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The long-term performance of a geosynthetic clay liner (GCL) above a drainage layer and a geocomposite drain (GCD) are investigated. Full-scale tests are used to: (i) assess the integrity of GCL and GCD in a double composite liner below a defect in the primary geomembrane with ageing, and (ii) establish the head at which there was internal erosion in GCL without a carrier geotextile (GTX) such that the bentonite is in direct contact with the underlying gravel drainage. Six years after contact with simulated landfill leachate at 85 °C through an intentional defect on the geomembrane, the GCL resting on the GCD had failed due to degradation of the GTX between the bentonite and the core of the GCD and subsequent erosion of the bentonite into the core structure of the GCD was observed. In addition to complete degradation of its GTX at some locations, the GCD had also experienced extensive stress cracking and rib rollover. The second test demonstrates that if a suitable gravel drainage layer had been used instead of the GCD, the GTX component of the GCL would not have been required for acceptable long-term performance under normal design conditions and indeed could withstand a head of up to 15 m before problems became evident. The findings serve as a warning landfill designers and regulators that more attention must be paid to the service life of all components of double liner systems used in Municipal Solid Waste (MSW) landfills.
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http://dx.doi.org/10.1016/j.wasman.2023.02.004 | DOI Listing |
JAMA Netw Open
September 2025
Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
Importance: Patients with advanced cancer frequently receive broad-spectrum antibiotics, but changing use patterns across the end-of-life trajectory remain poorly understood.
Objective: To describe the patterns of broad-spectrum antibiotic use across defined end-of-life intervals in patients with advanced cancer.
Design, Setting, And Participants: This nationwide, population-based, retrospective cohort study used data from the South Korean National Health Insurance Service database to examine broad-spectrum antibiotic use among patients with advanced cancer who died between July 1, 2002, and December 31, 2021.
Eur J Trauma Emerg Surg
September 2025
French Military Medical Service Academy - École du Val-de-Grâce, Paris, France.
Background: Delivering intensive care in conflict zones and other resource-limited settings presents unique clinical, logistical, and ethical challenges. These contexts, characterized by disrupted infrastructure, limited personnel, and prolonged field care, require adapted strategies to ensure critical care delivery under resource-limited settings.
Objective: This scoping review aims to identify and characterize medical innovations developed or implemented in recent conflicts that may be relevant and transposable to intensive care units operating in other resource-limited settings.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz
September 2025
School of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Clarice Pears Building, 90 Byres Road, G12 8TB, Glasgow, UK.
The rate of improvement in life expectancy and mortality slowed considerably in a number of high-income countries from the early 2010s, predating the COVID-19 pandemic by almost a decade. Evidence for different countries, including the separate nations of the United Kingdom (e.g.
View Article and Find Full Text PDFEur J Prev Cardiol
September 2025
Department of Cardiology, Esbjerg and Grindsted Hospital - University Hospital of Southern Denmark, Esbjerg, Denmark.
Aim: This study aimed to establish general consensus on a systematic needs assessment model to determine eligibility for cardiac rehabilitation (CR) as part of secondary prevention in individuals with atrial fibrillation (AF). Specific objectives included identifying relevant needs assessment criteria and establishing consensus on referral criteria.
Methods: A Delphi study was conducted following the ACCORD guidelines (ACcurate COnsensus Reporting Document) with participation of an international, multi-disciplinary expert panel including physicians, nurses and other healthcare professionals, across primary and secondary care as well as academic research.
J Thorac Oncol
September 2025
Institut du Thorax Curie-Montsouris, Paris, France; Paris-Saclay University, UVSQ-Versailles, France.
Introduction: Amivantamab plus lazertinib significantly improved progression-free and overall survival versus osimertinib in patients with previously untreated, EGFR-mutant advanced NSCLC. EGFR-targeted therapies are associated with dermatologic adverse events (AEs), which can affect quality of life (QoL). COCOON was conducted to assess prophylactic management and improve treatment experience.
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