analysis, as well as the general lack of available data. The current study utilized annual measurements of 13,701 seedlings beginning immediately after planting to evaluate growth and mortality of planted interior Douglas-fir (Pseudotsuga menziesii var. glauca [Mirb.] Franco) and western larch (Larix occidentalis Nutt.) seedlings across multiple contrasting sites in northern Idaho and eastern Oregon for the first two years. Our results indicate that growth and mortality of seedlings were strongly influenced by their initial diameter and height such that slimmer and taller seedlings had higher mortality, while diameter and height growth was positively related to initial diameter and height, respectively. Weather conditions, especially measures of temperature and precipitation, had a similarly important role on seedling growth and mortality. The effects of root growth potential and competing vegetation were generally insignificant as pre-planting chemical preparation was applied to all sites. Improved western larch seedlings from seed orchards had higher growth rates with small increases in mortality compared to wild collected sources, but improved Douglas-fir had minimal gains in growth and much higher mortality. The developed seedling models readily fit into the architecture of current individual tree growth and yield models, which extend these models' ability to forecast seedlings during and after establishment. The identified influential factors and specific differences in seedling growth and mortality during the establishment phase provide critical information and guidance to the increasingly important reforestation practice of planting, and the overall analytical framework presented in this analysis is generally applicable to species beyond Douglas-fir and western larch.

MORBI-MORTALITY RELATED TO ILEOSTOMY AND COLOSTOMY CLOSURE AT TERTIARY CARE HOSPITAL BIKANER

Background: To study the morbi-mortality related to ileostomy or colostomy closure at tertiary care hospital Bikaner&#x0D; Material and Method: prospective hospital based study. 30 patients reporting to the General Surgery dept. within study duration and eligible as per inclusion criteria will be included in the study.&#x0D; Results: Out of 30 Cases ,(30.00%) patients had hypertension ,6(20.00%) had diabetes, 5 (16.67%) had renal dysfunction and 2(6.67%) cases had COPD. 11 (36.67%) patients developed complications post closure of ileostomy or colostomy. Medical complications accounted for a large proportion of complications (n=5), while major (n=4) and minor complications (n=2) were present.&#x0D; Conclusion: ileostomy is effective and feasible as a diversion procedure and has reduced morbidity and complication rates. &#x0D; Keywords: Ileostomy, Colostomy. Complications.

Assessment of external apical root resorption and root shape: Periapical VS panoramic films of maxillary incisors during orthodontic treatment: A prospective study

Background of the study: External apical root resorption (EARR) is the permanent loss of root structure involving the apical region which can be attributed to the forces acting on to the teeth by fixed appliance & more commonly seen in the upper incisors. The aim of this study was to analyse the amount of EARR (external apical root resorption) of maxillary incisors and to evaluate the root shape by comparing with periapical and panoramic films and also to evaluate the contribution of the gender and duration (pre & post space closure). Methodology: 30 subjects undergoing orthodontic treatment were selected for this study and were divided into 15 male and 15 female patients within the age range of 12-26 yrs. Totally 120 teeth were scanned (central & lateral). At the pre-treatment stage, standardized intraoral periapical films and digitalized panoramic films were taken. Crown and root lengths of the four maxillary incisors on the scanned periapical and panoramic films were measured. At post space closure follow up films were obtained and EARR were measured. All measurements were performed for each tooth separately. Any image distortion between the crown lengths for pre-treatment and post space closure films was corrected by using correction factor (CF). A root shape assessment was performed for each tooth by a 5 parameter ordinale scale which was categorized into the following, D----dilacerated, O----bottle shaped, B----blunted, P----pointed, N----normal. All the data underwent statistical analysis for comparison between groups. Results: Out of 120 teeth scanned through periapical and panoramic films, both central and lateral incisor showed EARR and the amount was greater for the maxillary lateral incisors compared to -bcxthe central incisors which was more evident in panoramic films. Based on gender, females showed more EARR compared with males and tendency being more for maxillary lateral incisors and the frequency of abnormal shapes in panoramic films were more compared with periapical films. Conclusions: The study concluded that all maxillary incisors showed significant root resorption post space closure, the amount of EARR being more for lateral than central incisors in both the films. Females showed more EARR than males and it was more clinically significant for lateral incisors. Root shape are more difficult to assess on panoramic films as the amount of root resorption will be exaggerated.

Antibiotic utilization in open fractures.

Open fractures are complex presentations with elevated risks of infection and nonunion due to a multitude of factors. Along with early surgical debridement, antibiotics have been heavily utilized and have become part of standard of care to reduce the risks of fracture-related infections. Many aspects of their use have been studied and debated. The early administration of intravenous antibiotics has been shown to significantly reduce the incidence of infection. Furthermore, current standards do not recommend prolonged antibiotic administration post wound closure. Recently, an increasing number of studies have assessed the utility of locally administered antibiotics. Clinical and basic science studies have been relatively supportive of their usage, but further studies are still warranted to further delineate their effects.