Congo River sand and the equatorial quartz factory

A never solved problem in sedimentary petrology is the origin of sandstone consisting exclusively of quartz and most durable heavy minerals. The Congo River offers an excellent test case to investigate under which tectonic, geomorphological, climatic, and geochemical conditions pure quartzose sand is generated today. In both upper and lowermost parts of the catchment, tributaries contain significant amounts of feldspars, rock fragments, or moderately stable heavy minerals pointing at the central basin as the main location of the "quartz factory". In Congo sand, quartz is enriched relatively to all other minerals including zircon, as indicated by Si/Zr ratios much higher than in the upper continental crust. Selective elimination of old zircons that accumulated radiation damage through time is suggested by low percentages of grains yielding Archean U-Pb ages despite the basin being surrounded by Archean cratonic blocks. Intense weathering is documented by the lack of carbonate grains in sand and by dominant kaolinite and geochemical signatures in mud. In sand, composed almost entirely of SiO2, the weathering effect is masked by massive addition of quartz grains recycled during multiple events of basin inversion since the Proterozoic. Changes in mineralogical, geochemical, and geochronological signatures across Bas-Congo concur to suggest that approximately 10% of the sand supplied to the Atlantic Ocean is generated by rapid fluvial incision into the recently uplifted Atlantic Rise. The Congo River connects with a huge canyon similar to 30 km upstream of the mouth, and pure quartzose sand is thus funnelled directly toward the deep-sea to feed a huge turbidite fan. Offshore sediments on both sides of the canyon are not derived from the Congo River. They reflect mixed provenance, including illite-rich dust wind-blown from the arid Sahel and augite, hypersthene, and smectite ejected from volcanic centres probably situated along the Cameroon Line in the north. Because mixing of detritus from diverse sources and supply of polycyclic grains almost invariably occurs in the terminal lowland tract of a sediment-routing-system, no ancient sandstone can be safely considered as entirely first-cycle. Moreover, the abundance of pure quartzarenite in the rock record can hardly be explained by chemical weathering or physical recycling alone. The final cleansing of minerals other than quartz, zircon, tourmaline, and rutile requires one or more cycles of chemical dissolution during diagenesis, which operates at higher temperatures and over longer periods than weathering at the Earth's surface

Effects of mesh size and effort changes on the ibero-atlantic hake (Merluccius merluccius L.) fishery (Div. VIIIc (W) + IXa)

This paper concerns Hake fishery from the North of Galicia (Spain) to the South of Portugal. It represents one more attempt in obtaining more informations about the exploitation state of hake stock in this area. The aim of this study is to assess the immediate and long-term effects in this fishery with different fishing strategies. The models used were the following: a) increases in mesh-size: - Gulland (1961), Jones (1974), Ricker (1975), Cadima (1976,1978). b) increases in mesh-size and changes in fishing effort: - Jones (1974) and Ricker (1975). To apply such methods we used the data concerning the mean catches (from 1974 to 1977) belonging to the Galician and Portuguese fleets.Ce travail concerne la pêcherie du merlu de la côte nord de la Galice (Espagne), jusq'au sud du Portugal. Il répresente un essai en plus pour améliorer notre connaissance sur l'état d'exploitation du stock du merlu dans cette même region. Le but de cet étude c'est l'évaluation des effects immédiats et a long terme sur la pêcherie selon des stratégies de peche différentes. Les modeles appliqués ont été les suivants: a) pour les accroissements des maillages: Gulland (1961), Jones (1974), Ricker (1975), Cadima (1976,1978). b) pour les variations de l'effort et augmentations des mail lages: Jones (1974) et Ricker (1975). Pour l'application des méthodes mentionnées, nous avons utilisé les données rélatives a la moyenne des captures réalisées par les flotilles espagnole (Galicienne) et portugaise, pendant la période 1974-77

A 6-month randomized controlled trial to test the efficacy of a lifestyle intervention for weight gain management in schizophrenia

Background: Patients with schizophrenia have lower longevity than the general population as a consequence of a combination of risk factors connected to the disease, lifestyle and the use of medications, which are related to weight gain.Methods: A multicentric, randomized, controlled-trial was conducted to test the efficacy of a 12-week group Lifestyle Wellness Program (LWP). the program consists of a one-hour weekly session to discuss topics like dietary choices, lifestyle, physical activity and self-esteem with patients and their relatives. Patients were randomized into two groups: standard care (SC) and standard care plus intervention (LWP). Primary outcome was defined as the weight and body mass index (BMI).Results: 160 patients participated in the study (81 in the intervention group and 79 in the SC group). On an intent to treat analysis, after three months the patients in the intervention group presented a decrease of 0.48 kg (CI 95% - 0.65 to 1.13) while the standard care group showed an increase of 0.48 kg (CI 95% 0.13 to 0.83; p=0.055). At six-month follow-up, there was a significant weight decrease of -1.15 kg, (CI 95% -2.11 to 0.19) in the intervention group compared to a weight increase in the standard care group (+0.5 kg, CI 95% -0.42-1.42, p=0.017).Conclusion: in conclusion, this was a multicentric randomized clinical trial with a lifestyle intervention for individuals with schizophrenia, where the intervention group maintained weight and presented a tendency to decrease weight after 6 months. It is reasonable to suppose that lifestyle interventions may be important long-term strategies to avoid the tendency of these individuals to increase weight. Clinicaltrials.gov identifier: NCT01368406Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Eli Lilly do BrasilCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Ministry of EducationJanssen-CilagNovartisRocheConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundacao SafraFundacao ABRADSLundbeckEli Lilly laboratoryUniversidade Federal de São Paulo, Dept Psychiat, BR-04044000 São Paulo, BrazilUniv São Paulo, Med School, Dept & Inst Psychiat, BR-05403010 São Paulo, BrazilCAISM Ctr Atencao Integrada Saude Mental Irmandad, BR-04017030 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Med, Div Endocrinol, BR-04039002 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, BR-04044000 São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Med, Div Endocrinol, BR-04039002 São Paulo, BrazilFAPESP: 2007/00464-6Web of Scienc

A protocol for a multicentre, parallel-group, pragmatic randomised controlled trial to evaluate the NEVERMIND system in preventing and treating depression in patients with severe somatic conditions

Background Depressive symptoms are common in individuals suffering from severe somatic conditions. There is a lack of interventions and evidence-based interventions aiming to reduce depressive symptoms in patients with severe somatic conditions. The aim of the NEVERMIND project is to address these issues and provide evidence by testing the NEVERMIND system, designed to reduce and prevent depressive symptoms in comparison to treatment as usual. Methods The NEVERMIND study is a parallel-groups, pragmatic randomised controlled trial to assess the effectiveness of the NEVERMIND system in reducing depressive symptoms among individuals with severe somatic conditions. The NEVERMIND system comprises a smart shirt and a user interface, in the form of a mobile application. The system is a real-time decision support system, aiming to predict the severity and onset of depressive symptoms by modelling the well-being condition of patients based on physiological data, body movement, and the recurrence of social interactions. The study includes 330 patients who have a diagnosis of myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants are randomised in blocks of ten to either the NEVERMIND intervention or treatment as usual as the control group. Clinical interviews and structured questionnaires are administered at baseline, at 12 weeks, and 24 weeks to assess whether the NEVERMIND system is superior to treatment as usual. The endpoint of primary interest is Beck Depression Inventory II (BDI-II) at 12 weeks defined as (i) the severity of depressive symptoms as measured by the BDI-II. Secondary outcomes include prevention of the onset of depressive symptoms, changes in quality of life, perceived stigma, and self-efficacy. Discussion There is a lack of evidence-based interventions aiming to reduce and prevent depressive symptoms in patients with severe somatic conditions. If the NEVERMIND system is effective, it will provide healthcare systems with a novel and innovative method to attend to depressive symptoms in patients with severe somatic conditions. Trial registration DRKS00013391. Registered 23 November 2017

Long-term follow-up of patients with chronic hepatitis C with sustained virologic response to interferon

BACKGROUND AND AIM: The durability of the sustained virologic response (SVR) in patients with chronic hepatitis C after treatment and the ideal follow-up time for these patients remains undefined. The objective of the study was to evaluate the durability of the virologic response in patients with chronic hepatitis C followed up for at least 12 months after SVR at HCFMRP-USP. METHODS: The study was conducted on 174 patients with chronic hepatitis C treated with different antiviral regimens who had achieved SVR. Qualitative serum HCV-RNA was determined by the commercial kit (COBAS AMPLICOR HCV, v2.0). RESULTS: There was predominance of male (73%) with a mean age of 45.6 ± 10 years. Liver cirrhosis was present in 16.1% of the study subjects. Mean follow-up time after SVR was 47 months (12-156 months). Twenty-two patients received monotherapy with interferon; 94 received interferon plus ribavirin, and 58 received pegylated interferon plus ribavirin. A total of 134 patients (77.0%) received one treatment course, 29 (16.7%) received two courses, and 11 (6.3%) received three courses. The distribution of HCV genotypes was: genotype 1 (40.2%), genotype 3 (40.8%) and genotype 2 (10.3%). Genotype was undetermined in 8.7% of cases. None of the 174 patients had recurrence of HCV infection. Two cirrhotic patients developed hepatocellular carcinoma (HCC) during follow-up. CONCLUSIONS: Among patients with SVR there was no recurrence of HCV infection or evidence of liver disease progression in any patient followed up for a mean of 47 months after SVR, except for patients with advanced hepatic disease before treatment, who may develop HCC despite SVR. Therefore, one can assume that SVR is associated with long term good prognosis.(FAEPA) Fundação de Apoio ao Ensino Pesquisa e Assistênci

A Western single-center experience with endoscopic submucosal dissection for early gastrointestinal cancers

Endoscopic submucosal dissection (ESD) has gained worldwide acceptance as a treatment for early gastrointestinal cancers (EGICs). However, the management of these tumors in the Western world is still mainly surgical. Our aim was to evaluate the safety and feasibility of ESD at a European center. Based on the knowledge transferred by one of the most experienced Japanese institutions, we conducted a pilot study on 25 consecutive patients with EGICs located in the esophagus (n = 3), stomach (n = 7), duodenum (n = 1), and colon (n = 14) at our tertiary center over a 2-year-period. The main outcome measurements were complete (R0) resection, as well as en-bloc resection and the management of complications. The R0 and en-bloc resection rates were 100% and 84%, respectively. There were three cases of bleeding and five cases of perforation. With a median follow up of 18 months, two recurrences were observed. We conclude that ESD for early esophageal and gastric cancers is feasible and effective, while colonic ESD requires more expertise

British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma

Gastric adenocarcinoma carries a poor prognosis, in part due to the late stage of diagnosis. Risk factors include Helicobacter pylori infection, family history of gastric cancer - in particular, hereditary diffuse gastric cancer and pernicious anaemia. The stages in the progression to cancer include chronic gastritis, gastric atrophy (GA), gastric intestinal metaplasia (GIM) and dysplasia. The key to early detection of cancer and improved survival is to non-invasively identify those at risk before endoscopy. However, although biomarkers may help in the detection of patients with chronic atrophic gastritis, there is insufficient evidence to support their use for population screening. High-quality endoscopy with full mucosal visualisation is an important part of improving early detection. Image-enhanced endoscopy combined with biopsy sampling for histopathology is the best approach to detect and accurately risk-stratify GA and GIM. Biopsies following the Sydney protocol from the antrum, incisura, lesser and greater curvature allow both diagnostic confirmation and risk stratification for progression to cancer. Ideally biopsies should be directed to areas of GA or GIM visualised by high-quality endoscopy. There is insufficient evidence to support screening in a low-risk population (undergoing routine diagnostic oesophagogastroduodenoscopy) such as the UK, but endoscopic surveillance every 3 years should be offered to patients with extensive GA or GIM. Endoscopic mucosal resection or endoscopic submucosal dissection of visible gastric dysplasia and early cancer has been shown to be efficacious with a high success rate and low rate of recurrence, providing that specific quality criteria are met

British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma

Gastric adenocarcinoma carries a poor prognosis, in part due to the late stage of diagnosis. Risk factors include Helicobacter pylori infection, family history of gastric cancer - in particular, hereditary diffuse gastric cancer and pernicious anaemia. The stages in the progression to cancer include chronic gastritis, gastric atrophy (GA), gastric intestinal metaplasia (GIM) and dysplasia. The key to early detection of cancer and improved survival is to non-invasively identify those at risk before endoscopy. However, although biomarkers may help in the detection of patients with chronic atrophic gastritis, there is insufficient evidence to support their use for population screening. High-quality endoscopy with full mucosal visualisation is an important part of improving early detection. Image-enhanced endoscopy combined with biopsy sampling for histopathology is the best approach to detect and accurately risk-stratify GA and GIM. Biopsies following the Sydney protocol from the antrum, incisura, lesser and greater curvature allow both diagnostic confirmation and risk stratification for progression to cancer. Ideally biopsies should be directed to areas of GA or GIM visualised by high-quality endoscopy. There is insufficient evidence to support screening in a low-risk population (undergoing routine diagnostic oesophagogastroduodenoscopy) such as the UK, but endoscopic surveillance every 3 years should be offered to patients with extensive GA or GIM. Endoscopic mucosal resection or endoscopic submucosal dissection of visible gastric dysplasia and early cancer has been shown to be efficacious with a high success rate and low rate of recurrence, providing that specific quality criteria are met

The NEVERMIND e-health system in the treatment of depressive symptoms among patients with severe somatic conditions: A multicentre, pragmatic randomised controlled trial

Background This study assessed the effectiveness of the NEVERMIND e-health system, consisting of a smart shirt and a mobile application with lifestyle behavioural advice, mindfulness-based therapy, and cognitive behavioural therapy, in reducing depressive symptoms among patients diagnosed with severe somatic conditions. Our hypothesis was that the system would significantly decrease the level of depressive symptoms in the intervention group compared to the control group. Methods This pragmatic, randomised controlled trial included 425 patients diagnosed with myocardial infarction, breast cancer, prostate cancer, kidney failure, or lower limb amputation. Participants were recruited from hospitals in Turin and Pisa (Italy), and Lisbon (Portugal), and were randomly assigned to either the NEVERMIND intervention or to the control group. Clinical interviews and structured questionnaires were administered at baseline, 12 weeks, and 24 weeks. The primary outcome was depressive symptoms at 12 weeks measured by the Beck Depression Inventory II (BDI-II). Intention-to-treat analyses included 425 participants, while the per-protocol analyses included 333 participants. This trial is registered in the German Clinical Trials Register, DRKS00013391. Findings Patients were recruited between Dec 4, 2017, and Dec 31, 2019, with 213 assigned to the intervention and 212 to the control group. The sample had a mean age of 59·41 years (SD=10·70), with 44·24% women. Those who used the NEVERMIND system had statistically significant lower depressive symptoms at the 12-week follow-up (mean difference=-3·03, p<0·001; 95% CI -4·45 to -1·62) compared with controls, with a clinically relevant effect size (Cohen's d=0·39). Interpretation The results of this study show that the NEVERMIND system is superior to standard care in reducing and preventing depressive symptoms among patients with the studied somatic conditions. Funding The NEVERMIND project received funding from the European Union's Horizon 2020 Research and Innovation Programme under grant agreement No. 689691