The Anthropocene is functionally and stratigraphically distinct from the Holocene

Human activity is leaving a pervasive and persistent signature on Earth. Vigorous debate continues about whether this warrants recognition as a new geologic time unit known as the Anthropocene. We review anthropogenic markers of functional changes in the Earth system through the stratigraphic record. The appearance of manufactured materials in sediments − including aluminum, plastics and concrete − coincides with global spikes in fallout radionuclides and particulates from fossil-fuel combustion. Carbon, nitrogen, and phosphorus cycles have been substantially modified over the last century. Rates of sea-level rise, and the extent of human perturbation of the climate system, exceed Late Holocene changes. Biotic changes include species invasions worldwide and accelerating rates of extinction. These combined signals render the Anthropocene stratigraphically distinct from the Holocene and earlier epochs

Colonization of the Americas, 'Little Ice Age' climate, and bomb-produced carbon: their role in defining the Anthropocene

A recently published analysis by Lewis and Maslin (Lewis SL and Maslin MA (2015) Defining the Anthropocene. Nature 519: 171–180) has identified two new potential horizons for the Holocene−Anthropocene boundary: 1610 (associated with European colonization of the Americas), or 1964 (the peak of the excess radiocarbon signal arising from atom bomb tests). We discuss both of these novel suggestions, and consider that there is insufficient stratigraphic basis for the former, whereas placing the latter at the peak of the signal rather than at its inception does not follow normal stratigraphical practice. Wherever the boundary is eventually placed, it should be optimized to reflect stratigraphical evidence with the least possible ambiguity

GANGLION POTKOLJENICE – RIJETKA LOKALIZACIJA GANGLIONA

Ganglions (hygromas) are cystic tumors of soft tissue filled with jelly like substance. Most often they are localized on hands and feet. Very rarely they are localized in other sites.A very rare localization of the ganglion has been presented here found on the lateral side of the left lower leg starting from the proximal tibiofibular joint

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Prikaz slučaja 17-godišnje djevojke s okluzijom lijeve poplitealne i desne radijalne arterije

This is a case of a 17-year old girl with right radial and left popliteal arterial occlusion. This was diagnosed with clinical examination, arterial colour doppler and pletismography. For further evaluation this girl was refered to KBC Zagreb, Pediatric clinic and Clinic for heart and coronary deseases where she was diagnosed with antiphospholipidal syndrome. Her laboratory parameters tested positive for lupus anticoagulant. Digital subtraction angiography confirmed the colour dopler results

Is the Anthropocene distinct from the Holocene? [abstract only]

The inaugural meeting of the Anthropocene Working Group of the Subcommission on Quaternary Stratigraphy in Berlin (Oct. 2014) produced a consensus statement that “humans have altered geologic processes across the Earth system sufficiently to cause a planetary transition to a new interval of geological time”, with the timing of the onset the focus of continued debate, but with a majority in favour of a mid-20th century beginning. The name has driven the assumption that the Anthropocene should be an epoch, but are its signatures truly driven out of the range evident for most of the Holocene, or are changes comparable or subsidiary to Holocene stages? The evidence rests upon a broad range of signatures reflecting humanity’s significant and increasing modification of Earth systems. These are visible in anthropogenic deposits in the form of the greatest expansion of novel minerals in the last 2.4 billion years and development of ubiquitous materials, such as plastics, present in the environment only in the last 60 years. Globally distributed spherical carbonaceous particles of fly ash represent another near-synchronous and permanent proxy. The artefacts we produce, the technofossils of the future, provide a decadal to annual stratigraphical resolution. These materials and deposits have in recent decades extended into the oceans and increasingly into the subsurface both onshore and offshore. These anthropogenic deposits are transported at rates exceeding those of the sediment carried by rivers by an order of magnitude, fluvial systems themselves showing widespread sediment retention in response to dam construction across most major river systems. The Anthropocene is evident in sediment and glacial ice strata as chemical markers. CO2 in the atmosphere has risen by ~45 percent above pre-Industrial Revolution levels, mainly through combustion of hydrocarbons over a few decades. Although average global temperature increases and resultant sea-level rises are still comparatively small, the shift to more negative δ13C values in tree-rings, limestones, speleothems, calcareous fossils and δ13CO2 in ice forms a permanent record. Nitrogen and phosphorus contents in surface soils has approximately doubled through increased use of fertilizers to increase agricultural yields as the human population has also doubled in the last 50 years. Industrial metals such as Cd, Cr, Cu, Hg, Ni, Pb, Zn and persistent organic compounds have been widely and rapidly dispersed. A clear novel signature is radioactive fallout from atomic weapons testing, initiated in 1945 but becoming global in 1952 and in the case of Pu239 representing a long-lasting marker event. The Earth still has most of its complement of biological species, though many now as small populations: current trends of habitat loss and predation, if maintained, will push the Earth into the sixth mass extinction event in the next few centuries. Dramatic elapsed changes include trans-global species invasions and population modification through agricultural development on land and contamination of coastal zones. Although these changes are not synchronous, within near coastal environments microfauna/flora commonly show pronounced assemblage changes in the mid-20th century. Considering the entire range of environmental changes reflected in stratigraphic signatures, the global, large and rapid scale of change related to the mid-20th century is clearly distinct from previous Holocene signatures, consistent with interpretation of the Anthropocene as a potential epoch

Scale and diversity of the physical technosphere: a geological perspective

We assess the scale and extent of the physical technosphere, defined here as the summed material output of the contemporary human enterprise. It includes active urban, agricultural and marine components, used to sustain energy and material flow for current human life, and a growing residue layer, currently only in small part recycled back into the active component. Preliminary estimates suggest a technosphere mass of approximately 30 trillion tonnes (Tt), which helps support a human biomass that, despite recent growth, is ~5 orders of magnitude smaller. The physical technosphere includes a large, rapidly growing diversity of complex objects that are potential trace fossils or ‘technofossils’. If assessed on palaeontological criteria, technofossil diversity already exceeds known estimates of biological diversity as measured by richness, far exceeds recognized fossil diversity, and may exceed total biological diversity through Earth’s history. The rapid transformation of much of Earth’s surface mass into the technosphere and its myriad components underscores the novelty of the current planetary transformation

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701