Equatorial Layered Deposits (ELDs) reveal aspects of past depositional environments useful for timing climatic and geological events on Mars. However, their formation has several contending ...hypotheses which reflect a diverse range of possible environments. To better constrain their formation mechanism, we analyzed the stratigraphic and mineralogical characteristics and mapped the distribution of ELDs within three close craters, Sera, Jiji, and an unnamed crater in central Arabia Terra. Analyses of craters' geology allowed us to reconstruct the paleo‐environments where ELDs have been deposited. Thinning and thickening sequence trends show shared and repeated variations in the depositional environment, reflecting sediment accumulation strongly controlled by a regional groundwater reservoir. Layered deposits are characterized by monohydrated and polyhydrated sulfate signatures implying an interaction between water and rock in acidic conditions. Our study contributes to the understanding of regional geological processes in Arabia Terra revealing long‐term aqueous activity.
Plain Language Summary
Despite years of orbital observations of the surface of Mars, mid‐to low‐latitude layered deposits (LD) in Arabia Terra are not yet fully understood. These deposits record an important geological sequence of the early Martian history, but their exact formation, specifically the putative role of the water in their formation and preservation, remains an unanswered question. This study helps in further understanding these processes by comparing and contrasting LD present in craters in very close proximity to each other. In this way, proposed hypotheses benefit from having a control that is not limited to a singular crater or location. Our study contributes to the understanding of regional geological processes in Arabia Terra revealing long‐term aqueous activity. Results combine various analyses, including measurements of layer thickness and attitudes, orbital spectroscopy, basin geometry, and morphologies aimed at reconstructing the geological evolution of the area. In particular, we interpreted that LD were emplaced in a depositional environment reflecting sediment accumulation strongly controlled by a regional groundwater reservoir in acidic conditions.
Key Points
Regional groundwater fluctuations influenced the deposition, mineralogy, and preservation of Equatorial Layered Deposits (ELDs) in Arabia Terra
Four different stratigraphic sequences of layered deposits have been identified on the basis of strata thickness and attitude
Mineralogical analyses of ELDs suggest the presence of different levels of hydration of sulfates
The Gamma Ray Spectrometer (Mars Odyssey spacecraft) has revealed elemental distributions of potassium (K), thorium (Th), and iron (Fe) on Mars that require fractionation of K (and possibly Th and ...Fe) consistent with aqueous activity. This includes weathering, evolution of soils, and transport, sorting, and deposition, as well as with the location of first-order geomorphological demarcations identified as possible paleoocean boundaries. The element abundances occur in patterns consistent with weathering
in situ and possible presence of relict or exhumed paleosols, deposition of weathered materials (salts and clastic minerals), and weathering/transport under neutral to acidic brines. The abundances are explained by hydrogeology consistent with the possibly overlapping alternatives of paleooceans and/or heterogeneous rock compositions from diverse provenances (e.g., differing igneous compositions).
In the United States, from 1999 to 2019, opioid overdose, either regularly prescribed or illegally acquired, was the cause of death for nearly 500,000 people. In addition to this pronounced mortality ...burden that has increased gradually over time, opioid overdose has significant morbidity with severe risks and side effects. As a result, opioid misuse is a cause for concern and is considered an epidemic. This article examines the trends and consequences of the opioid epidemic presented in recent international literature, reflecting on the causes of this phenomenon and the possible strategies to address it. The detailed analysis of 33 international articles highlights numerous impacts in the social, public health, economic, and political spheres. The prescription opioid epidemic is an almost exclusively North American problem. This phenomenon should be carefully evaluated from a healthcare systems perspective, for consequential risks and harms of aggressive opioid prescription practices for pain management. Appropriate policies are required to manage opioid use and prevent abuse efficiently. Examples of proper policies vary, such as the use of validated questionnaires for the early identification of patients at risk of addiction, the effective use of regional and national prescription monitoring programs, and the proper dissemination and translation of knowledge to highlight the risks of prescription opioid abuse.
Although healthcare-associated infections (HAIs) pose an extraordinary burden on public health, the impact of coronavirus disease 2019 (COVID-19) is still a matter of debate.
To describe trends of ...HAIs in Italian intensive care units (ICUs) from 2006 to 2021, and to compare characteristics and outcomes of patients with or without COVID-19.
We evaluated patients participating in the ‘Italian Nosocomial Infections Surveillance in Intensive Care Units’ (SPIN-UTI) project, who were admitted to ICUs for more than 48 h. Data regarding diagnosis, clinical conditions, therapies, treatments and outcomes of COVID-19 patients were also collected.
From a total of 21,523 patients from 2006 to 2021, 3485 (16.2%) presented at least one HAI. We observed an increasing trend for both the incidence of patients with HAI and the incidence density of HAIs (P-trend <0.001). Compared with the pre-pandemic period, the incidence density of HAIs increased by about 15% in 2020–2021, with pneumoniae being the greatest contributors to this increase (P-trend <0.001). Moreover, incidence of HAIs was higher in ICUs dedicated to COVID-19 patients (P<0.001), who showed a greater risk of HAIs and death than patients without COVID-19 (P-values <0.001). Accordingly, the mortality in ICUs increased over the years and doubled during the pandemic (P-trend <0.001). Notably, co-infected patients had higher mortality (75.2%) than those with COVID-19 (66.2%) or HAI (39.9%) alone, and those without any infection (23.2%).
Our analysis provides useful insight into whether and how the COVID-19 pandemic influenced HAI incidence and death in Italian ICUs, highlighting the need for evaluation of the long-term effects of the pandemic.
Pain is a symptom that should be evaluated along with its comorbidities in order to plan an effective holistic treatment strategy involving specific pharmacological interventions, side effect ...management, psychological support, control of therapeutic effects over time, and dialogue with the patient and their relatives. In this holistic process of caring for patients with pain, nurses play a central role as they deal with suffering patients directly and continuously. The purpose of this study was to evaluate the types of pain identified by nurses in their daily clinical practice and the associated comorbidities (anamnestic history taking) by geographical region and to evaluate the pharmacological strategies used.
A cross-sectional survey was performed among 696 registered nurses in Italy. Data were collected using an online questionnaire.
There was a significant difference between geographical regions in terms of reports of acute and chronic pain: acute pain was more frequently reported in the South (63.5%), while chronic pain was more frequent in the Central region (32.3%; p=0.0008). Additionally, chronic oncological pain was more frequent in the Northeast (29.6%), while chronic non-oncological pain was more frequently reported in the Central region (33.9%; p=0.0001). The underlying pain disorders reported were also different between geographical regions; rheumatic pain (21.8%) and neurological pain (18.6%) were more frequent in the Central region, while musculoskeletal pain was significantly more frequent in the South (43.4%; p=0.004). Anxiety, sleep disorders and somatization were found in acute pain (60.82%, 43.56% and 53.12%), while depression and mood disorders were more frequently detected in chronic pain condition (p<0.001).
Our study showed differences among Italian regions in pain assessment. Specific education on pain management nursing is essential for nurses. Promotion of optimal nursing care for people affected by pain is the main focus of pain management nursing. Nowadays, nurses should focus on personalized complex care and research in order to improve the patient's quality of life.
Although preventive strategies have been proposed against catheter-associated urinary tract infections (CAUTIs) in intensive care units (ICUs), more efforts are needed to control the incidence rate.
...To distinguish patients according to their characteristics at ICU admission, and to identify clusters of patients at higher risk for CAUTIs.
A two-step cluster analysis was conducted on 9656 patients from the Italian Nosocomial Infections Surveillance in Intensive Care Units project.
Three clusters of patients were identified. Type of admission, patient origin and administration of antibiotics had the greatest weight on the clustering model. Cluster 1 comprised more patients with a medical type of ICU admission who came from the community. Cluster 2 comprised patients who were more likely to come from other wards/hospitals, and to report administration of antibiotics 48 h before or after ICU admission. Cluster 3 was similar to Cluster 2 but was characterized by a lower percentage of patients with administration of antibiotics 48 h before or after ICU admission. Patients in Clusters 1 and 2 had a longer duration of urinary catheterization median 7 days, interquartile range (IQR) 12 days for Cluster 1; median 7 days, IQR 11 days for Cluster 2 than patients in Cluster 3 (median 6 days, IQR 8 days; P<0.001). Interestingly, patients in Cluster 1 had a higher incidence of CAUTIs (3.5 per 100 patients) compared with patients in the other two clusters (2.5 per 100 patients in both clusters; P=0.033).
To the authors' knowledge, this is the first study to use cluster analysis to identify patients at higher risk of CAUTIs who could gain greater benefit from preventive strategies.
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