Circadian rhythm of cardiac troponin I and its clinical impact on the diagnostic accuracy for acute myocardial infarction

High-sensitivity cardiac troponin T (hs-cTnT) blood concentrations were shown to exhibit a diurnal rhythm, characterized by gradually decreasing concentrations throughout daytime, rising concentrations during nighttime and peak concentrations in the morning. We aimed to investigate whether this also applies to (h)s-cTnI assays and whether it would affect diagnostic accuracy for acute myocardial infarction (AMI).; Blood concentrations of cTnI were measured at presentation and after 1 h using four different cTnI assays: three commonly used sensitive (s-cTnI Architect, Ultra and Accu) and one experimental high-sensitivity assay (hs-cTnI Accu) in a prospective multicenter diagnostic study of patients presenting to the emergency department with suspected AMI. These concentrations and their diagnostic accuracy for AMI (quantified by the area under the curve (AUC)) were compared between morning (11 p.m. to 2 p.m.) and evening (2 p.m. to 11 p.m.) presenters.; Among 2601 patients, AMI was the final diagnosis in 17.6% of patients. Concentrations of (h)s-cTnI as measured using all four assays were comparable in patients presenting in the morning versus patients presenting in the evening. Diagnostic accuracy for AMI of all four (h)s-cTnI assays were high and comparable between patients presenting in the morning versus presenting in the evening (AUC at presentation: 0.90 vs 0.93 for s-cTnI Architect; 0.91 vs 0.94 for s-cTnI Ultra; 0.89 vs 0.94 for s-cTnI Accu; 0.91 vs 0.94 for hs-cTnI Accu).; Cardiac TnI does not seem to express a diurnal rhythm. Diagnostic accuracy for AMI is very high and does not differ with time of presentation.; NCT00470587, http://clinicaltrials.gov/show/NCT00470587

Landslides Triggered by the MW 7.8 14 November 2016 Kaikoura Earthquake, New Zealand

The MW 7.8 14 November 2016 Kaikoura earthquake generated more than 10000 landslides over a total area of about 10000 km2, with the majority concentrated in a smaller area of about 3600 km2. The largest landslide triggered by the earthquake had an approximate volume of 20 (±2) M m3, with a runout distance of about 2.7 km, forming a dam on the Hapuku River. In this paper, we present version 1.0 of the landslide inventory we have created for this event. We use the inventory presented in this paper to identify and discuss some of the controls on the spatial distribution of landslides triggered by the Kaikoura earthquake. Our main findings are (1) the number of medium to large landslides (source area ≥10000 m2) triggered by the Kaikoura earthquake is smaller than for similar sized landslides triggered by similar magnitude earthquakes in New Zealand; (2) seven of the largest eight landslides (from 5 to 20 x 106 m3) occurred on faults that ruptured to the surface during the earthquake; (3) the average landslide density within 200 m of a mapped surface fault rupture is three times that at a distance of 2500 m or more from a mapped surface fault rupture ; (4) the “distance to fault” predictor variable, when used as a proxy for ground-motion intensity, and when combined with slope angle, geology and elevation variables, has more power in predicting landslide probability than the modelled peak ground acceleration or peak ground velocity; and (5) for the same slope angles, the coastal slopes have landslide point densities that are an order of magnitude greater than those in similar materials on the inland slopes, but their source areas are significantly smaller

Landslides caused by the Mw7.8 Kaikōura earthquake and the immediate response

Tens of thousands of landslides were generated over 10, 000 km2 of North Canterbury and Marlborough as a consequence of the 14 November 2016, MW7.8 Kaikōura Earthquake. The most intense landslide damage was concentrated in 3500 km2 around the areas of fault rupture. Given the sparsely populated area affected by landslides, only a few homes were impacted and there were no recorded deaths due to landslides. Landslides caused major disruption with all road and rail links with Kaikōura being severed. The landslides affecting State Highway 1 (the main road link in the South Island of New Zealand) and the South Island main trunk railway extended from Ward in Marlborough all the way to the south of Oaro in North Canterbury. The majority of landslides occurred in two geological and geotechnically distinct materials reflective of the dominant rock types in the affected area. In the Neogene sedimentary rocks (sandstones, limestones and siltstones) of the Hurunui District, North Canterbury and around Cape Campbell in Marlborough, first-time and reactivated rock-slides and rock-block slides were the dominant landslide type. These rocks also tend to have rock material strength values in the range of 5-20 MPa. In the Torlesse 'basement' rocks (greywacke sandstones and argillite) of the Kaikōura Ranges, first-time rock and debris avalanches were the dominant landslide type. These rocks tend to have material strength values in the range of 20-50 MPa. A feature of this earthquake is the large number (more than 200) of valley blocking landslides it generated. This was partly due to the steep and confined slopes in the area and the widely distributed strong ground shaking. The largest landslide dam has an approximate volume of 12(±2) M m3 and the debris from this travelled about 2.7 km2 downslope where it formed a dam blocking the Hapuku River. The long-term stability of cracked slopes and landslide dams from future strong earthquakes and large rainstorms are an ongoing concern to central and local government agencies responsible for rebuilding homes and infrastructure. A particular concern is the potential for debris floods to affect downstream assets and infrastructure should some of the landslide dams breach catastrophically. At least twenty-one faults ruptured to the ground surface or sea floor, with these surface ruptures extending from the Emu Plain in North Canterbury to offshore of Cape Campbell in Marlborough. The mapped landslide distribution reflects the complexity of the earthquake rupture. Landslides are distributed across a broad area of intense ground shaking reflective of the elongate area affected by fault rupture, and are not clustered around the earthquake epicentre. The largest landslides triggered by the earthquake are located either on or adjacent to faults that ruptured to the ground surface. Surface faults may provide a plane of weakness or hydrological discontinuity and adversely oriented surface faults may be indicative of the location of future large landslides. Their location appears to have a strong structural geological control. Initial results from our landslide investigations suggest predictive models relying only on ground-shaking estimates underestimate the number and size of the largest landslides that occurred

Landslides caused by the Mw7.8 Kaikōura earthquake and the immediate response

Tens of thousands of landslides were generated over 10, 000 km2 of North Canterbury and Marlborough as a consequence of the 14 November 2016, MW7.8 Kaikōura Earthquake. The most intense landslide damage was concentrated in 3500 km2 around the areas of fault rupture. Given the sparsely populated area affected by landslides, only a few homes were impacted and there were no recorded deaths due to landslides. Landslides caused major disruption with all road and rail links with Kaikōura being severed. The landslides affecting State Highway 1 (the main road link in the South Island of New Zealand) and the South Island main trunk railway extended from Ward in Marlborough all the way to the south of Oaro in North Canterbury. The majority of landslides occurred in two geological and geotechnically distinct materials reflective of the dominant rock types in the affected area. In the Neogene sedimentary rocks (sandstones, limestones and siltstones) of the Hurunui District, North Canterbury and around Cape Campbell in Marlborough, first-time and reactivated rock-slides and rock-block slides were the dominant landslide type. These rocks also tend to have rock material strength values in the range of 5-20 MPa. In the Torlesse 'basement' rocks (greywacke sandstones and argillite) of the Kaikōura Ranges, first-time rock and debris avalanches were the dominant landslide type. These rocks tend to have material strength values in the range of 20-50 MPa. A feature of this earthquake is the large number (more than 200) of valley blocking landslides it generated. This was partly due to the steep and confined slopes in the area and the widely distributed strong ground shaking. The largest landslide dam has an approximate volume of 12(±2) M m3 and the debris from this travelled about 2.7 km2 downslope where it formed a dam blocking the Hapuku River. The long-term stability of cracked slopes and landslide dams from future strong earthquakes and large rainstorms are an ongoing concern to central and local government agencies responsible for rebuilding homes and infrastructure. A particular concern is the potential for debris floods to affect downstream assets and infrastructure should some of the landslide dams breach catastrophically. At least twenty-one faults ruptured to the ground surface or sea floor, with these surface ruptures extending from the Emu Plain in North Canterbury to offshore of Cape Campbell in Marlborough. The mapped landslide distribution reflects the complexity of the earthquake rupture. Landslides are distributed across a broad area of intense ground shaking reflective of the elongate area affected by fault rupture, and are not clustered around the earthquake epicentre. The largest landslides triggered by the earthquake are located either on or adjacent to faults that ruptured to the ground surface. Surface faults may provide a plane of weakness or hydrological discontinuity and adversely oriented surface faults may be indicative of the location of future large landslides. Their location appears to have a strong structural geological control. Initial results from our landslide investigations suggest predictive models relying only on ground-shaking estimates underestimate the number and size of the largest landslides that occurred