Amphibious Seismic Survey Images Plate Interface at 1960 Chile Earthquake

The southern central Chilean margin at the site of the largest historically recorded earthquake in the Valdivia region, in 1960 (Mw = 9.5), is part of the 5000-km-long active subduction system whose geodynamic evolution is controversially debated and poorly understood. Covering the area between 36° and 40°S, the oceanic crust is segmented by prominent fracture zones. The offshore forearc and its onshore continuation show a complex image with segments of varying geophysical character, and several fault systems active during the past 24 m.y. In autumn 2001, the project SPOC was organized to study the Subduction Processes Off Chile, with a focus on the seismogenic coupling zone and the forearc. The acquired seismic data crossing the Chilean subduction system were gathered in a combined offshore-onshore survey and provide new insights into the lithospheric structure and evolution of active margins with insignificant frontal accretion

Intraoperative ventilator settings and their association with postoperative pulmonary complications in neurosurgical patients: post-hoc analysis of LAS VEGAS study

BACKGROUND: Limited information is available regarding intraoperative ventilator settings and the incidence of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgical procedures. The aim of this post-hoc analysis of the 'Multicentre Local ASsessment of VEntilatory management during General Anaesthesia for Surgery' (LAS VEGAS) study was to examine the ventilator settings of patients undergoing neurosurgical procedures, and to explore the association between perioperative variables and the development of PPCs in neurosurgical patients. METHODS: Post-hoc analysis of LAS VEGAS study, restricted to patients undergoing neurosurgery. Patients were stratified into groups based on the type of surgery (brain and spine), the occurrence of PPCs and the assess respiratory risk in surgical patients in Catalonia (ARISCAT) score risk for PPCs. RESULTS: Seven hundred eighty-four patients were included in the analysis; 408 patients (52%) underwent spine surgery and 376 patients (48%) brain surgery. Median tidal volume (VT) was 8 ml [Interquartile Range, IQR = 7.3-9] per predicted body weight; median positive end-expiratory pressure (PEEP) was 5 [3 to 5] cmH20. Planned recruitment manoeuvres were used in the 6.9% of patients. No differences in ventilator settings were found among the sub-groups. PPCs occurred in 81 patients (10.3%). Duration of anaesthesia (odds ratio, 1.295 [95% confidence interval 1.067 to 1.572]; p = 0.009) and higher age for the brain group (odds ratio, 0.000 [0.000 to 0.189]; p = 0.031), but not intraoperative ventilator settings were independently associated with development of PPCs. CONCLUSIONS: Neurosurgical patients are ventilated with low VT and low PEEP, while recruitment manoeuvres are seldom applied. Intraoperative ventilator settings are not associated with PPCs

Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p

How Effective Are School BullyingIntervention Programs? A Meta-Analysis of Intervention Research

Research on effectiveness of school bullying interventions has lagged behind descriptive studies on this topic. The literature on bullying intervention research has only recently expanded to a point that allows for synthesis of findings across studies. The authors conducted a meta-analytic study of school bullying intervention research across the 25-year period from 1980 through 2004, identifying 16 studies that met our inclusion criteria. These studies included 15,386 K through 12 student participants from European nations and the United States. Applying standard meta-analysis techniques to obtain averaged effect size estimates across similar outcomes, the authors found that the intervention studies produced meaningful and clinically important positive effects for about one-third of the variables. The majority of outcomes evidenced no meaningful change, positive or negative. The authors conclude that school bullying interventions may produce modest positive outcomes; that they are more likely to influence knowledge, attitudes, and self-perceptions rather than actual bullying behaviors; and that the majority of outcome variables in intervention studies are not meaningfully impacted. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Ecological Momentary Assessment of Older Women\u27s Health

Living with chronic co-morbidities implies long-lasting, always present conditions associated with highly variable health trajectories. In this study, ecological momentary assessment was used to explore nine older women\u27s experiences of living with co-morbidities. Each participant completed a daily diary, which focused on 10 variables related to energy, pain, effort expended, and an overall health rating, for 21 days. Hierarchical linear modeling was used to explore intra-individual variation in daily health experiences and health-related burden, and determine the extent to which health-related burden was related to daily health experiences. Each of the daily health experience variables sipiificantly predicted health-related burden. Over half of the variation was attributed to the predictor variables. These findings reveal the dynamic nature of living with multiple chronic conditions and demonstrate the utility of daily diaries for measuring fluctuating states of health in community-dwelling older wofnen