Several Laser in-situ keratomileusis (LASIK) complications have been identified over the years.Reporting complications of LASIK surgery will help refine the approach to their management.LASIK was introduced in the late 1980s with the development of the ophthalmic excimer laser [1,2].To avoid the disadvantages of photorefractive keratectomy (PRK), LASIK was introduced [3].LASIK rapidly increased in popularity and became the predominant form of refractive surgery in the late 1990s and continues till today [4].Correcting different refractive errors, including myopia, hyperopia, and astigmatism, is the main aim of all laser refractive procedures.LASIK has been used to treat many degrees of myopia with promising results, and there are great expectations for treating farsightedness.Compared to PRK, LASIK is advantageous in causing minimal postoperative discomfort, rapid restoration of visual clarity and stability of refractive changes, less frequent opacification, and better ability to correct high levels of myopia.Intraoperative complications, although infrequent, include Microkeratome-related flap complications (flap buttonhole, free cap, and incomplete, short, or irregular flaps), corneal perforation, corneal epithelial defect, conjunctival bleeding, subconjunctival hemorrhage, and interface debris [6].Post-operative Complications include inaccurate correction, visual aberrations, flap striae (macrostriae -microstriae) [6], flap dislocation, dry eye, diffuse lamellar keratitis (DLK), pressure-induced stromal keratitis (PISK), infectious keratitis [7], and epithelial ingrowth [8].Aim of the Study: To assess incidences, possible aetiology of the intra-operative, and early post-operative complications of LASIK.Literature-based Methodology: The intra-operative complication rate, reported between 0.7% and 6.5% [6], is most commonly associated with flap-related issues, including mechanical or FS Laser complications.
(ProQuest: ... denotes formulae omitted.)IntroductionThe water and soil are considered critical factors in the economic, social, cultural and even political. The water and soil are the key elements in the process of agricultural production, and thus the continuation of humanity.The water erosion causing soil erosion, and despoiled of mineral resources, leading to abandonment of the land, because of the damage left by the non-reclamation. As well as deposition of mud and deposits of gravel in the streams behind the dams to reduce the storage capacity of the water, leading to damage and disorder in the activity of water erosion within the main stream, causing the collapse of soil erosion on both sides of the channels.Now, soil erosion threatens starvation for people or even its existence. Efforts have been made in order to protect the water supply and soil. Corrosion usually leads to decreasing in agricultural production.At the present, the intensive use of resources causing intensive bargain between human and natural elements, leading to reassuring crises and unrest. Undoubtedly, an important factor of continuous development is accurate information, Geographic Information System (GIS) and Remote Sensing (RS) considered one of the most important tools for the management of resources, to prevent the bad effects of erosion, and their impacts on the surface of the land.The GISR extend from the north east towards the south-west, as belt form upstream toward out let of basin with parallel secondary belts, cover about 32.81% of basin area, the chart represented these formations.- Jurassic formations; appeared in watershed zone of the basin, it is constitute about 8.37% of basin area, these formations including two rock type, first consist of melange including blocks of sandstone, chert, limestone, and basalt in muddy matrix. Ascend type consisted of massive sandstone; inter bedded sandstone, mudstone, and siliceous mudstone. …
This study combined gravity data from the Earth Gravitational Model (EGM2008) with other data to better understand the spatial variations of the sedimentary cover and the structural trends that affect groundwater flow in the Nubian Sandstone Aquifer System. Our findings were verified and evidenced by geological, geochronological, geochemical data, and earthquake records: 1) The Uweinat-Aswan basement uplift, which runs east-west, partially isolates the Dakhla subbasin from the shallower northern Sudan subbasin, and thereby impeding the south-to-north groundwater flow from northern Sudan platform to the Dakhla subbasin; 2) A thickening of the sedimentary cover in the NE-SW direction from the southern Kufra through the northern Kufra to the Dakhla subbasin; 3) The sedimentary cover was found to increase from less than 500 m in the south (Northern Sudan and Uweinat region) to more than 6 km in the north (Mediterranean coast); 4) A number of structural trends (NE-SW, N-S, E-W, and NW-SE) affecting the region; 5) A large Pelusium megashear system that runs northeast to southwest makes it easier for groundwater to flow from the Kufra subbasin to the Dakhla subbasin; 6) Along the paths that groundwater takes, like from Siwa to Qattara and from northwest Farafra to north Bahariya, and along structures that run in the same direction as the flow, a progressive increase in 36 Cl groundwater ages were observed; 7) It is a better way to learn about the hydrogeological context of large aquifers and figure out how to best manage these underground water sources.
Abstract Background People living at home with advanced illness require around-the-clock care. Telephone-based advice lines are critical for accessing help, yet evidence is limited. Aim To explore ‘out-of-hours’ telephone-based advice lines available to adults living at home with advanced illness and their carers across the UK, and construct a practical framework to improve services. Design Structured qualitative interviews with thematic analysis. A patient and public involvement workshop was conducted to refine the proposed framework. Setting/participants Professionals with palliative/end-of-life care commissioning responsibilities, or knowledge of out-of-hours service provision, were purposively sampled to ensure UK-wide representation. Results Seventy-one interviews were conducted, covering 60 geographical areas. Five themes were identified. Availability: Ten models of advice lines were described. Variation led to confusion about who to call and when. Accessibility, awareness and promotion: It was assumed that patients/carers know who to call out-of-hours, but often they did not. Practicalities: Call handlers skills/expertise varied, which influenced how calls were managed. Possible responses ranged from simply signposting to organising home visits. Integration/continuity of care: Integration between care providers was limited by electronic medical records access and information sharing. Service structure/commissioning: Sustained funding was often an issue for charitably funded organisations. Conclusions Multiple advice lines lead to confusion and delays in obtaining care, as many default to general ‘out-of-hours’ advice lines. Dedicated advice lines are valuable for patients with advanced illness as long as they are implemented well. A practical framework (including a comprehensive overview of components) is provided for guiding how these are delivered. Key statements What is already known about the topic? People living at home with advanced illness and those that care for them need access to dedicated palliative and end-of-life care 24 hours a day, 7-days a week . While understanding of telephone advice lines often exists at a single service level, there is limited knowledge in terms of national provision . What does this paper add? This qualitative study provides an understanding of multiple telephone-based advice line services available out-of-hours at a national-level, and identifies a lack of consistency and challenges with integration between available services . Promotion of dedicated advice lines (or an area equivalent) needs to ensure that people with advanced illness are aware of how to access such support, but there is variation in how this is done . Incorporating the views of patients with advanced illness and carers in the development of telephone-based advice is essential to ensure the care delivered is centred around their needs . Implications for practice, theory or policy The practical framework developed in this research (using key considerations from professionals based on structured interviews and a patient and public involvement workshop) can be used to guide commissioners and service providers .
Abstract A severe threat to natural resources and human livelihood is groundwater scarcity. Therefore, mapping groundwater potentiality (GWP) is necessary for future resource management. In this article, a framework for conducting ensemble modeling is introduced. This framework will be used to map GWP at the national level under the climate change scenario. Thirteen elements linked to topography, geology, hydrology, and land cover, as well as six climatic indicators based on historical time series data, were used to map the GWP. To provide extremely reliable groundwater potentiality mapping, three traditional standalone machine learning techniques such as logistic model tree (LMT), logistic regression (LR), and artificial neural network (ANN) have been merged with a stacking ensemble framework. Using the empirical and binormal receiver operating characteristic curves, the GWP mapping has been validated (ROC curve). According to research, Bangladesh's major rivers run along the high GWP zones in the country's southern and central regions. Additionally, the validation using the ROC curve demonstrates that the stacking model which had all three MLAs—performed better than other models (AUC: 0.971). The study may have a substantial impact on Bangladesh's national water planning and policy, which will be made using evidence. Additionally, the suggested method might be applied to map GWP on a broader scale in additional nations as well as at the continental level.
The recent research aims to investigate the petrophysical and hydrogeological parameters of the Nubian aquifer system (NAS) in Northern Khartoum State, Sudan, using integrated geophysical methods, including surface electrical resistivity and geophysical well-logging. The Nubian aquifer is a transboundary regional aquifer that covers vast areas in Sudan, Egypt, Libya and Chad. The well-logs, including self-potential (SP), natural gamma ray (GR), and long normal resistivity (RS), are integrated with Vertical Electrical Sounding (VES) measurements to delineate the hydrostratigraphical units. As a result, two aquifers are detected. An upper aquifer comprises coarse sand with an average thickness of 50 m and a lower aquifer of sandstone with more than 200 m thickness. For a thorough evaluation of the aquifers, in the first stage, the petrophysical and hydrogeological parameters, including formation factor, total and effective porosity, shale volume, hydraulic conductivity, and transmissivity, are measured solely from geophysical well-logs. In the second step, the results of geophysical well logs are combined with VES and pumping test data to detect the spatial variation of the measured parameters over the study area. As a result, the hydraulic conductivity of the Nubian aquifers ranged from 1.9 to 7.8 m/day, while the transmissivity varied between 120 and 733 m 2 /day. These results indicated that the potentiality of the Nubian formation is high; however, in some regions, due to the sediment heterogeneity, the aquifers have intermediate to high potential. According to the obtained results, it can be concluded that the Nubian Aquifer in Khartoum state is ideal for groundwater development. This research discovered that geophysical approaches can be used to characterize moderately heterogeneous groundwater systems by comparing the Nubian aquifer with similar aquifer systems that have similar hydrogeological settings. This study emphasized the application of universal principles in extrapolating hydraulic parameters in hydrogeophysical surveys. This approach aims to reduce the costs and efforts associated with traditional hydrogeological approaches.