Summary
This study examines the association of the levels of different airborne pollutants on the incidence of osteoporotic hip fracture in a southern European region. Association was detected ...between SO
2
and NO
2
and hospital admissions due to hip fracture.
Introduction
To examine the short-term effects of outdoor air pollution on the incidence of osteoporotic hip fracture in a southern European region.
Methods
This is an ecological retrospective cohort study based on data obtained from three databases. In a time-series analysis, we examined the association between hip fracture incidence and different outdoor air pollutants (sulfur dioxide (SO
2
), monoxide (NO), nitrogen dioxide (NO
2
), ozone (O
3
), and particulate matter in suspension < 2.5 (PM
2.5
) and < 10-μm (PM
10
) conditions by using general additive models (Poisson distribution). The incidence rate ratio (IRR), crude and adjusted by season and different weather conditions, was estimated for all parameters. Hip incidence was later analyzed by sex and age (under or over age 75) subgroups. The main outcome measure was daily hospital admissions due to fracture.
Results
Hip fracture incidence showed association with SO
2
(IRR 1.11 (95% CI 1.04–1.18)), NO (IRR 1.01 (95% CI 1.01–1.02)), and NO
2
(IRR 1.02 (95% CI 1.01–1.04)). For O
3
levels, this association was negative (IRR 0.97 (95% CI 0.95–0.99)). The association persisted for SO
2
and NO
2
when the models were adjusted by season. After adjusting by season and weather conditions, the association persisted for NO
2
. When participants were stratified by age and sex, associations persisted only in women older than 75 years.
Conclusions
A short-term association was observed with several indicators of air pollution on hip fracture incidence. This is the first study that shows these associations.
Abstract
Health care-related infections are frequent and among them surgical site infection (SSI) are the most frequent in hospitals. The objective was to evaluate the adequacy of antibiotic ...prophylaxis in patients undergoing neck surgery and its relationship with the incidence of surgical site infection (SSI). Prospective cohort study. The adequacy of antibiotic prophylaxis in patients undergoing neck surgery was evaluated. Antibiotic prophylaxis was considered adequate when it conformed to all items of the protocol (antibiotic used, time of administration, administration route, dose and duration). The cumulative incidence of SSI was calculated, and the relationship between SSI and antibiotic prophylaxis adequacy was determined using adjusted relative risk (RR). Antibiotic prophylaxis was administered in 63 patients and was adequate in 85.7% (95% CI 75.0–92.3) of them. The cumulative incidence of SSI was 6.4% (95% CI 3.4–11.8). There was no significant relationship between antibiotic prophylaxis inadequacy and the incidence of SSI (RR = 2.4, 95% CI 0.6–10.6). Adequacy of antibiotic prophylaxis was high and it did not affect the incidence of SSIs.
The Glen Torridon (GT) region within Gale crater, Mars, occurs in contact with the southern side of Vera Rubin ridge (VRR), a well-defined geomorphic feature that is comparatively resistant to ...erosion. Prior to detailed ground-based investigation of GT, its geologic relationship with VRR was unknown. Distinct lithologic subunits within the Jura member (Murray formation), which forms the upper part of VRR, made it possible to be also identified within GT. This indicates that the strata pass across the geomorphic divide between regions. Furthermore, the cross-bedded lower part of the overlying Knockfarril Hill member (Carolyn Shoemaker formation) also occurs within both VRR and GT. Correlation of both units demonstrates that the strata form a continuous stratigraphic succession regardless of large-scale geomorphic expression. The lithologic change from mudstone (Jura member) to cross-bedded sandstone (Knockfarril Hill member) heralds a significant shift in paleoenvironment from lacustrine to fluvial. The upper part of the Knockfarril Hill member consists of interbedded mudstone and sandstone that transitions to the overlying finely laminated mudstone of the Glasgow member, and a return to lacustrine deposition. In GT, the Stimson formation unconformably overlies the Glasgow member, where it demarks the southern boundary of GT. Contacts for each stratigraphic unit were defined and transferred to a high-resolution image base to make a geologic map and cross sections perpendicular to the NE strike. Stratal dips cannot exceed 2° NW to retain the positions of stratigraphic units in the locations they are exposed throughout GT.
Adjuvant chemotherapy (CT) significally reduces the rate of relapse in +pN (stage III) colon cancer and in some pN0 (stage II) with risk factors such as pT4, vascular invasion V1, perineural invasion ...Pn1, and complicated tumors. However, unexpectedly, 20-30% of pN0 present a relapse in the follow-up, which may suggest that the lymph node involvement was not discovered in the conventional histological study (CS), and its finding with a superstudy (SS) could increase the number of patients who would benefit from neoadjuvant CT. It is not possible to perform this SS in every lymph node (LN) from the specimen, but it is possible in a small group of LN which are representative of the N status (definition of sentinel node SN). The aim of our work is to state the representativeness of the SN and to analyze de number of patients who are suprastaged after the SS of the SN.
Prospective study of a series of patients who have undergone curative surgery for colon cancer, to whom we perform selective biopsy of sentinel node. Identification of SN was carried out with in vivo injection of the radiotracer, with ex vivo isolation of SN. Once the specimen is out, we take pictures of the surgical bed to rule out the presence of aberrant drainage routes, out of the routine oncological resection area. We performed the histological CS (hematoxilin-eosin stain in conventional sections) in the rest of the LN from the mesocolon. In the SN we performed the CS and a SS with hematoxilin-eosin in serial sections, immunohistochemistry (IHC) and molecular study with One Step Nucleic Acid Amplification (OSNA®). Diagnostic validity study od selective biopsy of sentinel node was carried out, defining the false negative (FN) as the negativity of the SN while other LN are positive (N+), as well as a valuation of the suprastaging due to the SS of the SN.
We performed lymphatic map in 72 patients, finding the SN in 62 of them (87.3%). The 9 identification failures happened in the first 17 cases. We have not found aberrant drainage routes. A total of 1.164 LN were studied in the 62 patients (18.8 LN/ patient), from which 145 are SN (2,34 SN/ patient), having found 103 positive LN with the CS and 112 positive with the SS of SN (9 +LN more in 8 patients than detected with the CS). Positivity after CS in the SN group is 17.24% (25/145), while it is 8.53% in the rest (87/1.019) (p<.001). With the CS, 50% of the patients (31/62) were pN+ (4 are N+ exclusively in the SN), and after the SS of the SN, only 1 of the 31 pN0 patients (3.2%) becomes pN1a, with a definitive 51.6% of N+ in the whole series (32 N+ in the 62 patients) (5 are N+ exclusively in the SN). Exclusively with the SS of the SN, FN rate ("-SN, +others", meaning patients who are N+ having -SN) is 54.8% (17/31). With the SS of the SN, 8 of the 62 patients (12.9%) increase their total number of +LN: apart from the patient who turns from pN0 to pN1a, suprastaging from IIA to IIIB (and therefore increasing the total number of pN+ to 32), 5 of the 17 FN in the CS turns into positive (2 change the pN subindex and one is suprastaged from IIIB to IIIC), decreasing FN to 37.5% (12/32 cases). Besides, 2 patients whose SN is already positive in the CS increase the number of +SN after the SS of the SN, therefore both changing their pN subindex and one of them suprastaging from IIIB to IIIC. In summary, 8 patients increase the total number of positive SN after the SS (8/62, 12.9%), 5 of them changing the pN subindex (5/62, 12.9%), even if only 3 of them get suprastaged (3/62, 4.8%), among them the one who turns from pN0 to pN1a.
Technique is valid and reproducible, with a high detection rate even with a high learning curve. It globally increases the number of affected LN in 12.9% of patients, having prognostic implications in 4.8% (suprastaging rate). Only 3.2% of pN0 patients in the CS turn to be +pN after the SS of the SN, with its therapeutic implications (prescription of adjuvant CT), which could be relevant when extrapolated to a big number of patients. The high FN rate (37.5%) prevents us from accepting the representativeness of SN as the global N status, but it is not clinically relevant in colon cancer, as its aim is not to avoid lymphadenectomy, which remains mandatory (opposite to breast cancer or melanoma in which SN detection decides upon whether to perform or not the lymphadenectomy), but to decide which patients would benefit from adjuvant CT.
Early observations from the Perseverance rover suggested a deltaic origin for the western fan of Jezero crater only from images of the Kodiak butte. Here, we use images from the SuperCam Remote ...Micro‐Imager and the Mastcam‐Z camera to analyze the western fan front along the rover traverse, and further assess its depositional origin. Outcrops in the middle to lower half of the hillslopes comprise planar and inclined beds of sandstone that are interpreted as foresets of deltaic deposits. Foresets are locally structured in ∼20–25 m thick, ∼80–100 m long, antiformal structures interpreted as deltaic mouth bars. Above these foresets, interbedded sandstones and boulder conglomerates are interpreted as fluvial topset beds. One well‐preserved lens of boulder conglomerate displays rounded clasts within well‐sorted sediment deposited in overall fining upward beds. We interpret these deposits as resulting from lateral accretion within fluvial channels. Estimations of peak discharge rates give a range between ∼100 and ∼500 m3 s−1. By contrast, boulder conglomerates exposed in the uppermost part of hillslopes are poorly sorted and truncate the underlying beds. The presence of these boulder deposits suggests that intense sediment‐laden flood episodes occurred after the deltaic foreset and topset beds were deposited, although the origin, timing, and relationship of these boulder deposits to the ancient lake that once filled Jezero crater remains undetermined. Overall, these observations confirm the deltaic nature of the fan front, and suggest a highly variable fluvial input.
Plain Language Summary
Early observations from the Perseverance rover of the Kodiak butte suggested a deltaic origin for the western fan of Jezero crater. Here, we use images from the SuperCam Remote Micro‐Imager and the Mastcam‐Z camera to analyze the western fan front along the rover traverse, and further assess its origin. We observe strata in the lower part of the fan front that we interpret as deltaic deposits formed below water in a lake. The strata of the upper part of the fan front contain sediments interpreted as fluvial deposits formed under various fluvial regimes, with some of them being deposited by the rivers that also fed the Jezero paleolake. Overall, these observations confirm the deltaic nature of the fan front, and suggest a highly variable fluvial input.
Key Points
New observations from the Perseverance rover of the western fan front confirm a deltaic origin
Deltaic foresets in the lower fan front are organized as antiformal structures interpreted as delta mouth bars
Sandstones and conglomerates in the upper part of the fan front suggest a highly variable fluvial input
Increasing evidence demonstrates that oxidative stress causes damage to cell function with aging and is involved in a number of age-related disorders including atherosclerosis, arthritis, and ...neurodegenerative disorders. Cellular changes show that oxidative stress is a condition that precedes the appearance of the hallmark pathologies of the disease, neurofibrillary tangles and senile plaques. The aim of this article is to analyze the different biomarkers of oxidative stress in Alzheimer patients, in different stages of the illness, and compare the results with a control group. A nutritional evaluation was carried out, including anthropometric and biological measures and a 3 day dietary record. The concentration of substances which react to thiobarbituric acid (TBARS) was measured as a marker of the degree of peroxidation using the HPLC method. The oxidation of proteins was analyzed by measuring the carbonyl groups in plasma. In addition, measurements were made of the total antioxidant activity in plasma and the activity of endogenous antioxidant enzymes such as gluthatione peroxidase, gluthatione reductase and superoxide dismutase. The total antioxidant plasmatic status of the patients with Alzheimer both in light-moderate phase and in advanced phase was lower than in the control. No significant differences were observed between the different stages of the disease in protein oxidation levels. Peroxidation was higher in patients in the advanced stage of the disease than in the control group. However, no significant differences were observed between the different stages of the disease. In this preliminary study, it was observed that Alzheimer patients in the light-moderate stage already present oxidative stress levels above those of the control group.
High‐resolution 2D and 3D data remotely acquired by SuperCam's Remote Micro‐Imager and Mastcam‐Z aboard the Perseverance rover enabled us to characterize the stratigraphic architecture and ...sedimentary record of the Kodiak butte, an isolated remnant of the western delta fan of Jezero crater. Using these data, we build up on previous interpretations of the butte interpreted as a prograding Gilbert‐type deltaic series. We characterize three individual stratigraphic Units 0 to 2 on the eastern and northern faces of the butte. Each Unit displays the same vertical succession of prodeltaic/lacustrine bottomsets, delta slope toesets and foresets, and fluvially influenced topsets of a deltaic plain with a braided river pattern, shown by 11 individual sedimentary facies. We infer that these individual Units record the formation of three distinct deltaic mouth bars successively across time and space. For the first time on another planet than Earth, we are able to construct a precise sequence stratigraphic framework to highlight lake‐level fluctuations at the time the Kodiak butte was emplaced, during the latest stages of deltaic activity. We identify four hydrogeological cycles indicated by alternating rises and falls of the lake‐level on the order of 5–10 m. These were most probably linked to climatic events and variations controlling lake water inputs in probable relation to an astronomical control.
Plain Language Summary
Kodiak butte is an isolated remnant of the main western sedimentary fan of Jezero crater. It displays the characteristic structures of a Gilbert‐type delta, a structure that shows deposition of fluvial material into a standing body of water, here interpreted to be a lake within Jezero crater. 11 individual sedimentary facies (textures, grain‐sizes, and structures) of the rocks exposed at Kodiak suggest that the depositional environments ranged from the fluvial plain to a steep subaqueous slope and into the bottom of the shallow Jezero lake. Our observations further show that Kodiak butte is organized into three distinct stratigraphic Units (0–2), each displaying the same vertical succession of bottomsets, toesets, foresets and topsets. This architecture is interpreted as reflecting three distinct deltaic packages, formed consecutively and not at the same time. Using these facies and stratigraphic architecture data, we are able for the first time on another planet than Earth, to precisely construct a sequence stratigraphic framework for the formation of Kodiak. This framework illustrates with unprecedented precision successive episodes of rises and falls of the paleo‐lake‐level (in the order of 5–10 m) involved in the construction and evolution of the western Jezero delta.
Key Points
New observations on the Kodiak delta remnant were carried out to characterize its detailed facies and stratigraphic architecture
Three deltaic mouth bars are identified showing 4D succession of depositional settings ranging from deltaic plain to slope to shallow lake
The first ever sequence stratigraphic framework on Mars shows four cycles of alternating rises and falls of the lake‐level within 5–10 m
Sedimentary fans are key targets of exploration on Mars because they record the history of surface aqueous activity and habitability. The sedimentary fan extending from the Neretva Vallis breach of ...Jezero crater's western rim is one of the Mars 2020 Perseverance rover's main exploration targets. Perseverance spent ∼250 sols exploring and collecting seven rock cores from the lower ∼25 m of sedimentary rock exposed within the fan's eastern scarp, a sequence informally named the “Shenandoah” formation. This study describes the sedimentology and stratigraphy of the Shenandoah formation at two areas, “Cape Nukshak” and “Hawksbill Gap,” including a characterization, interpretation, and depositional framework for the facies that comprise it. The five main facies of the Shenandoah formation include: laminated mudstone, laminated sandstone, low‐angle cross stratified sandstone, thin‐bedded granule sandstone, and thick‐bedded granule‐pebble sandstone and conglomerate. These facies are organized into three facies associations (FA): FA1, comprised of laminated and soft sediment‐deformed sandstone interbedded with broad, unconfined coarser‐grained granule and pebbly sandstone intervals; FA2, comprised predominantly of laterally extensive, soft‐sediment deformed laminated, sulfate‐bearing mudstone with lenses of low‐angle cross‐stratified and scoured sandstone; and FA3, comprised of dipping planar, thin‐bedded sand‐gravel couplets. The depositional model favored for the Shenandoah formation involves the transition from a sand‐dominated distal alluvial fan setting (FA1) to a stable, widespread saline lake (FA2), followed by the progradation of a river delta system (FA3) into the lake basin. This sequence records the initiation of a relatively long‐lived, habitable lacustrine and deltaic environment within Jezero crater.
Plain Language Summary
Fan‐shaped deposits are important exploration targets on Mars because they record the activity of water and conditions suitable for life on the surface. The Mars 2020 Perseverance rover has been exploring an ancient impact crater, named Jezero, since landing on Mars in February 2021. One of the rover's main exploration targets is a fan‐shaped deposit of sedimentary rock extending into the crater from the western rim. One Earth year into the rover's mission, Perseverance arrived at the eroded edge of this fan, exploring several outcrops of sedimentary rock, and collecting seven rock samples. This study uses images and data from Perseverance to describe these rocks, called the “Shenandoah” formation, and to determine how they formed. The oldest rocks of the Shenandoah formation contain sand and pebbles that were likely laid down at the edge of an alluvial fan. Next, very fine‐grained rocks were deposited in a lake setting. Dipping layers of alternating sand and pebbles represent a change in the local setting and the growth of a delta into a relatively long‐lived lake. The rover's observations of the Shenandoah formation show that past conditions in Jezero crater were capable of hosting and preserving signs of ancient life.
Key Points
The Shenandoah formation is a sand‐dominated, clastic, sedimentary sequence comprising the lower 25 m of Jezero's western fan
This sequence records the transition from an alluvial fan setting to a lacustrine setting, followed by progradation of a river delta
This sequence records evidence for a warm, wet, habitable depositional setting with the potential to preserve biosignatures
OBJECTIVETo assess compliance with the antibiotic prophylaxis protocol for patients who underwent renal surgery and its effect on the incidence of surgical wound infection. MATERIAL AND METHODSWe ...performed a prospective cohort study and assessed the overall compliance and each aspect of the antibiotic prophylaxis (start, administration route, antibiotic of choice, duration and dosage) and reported the compliance rates. The qualitative variables were compared with the chi-squared test, and the quantitative variables were compared with Student's t-test. We studied the effect of antibiotic prophylaxis compliance on the incidence of surgical wound infection in renal surgery, with the relative risk. RESULTSThe study included 266 patients, with an overall compliance rate of 90.6%. The major cause of noncompliance (3.8%) was the start of the prophylaxis, and the incidence rate of surgical wound infections was 3.4%. We found no relationship between antibiotic prophylaxis noncompliance and surgical wound infections (RR=0.26; 95%CI: 0.1-1.2; P>.05). Laparoscopic surgery had a lower incidence of surgical wound infections than open surgery (RR=0.10; 95%CI: 0.01-0.79). CONCLUSIONSThe antibiotic prophylaxis compliance was high. The incidence of surgical site infection was low, and there was no relationship between the incidence of surgical site infection and antibiotic prophylaxis compliance. The incidence of infection was lower in laparoscopic surgery.
Wave modeling and analysis of sedimentary structures were used to evaluate whether four examples of symmetrical, reversing, or straight‐crested bedforms in Gale crater sandstones are preserved wave ...ripples; deposition by waves would demonstrate that the lake was not covered by ice at that time. Wave modeling indicates that regardless of atmospheric density, winds that exceeded the threshold of aeolian sand transport could have generated waves capable of producing nearshore wave ripples in most grain sizes of sand. Reversing 3‐m‐wavelength bedforms in the Kimberley formation are interpreted not as wave ripples but rather as large aeolian ripples that formed in an atmosphere approximately as thin as at present. These exhumed bedforms define many of the ridges at outcrops that appear striated in satellite images. At Kimberley these bedforms demonstrably underlie and therefore predate subaqueous beds, suggesting that a thin atmosphere existed at least temporarily before subaqueous deposition ceased in the crater. The other three candidate wave ripples (Square Top, Hunda, and Voe) are consistent with modeled waves, but other origins cannot be excluded. The predominance of flat‐laminated (non‐rippled) beds in the lacustrine Murray formation suggests that some aspect of the lake was not conducive to formation or preservation of recognizable wave ripples. Water depths may generally have been too deep, lakebed sediment may have been too fine‐grained, the lake may have been smaller than modeled, or the lake may have been covered by ice.
Plain Language Summary
Wave modeling and analysis of sedimentary structures were used to evaluate whether ancient lake deposits in Gale crater contain ripples formed by waves on the surface of the lake. Deposition by waves would show that the lake was not covered by ice at that time. Modeling shows that regardless of atmospheric density, winds capable of moving sand on land would generally have been strong enough to form waves that would produce ripples near shore. Large bedforms in the Kimberley formation are interpreted as ripples formed by the wind in an atmosphere similar to that of Mars today. These bedforms underlie and are older than other beds deposited in water, thereby showing that a thin atmosphere existed at least temporarily before deposition in water ceased in the crater. Three other candidate wave ripples are consistent with modeled waves, but other origins are possible. Thick sequences of sedimentary rock in Gale crater are flat‐laminated rather than rippled, suggesting that some aspect of the lake was not favorable for their formation or preservation. Much of the lake may have been too deep or ice‐covered, or the lake may have been smaller than modeled or had sediment too fine to form easily observed ripples.
Key Points
Wave modeling was used to test the hypothesis that 4 examples of lithified bedforms observed by the Curiosity rover are wave ripples
3‐m‐wavelegnth bedforms are thin‐atmosphere aeolian ripples formed before the last subaqueous deposition ended in Gale crater
Three examples remain viable candidates for wave ripples‐which would indicate a lake that was largely free of ice at time of deposition
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